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Getting teeth cleaned on aged cat
I had two cats but unfortunately we had to put down Minna 5 months ago. My other cat Djinty has not been eating well since then, a remarkable difference because she used to be a big eater, in fact we had to keep her away so that she wouldn’t eat also Minna’s food. At first I thought maybe she’s just depressed, she suddenly has to be alone, when we work for example. On the vet’s advice we even tried something called Zylkene (it’s against stress and so on) I could buy it from the pet store. But no difference.
So we have always had the same routine with our cats since they were young. They eat at fixed times, four times a day, no free feeding. In the morning breakfast wet food. Now as for lunch it depends on if I’m home and not working, if I’m going to work (about two days a week) I leave food out for her in a whiteboard game thing, she has to make the effort to get the kibbles (when Minna was still alive it was just a feeder on a timer). If I’m at home during lunch time we play a game called “throw kibbles” it is her favourite, we discovered it by accident when she was young and have been doing it ever since, for Djinty it is a daily routine. So I throw a kibble to the left, and she runs after it, she dives on it. Then I throw one to the right and there she goes chasing it. She loves this game so much! Dinner time around 6 p.m. as we have dinner the cats would get wet food again. And then at last before going to bed at 10 p.m. we play throw kibbles again. I do want her to eat at least a combination of wet and dry, because she has had a problem urinating in the past. So the vet said she needs to drink enough fluids.
Now as I said she still wants to run after her kibbles, she loves it! But she only wants Royal Canin British shorthair kibbles, they are really big, but she swallows them whole, no chewing. This is the only thing she wants. She does not want any type of wet food, and I’ve tried so many different kinds. She’s not having it. Except I have noticed a bit of mousse if I put it on my finger and she licks it. Any other kind of kibbles she refuses. But we noticed something else, when she tries to eat something else, like yesterday a few of a smaller kind of kibble. She had a problem picking it up, same with the mousse she likes to lick it, but after a bit more amount she suddenly stops. She takes a jump back, she then turns her head sideways. And then she does this thing with her paw, she starts rubbing it against her chin on one side. Like as if she has pain from eating.
So this morning I took her to the vet. It is possible that it could be her teeth, they are not in a very good condition. This is known with Djinty though, she has had bad teeth in the past, we had them cleaned some years ago. I wonder if it is a breed thing, British shorthair having bad teeth, I’ve heard. Anyway, the vet said she cannot see any infection and if there is a whole or something else can only be seen from an X-ray. But the point is anyway to have her teeth cleaned she would have to go under sedation, and she is 16 years old. There are risks involved. They took a blood test to check her vitals and everything was good. So for now we went home with a pain killer and anti-inflammatory. But the vet said that if in a week’s time it’s not better we have to make de decision on whether or not have her teeth cleaned. I want her to be as comfortable as possible, other than this she seems fine, she is still such a playful cat. She loves to play. My only concern is it safe to have an older cat under sedation?
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2 Replies
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I wanted to edit the previous message, I just realised it’s way too long and I want to make it more to the point. But unfortunately I can’t see how to edit. There is only the option to delete the picture I had posted.
The point is my cat Djinty of 16 and a half years old has bad teeth. It’s been causing her a lot of discomfort. She sneezes and snorts quite a lot and I didn’t realise at the time that it could be related. Then it’s the rubbing her chin with her paw after she eats. But what got me worried was that she wasn’t eating much, she refused wet food or anything she had to shew. She would only accept Royal Canin British Shorthair kibbles, which she swallows whole.
So after going to the vet last Friday she has now been on painkillers for 5 days now, and there was a big difference. She is suddenly eating and she has quite an appetite. But my concern is that the painkillers are not solving the problem, is it now? Once we stop the painkillers will she stop eating again?
The blood test and the examination at the vet went well, she is an otherwise healthy senior kitty. My husband and I are thinking that maybe the best thing to do is to get her teeth cleaned at the vet. Unfortunately the vet said they only do that if she is under sedation, and said that there are risks involved because of her age. But we also don’t want her to go around being uncomfortable or in pain. My workmate also scared me with the story that he once had a cat of hers in for teeth cleaning, but then the cat died within the same week. She said he went to the grave with clean white teeth. What would be the best course of action?
