Kitty Dental Concerns

Hello all,

I'm new to the forum and would like to get some dental advice regarding my 14 year old male kitty named James.  I've had James since he was 7 weeks old and he's been and he's been a joy to have in my life. I've had his teeth cleaned 4-5 times since I've had him, mainly because he tends to get a lot of plaque buildup on his teeth. Each time his teeth were cleaned everything went as planned without any problems "EXCEPT" for the last time. On this occasion, the vet, explained that while retracting the endotracheal tube from his trachea the balloon cuff may have damaged part of trachea. That wasn't very good news to hear. I knew something was wrong as soon as I picked james up from the vet. He was glad to see me and he was purring, but his purr had a different sound. it was much lower in tone and very throaty. The vet told us to feed him just canned food and add water to it to make a slurry, and to do this until his throat healed. James, prior to this incident ate only dry food.Well, I continued with the slurry diet for 2 weeks and then tried to give him some dry food. He ate some of it and quickly vomited it all up. I went back to the slurry diet and tried the dry food again about a week later, the same thing happened he ate some and then vomited it all up. I was in close contact with my vet while this was happening and she said she didn't know why. But suggested adding water to the dry food to make it softer and see if he will keep it down. It didn't work, James ate some and he immediately threw it up, just like he had the other times. Eventually,he was able to eat and keep down the canned food without the water, but it had to be a very fine and smooth canned food. Any canned food that was bulky or had bits and pieces in it, he couldn't keep down. It's now 2 1/2 years later, since the disastrous teeth cleaning that damaged his trachea and he can only eat soft canned food anything other than that he can't keep down.  And, now I'm very worried about his dental health.  Because of his history, and because now he only eats canned food, which is not as good for his dental health as dry food was , I worry that his teeth need to be cleaned again. Also his breath is very bad. But because of the damage he suffered to his trachea from the last time he had his teeth cleaned, I don't want to put him through another general anesthesia. My vet doesn't recommend getting his teeth cleaned because of what happened last time but doesn't provide any alternatives. So, what should I do. Doing nothing, doesn't sit right with me and I'm concerned by doing nothing, his teeth will only get worse and may begin to bother and hurt him, if not already. Please let me know what are some alternatives to this problem. I'd appreciate and and all suggestions and advice. thank you timon

So sorry to hear about your experience last time!

Would you be able to brush kitty's teeth? If you're able to, this will definitely help prevent any build up. I use CET toothpaste when I brush my cat's teeth. They're are also a ton of videos online regarding how to introduce teeth brushing to your cat.

I would also keep feeding wet food, just as you have. It looks obvious to me that he can no longer handle dry food, even if it has water added to it.

hi Nora1,

thank you fro your reply. Unfortunately, It would be all but impossible for me to brush his teeth.  James (my kitty) is very very high strung and doesn't like "anything" done to him. I have and will continue to feed him the wet food. I can't help but worry though, about his teeth. I know what it's like to have a toothache, so the thought that he could now or someday develop one, is upsetting to me. I'm starting to feel it may be my only option to resume the dental cleaning, even though the last time was a horrible experience that left a permanent damage. What also makes me bitter, is that the vet didn't do anything or take responsibility for this. I've done a lot of research regarding trachea damage during general anesthesia and it's almost always caused by something the technicians did or didn't do. Tell me what you think about resuming his dental cleaning. thanks timon

have you consulted another vet? maybe a cat-only vet?

if you do decide to the dental cleanings again, you could try to find a board-certified veterinary dentist

http://www.avdc-dms.org/dms/list/diplomates-map.cfm

timon said:

hi Nora1,

thank you fro your reply. Unfortunately, It would be all but impossible for me to brush his teeth.  James (my kitty) is very very high strung and doesn't like "anything" done to him. I have and will continue to feed him the wet food. I can't help but worry though, about his teeth. I know what it's like to have a toothache, so the thought that he could now or someday develop one, is upsetting to me. I'm starting to feel it may be my only option to resume the dental cleaning, even though the last time was a horrible experience that left a permanent damage. What also makes me bitter, is that the vet didn't do anything or take responsibility for this. I've done a lot of research regarding trachea damage during general anesthesia and it's almost always caused by something the technicians did or didn't do. Tell me what you think about resuming his dental cleaning. thanks timon

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I would search for a cat only vet, if you're considering getting more cleanings done.

Personally, I wouldn't risk it, if there wasn't a cat specialist available. The risks of further damage is too great, in my own personal opinion!

There are other alternatives to brushing their teeth. I've food and water additives that people use instead. It might be worth looking into, especially if James doesn't like being "fussed" over.

I second the veterinary dentist idea. They take less time to perform a prophylactic cleaning, and they take less time to extract teeth, the real anesthesia concern that prolongs duration of anesthetic gas time.

Not all of them are only at specialty hospitals or college/teaching hospitals, although this is a good source for you. In the Triangle and Charlotte areas here in NC for example, there are at least 4 small animal practice vets that are board certified in dentistry and can do extensive dental work, such as crowns and root ablasions.

Ask one of the vets at your clinic if they know of any small animal vets that offer this specialty or you can get referred to a specialty hospital. It will be 25-30% higher than a regular vet's financial estimate, but well worth the experience and targeted skills they offer. And they use certified nurses/techs.

I, too, would be suspicious of inappropriate intubation, including excessively inflating the air cuff you mentioned, or not deflating it before extubating (removing the endotracheal tube). Some smaller clinics have the veterinarian induce (start anesthesia) and intubate, as they only have new/less experienced assistant support staff. Either way, the responsibility lies with the doctor who oversaw and/or performed your cats dental procedure. It's always best to accept an anesthesia error, rather than label it as unknown cause or hedging, calling it a strange or prolonged reaction to intubating him.

Some "new age" vets, so to speak, offer anesthesia free dental cleanings, but they cannot perform extractions, so if has any oral resorptive lesions (FORLs) or known dental disease, other than evident calculus accumulation on his crowns which is just scaled/polished, this isn't an option.

Minimizing anesthesia time, fully protecting his airway without over-inflating his ET tube's cuff, and maximizing pain control, such as local nerve blocks for extractions, will all be considerations you can emphasize with his next anesthetizing doctor/nursing team.

I'm sorry he had such a negative experience that has affected him so long. It's strange it's affected his GI tract like that, rather than causing reduced blood circulation at the cuff site within his trachea. We see tissue loss or some aspiration of saliva/flush with such improper or prolonged intubation, not vomiting. You could ask for a limited ultrasound study of his neck anatomy, too see if his trachea has a wide, scarred area that is compressing his esophagus chronically now, or other changes that could account for the vomiting. It'd be a good idea to do this prior to his next anesthetic event anyway, in addition to the usual bloodwork screening.

Good Luck with your boy!