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Civie dental dilemma - thoughts please!

Discussion in 'Feline Health - (The Main Forum)' started by Diana&Tom, Nov 5, 2019.

  1. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Would really appreciate any thoughts on the following, please...

    My beautiful nine-year-old civie, Sapphire, has never needed any vet treatment but at her annual check-up last week the vet said she needed two teeth out. Sigh... I know dental disease is common in cats but this came as quite a shock as last year her teeth were ok.

    The vet assured me that bloods and xrays would be done beforehand, and that she had done many dentals before. If it was someone else's cat I would no doubt do my best to reassure them that dentals were common, routine and necessary. I know these things. My problem is that my previous kitty, Sophie (sister of Tom, my avatar) tragically passed on the operating table some years ago - not due to a vet error, I think it was more that she was 17 and her heart couldn't take it. I was beyond devastated at the time and since adopting Sapphire soon after (and going to a different vet practice because that was where the rescue I got her from had registered her) we've been lucky to have avoided vet treatment.

    I know the dental has to be done, no two ways about it. But my dilemma is this - do I go ahead and take Saff to the current vet, where the facilities and standard of care seem to be ok and may well be perfectly fine, it's just that I have no real experience of them? Or do I take her to the local "gold standard" hospital (it has an amazing website) where a friend of mine takes all her cats and can't speak highly enough of them? The first vet is friendly enough, and was reasonably sympathetic when I told them about Sophie - she could see my anxiety - whilst also being quite matter-of-fact. Saff and I haven't seen the other potential vet yet - I just made a phone enquiry today and have to say I was blown away by the friendliness, empathy, and explanation of what would be involved... it was suggested that if I wanted to, I take Saff in for an initial look at her teeth and go from there, no pressure.

    I just don't know what to do. The first vet is probably fine and is only a mile / five minutes' drive away. If Saff needed to stay overnight there would be no extra charge (dental alone is £500+). The second vet may or may not be any better, I don't know - it's a bigger "hospital" I think and according to the website has all the latest state-of-the-art equipment etc. A significant downside is that it is more like 30 minutes away, so a more stressful car ride in probably rush-hour traffic.

    I've already spoken to several people/friends both on and off the board about the principle of the dental itself, and everyone has been incredibly kind and understanding. Since then though I've spoken to vet number two and feel really torn about how to proceed... I think the word is "procrastination"!

    Any thoughts gratefully received :)
     
  2. Dusty Bones

    Dusty Bones Member

    Joined:
    Oct 20, 2013
    If you don't take care of her teeth it could lead to diabetes or other issues so I think the risk is well worth it. Both my kitties Dusty (15) and Beni (civie 16) had their teeth cleaned and removed just a few years ago and did just fine. It's like any surgery; human or animal, anything can go wrong but most go off without a hitch. Only you can decide but no tooth care will lead to future problems. :bighug:
     
    Last edited: Nov 5, 2019
    Diana&Tom likes this.
  3. Sarah&Soph

    Sarah&Soph Member

    Joined:
    Jun 18, 2019
    I was so so SO scared when my 9 year old got her dental a few months ago, but it went off without any problems at all. In addition to the bloodwork and xrays, another group I’m in highly suggested that I get a proBNP test which checks the heart, so I would also recommend that test to ease your mind some.

    The vet clinic that did it has the only board certified dentist in the state which definitely helped my nerves as well. I have since moved and toured another clinic that’s closer to me and it seems like a great clinic as well, very clean and they regularly do dentals, but I think for future dentals I would still take her to the one I know, because I know they do good work and can take care of her. So I think you just have to go with whichever clinic you think you would be the most at ease using
     
  4. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    In the distant past, if my cats needed anything dental done, it was done by their regular vet (5 mins away), and there were never any issues, but the first time I took one of them to a dental specialist (20 mins away), I decided I would always take them to the specialist for any dental care. It is just a different level of care. I am sure that who the specialist is makes a difference (there are 'good' and 'bad' in every profession), and I am fortunate to have a wonderful one, but it goes beyond that. My regular vet is at a nice animal hospital, but they do not have the level of facilities or equipment that the specialty clinic does. The methods/procedures used for anesthesia and monitoring, for example, at the specialty clinic are 'gold standard'. Anesthesia is the scariest part of these procedures, in my opinion, so I am 100% for anything I can do to reduce risk in that area. And, obviously, someone who is a specialist is going to have more training and experience than someone who is a general vet, so I feel that they are better equipped to handle whatever may arise. I also like the fact that the specialty clinic is full of specialist in many different areas with whom the dental specialist can easily collaborate if there is ever a need.

