dental questions

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PeterDevonMocha

PeterDevonMocha

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Within the next month or two we plan on having a dental done on mocha. This will be my first dental ever on a cat I have been owned by. I am very nervous about this. I've been trying to read threads on here about dentals and most of the time walk away confused.

I know there is a list of questions to ask, but I don't know if they are all in one spot? Is there a link to these questions somewhere? Also, do all of you take your cats to your regular vet for dentals? I mean, are vets experienced in the dental area, or is there usually a specialist that does the cleaning?

Yesterday at the grocery store the cashier rung up mochas wet food and commented, lucky kitty, my cat's only eat dry. We said to her, yes, well she gets wet because she is a diabetic cat and wet food is much better for cats, especially diabetic cats. Then she went on to talk about her kitty, and how she recently had a "dental" done on her, and that the front two huge teeth were removed and it didn't go well. When I asked what went wrong, she told me that her cat was drooling really bad for awhile and so she took her back to the vet, and then the holes weren't healing so they ended up having to do some sort of skin graft over the holes with skin from her cheek! And she said it was very expensive.

That really didn't make me feel very good at all and now I'm even more nervous about this whole thing. I know it should be done, but that's only cause it's so often talked about on here. Plus our funds are limited and I'm nervous that once the vet gets in there, there might be some major problems we aren't aware of and we won't know what to do cause we won't be able to afford the cadillac of all dental treatments if that makes sense. I wonder if maybe we shouldn't even start in on her teeth? But then again, it might help her numbers out. But then again, if something as serious as what that cashier was telling me happened to her cat, happened to mocha, well, I just don't know what we would do!

Any and all help is appreciated!!!
 
Hi Peter

The petdiabetes wiki has a link to dental info but here are a few things to consider/talk about prior

1. is predental blood work required?
2. are predental antibiotics required?
3. will xrays be done first?
4. what kind of sedative and what kind of anasthesia are used?
5. what pain killers will be used and at what point?
6. do they monitor blood pressure?
7. if extractions are required, will they call you first?
8. what is their procedure for diabetics; ie should insulin be given in the am and if so just partial dose or ? and will they monitor bgs at all?
 
And find out for sure what vet is going to do the dental. Check out his status on the state Veterinary board to see if he/she has had any disciplinary actions. Like the others said ask about anesthetic and if something feels wrong, get a second opinion from another vet.

I asked them to get permission from me before they pulled any teeth on Regis. They didn't. Regis suffered so.
 
PeterDevonMocha said:
When I asked what went wrong, she told me that her cat was drooling really bad for awhile and so she took her back to the vet, and then the holes weren't healing so they ended up having to do some sort of skin graft over the holes with skin from her cheek!
Click to expand...

If there were HOLES from teeth being extracted, there was a serious problem with the way they were removed! Pablo just had his upper canines removed, and the vet performed oral surgery to remove the tooth and create a skin flap so the hole could be sutured shut. He ended up with about 10 stitches total, and at his recheck yesterday, his incisions were completely healed and looked awesome! :-D If you just yank teeth out (in most cases), there will be a hole where debris (read: food, hair, etc.) collects. And speaking from experience, the smell of three-day-old food that is impacted in one of those holes is enough to make anyone gag...imagine how it feels and tastes for the cat!

That's not to say that teeth can never be extracted without surgery to close the gum tissue. If they're almost falling out, pulling the teeth without further treatment may be possible. But I would definitely discuss the procedure for removing teeth in addition to whether or not you will be notified beforehand. As you can see from the cashier's experience, you can have really painful and expensive end result if extractions aren't done properly.

When I get home today, I'll get out all my stuff from Pablo's dental and try to better explain everything that was done for him. The vet who did is dental his a Fellow of the Academy of Dentistry of which there are less than 100 members worldwide. Simply put, she knew her stuff. She did everything I could have wanted and more, and Pablo had an amazing recovery because of it. The veterinarians who are members are listed on their website, so you could check if your vet or one in your area is a member (website: http://www.avdonline.org/avdmembers.html). You can pretty well be assured that you'll get quality care from one of those vets because becoming a Fellow isn't an easy thing and they have to meet many requirements. Just a thought!
 
thank you all for the replies. I checked out the list of vets you sent me holly, the closest one to me is over an hour away. I would be nervous taking mocha so far from home and having a dental done. What if something went wrong? I mean, after her dental of course. I would hate to have to rush back to some place over an hour away. Then on the other hand, if my regular vet does it, how do I know she is certified or able to do it?

