Dental Problems; worried & nervous

I have a vet appointment set for August 2nd at 8:30am for my kitty at one of the most recommended vets in my area.

I adopted my first kitty in March of this year, and he has been to the vet twice so far. The first one was a general check up which I left with tapeworm medication (yuck!) and respiratory medicine. The second visit was for his ear mites. This time he's going for his teeth.

He's had some really rancid fish breath since I got him. Being my first cat I thought it was the fact I'd been feeding him fishy flavored wet food, so I began feeding him beef and chicken. The bad breath went away.

Last night I finally got brave, and gave him a good in-depth health check. He HATES having his mouth opened, so I grabbed his scruff and pinned him down while my girlfriend pulled his lips back... and what I got was a huge whiff of that rancid kitty breath, and saw a horrible, disfigured, grey sludge-looking molar. He kept fighting so I didn't get a good look at it... but I know that it has got to hurt.

So the first thing I did was make a vet appointment this morning. The soonest I could get him in was August 2nd.

I guess I'm just a little bit worried... they said they're going to have to put him under sedation to clean his teeth, and a few years back I had my dog sedated for an x-ray and he never woke up. I've also never had an animal with dental problems before so I'm not sure what to expect.

Has anyone ever had this problem before, and can help ease my fears? Is there anything I can do to ease his pain for the next 2 weeks while we wait?

You might want to search for a thread by LawGuy, whose little guy recently had some dental work. FWIW, my two adults have both had their teeth cleaned twice, which includes sedation. You just can't do a good job on a cat without them being asleep. I was worried, yes - and they've been fine.

Don't feel shy about sharing your concerns with the vet. Definitely opt for bloodwork before the procedure (most vets very strongly recommend it) and if your vet suggests IV support during the procedure, I'd go for it.

BTW, if your vet doesn't check kitty's teeth during every exam (and I know it's tough - they wiggle at best!!!), do consider getting another vet. Ideally you can catch tooth problems when it's just some tartar or placque, and the cleaning can be done more quickly.

Yes, no procedure is without risk - but, it's far more likely your cat will feel tremendously better after the procedure.

Is your cat eating ok, peeing ok, etc.? If not, call the vet back and see if there's any way the procedure can be moved up. Actually, as the vet seen your cat's teeth, or did you just book the procedure over the phone. I'm a horribly nervous mom - I'd be dragging the cat in for an exam right now if the vet hasn't seen him.

I adopted Buddy in March of this year. He's been to two different vets so far (I didn't like either one of them). Neither vet has stopped to check his teeth because he will NOT let you open his mouth unless you physically pin him down. I asked them to, but they gave up quickly and said he was fine. I can't believe I trusted them. -rolls eyes- So this time I asked around and found supposedly "the best vet in town". I'll be the judge of that.

Buddy is eating fine, and peeing buckets. The tooth doesn't appear to be causing him any agony, but I know it is... I have dental problems too, and so I can sympathize with him. I don't know his medical history, but I think it's safe to say he's never had a routine dental cleaning before, and the shelter I got him from said he's about 5 years old. I am going to ask the vet when I take him in to see if that's true.

What kind of bloodwork should I ask the vet to do? Is there something serious about a bad tooth that I should know about? Now I'm nervous...

One of my cats had a dental and 5 extractions this past February. This was with a new vet and it's the first time a vet got a good look at her teeth for the same reason. She gets so stressed at the vet's but this vet was persistent, though gentle, and she got a good exam this time. I have only heard the bloodwork called pre-op bloodwork. When my cats were altered as kittens it was optional and I paid to have it done, this time it was part of the deal. It's complete bloodwork to make sure that the organs are working properly particularly the liver and kidneys. Alice did fine and was even eating kibble that night. She was given pain medication to take at home afterward because of the extractions but nothing before the dental.

Oh, okay. I've never heard of doing pre-op bloodwork, but I suppose it makes sense. The shelter I adopted Buddy from lied about pretty much everything. He was an older cat, a male, black and white, and huge... he wasn't exactly on the top of the adoptable list. I was told he tested negative for FIV and FeLV, but I don't believe he was ever tested. I only assume because they also said that he'd been microchipped, which he was not.

I'll ask my vet... but if he does have some horrible kitty disease, would it cause complications with the sedation?

I know kidney and liver problems can complicate anesthetic because they filter toxins out of the systems. One of my cats had to have a feeding tube put in temporarily last year because of liver disease. The vet said it was a really good sign that he came right out of the anesthetic. She said that cats with liver disease often are slow coming out of anesthetic.

