dental questions

Within the next month or two we plan on having a dental done on mocha. This will be my first dental ever on a cat I have been owned by. I am very nervous about this. I've been trying to read threads on here about dentals and most of the time walk away confused.

I know there is a list of questions to ask, but I don't know if they are all in one spot? Is there a link to these questions somewhere? Also, do all of you take your cats to your regular vet for dentals? I mean, are vets experienced in the dental area, or is there usually a specialist that does the cleaning?

Yesterday at the grocery store the cashier rung up mochas wet food and commented, lucky kitty, my cat's only eat dry. We said to her, yes, well she gets wet because she is a diabetic cat and wet food is much better for cats, especially diabetic cats. Then she went on to talk about her kitty, and how she recently had a "dental" done on her, and that the front two huge teeth were removed and it didn't go well. When I asked what went wrong, she told me that her cat was drooling really bad for awhile and so she took her back to the vet, and then the holes weren't healing so they ended up having to do some sort of skin graft over the holes with skin from her cheek! And she said it was very expensive.

That really didn't make me feel very good at all and now I'm even more nervous about this whole thing. I know it should be done, but that's only cause it's so often talked about on here. Plus our funds are limited and I'm nervous that once the vet gets in there, there might be some major problems we aren't aware of and we won't know what to do cause we won't be able to afford the cadillac of all dental treatments if that makes sense. I wonder if maybe we shouldn't even start in on her teeth? But then again, it might help her numbers out. But then again, if something as serious as what that cashier was telling me happened to her cat, happened to mocha, well, I just don't know what we would do!

Any and all help is appreciated!!!

 

Hi Peter

The petdiabetes wiki has a link to dental info but here are a few things to consider/talk about prior

1. is predental blood work required?
2. are predental antibiotics required?
3. will xrays be done first?
4. what kind of sedative and what kind of anasthesia are used?
5. what pain killers will be used and at what point?
6. do they monitor blood pressure?
7. if extractions are required, will they call you first?
8. what is their procedure for diabetics; ie should insulin be given in the am and if so just partial dose or ? and will they monitor bgs at all?

 

http://petdiabetes.wikia.com/wiki/Dental_procedure

 

thank you jen!

 

In addition, please inquire about the following:

what anesthesia will be used - as several were recently recalled:

Ketamine et al recall


More on the discussion

Also, find out what pain meds they plan to use, before, during, after and read this on the subject:

Metacam/Buprenex discussion

 

And find out for sure what vet is going to do the dental. Check out his status on the state Veterinary board to see if he/she has had any disciplinary actions. Like the others said ask about anesthetic and if something feels wrong, get a second opinion from another vet.

I asked them to get permission from me before they pulled any teeth on Regis. They didn't. Regis suffered so.

 

If there were HOLES from teeth being extracted, there was a serious problem with the way they were removed! Pablo just had his upper canines removed, and the vet performed oral surgery to remove the tooth and create a skin flap so the hole could be sutured shut. He ended up with about 10 stitches total, and at his recheck yesterday, his incisions were completely healed and looked awesome! If you just yank teeth out (in most cases), there will be a hole where debris (read: food, hair, etc.) collects. And speaking from experience, the smell of three-day-old food that is impacted in one of those holes is enough to make anyone gag...imagine how it feels and tastes for the cat!

That's not to say that teeth can never be extracted without surgery to close the gum tissue. If they're almost falling out, pulling the teeth without further treatment may be possible. But I would definitely discuss the procedure for removing teeth in addition to whether or not you will be notified beforehand. As you can see from the cashier's experience, you can have really painful and expensive end result if extractions aren't done properly.

When I get home today, I'll get out all my stuff from Pablo's dental and try to better explain everything that was done for him. The vet who did is dental his a Fellow of the Academy of Dentistry of which there are less than 100 members worldwide. Simply put, she knew her stuff. She did everything I could have wanted and more, and Pablo had an amazing recovery because of it. The veterinarians who are members are listed on their website, so you could check if your vet or one in your area is a member (website: http://www.avdonline.org/avdmembers.html). You can pretty well be assured that you'll get quality care from one of those vets because becoming a Fellow isn't an easy thing and they have to meet many requirements. Just a thought!

 

thank you all for the replies. I checked out the list of vets you sent me holly, the closest one to me is over an hour away. I would be nervous taking mocha so far from home and having a dental done. What if something went wrong? I mean, after her dental of course. I would hate to have to rush back to some place over an hour away. Then on the other hand, if my regular vet does it, how do I know she is certified or able to do it?