I already know Im going to be a nervous wreck. I already have the anxious butterfly feeling in my stomach just thinking about it, and I'm still in the research stage! I just feel so nervous something bad will happen to her and I'll never be able to forgive myself. I know I can't think things like that, but I really can't help it!
 

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Devon..is it just a routine cleaning? Did the vet seem to think they would have to do any extractions? I had 2 done on 2 different cats and they both went well. Of course, neither needed an extraction and neither were diabetic at the time. Maybe you would feel better after a consult with your vet.
 
My vet does an awesome job; is there any reason to think yours won't? Does your vet DO dentals? If you like and trust your vet, go through the questions and relax a bit! Just because some people warn you about what can go wrong (and they are right to warn you), you shouldn't expect that it will happen for you!

Jen
 
mocha has never had a dental. None of my kitties ever had dentals done. The only time any vet looked at mochas mouth was back in may of 09, when she went in for her rabies shot, and then was diagnosed diabetic. The vet said, teeth and gums look ok, and that was it. I do know that the vets office that mocha goes to now (a new vet) does do cleanings because they had a sticker on their door for dental care and I said oh you do dental cleanings here, but it was the receptionist and she didn't know hardly anything about it.

We aren't able to afford to take mocha in right now, just to have her teeth looked at. The dental would be in the next month or so when we can budget it in. So as of right now, the way she acts, I would imagine it would just be a routine cleaning, she doesnt paw at her mouth or drool from it. She seems to eat fine, she eats slow, but manages to get it all down, whatever is in the bowl for her. I just don't know.
 
You are right, you don't know and you are getting yourself really worried and it may be for naught! Talk with the vet now about what they do so you have time to make a calm and educated decision. Dental cleanings are very impoertant and usually go off without any hitch, and if there is a hitch it will be important for you and your vet to have a game plan ahead of time. Don't let scary stories scare you off; I have my own scary story but that doesn't stop us :)
 
thanks jen. I ALWAYS work myself up over nothing. I think we will start calling around to a few vets to see what they offer. I emailed two vets nearby off the list that Holly sent me but peter is nervous about taking mocha that far away ( 1 1/2 hours to the nearest two, 2 1/2 to the third in our state) Im also nervous about taking her that far, but then again, I'm nervous about having it done locally, and not having it done right! Decisions, decisions!
 
Ok, I have e mailed two of the three vets on the list jen sent me and they both have responded. It was a general e mail sent out to both, just asking for any info on doing a dental cleaning on a diabetic cat, and what's involved. Here are their responses so far.

Vet 1:
Hi,
We need to see her to evaluate. The cost for an oral exam, consultation and plan is $80.00. To have me clean the teeth, polish and fluoride treatment and assess, the minimum is $304 including anesthesia and preanesthetic laboratory work. It costs less for a tecnician to clean, and a veterinarian other than me to check the work. If you would like to make an appointment please feel free to call () Thank you and I wish for a long and happy life for you and Mocha.

Vet 2:
Our dental cleaning for cats includes: warm water blanket while under anesthesia, warm IV fluids, blood pressure monitor, temperature monitor, pulse oximetry, respiratory monitor/CO2 monitor, EKG, assistant monitoring, complete oral exam and cleaning by myself, dental Xrays as needed, polishing, flouride and oral sealant. If the teeth are fine, this usually costs approximately $200 - $300.
Hope this helps, we would be happy to see your kitty, and yes, cleaning of the teeth can be helpful for diabetics.


The second vet gave us a lot more info on what exactly is included in their cost, plus they are already quoting us a cheaper price. Does it sound like a good deal? What we should be looking for?
Thanks!
 
