Neurotic question -- dental + anesthesia

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allie and newkitty

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Newkitty needs a dental....her teeth look bad and I have been putting it off due to her many issues (diabetes, IBD, pancreatitis, high dose of pred). I am TERRIFIED of anesthesia for her, not to mention how she does not rebound from stress very quickly these days.

How dangerous is it? I will of course get the pre-bloodwork. I have had dentals for her and our other cats before. But they were (at the time) perfectly healthy and not on any meds.

I would keep putting it off like I do her vaccinations BUT she is now mouthing her kibbles and spitting them out or spitting out half pieces. She eats her wet food just fine. This makes me think she is in pain. She does have redness around the gums.

Sorry for starting a new thread but this is a completely different topic. I guess I need something to worry about to distract me from all these huge tornadoes. :(
 
please do not put it off. get her blood work done, talk about what they do for induction, etc. make sure they they give fluids, that there is a blood pressure monitor and even a pulse oximeter. talk about meds during and after. and breathe :)
 
I put Pearl's off for the same reason and she ended up with HORRIBLE infections. We did it because there was no choice and she was under for 2.5 HOURS and had five extractions because we waited so long. It would have been far shorter if it had not been so bad. She came through like a champ although it took a good 3 days for her to begin to act normally (I think it was the length of time under anesthesia). So I recommend to NOT wait. With these cats they take LOTS of precautions during the surgery. I cannot recommend highly enough to NOT wait for it to get that bad. I shouldn't have been such a coward.
 
Karen & Pearl said:
I cannot recommend highly enough to NOT wait for it to get that bad.

A big "ditto" to this and to Jen's discussion above of BP monitoring, etc.

I just finished my vaccine page with a plea for people to stop over-vaccinating and to start putting the money toward proper dental care...which we all (myself included) too often neglect due to our fears of general anesthesia.

Now...I need to find the time to write my next webpage....called "Dental Health".
 
While my Janeway does not have anything wrong with her except mild IBD and Chronic gingivitis, she just had a dental because of her gingivitis history and I noticed some pawing of her face after eating. She ended up having a very loose tooth that did need extraction but they didnt have to pull very hard due to how loose it was. Obviously, her bloodwork was fine and thats why I went ahead with it. I didnt want to have a bad mouth full of gingivitis and loose teeth and NOT be able to do one.

Janeway is 22..
 
Lisa dvm said:
Karen & Pearl said:
I cannot recommend highly enough to NOT wait for it to get that bad.

A big "ditto" to this and to Jen's discussion above of BP monitoring, etc.

I just finished my vaccine page with a plea for people to stop over-vaccinating and to start putting the money toward proper dental care...which we all (myself included) too often neglect due to our fears of general anesthesia.

Now...I need to find the time to write my next webpage....called "Dental Health".
Lisa, my vet (whose practice is only cats, no other animals) does dental cleaning without anesthesia if the cat is willing. (If the cat fights it, he does not do it that way.) His reasoning is that anesthesia should be used only when necessary because of its risks--maybe only one cat in a thousand dies from anesthesia, he says, but you don't want your cat to be that thousandth cat. His method of non-anesthetized dental cleaning worked very well with my cat when I had it done in February. Two vet techs held the cat's feet so that he wouldn't paw to try to get that *thing* out of his mouth. Lying him on his side worked best so he didn't have the instinct to push off the table with his back feet. He was surprisingly patient with it. The vet stopped every few minutes and gave him some B vitamin syrup as a treat. The whole thing took probably ten minutes and was seemingly less traumatic than blood drawing and other procedures that are done at an office visit.

Is there a move afoot to encourage vets to do dental cleaning without anesthesia? If the cat will put up with it, it is easier on both cat and owner, less risky for the cat, not to mention considerably cheaper. If the vet had wanted me to go through the whole rigamarole of bloodwork and anesthesia, I would definitely have put it off because of cost at a time when I was already spending more than I can afford on vet bills.

I'm sure it won't do for every cat, but it seems worth trying and only then, if the cat won't put up with it, move on to the full monty.
 
BRW said:
Lisa, my vet (whose practice is only cats, no other animals) does dental cleaning without anesthesia if the cat is willing.

I am 100% opposed to this as would any vet that I know and respect. Sorry...harsh words but it is absolutely ridiculous to think that any cat is going to allow a *proper* dental cleaning/exam while awake and I would never subject any cat to this type of close-to-worthless 'procedure'.

The main problems are UNDER the gum line and given that I just had my own teeth cleaned and PROPERLY probed, I will repeat - NO awake cat is going to allow this.

Anesthesia-free dentistry is a pretty anger-provoking topic among veterinarians who are dedicated to quality medicine so...no....there is no "move" toward this inferior type of medical practice.

All anesthesia-free dentistry does is give the cat owner a false sense of security...leading them to believe that they have *properly* addressed their cat's dental needs.

In fact, the first paragraph of my Dental Health page will be speaking out against this practice and if you look at the last paragraph of my new Vaccine page, you will see that I have already spoken out against this.
 
