Pre-dental results in, need advice! Possible cardiomyopathy!

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Gwen and Morris

Gwen and Morris

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Morris went to the vets last Thursday for his pre-dental work up. He had his labwork done & also an ECG since he seems to drop a heart beat about once per minute. Our vet called with all the results today & now I need to make some pretty big decisions and let her know tomorrow!

She said a couple of his kidney numbers were slightly out of whack compared to what they should be, but that she wouldn't recommend any changes to his care. His fructosamine was 450 - on the boarder between good/fair control according the the vetsulin website (she said she thought this was a good number considering how bad his teeth are right now). Everything else seemed to be fine.

The big news - the ECG report! Unfortunately, they did not document his arrythmia on the strip. With all of his medical data, plus the ECG that was done, they think there is a possibility he has an enlarged ventricle and/or cardiomyopathy! They are recommending an xray (my vet is not sure she could diagnose this herself on an xray - would need to be sent to a radiologist) or better yet an ultrasound. Both of these options are pretty expensive around here & I'm not sure we have the extra cash to pay for these extras.

I asked her what would happen IF we did these tests & confirmed these diagnosis - she said then she wouldn't be wanting to put him under anesthesia. She went on to say, that with how awful his teeth are at this point, if we can't do this dental, then maybe we should have the PTS discussion :o as he is already at the point where he's not eating & it will only get worse.

I then asked if she would be willing to do the dental on him if we did not do the other expensive tests. She would be willing to do it, but there are no guarantees that he would tolerate it.

I then said, OK - lets take a deep breath & just hope for the best this Thursday as planned. She then convinced me to think about things overnight & discuss with my dh. nailbite_smile

If we are going to proceed on Thursday (I have to call the office tomorrow & let them know my decision), then she wants me to come get some antibiotics to start with before the dental on Thursday. She wants me to feed him until midnight the night before the dental with regular insulin the night before. The morning of, she said no food & give 1/2 dose insulin.

Any thoughts/comment/suggestions? :shock:
 
Re: Pre-dental results in, need advice! Possible cardiomyopa

My 16 year old kitty Turtle has had Hypertrophic Cardiomyopathy for years...wow, I'm gonna say 8 now? She also had terrible teeth, and I had to get the kitty cardiologist's OK before she had dental work done. He OK'd anesthesia for Turtle several times based on her Echo Cardiogram results. So your kitty having a CM may not automatically rule out ever having anesthesia again. There are gentler protocols and chemicals they can use which make it less risky. The Echos *are* expensive - ugh -- but it might be worth having one done so you know exactly what condition you're dealing with...a Kitty Cardiologist can tell you for sure whether anesthesia is safe (or at least relatively so-- there is always some risk with anesthesia, even with healthy cats) and give your Vet instructions on how to administer it for the least risk to Kitty.

Hope this gives you a little reassurance. . . as I have found out over the years it is possible for CM to be managed, so there is room for optimism!
 
Re: Pre-dental results in, need advice! Possible cardiomyopa

Hi Gwen,
How bad are his teeth and does the vet intend to extract all of the teeth?
I am just wondering about it because if the vet finds that most are bad and need extracting, you could consider getting all removed at this one session and save the trouble later if he does have heart issues since they could get worse later.

There are lots of owners that have had all teeth extracted and the kitties do just fine with eating later.

I have no experience either but wanted to say that one specialist suggested cardiomyopathy for Oliver when Xrays done, but when his u/s was done later on, there was no cardiomyopathy. I would think better to spend more on the mouth while he's already under, than waste money on an expensive searching for something that may not be.
 
Re: Pre-dental results in, need advice! Possible cardiomyopa

I am sorry to hear this - again. You are the third in two days that has gotten a possible or confirmed dx of cardiomyopathy.

I posted general info about Beau's HCM in the thread that Sue linked, but I would suggest that you speak to your vet about different anesthesia or how she wants to handle him while he is under. I am not sure that I agree with the idea to just PTS because of the teeth and possible cardiomyopathy. That seems a little extreme to me.

Cats that can not have anesthesia can have pulse ABs given every 4-6 weeks to knock out the worst of the bacteria, but if he has mouth pain, then he probably needs an extraction(s).

My vet talked about giving my very senior cat "puffs of gas (anesthesia)" to just keep her barely under. I think the gas anesthesia doesn't stay in their system as long and they can come out of it faster if needed. I never had this done because we did ABs and she seemed better. Her mouth did bother her in the end somewhat, but she was eating well. With kidney failure and hyperT if just seemed too risky. She died at age 18-1/2 from cancer.
 