Here you decide: here is the estimate I was given for Maui:

$73 vet screen
$47 CBC
$76 anesthesia w/dental
$13 anesthesia ring block (no clue what this means)
$20 anesthesia pre-med/monitoring
$15 medical waste fee
$76 fluid therapy (venoset/IV tube, IV catheter, fluids - 500 mls, t port extension set)
$31 daily hospitalization fee
$30 primary medication - hospital
$13 pain meds
$77 dental w/extractions - grade 1 (price less if no extractions needed)
$30 medications (take home)
---------------
$501 + tax = $503.10

My understanding is that they have 4 vets who do surgeries and dentals. Depending on day, it will be one of the vets performing it. Whether they use assistants too, I didn't ask.

While it's important to not overpay for the service, the reality is - you need to feel comfortable with the people in the office. So, while one vet provided more detail than the other and quoted a lower price, before making any final decisions, I recommend that you make a consult appoint and go there and check them out. Also, during the consult appoint, ask they will allow you to see the "hospital" and surgery areas. They may or may not, but in order to increase your comfort level - ask and see what they say.

It may be worth paying two consult fees, just to have more knowledge and feel more comfortable with your choice.
 
I quite like the details in the second quote, especially the mention of xrays, which the first ignored. You could ask them about this (#1 that is). Not sure whether an ekg is required but as the price is reasonable I see no reason why not. One thing #2 did not do is mention pre dental bloodwork which should be done if the cat is over 10, and may be done for any cat if you feel more comfortable. The only other thing that I'd want to know from both is what sedative they use, what anaesthesia they use and what pain meds.

When Squeak needs a simple cleaning, our vet techs do the work but our vet oversees things and if any extractions are done then obviously she does it.
 
Regarding "$13 anesthesia ring block (no clue what this means)"

A ring block is where they inject a local anesthesia such as lidocaine around specific nerves in the jaws to help prevent pain. To my knowledge they are only used for extractions in specific locations.
 
thank you all for the replies. I haven't contacted either vet for a consult yet, as peter works mon-fri and I don't feel comfortable driving that far on my own. I can e mail the second vet with more questions, specific to pre dental bloodworks, sedatives and what type of anesthesia is used. I already e mailed the first vet back with those questions, but they have not e mailed me back yet. I will e mail the second vet later today and hope for an answer early next week. Unfortunately we can't really afford to go to both vets for a consult if they are going to charge us, it will be us scrapping pennies to get her the dental in the first place. I just hope we decide the right vet for her.
 
yes I hope to call the vet sometime this week and ask them the questions off the list I was given. Tonight after mochas shot I had peter pry up mochas lips so we could glance at her teeth. Upon closer inspection of her teeth we noticed that her very front teeth, the really small ones in between her canines, well one of them is definitely dark colored. Perhaps dead? I have a feeling that tooth will most certainly need to be pulled. I told peter I cannot even imagine how they would pull such a tiny tiny tooth like that!

Are all cats front teeth normally that small? I've never really looked into a cats mouth before, but it seems like you would need a microscope to even check out those teeth! tiny tiny tiny ...
 
The six teeth between the canines are called incisors. They are always small in cats. They are relatively innocuous and cause little problems. Frequently a few are missing (fell out) in cats for no real reason.
 
Thank you larry. They sure are tiny aren't they?? :shock:

Ok, I received another e mail from the second vet after I sent her one with a few more questions. This is what she had to say

Yes, we offer preanesthetic bloodwork which we can do in house that same day. I would definitely ck blood glucose pre and post. We have a Cardell monitor, non-invasive blood pressure. We sedate with what we think will work best: acepromazine, butorphanol, morphine, isoflurane, ketamine, valium are a few.

Now, isn't the ketamine part of the recall from a few weeks back? Plus, isn't the right monitor called a doppler monitor? Should I question her on these, or does anyone know if that is a good machine as well?

I can't believe the amount of research and worry that goes into a dental!
 
Only specific ketimine was recalled (Those made by Teva and sold under different labels). These is good ketamine out there. If ketamine is used just ack the to ensure that it is not on the recall list.

Cardell monitors are excellent monitors. A Doppler machine is typically a manual one where a person manually inflates and deflates the cuff. The Cardell monitors do it automatically. Doppler is the way they measure when the blood flow is stopped/resumed and the blood pressure is read off a meter on the cuff system. See the following for info about Cardell monitors:

http://www.paragonmed.com/cardmonitors.shtml
 
thanks larry, you are putting my mind at ease. So now I just need to find out what ketamine they are using, and make sure it was not part of the recall. Should I ask any other questions?
 