    The first time I met the specialist, I was VERY anxious. The last time I had left a cat at the vet for a procedure and anesthesia, he died. It was not for dental work, he had a biopsy. Earlier in the afternoon, they had told me he was recovering well and doing just fine. Then, when I was on my way from work to get him, he died. I was devastated. I did not take my cats to the vet after that for something like 6 1/2 to 7 years. The specialist was so kind and understanding. He went into great detail with me as to what steps they take to reduce the risk. I was so impressed, not only with the information he gave me, but with his calm, caring, reassuring manner.

    My suggestion is to get as much detail as you can from each vet as to their methods/procedures and decide what you are most comfortable with... their willingness to share information and manner in which they deal with you should factor in as well. There is always going to be some risk no matter where you go, so I think it is about choosing the option where that risk is as reduced/managed as possible.
     
    Diana&Tom likes this.
  5. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Thank you - it's not a question of whether to do the dental or not, it's a question of where to get it done for maximum safety and peace of mind bearing in mind the previous experience I went through.
    I'm glad your two did well - it must have been a big relief.
     
  6. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Thank you - that's interesting, I'll definitely get whatever tests necessary done. As for which clinic I'm most at ease with - that's tricky, I'm having to give it so much thought.
    Good to hear that your kitty did so well :)
     
  7. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Thank you - I think this says it all. I just want to reduce the risk so it's weighing up the options.
    I'm so sorry to hear about your sad experience. I can relate. It's devastating :(
     
  8. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    @Georgiana & Perlutz (we spoke!) and @Kate & Toby - you've both experienced "usual" vet v "special centre" vet here in the UK.. how would you describe the comparisons and would you go for the more specialised one for mouth surgery? Interested to hear your thoughts/opinions - thank you!
     
  9. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    Hi Diana,

    Few things from my experience with Perlutz's dental and some from my personal experience with anaesthesia in recent years...

    I know some vets do quick blood tests in house on the admission day. This was an option for Perlutz but I've decided, along with the vet, that the best way would be to have blood and urine tests done few days in advance (depending on how long it takes to get the results). That way, if something - even a minor thing - came up, we'd know and be able to sort out or investigate further. I think the labs are one of the most important steps in making sure the procedure will go well, they determine any risk factors and possible interventions to minimise the risks, if any.

    Generally the procedure is carried out and the furry patient can come home within few hours, I don't think overnight stays are generally needed. But I would suggest talking to the person doing the dental what time of the day would be best to schedule it for. Sometimes they don't want first thing in the morning appointments as the cat would unnecessarily spent time in the crate while they sterilise the equipment and get the theatre ready. You might also want to check that the vet/dental specialist is working the day after the procedure, just in case something worries you, it's good to know they would be available, or if they won't, who would be able to help. For your peace of mind, maybe take the next day off/WFH to keep an eye on Saff?

    For Perlutz, the recommendation was to fast from 8 PM the night before but when I was doing my own little research into dentals and anaesthesia, I found that some vets don't recommend fasting. If they recommend fasting, I would make sure Saff can't get into any contraband food. If they say she can actually have some food, then I don't really know, I would probably ask here and search the internet as I know from my personal experience that fasting was of paramount importance.

    I would also ask who does the anaesthesia and whether they will be dedicated to monitoring Saff all the time or they are also doing the dental or help elsewhere in the practice. Also important is how will she be monitored after the procedure finishes, ideally someone will be able to monitor her all the time for the next 2-3 hours rather than checking every now and then.

    You will most likely be given some pain killer to give Saff the next days. I would discuss this before hand as the one I was given for Perlutz usually gives side effects (did so to HRH) and some vets and carers doubt this particular drug should be used or not. I don't remember the name of it, but I'll look up when I get home.

    Maybe if you ask more questions you can decide which vet to go for based on some of their answers and general attitude? Others experiences are also very useful, you already know about one of them, maybe you could find some reviews about the other as well?

    All in all, I think anaesthesia is generally very safe for cats but the person who administers and monitors is very important (I've myself "ran" from hospital after meeting my anaesthetist and to this day I believe it was the best decision I could've made that day!).
     