I already know Im going to be a nervous wreck. I already have the anxious butterfly feeling in my stomach just thinking about it, and I'm still in the research stage! I just feel so nervous something bad will happen to her and I'll never be able to forgive myself. I know I can't think things like that, but I really can't help it!

 

Devon..is it just a routine cleaning? Did the vet seem to think they would have to do any extractions? I had 2 done on 2 different cats and they both went well. Of course, neither needed an extraction and neither were diabetic at the time. Maybe you would feel better after a consult with your vet.

 

My vet does an awesome job; is there any reason to think yours won't? Does your vet DO dentals? If you like and trust your vet, go through the questions and relax a bit! Just because some people warn you about what can go wrong (and they are right to warn you), you shouldn't expect that it will happen for you!

Jen

 

mocha has never had a dental. None of my kitties ever had dentals done. The only time any vet looked at mochas mouth was back in may of 09, when she went in for her rabies shot, and then was diagnosed diabetic. The vet said, teeth and gums look ok, and that was it. I do know that the vets office that mocha goes to now (a new vet) does do cleanings because they had a sticker on their door for dental care and I said oh you do dental cleanings here, but it was the receptionist and she didn't know hardly anything about it.

We aren't able to afford to take mocha in right now, just to have her teeth looked at. The dental would be in the next month or so when we can budget it in. So as of right now, the way she acts, I would imagine it would just be a routine cleaning, she doesnt paw at her mouth or drool from it. She seems to eat fine, she eats slow, but manages to get it all down, whatever is in the bowl for her. I just don't know.

 

You are right, you don't know and you are getting yourself really worried and it may be for naught! Talk with the vet now about what they do so you have time to make a calm and educated decision. Dental cleanings are very impoertant and usually go off without any hitch, and if there is a hitch it will be important for you and your vet to have a game plan ahead of time. Don't let scary stories scare you off; I have my own scary story but that doesn't stop us

 

thanks jen. I ALWAYS work myself up over nothing. I think we will start calling around to a few vets to see what they offer. I emailed two vets nearby off the list that Holly sent me but peter is nervous about taking mocha that far away ( 1 1/2 hours to the nearest two, 2 1/2 to the third in our state) Im also nervous about taking her that far, but then again, I'm nervous about having it done locally, and not having it done right! Decisions, decisions!

 

Ok, I have e mailed two of the three vets on the list jen sent me and they both have responded. It was a general e mail sent out to both, just asking for any info on doing a dental cleaning on a diabetic cat, and what's involved. Here are their responses so far.

Vet 1:
Hi,
We need to see her to evaluate. The cost for an oral exam, consultation and plan is $80.00. To have me clean the teeth, polish and fluoride treatment and assess, the minimum is $304 including anesthesia and preanesthetic laboratory work. It costs less for a tecnician to clean, and a veterinarian other than me to check the work. If you would like to make an appointment please feel free to call () Thank you and I wish for a long and happy life for you and Mocha.

Vet 2:
Our dental cleaning for cats includes: warm water blanket while under anesthesia, warm IV fluids, blood pressure monitor, temperature monitor, pulse oximetry, respiratory monitor/CO2 monitor, EKG, assistant monitoring, complete oral exam and cleaning by myself, dental Xrays as needed, polishing, flouride and oral sealant. If the teeth are fine, this usually costs approximately $200 - $300.
Hope this helps, we would be happy to see your kitty, and yes, cleaning of the teeth can be helpful for diabetics.


The second vet gave us a lot more info on what exactly is included in their cost, plus they are already quoting us a cheaper price. Does it sound like a good deal? What we should be looking for?
Thanks!

 

Here you decide: here is the estimate I was given for Maui:

$73 vet screen
$47 CBC
$76 anesthesia w/dental
$13 anesthesia ring block (no clue what this means)
$20 anesthesia pre-med/monitoring
$15 medical waste fee
$76 fluid therapy (venoset/IV tube, IV catheter, fluids - 500 mls, t port extension set)
$31 daily hospitalization fee
$30 primary medication - hospital
$13 pain meds
$77 dental w/extractions - grade 1 (price less if no extractions needed)
$30 medications (take home)
---------------
$501 + tax = $503.10

My understanding is that they have 4 vets who do surgeries and dentals. Depending on day, it will be one of the vets performing it. Whether they use assistants too, I didn't ask.