Yes, a catheter should be inserted and used for IV fluids as well as induction. It was included in this line item:

$76 fluid therapy (venoset/IV tube, IV catheter, fluids - 500 mls, t port extension set)
 
thanks for the reply. That was quoted for hillary and the e mails I have received never said anything about a catherter, just warm IV fluids. Would those go through the catheter?
 
PeterDevonMocha said:
The e mails I have received never said anything about a catherter, just warm IV fluids. Would those go through the catheter?
Click to expand...

Yes, the catheter is the delivery device for the IV fluids.
 
thank you venita. I can't believe how little we know about this stuff. Im embarrassed to say we have never done a "dental" on any of our cats before :oops:
 
ok, heres some more updated info from the vet. Everything I think sounds ok, we would like to get mocha in before to long, but I guess we are just waiting because we are so nervous. Does that make sense??

me:
Thank you for the reply. Would it be better for the preanestethic bloodwork to be done a few days before, in case she needs to be on antibiotics for anything? Is it normal to do the bloodwork the morning of the dental cleaning? Also, would mocha have a catheter? And last ( I think!) if she does need extractions, generally how much more do they run? Would we be told about any extractions before they are pulled? Thank you again for all the help you are giving us!

Vet:
The bloodwork can be done either way, most of the time we do it the same day as it is just more convenient. Most pets do not need antibiotics beforehand, but some do, usually determined by the oral exam not the bloodwork.
Definitely she will have an IV catheter, and warm fluids during the procedure.
Extractions vary from $20 to $180, determined by the difficulty of the extraction; we would be able to give you an estimate that morning and then update it once we have her under anesthesia and have taken any needed Xrays.

Would you guys feel comfortable taking your cat here for a dental? She is a Fellow of the Academy of Dentistry and that is a good thing.
 
Sounds good to me as well and I like the part about AB's depending not a definitive. Which ties in to this thread on the other health board:
viewtopic.php?f=3&t=4136

And Dr Lisa chimes in about AB's and her change in recommendation.

Also, Jess brought up a new alternative as well, which is worth asking about.

And you're perfectly normal, being nervous, asking tons of questions and wanting to make sure you understand this.

My cats have had dentals in the past and I NEVER asked questions. I didn't know to or think about it. I blindly followed and trusted the vets. NOW I know better and will be making my list for the vet next week.

Oh and even after I get the answers and feel confident in their abilities, I will still be a nervous wreck on dental day. I will do my best not to show it and remain distracted, but I will constantly be thinking about it.

Look I think it's normal, our babies are away from us, in another location, out of sight and our control and we are entrusting them to someone else. What will lessen the fears, is knowing about the process, who is performing it and that the vet will do the best they can to ensure the cat's well being.

Your head will be fine - because it understands the process, it's your heart you will need to tame.
 
thanks hillary. I will ask about the nerve blocker? If we do get mocha in for a dental I know I am going to be a nervous wreck. Peter will take the day off work because I know I won't be able to handle taking her there on my own. He tends to be the more level headed one out of us!

A question about AB's. Do you think it is still important for her to have the AB's AFTER the cleaning? Isn't that what prevents any of the gunk from the cleaning from getting into her bloodstream?
 
does anyone else feel queasy when reading the article on the nerve blockers? I understand the concept, but it turns my stomach.
 
haven't read the article yet, so no stomach churning here.

regarding AB's - I'd follow Dr. Lisa's advice, if no extractions and nothing serious happening from dental, no AB's, but schedule a follow up in a week to make sure all is well. make sense?

You can always get AB's if needed, but why spend $$ and get if not really necessary.

think about when you go to dentist - you don't have AB's before or after a cleaning, why would kitty need it?

And if I get more than a cleaning done, I get happy gas - so there :mrgreen:
 
Just my two cents...

Of my 4 cats dental experience -- my two purebred cats have (had) poor teeth and had to have dentals and extractions. Both have lost a lower fang each, multiple incisors and molars. (lack of teeth doesn't bother them at all)

Fortunately, neither had any troubles or pain afterward - both needed AB. The first time they had some Metacam for pain. The second time for Mauser, the vet gave me a syringe of Bupe to use "if needed", and Mauser did not need it (he started eating as soon as he got home).

