Vet doesn't want to do dental....

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Jane & Boo (GA)

Jane & Boo (GA)

Member Since 2009
Boo is a rescue kitty I took in on New Years eve. She had been removed from her previous owner because of neglect. I immediately took her to the vet for a full blood panel, a physical exam and to schedule a dental because it's obvious that she has oral pain. A couple of days before the scheduled dental the blood panel results came back and indicated that Boo is diabetic. I was told that the dental should be postponed until she was started on insulin and her BG was regulated.

It's now a week since insulin was started and her BG seems to be getting higher. I'm thinking it could be because of the oral pain. When I asked the vet about doing the dental to give Boo some relief he said he wants to see her BG in the 200s first. He wants me to increase her dose to 2Units to see if that will get her to the 200s. Has anyone ever heard of this? What is the harm in doing the dental with high BG numbers.... especially when it's likely that those high numbers are the result of pain stress? Her kidney values are good and she's only 9 or 10 years old. I'm very fearful of increasing the insulin if her high numbers are pain related. Any advice?
 
I wouldn't increase by a whole unit, especially since Boo is getting into blue on the 1U dose. We only suggest increases in .25unit increments so we don't go past what might be a "perfect" dose

You're totally correct that the need for a dental could very well be effecting her numbers, but we seem to hear that "get the cat regulated first" around her a lot...it puts you between a rock and a hard place!!

I think it's more "old school thinking"....veterinary anesthesia is a lot better these days, so it's much safer to do a dental on older and sicker cats, but trying to get through that "old" thinking is a tough fight

You might want to consider a dental specialist at http://www.avdc.org/

There's lots of other great tips on dentals HERE
 
I just had my Dottie undergo dental surgery to remove all her teeth. In spite of the fact that she has a bad reaction to the anesthesia used during surgery, it was really necessary to do it immediately because she kept clawing at her mouth. My vet started her on insulin the day after surgery.

It was a rough haul, but we made it. She now has a sweet smelling little mouth, and is getting stabilized on insulin. Dental surgery can be done before insulin shots are set up, but it's a careful weighing of pros and cons. You said the vet wants her to get into the 200s. How high are her BG numbers? Dottie was in the 400 range. If your kitty is much higher than 400, perhaps there are other factors the vet is taking into account?
You mentioned that your kitty was neglected. What about dietary deficiencies? Is she painfully thin? Were there worm issues? And if you are uncomfortable with your vet's choice, you could always get a second opinion, just like you would if you weren't happy with your own doctor's diagnosis and opinion.
 
Chris & China said:
I wouldn't increase by a whole unit, especially since Boo is getting into blue on the 1U dose. We only suggest increases in .25unit increments so we don't go past what might be a "perfect" dose


You're totally correct that the need for a dental could very well be effecting her numbers, but we seem to hear that "get the cat regulated first" around her a lot...it puts you between a rock and a hard place!!

I think it's more "old school thinking"....veterinary anesthesia is a lot better these days, so it's much safer to do a dental on older and sicker cats, but trying to get through that "old" thinking is a tough fight

You might want to consider a dental specialist at http://www.avdc.org/

There's lots of other great tips on dentals HERE
Click to expand...


I totally agree you Chris, if there's infection present, achieving regulation is going to be next to impossible.
 
We just had another kitty Mama, @Ferndoc that went thru this with her kitty. The vet finally agreed to do the dental - and ended up finding all sorts of issues that were indeed likely causing a lot of high numbers. Here's a link to her condo after the dental - you can track her back and read more info. It might help you with more info for YOUR situation:

http://www.felinediabetes.com/FDMB/threads/we-are-almost-toothless-now.151264/
 
Merlin was 17 years old when he got his last dental. His numbers were in the 300 & occasionally in the 400's. When he had his pre-surgery blood test, we found out that he was in Stage 3 kidney disease. The vet decided to wait for one month to see if he was progressing with the CKD. In one month, the BUN/Creatine levels were the same so we went ahead with the dental. Diabetes was not the reason for the one month delay. He had one tooth extracted and did fine after surgery and his numbers improved. Hopefully your vet will proceed or you find another vet opinion.
 
I'm in a rural area.... no dental specialists. My guess is if I were to travel to one in the city the price would be outrageous. I will bump her up by a half unit and see what that does, but I'm not hopeful. Getting an appointment with another vet for a second opinion will be 3 weeks from now. I know that the uncontrolled diabetes makes her hungry. Will that hunger trump the pain and prevent her from refusing to eat? I'll take a look at how Mama, @Ferndoc dealt with this. Thank you all!
 
I just had my unregulated girl with IAA in for a dental. My vet said she could do it, but given Menace's diabetic status, we both agreed it would be better to have her done at the specialty hospital where she could be monitored more closely and have an internist available should the need arise. Menace went through the surgery with flying colours, lost three teeth including one canine, and apparently was entertaining the staff at the hospital with her "talk" after she woke up. In short, she is no worse for wear as a result. Perhaps your vet, like mine, just feels more comfortable dealing with a regulated diabetic. I have no idea what the costs would have been at my vet, but the money I spent to keep Menace safe was worth every penny although I have to admit having sticker shock at the final bill.
 
I wish I could say that I had to convince my vet. But mine did not say anything like we need to get to 200 to do a dental just that we need to make sure he is stable. He had a rough start and had ketones in his blood when he was diagnosed. As I said in my post I made the appointment then said let me know if the vet doesn't think this is a good idea. The vet said I think we are good with this. Fern was never in any pain nor was his breath terrible so I likely wouldn't have pushed it if they said lets wait a bit more.

Lucky for me even though he is really laid back he is a fighter when it comes to his health. He was under pretty long yesterday and the vets office was amazed how well he bounced back from it.
 
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