Freaked out about teeth-cleaning tomorrow

[Terwilliger1]

My Timmy has an appointment tomorrow to have her teeth cleaned. I'm starting to get really anxious about it. She's 17-years old and I'm worried about the anesthesia. All her bloodwork has been normal accept for some high neutrophils (inflammation). Her blood pressure is normal, no kidney problems, and everything else good (accept for the diabetes of course). Her BG's have been pretty good for over a month now. She's been on Clavamox twice a day for over a week now and is tolerating it well. The vet seems to think her dental problems might be keeping her from going into remission, and that's the only reason I'm going ahead with the cleaning. I'm worried that she'll need one or more tooth extractions. I'm worried how she'll recover from that if it's necessary. Just really worried in general. I was wondering if anyone else has had this done on an older cat, and how everything went? I'll have to give the okay on any tooth extractions, and I get super-anxious about making snap decisions. I figured she should only have teeth extracted if they are in really bad shape and maybe leave the iffy ones alone. I don't know, she might not need any teeth extracted at all. I really don't know anything about cat teeth. Just looking for a little reassurance I guess.

 

[squeem3]

There's an overview of a dental procedure here as well as questions to ask the vet: http://petdiabetes.wikia.com/wiki/Dental_procedure

My diabetic had 2 dentals done, including extractions, and there was no complications. Make sure that the vet prescribes a pain medicine. Extractions are painful. Buprenex is a popular one. The liquid is squirted into the side of the mouth and will get absorbed.

 

[Terwilliger1]

Thanks for the reply. The procedure link was really helpful. I had read some things previously but not specifically for diabetic cats. I always feel better if I have the right questions to ask.

 

[Hillary & Maui (GA)]

Personally, I would allow the vet to remove any iffy teeth. Better out than in. Plus when they do get worse and they will most likely, you will have to go through the whole dental procedure once again. and every time you do a dental, it's time to worry. So, if there is any question about out or in, I vote for out.

Also, make sure the vet takes xrays, so that they know what they are looking at and of course make sure the vet knows the cat is diabetic, so they can be prepared for anything that may arise as a result.

In addition, don't let the vet use metacam as a pain med - use buprenex instead or ketamine - as an inducer - there was a recall on it about a year ago and while the problem may be corrected, I wouldn't risk it, there are plenty of other inducers they can use instead.

 

[Julia & Bandit (GA)]

Gabby was 15 when she had her last dental and she needed several extractions--she had a heart murmur as well so I was especially worried about the anesthesia with that and her age. However, she came through just fine--anesthesia has improved in spades in the past decade and it's not as dangerous as it used to be, especially because of increased monitoring while the cat is under.

Gabby was like a new cat after the dental--I never realized how much pain her teeth must have been causing her. She was running around and playing like a kitten after she was all healed up.

I can tell you that Bandit had to have teeth done before his numbers improved--if there's bad teeth and an infection in the mouth, there's no hope regulating until the teeth are pulled. You can see from Bandit's spreadsheet what happened to his numbers after he got his dental (I highlighted the day in purple).

One thing that's very important--since your cat is 17 make SURE they give Buprenorphine and not Metacam (meloxicam) for pain during and after the dental. While younger cats do fine on metacam (as long as they aren't overdosed), cats with any sort of loss of kidney function should not have metacam. Kidney disease is so prevalent in senior cats that even if it hasn't shown up in bloodwork yet (it doesn't show until about 75% of function is gone), chances are there is some loss of function just due to age.

 

[Terwilliger1]

Thanks to everyone for your replies. I feel a lot better now. I talked to the vet again to make sure they will not be using Metacam. She said they would probably use Gabapentin for pain if there were any extractions done, and that she does not use Metacam. I know a lot of people on this site have much bigger health issues with their cats than a routine dental procedure, but after losing Timmy's sister suddenly last year, I'm just hypersensitive now. Thanks again for your replies.

 

[hmjohnston]

Hey- my cat is 17 and that is something that will most likely be coming up soon.

These people don't just care only about the fd your sugar bear is facing- they care about all of it. Someone has been through it, knows about it, can give advice on it.

Not only is it a car trip and a vet trip it is a trip your cat just doesn't really understand. The answers given have helped you calm down and when the bean is calm the cat is... well- a trip to the vet might top the calm of the bean- but it helps you.

I don't remember from what book/movie/tv show it is but the phrase "These are good people." Always come to mind.

I'm rooting for you and Timmy .

 

[Vyktors Mum]

One thing that's very important--since your cat is 17 make SURE they give Buprenorphine and not Metacam (meloxicam) for pain during and after the dental. While younger cats do fine on metacam (as long as they aren't overdosed), cats with any sort of loss of kidney function should not have metacam. Kidney disease is so prevalent in senior cats that even if it hasn't shown up in bloodwork yet (it doesn't show until about 75% of function is gone), chances are there is some loss of function just due to age.

I wouldn't let a younger cat have Metacam either - check out metacamkills.com

 

[Martica and Fred]

My Fred was 17 when he had his last dental. Apparently his blood pressure dropped super low--to 40--and so they had to rush the procedure to get him out of anesthesia. he had only about 2 teeth left at that point, but despite the emergency, he came out of it ok and lived another 3 years.

 

[Lisa dvm]

Personally, I would allow the vet to remove any iffy teeth. Better out than in. Plus when they do get worse and they will most likely, you will have to go through the whole dental procedure once again. and every time you do a dental, it's time to worry. So, if there is any question about out or in, I vote for out.

Absolutely. Any questionable teeth need to be in the trash can before the patient wakes up.

 

[Julia & Bandit (GA)]

One thing that's very important--since your cat is 17 make SURE they give Buprenorphine and not Metacam (meloxicam) for pain during and after the dental. While younger cats do fine on metacam (as long as they aren't overdosed), cats with any sort of loss of kidney function should not have metacam. Kidney disease is so prevalent in senior cats that even if it hasn't shown up in bloodwork yet (it doesn't show until about 75% of function is gone), chances are there is some loss of function just due to age.

I wouldn't let a younger cat have Metacam either - check out metacamkills.com

I don't want to repeat the same old debate with Metacam, but there are cases where it is is an appropriate choice because it is the only nsaid option. When Metacam is dosed correctly and not given to a cat with impaired kidney function, gastro-intestinal problems, liver problems, or heart problems, it's not dangerous. The problem with Metacam is that it's been administered to many cats despite their having the warned secondary conditions (nearly all cats over the age of 12 will have reduced kidney function), or has been dosed inappropriately.

Bandit had Metacam after his first dental a few years ago--and knowing the problems with metacam I triple checked to make sure the dose was appropriate. He also did not take it repeatedly. Because it is also an anti-inflammatory, it is better suited for dealing with post-extraction pain. However, since he's getting older and has presented some gastro issues since then, I opted for buprenex at his last dental to be safe.

People may also consider it for cats with chronic pain issues that need an anti-inflammatory despite age--there are times when you might choose to take the potential risk of renal failure to improve the the quality of life for a cat with such problems. I also considered Metacam towards the end of Gabby's cancer if needed--she did not tolerate opiates well and if I had thought she had need a pain medication I would have gone for it even though she had kidney disease. Sometimes you need to take that risk when you're that far into palliative care.

While it's absolutely horrible the way metacam has been mis-used in the past, it's misleading to say that it should never be used for all cats. Check out the current guidelines for NSAID use in cats: http://www.catvets.com/uploads/PDF/NSAIDs Guidelines.pdf. I really hope that there is a safer NSAID for cats someday, but until then Metacam still does still have its uses.