How to clean teeth for a CRF FD kitty?

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myla

myla

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Hi all!
My kitty Purrcie is 15 this year. He has CRF and FD. He has had dentals done as recently as a year and a half ago but with his age and CRF the vet thinks the anesthesia might be too hard on his kidneys anymore. So my question is what can I do to clean his teeth? I can brush the front ones but a battle ensues if I try to get to the teeth that really need the cleaning. You know the ones on the sides and back that get the plaque.

Any suggestions?
 
myla said:
Hi all!
My kitty Purrcie is 15 this year. He has CRF and FD. He has had dentals done as recently as a year and a half ago but with his age and CRF the vet thinks the anesthesia might be too hard on his kidneys anymore. So my question is what can I do to clean his teeth? I can brush the front ones but a battle ensues if I try to get to the teeth that really need the cleaning. You know the ones on the sides and back that get the plaque.

Any suggestions?
Click to expand...

Stormy Blue is FD and CRF is 14 years old now.. He was "boxed down" with isoflurane for his dental last Fall and given clindamycin before AND after the dental.
He was also on an IV before, during, and after the procedure. He was also given pain medications, (bupe), for 3 days following the cleaning.

On a regular basis, I just scrub his teeth with a damp washcloth. It seems to work. A toothbrush would not work on him, either.
I just stick my finger into the washcloth, scruff him, and scrub away, repositioning the wash cloth on the finger as needed.

~M
 
What do you mean by "boxed down"? And what is isoflurane? That sounds like alot of procedures to go through for his teeth. Do you have to do it that way every year? I understand if it is necessary and he can handle the stress ok. I also realize poor dental health can escalate issues with CRF and many other health problems so I want to do the best I can for Purrcie too.

Thank you for sharing your information!
 
myla said:
What do you mean by "boxed down"? And what is isoflurane? That sounds like alot of procedures to go through for his teeth. Do you have to do it that way every year? I understand if it is necessary and he can handle the stress ok. I also realize poor dental health can escalate issues with CRF and many other health problems so I want to do the best I can for Purrcie too.

Thank you for sharing your information!
Click to expand...

Isoflurane is an anesthetic gas. Boxed down means that the Isoflurane is given via face mask to get the cat anesthetized enough to be intubated and then given a maintenance dose of the gas during the procedure. Some vets, with hard to handle cats, place the cat into a tightly sealed plastic box, then add the gas until patient passes out. Then the cat is removed from the box, and intubated in order to give a maintenance dose of the gas during the procedure.

~M
 
Boxing/masking/gassing down for induction sends the veterinary anesthesiologists on VIN, as well as Dr Lisa, into fits. Meowzi was very stressed and had a difficult recovery from her last boxing experience at the radiologist's; I am still beating myself up for letting the radiologist's staff (not our regular vet, who doesn't believe in boxing or masking her) talk me into it. She was also boxed down for all her her post-chemo check-ups at the oncologist's, and she HATED it. I will not allow her to be boxed down anymore, and will drive long distances to find specialists who won't gas down.

From VASG's page on induction protocols:
6) Sevoflurane/Isoflurane Mask Induction

a) General Description
i) Low solubility inhalant agents

b) Patient selection
i) Recommended use
(1) Mask inductions are not recommended for most patient groups

ii) Cautionary information
(a) Increased patient stress
-- (i) Increased arrhythmic risk
(b) Unnecessary staff exposure to anesthetic agents
(c) Time required for complete induction of anesthesia is longer than compared to IV agents.
(d) Prolonged period of unsecured airway with an increased risk of airway compromise or obstruction
(e) High concentrations of inhalant agents are required to achieve mask induction. Higher doses produce more cardiovascular and respiratory depression than seen with comparable doses of IV induction agents.
-- (i) During intubation removal of the mask results in cessation of drug administration of the drug and recovery from anesthesia begins as the drug is eliminated.
-- (ii) Once intubated higher concentrations of inhalant are required compared to use of IV induction drugs.
(f) Contraindicated in brachycephalic patients

Note however that iso and sevo, with proper monitoring, are perfectly acceptable and generally safe for maintenance http://vasg.org/maintenance_protocols.htm. But not for induction.
 
Purrcie also has asthma so any kind of gassing scares me to death.

So I'd love to find a way to clean his teeth and not have to go through this.
 
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