From the AVDC (American Veterinary Dental College):


Owners of pets naturally are concerned when anesthesia is required for their pet. However, performing NPDS on an unanesthetized pet is inappropriate for the following reasons:

1. Dental tartar is firmly adhered to the surface of the teeth. Scaling to remove tartar is accomplished using ultrasonic and sonic power scalers, plus hand instruments that must have a sharp working edge to be used effectively. Even slight head movement by the patient could result in injury to the oral tissues of the patient, and the operator may be bitten when the patient reacts.

2. Professional dental scaling includes scaling the surfaces of the teeth both above and below the gingival margin (gum line), followed by dental polishing. The most critical part of a dental scaling procedure is scaling the tooth surfaces that are within the gingival pocket (the subgingival space between the gum and the root), where periodontal disease is active. Because the patient cooperates, dental scaling of human teeth performed by a professional trained in the procedures can be completed successfully without anesthesia. However, access to the subgingival area of every tooth is impossible in an unanesthetized canine or feline patient. Removal of dental tartar on the visible surfaces of the teeth has little effect on a pet’s health, and provides a false sense of accomplishment. The effect is purely cosmetic.

3. Inhalation anesthesia using a cuffed endotracheal tube provides three important advantages – the cooperation of the patient with a procedure it does not understand, elimination of pain resulting from examination and treatment of affected dental tissues during the procedure, and protection of the airway and lungs from accidental aspiration.

4. A complete oral examination, which is an important part of a professional dental scaling procedure, is not possible in an unanesthetized patient. The surfaces of the teeth facing the tongue cannot be examined, and areas of disease and discomfort are likely to be missed.

End excerpt.

So many dogs and cats have had to suffer in silence - with painful teeth - because people sign up for anesthesia-free dentistry and I find that very sad.

I remember a very interesting lecture where the speaker put up pictures of two dog mouths.

Dog #1....VERY clean looking teeth but once under anesthesia, it was found that he had a lot of problems under the gum line and needed several extractions.

Dog #2...HORRIBLE looking mouth...huge hunks of tartar but when the teeth were cleaned up and *probed* under general...the dog needed no extractions.

You just can't tell until you get in their with your sharp...painful...probes to look for deep pockets under the gum line and for that, the animal must be fast asleep.

I also remember a FDMB board member who lived near me. He took his cat to a friend of mine for dentistry. This man had signed up for anesthesia-free dentistry for the past many years of the cat's life. The cat's mouth was a mess and needed multiple extractions.
 
BRW

My Squeak has had chronic dental issues and we've spent a lot of money on dentals ...and he almost died once, and threatened to a few other times. We learned quickly that he can't tolerate opiates and he's well monitored through each procedure....he has a bit of a 'rep' at our clinic.

I will continue to subject him to this for his health. I SHOULD be a better mom and clean his teeth better but he hates it, I work and have 2 little kids, a busy husband and a neurotic dog so it falls through the cracks :(

Dr LIsa is a pretty amazing vet and contributor to this board. Please take her comments seriously but not personally.

Jen
 
I don't take them personally. I didn't feel that anything Lisa said was about me. Clearly, she has strong views and is passionate about them, and she is very knowledgeable and articulate. I respect that, and I admire the work she has put in and her generosity of spirit. As the person who has to live in my skin, I need to be totally comfortable with my own philosophy of animal care, and I am. You know the saying "Take what you can use and leave the rest." That's my intention here.
 
My diet controlled diabetic Smokey just has her dental a few months ago. Her BP runs 60s/30s when she is under - that is VERY scary! But my vet still wouldn't attempt to do her dental without anesthesia, they just monitor close and bring her out quickly. I haven't met a vet who'd mess with a cat's mouth while awake, the UofMN wouldn't either. Its not safe for a vet to try it and if they are going to try it, PLEASE find out how they plan to restrain Newkitty and keep her mouth open while they do it because I can't imagine how they could do that effectively and gently.

Smokey's BGs were not changed by her dental. She had some other medical stuff going on at the same time so her physical stress was high, but her BG just dipped slightly and then leveled back out in the 80s where she likes to hang.
 
Thank you for all the input, I really appreciate. As far as I know my vet only does it the anesthesia way. And Newkitty handles stress poorly (she always seems to feel ill for a few days after a vet visit, or a trip to the half-bath to hide from tornadoes, etc, etc). The awake way would likely upset and scare her. I would rather ME have the stress (much as it will suck and I will be on here asking for prayers & good vibes). My vet does not want to do a dental at this time until we get her CRF figured out a bit more. But when the times comes, I will bite the bullet.
 
Allie. Getting back to your origin question/concern, I had the concerns.

Fortunately. I have board certified dentist nearby who works in a 24/7 vet practice. I took the time to explain each of my girls issues and the dentiis(s) adjusted their protocols and drugs accordingly. We also took precautions for my early kidney girl to protect her kidneys by overnighting her with iv fluids. For my seizure prone girl, again drug adjustment and a lighter touch on the drugs.

All Three girls got dentals and Maui got two in one year. The kidney girl is the only one who appeared unaffected by the anesthesia and that could be because of the fluids before and after, flushed it out of her well.

Maui and the seizure one were slower to get back to normal and also required bupe.

The point is, you need to do the dental if you have a dental specialist nearby I say go there do. A consult, pay the money (as they may be more expensive than regular vet) and give yourself peace of mind. Knowing you have done the very best and that is all a dentist does so they will have lots of tricks and an array of drugs to use tailored for your cat.
 
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