While it's important to not overpay for the service, the reality is - you need to feel comfortable with the people in the office. So, while one vet provided more detail than the other and quoted a lower price, before making any final decisions, I recommend that you make a consult appoint and go there and check them out. Also, during the consult appoint, ask they will allow you to see the "hospital" and surgery areas. They may or may not, but in order to increase your comfort level - ask and see what they say.

It may be worth paying two consult fees, just to have more knowledge and feel more comfortable with your choice.

 

I quite like the details in the second quote, especially the mention of xrays, which the first ignored. You could ask them about this (#1 that is). Not sure whether an ekg is required but as the price is reasonable I see no reason why not. One thing #2 did not do is mention pre dental bloodwork which should be done if the cat is over 10, and may be done for any cat if you feel more comfortable. The only other thing that I'd want to know from both is what sedative they use, what anaesthesia they use and what pain meds.

When Squeak needs a simple cleaning, our vet techs do the work but our vet oversees things and if any extractions are done then obviously she does it.

 

Regarding "$13 anesthesia ring block (no clue what this means)"

A ring block is where they inject a local anesthesia such as lidocaine around specific nerves in the jaws to help prevent pain. To my knowledge they are only used for extractions in specific locations.

 

thank you all for the replies. I haven't contacted either vet for a consult yet, as peter works mon-fri and I don't feel comfortable driving that far on my own. I can e mail the second vet with more questions, specific to pre dental bloodworks, sedatives and what type of anesthesia is used. I already e mailed the first vet back with those questions, but they have not e mailed me back yet. I will e mail the second vet later today and hope for an answer early next week. Unfortunately we can't really afford to go to both vets for a consult if they are going to charge us, it will be us scrapping pennies to get her the dental in the first place. I just hope we decide the right vet for her.

 

Call and ask if you can visit and spend a few moments talking with vet (maybe they will do this for free). Ask, worse they will say is no.

 

yes I hope to call the vet sometime this week and ask them the questions off the list I was given. Tonight after mochas shot I had peter pry up mochas lips so we could glance at her teeth. Upon closer inspection of her teeth we noticed that her very front teeth, the really small ones in between her canines, well one of them is definitely dark colored. Perhaps dead? I have a feeling that tooth will most certainly need to be pulled. I told peter I cannot even imagine how they would pull such a tiny tiny tooth like that!

Are all cats front teeth normally that small? I've never really looked into a cats mouth before, but it seems like you would need a microscope to even check out those teeth! tiny tiny tiny ...

 

The six teeth between the canines are called incisors. They are always small in cats. They are relatively innocuous and cause little problems. Frequently a few are missing (fell out) in cats for no real reason.

 

Thank you larry. They sure are tiny aren't they?? :shock:

Ok, I received another e mail from the second vet after I sent her one with a few more questions. This is what she had to say

Yes, we offer preanesthetic bloodwork which we can do in house that same day. I would definitely ck blood glucose pre and post. We have a Cardell monitor, non-invasive blood pressure. We sedate with what we think will work best: acepromazine, butorphanol, morphine, isoflurane, ketamine, valium are a few.

Now, isn't the ketamine part of the recall from a few weeks back? Plus, isn't the right monitor called a doppler monitor? Should I question her on these, or does anyone know if that is a good machine as well?

I can't believe the amount of research and worry that goes into a dental!

 

Only specific ketimine was recalled (Those made by Teva and sold under different labels). These is good ketamine out there. If ketamine is used just ack the to ensure that it is not on the recall list.

Cardell monitors are excellent monitors. A Doppler machine is typically a manual one where a person manually inflates and deflates the cuff. The Cardell monitors do it automatically. Doppler is the way they measure when the blood flow is stopped/resumed and the blood pressure is read off a meter on the cuff system. See the following for info about Cardell monitors:

http://www.paragonmed.com/cardmonitors.shtml

 

thanks larry, you are putting my mind at ease. So now I just need to find out what ketamine they are using, and make sure it was not part of the recall. Should I ask any other questions?

 

Make it easy - just ask that they don't use any ketamine at all. Since they have other options they use, ask them to use something else.

 

A good alternate to ketamine/valium mixture for induction is propofol.

 

thanks for clarifying. Should mocha have a catheter? Should I ask about that?