Re: Pre-dental results in, need advice! Possible cardiomyopa

Hi Gwen

ECGs aren't the best for determining the type of heart disease a cat may have. If your cat is also having irregular heart beats, I'd see a cardiologist and get an echocardiogram. If you can only afford one, and your cat is not having trouble breathing (which he isn't), I'd get the echo. I don't know if there is a cardiologist in BC so you might have to get one from an internist. Do you know the cost, and can you swing this financially?

If you can't, I think risking a dental is more reasonable than euthanizing a cat rather than risking a dental. Ask for specifics about your vet's anesthesia protocol and I can give you feedback. There are heart-friendlier means of doing anesthesia, and a cardiac condition does not preclude anesthesia in an animal with urgent need of surgical/dental care.
 
Re: Pre-dental results in, need advice! Possible cardiomyopa

Gayle and Shadoe said:
How bad are his teeth and does the vet intend to extract all of the teeth?
I am just wondering about it because if the vet finds that most are bad and need extracting, you could consider getting all removed at this one session and save the trouble later if he does have heart issues since they could get worse later.
Click to expand...
His teeth are super bad right now. From the little look the vet did at his yearly checkup at the beginning of September, she was saying that he will more than likely need to loose all of his side teether & quite possibly even his 4 big front teeth - this is the minimum! She said she wouldn't know for sure until she got in there.

Sheila & Beau & Jeddie said:
I am not sure that I agree with the idea to just PTS because of the teeth and possible cardiomyopathy. That seems a little extreme to me.
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But I don't want to see him suffer either. He is already at the point where eating is a problem for him because of his teeth.

Jess & Earl said:
If you can only afford one, and your cat is not having trouble breathing (which he isn't), I'd get the echo. I don't know if there is a cardiologist in BC so you might have to get one from an internist. Do you know the cost, and can you swing this financially?
Click to expand...
I don't know if we have those kinds of specialists around here or not. I live on Vancouver Island, and I know there are not those specialists here. At a minimum, it would be at 2 hour ferry ride each way to get to the Lower Mainland to find a specialist, if available. The ferry ride is also kind of expensive, plus the stress that Morris would be in travelling that far. The only reason dh is letting me get the dental done for Morris right now is because I just settled a claim, after 3 years, from a car accident I was involved in. We got a little more than what we were thinking I would, so I am allowed to get this done for Morris right now.

Jess & Earl said:
I think risking a dental is more reasonable than euthanizing a cat rather than risking a dental.
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I think I agree with you. It sounds like a 50-50 (or possibly even better odds) chance that he will survive the dental & be a happier, healthier cat because of it. If, however, we don't do the dental - he is going to be a miserable unhappy, unhealthy cat. Some higher power brought Morris to live with us 12 years ago and I believe that same higher power brought him back to our house 2 years ago when he needed us (when he was diagnosed with FD). I just have to believe that this higher power will take care of him on Thursday as well.

Jess & Earl said:
Ask for specifics about your vet's anesthesia protocol and I can give you feedback. There are heart-friendlier means of doing anesthesia, and a cardiac condition does not preclude anesthesia in an animal with urgent need of surgical/dental care.
Click to expand...
Thanks Jess! I know my vet is not in the office today, but I will see if I can find out more information. She wants me to start him on antibiotics now, so I will be stopping by on my way home from work today to pick up the prescription.

Thank you all for you wonderful words of encouragment & helpful advice! I really appreciate it!
 
Re: Pre-dental results in, need advice! Possible cardiomyopa

Thanks for the link Hope. I have explored their website & it sounds absolutely amazing! Unfortunately, it looks like it would cost a minimum of around $700 for the consult, echo, ect. Assuming that pet specialists are similar to human specialists, it rarely costs the minimum - it usually is more! Plus the expense & hassle of getting over to the mainland. It just is not feasible for us.

I have called my vet's office & confirmed that we will go ahead with the dental on Thursday as planned. I will pick up the antibiotics on my way home from work tonight. I have requested the liquid type as my dh is the only person who can get Morris to take pills & dh will be away this weekend!
 
Re: Pre-dental results in, need advice! Possible cardiomyopa

make sure that they monitor her blood pressure and use a pulse oximeter if they have one. talk with them about pain killers and when they will give them and what type. talk with them about what they use for induction and what gas they use.

Jen (in Alberta)
 
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