My two mixed breed shelter-adoption cats have great teeth and have only needed to have a bit of plaque chipped off during their annual (awake and hissing) exams.

Tiggy has been with us now for almost one year, and has not needed any dental attention yet. He'll be going in for his annual exam in a few weeks.

ETA: My cats-only vet does the dentals herself -- we did not take our kitties to a specialist.
 
thank you everyone. Hillary, you are right. I don't take AB's after going to the dentist, but on the other hand, I'm so scared of needles that I don't ever get numbed for cavity fillings either! I would never make mocha go through that though.

I really feel like it's time to call and make an appointment but I have such a nagging feeling in my stomach about doing it "just in case" something was to go wrong. How would we ever live with ourselves if something happened?? I know I can't think like that and I just need to suck it up and make the call, right?? nailbite_smile
 
I will preface my comments by saying I don't know you but...

I think you are doing a great job of learning all you can about dentals and what to do/not to do, but I sense a whole ton of anxiety about this that cannot be good for you or your furry one. I can't tell you how you should handle things, but sometimes it is a good idea to have a little faith that things will go fine, rather than assuming the opposite....

I hope I haven't overstepped any boundaries by saying this ;-)
 
no jen, you haven't overstepped your boundaries at all. I have major anxiety issues over anything "unknown" to me and I know this is a problem. So does peter :lol: , that's why he is the cool, calm, collected one out of us! I feel like making the call and setting up mochas appointment. This vet that I have been corresponding to has been awesome at answering my e mails, plus she e mailed me today letting me know that the Michigan State Veterinary school actually refers people over to her, which is saying quite a bit, MSU has an awesome vet school. The one major thing that is holding us back is the distance it is to get to this vet. She's over an hour away and mocha REALLY stresses out in the car. (lots of bathroom issues) and we aren't sure how well she would handle herself in the car for an hour.
 
If Mocha has stress issues, I'd look into at the very least using bach's rescue remedy for awhile before and during the car rental....
 
you can find it at any health store - like gnc or vitamin shop - it's called rescue remedy and is a homeopathic remedy intended to calm ones nerves.

I have some, but not sure how it's administered in cats - maybe put a question out on that.
 
interesting article. never heard of that before. Has anyone on this board used this product? Mocha does not drink out of a water bowl she drinks from the sink (if she does drink) so it would have to be applied elsewhere. I don't think I would apply it to her gums since she would be going in for a dental, I would hate for it to cause a complication after the cleaning.
 
ok, I e mailed another vet, closer to home. This is what they had to say. It doesn't sound as thorough to me as the other vet an hour away. This vet is about 20 minutes away from home. Does it sound ok to you guys?

Sorry again for all the questions!

1. is predental blood work required? No but highly recommended. Cost for presurgical bloodwork is $38.00.
2. are predental antibiotics required? Depends on the severity of the dental.
3. will xrays be done first? Possibly, again this depends on what the doctor finds and the severity.
4. what kind of sedative and what kind of anasthesia are used? Depends on the pet and what the doctor chooses.
5. what pain killers will be used and at what point? This is optional and will depend also on the severity of the dental and if there are extractions. Pain medication is optional.
6. do you monitor blood pressure? Monitor heart rate? Yes
7. if extractions are required, will you call first? How much do they generally cost? No and it depends on the teeth that need to be extracted.
We can do a treatment plan for you when you come in
8. Are IV fluids given during cleaning? Depends on the case
9. do you administer pain meds during the dental and after? would like buprenex if there are extractions
10. post dental antiobiotics? This also depends on the severity of the dental.
11. perform post dental x-rays to make sure nothing was missed- If you would like them done.
12. what is their procedure for diabetics; ie should insulin be given in the am and if so just partial dose or ? and will they monitor bgs at all?
13. How much do dentals start out at? $117.00
14. How many dentals are done each month? We do 2-4 dentals every day.

This vet is NOT on the fellow member dentistry board like the other vet we have been e mailing back and forth is, but I know there are a lot of people on here, who do take their cats to vets who are not on that board.

The price is much cheaper to begin with at this vet, but apparently he doesnt have a range of what an extraction might cost either.
 
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