 

Yes, a catheter should be inserted and used for IV fluids as well as induction. It was included in this line item:

$76 fluid therapy (venoset/IV tube, IV catheter, fluids - 500 mls, t port extension set)

 

thanks for the reply. That was quoted for hillary and the e mails I have received never said anything about a catherter, just warm IV fluids. Would those go through the catheter?

 

Yes, the catheter is the delivery device for the IV fluids.

 

thank you venita. I can't believe how little we know about this stuff. Im embarrassed to say we have never done a "dental" on any of our cats before

 

ok, heres some more updated info from the vet. Everything I think sounds ok, we would like to get mocha in before to long, but I guess we are just waiting because we are so nervous. Does that make sense??

me:
Thank you for the reply. Would it be better for the preanestethic bloodwork to be done a few days before, in case she needs to be on antibiotics for anything? Is it normal to do the bloodwork the morning of the dental cleaning? Also, would mocha have a catheter? And last ( I think!) if she does need extractions, generally how much more do they run? Would we be told about any extractions before they are pulled? Thank you again for all the help you are giving us!

Vet:
The bloodwork can be done either way, most of the time we do it the same day as it is just more convenient. Most pets do not need antibiotics beforehand, but some do, usually determined by the oral exam not the bloodwork.
Definitely she will have an IV catheter, and warm fluids during the procedure.
Extractions vary from $20 to $180, determined by the difficulty of the extraction; we would be able to give you an estimate that morning and then update it once we have her under anesthesia and have taken any needed Xrays.

Would you guys feel comfortable taking your cat here for a dental? She is a Fellow of the Academy of Dentistry and that is a good thing.

 

The vet sounds good to me.

 

thank you larry!

 

Sounds good to me as well and I like the part about AB's depending not a definitive. Which ties in to this thread on the other health board:
viewtopic.php?f=3&t=4136

And Dr Lisa chimes in about AB's and her change in recommendation.

Also, Jess brought up a new alternative as well, which is worth asking about.

And you're perfectly normal, being nervous, asking tons of questions and wanting to make sure you understand this.

My cats have had dentals in the past and I NEVER asked questions. I didn't know to or think about it. I blindly followed and trusted the vets. NOW I know better and will be making my list for the vet next week.

Oh and even after I get the answers and feel confident in their abilities, I will still be a nervous wreck on dental day. I will do my best not to show it and remain distracted, but I will constantly be thinking about it.

Look I think it's normal, our babies are away from us, in another location, out of sight and our control and we are entrusting them to someone else. What will lessen the fears, is knowing about the process, who is performing it and that the vet will do the best they can to ensure the cat's well being.

Your head will be fine - because it understands the process, it's your heart you will need to tame.

 

thanks hillary. I will ask about the nerve blocker? If we do get mocha in for a dental I know I am going to be a nervous wreck. Peter will take the day off work because I know I won't be able to handle taking her there on my own. He tends to be the more level headed one out of us!

A question about AB's. Do you think it is still important for her to have the AB's AFTER the cleaning? Isn't that what prevents any of the gunk from the cleaning from getting into her bloodstream?

 

I am asking my vet about nerve blockers, but if your vet doesn't do them don't let stop you from going ahead

 

does anyone else feel queasy when reading the article on the nerve blockers? I understand the concept, but it turns my stomach.

 

haven't read the article yet, so no stomach churning here.

regarding AB's - I'd follow Dr. Lisa's advice, if no extractions and nothing serious happening from dental, no AB's, but schedule a follow up in a week to make sure all is well. make sense?

You can always get AB's if needed, but why spend $$ and get if not really necessary.

think about when you go to dentist - you don't have AB's before or after a cleaning, why would kitty need it?

And if I get more than a cleaning done, I get happy gas - so there :mrgreen:

 

Just my two cents...

Of my 4 cats dental experience -- my two purebred cats have (had) poor teeth and had to have dentals and extractions. Both have lost a lower fang each, multiple incisors and molars. (lack of teeth doesn't bother them at all)

Fortunately, neither had any troubles or pain afterward - both needed AB. The first time they had some Metacam for pain. The second time for Mauser, the vet gave me a syringe of Bupe to use "if needed", and Mauser did not need it (he started eating as soon as he got home).

My two mixed breed shelter-adoption cats have great teeth and have only needed to have a bit of plaque chipped off during their annual (awake and hissing) exams.