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Hi Monica, thank you for sharing. It definitely sounds like your cat is likely to have oral pain from your descriptions of trouble prehending some food, her reaction, rubbing the mouth and a very noticeable response from the pain medication. It is impossible to say if this is from a tooth infection in one or more areas or if it may be related to one or more resorptive lesions, which can also be painful and cause that behavior.
I think it’s important to clarify that a full dental procedure is done under anesthesia, not sedation, and they are different. Sedation is not “completely” under if you will, and has a limit to how long it lasts. We can’t do anything very thorough with the teeth or mouth with only sedation as pain can still be felt and stimulating anything uncomfortable like that will test the limits of the sedative and not be good for the patient either. You also can’t place an airway tube under sedation which is crucial for dental procedures, dental x-rays cannot be taken safely under sedation and if there are teeth requiring removal, sedation is not sufficient to protect from pain.
Anesthesia is needed for these procedures so that an airway tube can be placed to protect the airway and it allows us to manipulate the mouth freely without causing the patient pain. Just like in human dentistry, we have to use a lot of water in the mouth and we cannot risk this getting into the airway. Unlike in human dentistry, we can’t ask our patients to just swallow the water. It’s also impossible to safely position the dental plate for x-rays without anesthesia and there are some fairly pointy tools used in the mouth that would be too risky to use without. Anesthesia also allows for local injections of numbing agents (similar to what human dentists use) that help to mask the pain of tooth removal if needed.
I only explain all those details because it’s important to understand why anesthesia is a standard of care for dentistry work on animals, even though it’s not always needed in people (and yet it is still needed in some cases!).
For a 16 year old cat, there certainly are risks. These certainly can be mitigated by assessing for underlying organ function concerns or diseases that would either affect safe anesthesia drug use or would overrule the benefits of the dental procedure. Labwork, as you mentioned, is just one of those. It helps check for things that may affect safe anesthesia, like liver and kidney disease.
Screening for underlying heart disease in an older cat is extremely important as well. The risk for underlying heart disease we know increases with age and in many cats they show no outward signs it is present. A normal heart can tolerate anesthesia fine, but a cat with heart disease will have trouble with anesthesia as well as the intravenous fluids potentially. The proBNP blood test is a good screening test. If it’s normal, there is at least a really good chance heart disease is not present. I personally also do focused cardiac ultrasounds to check some basic measurements and see if there is any evidence of heart enlargement. The proBNP test is highly available but ultrasound availability and skill varies widely. Checking blood pressure and getting a baseline to rule out a hypertensive disorder is also a good idea in any older cat.
Chest x-rays may seem a little like overkill, but they can be useful to get a survey at least of what the chest and abdomen look like and if anything appears abnormal before an anesthetic procedure. Our practice’s senior wellness plan includes this just as a screening tool and it has been helpful in some cases.
Besides those health screening methods, I think it’s very important to have an idea of how your veterinarian performs dental procedures and monitors patients. Dental x-rays are extremely important as a standard of care now though not all practices have them. While I wish it wasn’t the case, anesthesia monitoring and how intensively patients are monitored during their recovery can vary widely among veterinary practices. All patients should have ECG monitoring, pulse ox monitoring, CO2 monitoring, and there should be a dedicated trained tech or assistant monitoring anesthesia during the whole procedure. After an anesthetic procedure, close monitoring should also take place for at least an hour or until the patient is awake, has a normal temperature, and most effects of the anesthesia have worn off.
I think it’s very appropriate to ask your veterinarian how their procedures are conducted and monitored. I think in many cases, patients who pass away during “routine” anesthetic procedures had an underlying health condition (like heart disease) that was unknown, or appropriate regular monitoring was not taking place.
Another option you can look into is if there is a board-certified dental specialist in your area. If your cat does have more significant dental disease and may require removal of one or more teeth, their skill may be able to shorten the anesthetic time needed to complete the procedure.
I think in your cat’s case, given that oral pain is likely present, the dental procedure may be necessary to resolve it. But like I said, I think it’s very appropriate to do as best as possible to screen for underlying health concerns and know how your veterinary practice conducts anesthetic procedure monitoring and post-procedure care.
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