Exactly - it's pre-op blood work, just checking to make sure the cat has no underlying health issues that might complicate things - or, if there is anything, the vet can adjust the procedure to cope. If your vet's office doesn't at least suggest blood work, take your kitty and run til you find one who does. Some vets mandate it, some vets strongly suggest it but worry that some clients will not do the dental if they have to pay for additional blood work. Most young cats will do just fine, but I felt better about getting the blood work....also, it serves as a nice baseline to have as your cat gets older - you have something to compare a new test to.

Some cats are very difficult to examine while they're awake!

My shelter was great - but I still took mine into my own vet for a full exam right away, where they checked for chips and we did a whole basic exam, including stool.

Hi there, my Bugsy has dentals often due to Stomatitis... never had an issue (and let me tell you, Bugsy has issues with EVERYTHING). I would highly recommend getting a pre-op bloodwork and IV support. Also, make sure you have on your files NO Ketamine. This is an anesthetic used for dogs and sometimes for cats - can be very dangerous for kitties.
Make sure you come home with antibiotics (I rather have injections as their mouths can be sore - convenia is good, since it is one shot you apply at the vet's office and lasts for 2 weeks, second option clyndamicin injections, given daily), pain medication, and wet food - if kitty has extractions, he might be on wet only for quite a few days. Bugsy was for 10 days due to rough extractions and bone cleaning.

I have several kitties w/o any teeth & almost everyone in my household has had a dental in the past 3 years. I think of 18 cats, 3 are toothless, 6 have had dentals w/ some extractions & the foster kitty had a dental done a bit over a month ago. I always opt for the pre-op bloodwork, just to cover my bases. All have come out of it just fine.

Thanks everyone!

While I was at work tonight a customer told me about her friend - my vet! I've never met him before, but she said he's a miracle worker. I'm glad I chose his office (not to mention he's booked for the next 2 weeks - that has to say something).

I'm making a list of things to ask during my appointment. So far I've got: Pre-op bloodwork, if an IV would be necessary during the procedure, injectable convenia (I don't think I could do injections myself), pain medicine... am I missing anything?

I'm also going to see if he can run some additional tests for FIV and FeLV during the bloodwork, and to check his ears because he has a history of ear mites and recently he's been scratching again. I might ask about his lungs as well, just because of his history with respiratory infections. He seems okay, but I want to make sure.

Edit: Oh, and he's already on wet food. He has a bowl of dry down so that my girlfriend can sleep through the night, but he gets wet twice a day. I'll be sure to pick up the dry food and feed him a can of wet before I leave for work (night shift).

I'd also ask for an anal gland check while kitty is out - my two have had issues in the past, and it's way easier to check a less than squirmy kitty. Also, great call on the ears - again, much easier to do a really thorough check while they're out.. I'm sure the vet would do that anyway, but doesn't hurt to ask.

Originally Posted by Mewsings

Thanks everyone!

While I was at work tonight a customer told me about her friend - my vet! I've never met him before, but she said he's a miracle worker. I'm glad I chose his office (not to mention he's booked for the next 2 weeks - that has to say something).

I'm making a list of things to ask during my appointment. So far I've got: Pre-op bloodwork, if an IV would be necessary during the procedure, injectable convenia (I don't think I could do injections myself), pain medicine... am I missing anything?

I'm also going to see if he can run some additional tests for FIV and FeLV during the bloodwork, and to check his ears because he has a history of ear mites and recently he's been scratching again. I might ask about his lungs as well, just because of his history with respiratory infections. He seems okay, but I want to make sure.

Edit: Oh, and he's already on wet food. He has a bowl of dry down so that my girlfriend can sleep through the night, but he gets wet twice a day. I'll be sure to pick up the dry food and feed him a can of wet before I leave for work (night shift).

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The only things I see here, is to request an IV regardless - you never know when an emergency will arise; you just can't predict that. IVs are used in case of emergency, and you just can't tell "If" it is going to be necessary ahead of time. I always get it no matter what, if a vet tells me he/sh thinks it will be ok without it, it is safer to have it . Also, remember to not use Ketamine (Ketamine and Metacam are two drugs you should have on your files as do NOT give - dangerous for cats, and some vets WILL use it).
Also, no eating or drinking 12 hours prior to the procedure - usually if in the morning by 10pm no food, by midnight no water. I am sure your vet will tell you that though

I'm reading about metacam and ketamine. From what I've read, there is scientific proof that metacam can cause renal failure in otherwise healthy cats so that's out for sure.
The side effect I'm reading about in ketamine is potential behavioural problems, but other than that it's not linking up to any ill-side effects in my research. Could you tell me what kind of behavioural problems, and any other side effects that ketamine causes?