    Diana&Tom likes this.
  10. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    Hey Diana, I am sorry to hear that Sapphire needs treatment, thankfully just routine though.

    I have to say, I would not hesitate to use the specialist vet hospital, they have specialists in all areas, there will likely be an anaesthetist present to do the "putting under" bit and then the dental specialist to carry out the procedure.

    As we all know from our diabetes experiences, general practice vets are a bit of a jack of all trades and whilst I am in no way saying your local vet would not be absolutely fine for the dental procedure and indeed most things, if you have a specialist available then I would be using them. If anything did go wrong, they would have a cardiologist, neurologist etc available.

    It really is a very personal choice and bearing in mind Sapphire is in great health generally I don't think you would be wrong to get your local vet to do the procedure, that being said, I feel this will be as upsetting for you as it will be for Sapphire and so you need to do what makes you most comfortable.

    Hugs xx
     
  11. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Thank you so much @Georgiana & Perlutz and @Kate & Toby for your comments, really much appreciated. I'd pretty much made up my mind today to go for the specialist place for all the reasons you say, mainly that bigger places should be better equipped and have more people on hand if needed than a smaller suburban "GP" vet. I think what was holding me back mainly was that the "usual" vet is five minutes away whereas the other one is 30 minutes - maybe not a big deal in some terms but added stress for a little kitty cooped up in a basket and feeling scared :(. Needless to say, I'd drive her to Scotland if I thought vets there had a magic, safe way of doing dentals, but as that's pie in the sky we'll stay local and 30 minutes' drive isn't too bad really.

    So my plan is to ring Vet B and ask for what they call a second opinion appointment, which they offer for free... if they agree that the dental is needed (which is almost certain), I'll ask all the questions, get them to do bloods, and then book Saff in for the not too distant future. I just want to do what's best for her. She is such an absolute cutie. I'll attach a pic.

    Big thank you again :)
     

    Attached Files:

  12. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    The main thing is Diana that you are happy and comfortable with your decision, its a big deal to put our babies through any sort of treatment, routine or otherwise, so its important you are happy with the plan.

    I agree with Georgiana that I would be asking questions about who does the monitoring during anesthesia, what the aftercare looks like, monitoring etc, aftercare for when you get her home. Don't be afraid to ask what experience the vet has with dentals, anesthesia etc. When Toby was referred to the specialists I had read all the vet profiles on their website and knew exactly who I wanted to treat him!

    Good luck and do let us know how you get on with your initial appointment.
     
    Diana&Tom likes this.
  13. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Thanks Kate, you're very kind. I'm rather out of practise with this sort of thing these days, so it's a big help to have people like you and Georgiana to give me a few pointers! Yes I'll let you know how it goes.

    Thanks also for being such an asset to the board - it's always nice to see more UKers participating across the forums.

    It's great to see Toby getting into better numbers - long may it last! You're doing an awesome job :)
     
    Georgiana & Perlutz likes this.
  14. Kate & Toby

    Kate & Toby Member

    Joined:
    Aug 23, 2019
    Ahh that's OK, I am sire when you have met the vets you will much more confident about it all.

    Bless you, I am always grateful to you all here as you "get it" we understand each others love and devotion to our kittens. My colleague said to me the other day as I was rushing home to get a mid cycle test in my lunch hour, "Just get another cat", which gives you an insight into their mentality, so I am always appreciative of the board.

    Yes he is doing so well, he is loving life in blue numbers, and hasn't had any more heart related episodes, I cherish him every day and love him like it his is last with me. As many others will say, this whole diabetes journey has been a big learning curve, but I love that I am seeing an improvement and that he clearly feeling better :) (I am currently sat at work, but I can see him on the web cam laying out in the morning sunshine in my lounge, I am such a cat stalker mum, I have cameras downstairs and upstairs!!)
     
  15. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Good grief - "just get another cat"??? I think I'd kill anyone who said that, it's shocking. I know that not everyone is an animal lover but to say that is incredibly insensitive... grrrrrrrrrrrr!