I'm one of those type of people. I have to know why, backed up with evidence upon evidence (pros and cons, for and against). I can google "Why are lemons bad for you" and get a million pages with "evidence". I need truth.

Originally Posted by Mewsings

I'm reading about metacam and ketamine. From what I've read, there is scientific proof that metacam can cause renal failure in otherwise healthy cats so that's out for sure.
The side effect I'm reading about in ketamine is potential behavioural problems, but other than that it's not linking up to any ill-side effects in my research. Could you tell me what kind of behavioural problems, and any other side effects that ketamine causes?

I'm one of those type of people. I have to know why, backed up with evidence upon evidence (pros and cons, for and against). I can google "Why are lemons bad for you" and get a million pages with "evidence". I need truth.

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Precautions and Side Effects

While generally safe and effective when prescribed by a veterinarian, ketamine can cause side effects in some animals.
Ketamine should not be used in animals with known hypersensitivity or allergy to the drug.
Ketamine should not be used in animals with hypertension, heart disease, liver disease, kidney disease, head trauma or known seizures.
Since ketamine is known to increase blood pressure as well as pressure within the eye, it should be avoided in animals with eye injuries.
Ketamine does not relax the muscles at the back of the throat so it should be avoided in procedures involving the pharynx, larynx and trachea.
Since ketamine does not offer good muscle relaxation, it should not be used as the sole agent for anesthesia. It works best when combined with another medication to provide the most effective anesthesia.
Ketamine may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with ketamine. Such drugs include narcotics, diazepam, halothane, chloramphenicol and thyroid medication.
Adverse effects of ketamine include increased blood pressure, elevated heart rate, respiratory depression, vocalization, erratic and prolonged recovery, spastic jerking movements and muscle tremors. In rare instances, ketamine has been shown to induce seizures.
As with most anesthetics, after administration of ketamine, the eyes remain open and unable to blink. To prevent drying or damage to the surface of the eyes, lubrication is strongly recommended.
When given intramuscularly, ketamine injection can be painful.

Ketamine is contraindicated in cats suffering from renal (kidney) or hepatic (liver) insufficiency, and certain other conditions.

here is a kitty who died because of it,in a dental:
http://gimmiesfishes.blogspot.com/

http://www.gimmiesfishes.org/docs/ke...ichardsDVM.pdf

this is fron anothr forum \t\t\t\t

\t\t\t\ta big NO to ketamine \t\t\t
\t\t\t \t\t\t \t\t \t\t \t\t \t\t\t \t\t\t

We have only had one experience with ketamine, and it was not with our cats, but with a one-year-old yorkie (dog). We took him in for a routine teeth cleaning. The vet said they used a mild anesthesia agent, it would take 20 minutes, and we could come back and pick him up in just a couple hours. We did come back to pick him up, he was very sleepy, and very wobbly, but the vet told us this was normal and he would be fine the next day.

The next day he started having seizures, constantly. We immediately took him back to the vet. They said "we don't know whats happening". Fortunately, we have a veterinary specialists hospital close by, so we rushed him there. Nothing could be done. They did an EEG...he had no brain activity due to the prolonged seizures, despite tons of medications to stop them.

We finally obtained the medical records from the original vet, and took them to the specialists hospital, where the vet there interpreted them for us.

Turns out our pup was given TOO MUCH ketamine, and not enough oxygen, so his brain was oxygen deprived. The original vet just said "oh, sorry!"

Needless to say, now we have only kitty cats. Our (new) vet has said they need their teeth cleaned. We can only say NO.

Sorry, our experience with ketamine is absolutely NO!

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A recent recall where at least 5 cats were killed: http://www.petconnection.com/blog/20...ore-questions/

Per my vet, they do not give Ketamine to the cats in the clinics because it can affect the heart, liver and kidney, if the kitty has an underlying problem - many of these problems can pass tests unidentified (especially heart), and when you use Ketamine, it is too late... Kitty can be in serious trouble already. So there are plenty of safer alternatives in the market - it is a drug that does not need to be used....

Thanks for the info! I will be sure to write no to ketamine and metacam on his initial paperwork.

I was reading an article earlier about metacam which was written by a vet. She suggested using buprenorphine (in the US) instead. Does anyone know anything about this anesthesia? What anesthesia (or combination) do you recommend?

Also, what about pain medications? Are there any to avoid? Any preference between liquid and pill (I can't do injections...)? I want my kitty nice and doped up so he won't feel the pain until his mouth is healed.

Of course I'll discuss all of this with my vet - I just want some light reading so I know what we're talking about. Buddy is my first cat, and while I'm familiar with rat vet lingo, cat vet lingo is still a foreign language to me.