    You're not the only cat stalker mum here, @Georgiana & Perlutz is another. I have a picture in my mind of you both at work, gazing at the webcam most of the day and doing a bit of work here and there, haha! Got to get your priorities right ;)
     
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  16. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    I actually can't stalk today, my camera has been knocked off. A certain furry bum knocked it when trying to hide from mummy pricking his ear in the morning :joyful:

    As for "just get another cat", I'm speechless :mad: When will people understand they're like our children? You don't just throw your kid out when they get sick and go get a new one :rolleyes:
     
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  17. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    Just a few more things I thought I would share.... With the specialist that I use, he has us get the blood work done in advance at our regular vet. That way, if there are any other issues, those can be addressed with the regular vet. (Like Georgiana mentioned.)

    I always try to be the very first procedure of the day whenever possible so there is plenty of time for them to monitor her initial recovery period before I pick her up. I usually get to pick up in mid-afternoon. There should be no access to food after midnight the night before the procedure. That is critically important to make sure all food is out of their stomach.

    The specialist has given me his mobile phone number and made it clear I can call if I have any concerns or questions. Twice, my girls ended up having procedures before a holiday weekend, but he assured me he would be in town and that I could call.

    He always gives pain medicine (Buprenorphine) and an anti-inflammatory (Onsior - robenacoxib). He only gives an antibiotic if there is reason to believe infection is present (he thinks antibiotics are unnecessarily given way too often for dental procedures). I have had him send home oral versions of those medications for me to administer for a few days, but there have also been times when I did not have any medicine to administer because he gave what was needed in a shot. Mia HATES having anything done to her mouth like putting medicine in it, so he gives her a 72 hour pain shot and a 24 hour anti-inflammatory shot. She has had two procedures with extractions (the latest last week) and that has worked out very well. There is always the option to get more pain medicine, if needed, but I have never had to do so.

    I am a 'stalker' too. I have a camera that covers the area where their food is as well as the entrance to their main litter box. I have motion zones set on it, so if I ever need to know who ate what or who visited the box, I can check the event history. I can also check in on them live. I have a second camera that I move to wherever I want it. I have set it in the bedroom when I am away to cover all the spots in there where they like to lay. It's great... definitely eases stress. Everyone should be a 'stalker'!
     
  18. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Thanks you sooo much @FurBabiesMama - it means so much to have suggestions and advice from everyone here. I'm making copious notes and will be making a proper nuisance of myself with these vets pretty soon!
     
  19. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    So I've booked an appointment with the new vet for next Thursday... it took a bit of time to pluck up the courage to make the call, I've been putting it off.... Anyway, it's done and I'll report back afterwards :)


    Grrr... vet called to change the appointment. She's not there on the day we arranged, and the next day we can both do is another week away. So now Thurs 21 Nov.
     
    Last edited: Nov 8, 2019 at 6:17 AM
    Reason for edit: Update
  20. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    Well done, Diana! I'm sure everything will go smooth and Saff will not resent you (much :joyful:), especially after you give her some yummy food when she's home :cat:
     
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  21. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    I feel your pain Diana. Nigel and Noah both had cardiomyopathy but Nigel was much younger and stronger when he needed two extractions. That was when my vet had a partner who did all dental work but my vet, a close friend, supervised the procedure causing some friction in the clinic. Noah was a different story and an extreme example. By the time he needed every last tooth pulled his heart had enlarged to the point it had pushed through the cardiac sac and had only a 10% chance of surviving the anesthetic. That's when we decided to let him be, he was the last of our five yellow cats and had been poked, prodded and scanned his whole life. He lived another three years pain free and always had an appetite thanks to transdermal BUPE. Occasionally I would catch him eating the SO kibble Marco needed for his constant UTI's.
    You know this already but going with your instincts about specialists and a talk with the anesthesiologist is so important. Trust your instincts and Sapphire will come home to you. Big hugs from the colonies. :bighug:
     
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  22. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Thanks Dickson... I'm slowly starting to feel less angst-ridden about Saff's dental thanks to all the wisdom and advice from lovely people here. I'm very out of practise these days as far as anything to do with vet treatment is concerned, so this has come as a bit of a shock! But I'm taking it all in and you can be sure I'll be making sure the vets know that only the best will do for my girl!
    Big hugs back!
     
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  23. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Our instincts are our best defense. The local emergency clinic has an MRI and specialists up the wahzoo but it's a cold and sterile place. The reading material in the lobby is about their payment plans. I bake for my vet and we're on a first name basis. Expensive equipment and letters after your name don't always make a good doctor.
    When Nigel passed they sent us flowers and a card, when was the last time you heard that?
    You'll know what to do Diana, you always have known.
     
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