Tiggy has been with us now for almost one year, and has not needed any dental attention yet. He'll be going in for his annual exam in a few weeks.

ETA: My cats-only vet does the dentals herself -- we did not take our kitties to a specialist.

 

thank you everyone. Hillary, you are right. I don't take AB's after going to the dentist, but on the other hand, I'm so scared of needles that I don't ever get numbed for cavity fillings either! I would never make mocha go through that though.

I really feel like it's time to call and make an appointment but I have such a nagging feeling in my stomach about doing it "just in case" something was to go wrong. How would we ever live with ourselves if something happened?? I know I can't think like that and I just need to suck it up and make the call, right?? nailbite_smile

 

I will preface my comments by saying I don't know you but...

I think you are doing a great job of learning all you can about dentals and what to do/not to do, but I sense a whole ton of anxiety about this that cannot be good for you or your furry one. I can't tell you how you should handle things, but sometimes it is a good idea to have a little faith that things will go fine, rather than assuming the opposite....

I hope I haven't overstepped any boundaries by saying this ;-)

 

no jen, you haven't overstepped your boundaries at all. I have major anxiety issues over anything "unknown" to me and I know this is a problem. So does peter :lol: , that's why he is the cool, calm, collected one out of us! I feel like making the call and setting up mochas appointment. This vet that I have been corresponding to has been awesome at answering my e mails, plus she e mailed me today letting me know that the Michigan State Veterinary school actually refers people over to her, which is saying quite a bit, MSU has an awesome vet school. The one major thing that is holding us back is the distance it is to get to this vet. She's over an hour away and mocha REALLY stresses out in the car. (lots of bathroom issues) and we aren't sure how well she would handle herself in the car for an hour.

 

If Mocha has stress issues, I'd look into at the very least using bach's rescue remedy for awhile before and during the car rental....

 

I am not familiar with that remedy?

 

you can find it at any health store - like gnc or vitamin shop - it's called rescue remedy and is a homeopathic remedy intended to calm ones nerves.

I have some, but not sure how it's administered in cats - maybe put a question out on that.

 

on their ears or in their water....

http://www.ehow.com/about_5070063_bach- ... -cats.html

 

interesting article. never heard of that before. Has anyone on this board used this product? Mocha does not drink out of a water bowl she drinks from the sink (if she does drink) so it would have to be applied elsewhere. I don't think I would apply it to her gums since she would be going in for a dental, I would hate for it to cause a complication after the cleaning.

 

many of us use it and there are no complications, and I'd put it in her mouth with no worries.

 

ok, I e mailed another vet, closer to home. This is what they had to say. It doesn't sound as thorough to me as the other vet an hour away. This vet is about 20 minutes away from home. Does it sound ok to you guys?

Sorry again for all the questions!

1. is predental blood work required? No but highly recommended. Cost for presurgical bloodwork is $38.00.
2. are predental antibiotics required? Depends on the severity of the dental.
3. will xrays be done first? Possibly, again this depends on what the doctor finds and the severity.
4. what kind of sedative and what kind of anasthesia are used? Depends on the pet and what the doctor chooses.
5. what pain killers will be used and at what point? This is optional and will depend also on the severity of the dental and if there are extractions. Pain medication is optional.
6. do you monitor blood pressure? Monitor heart rate? Yes
7. if extractions are required, will you call first? How much do they generally cost? No and it depends on the teeth that need to be extracted.
We can do a treatment plan for you when you come in
8. Are IV fluids given during cleaning? Depends on the case
9. do you administer pain meds during the dental and after? would like buprenex if there are extractions
10. post dental antiobiotics? This also depends on the severity of the dental.
11. perform post dental x-rays to make sure nothing was missed- If you would like them done.
12. what is their procedure for diabetics; ie should insulin be given in the am and if so just partial dose or ? and will they monitor bgs at all?
13. How much do dentals start out at? $117.00
14. How many dentals are done each month? We do 2-4 dentals every day.

This vet is NOT on the fellow member dentistry board like the other vet we have been e mailing back and forth is, but I know there are a lot of people on here, who do take their cats to vets who are not on that board.

The price is much cheaper to begin with at this vet, but apparently he doesnt have a range of what an extraction might cost either.

 

Wow, I have missed a lot in this string! Devon, we are taking Kitty in for a dental too. I talked with the vet last week and still felt nervous, so today I talked with a vet anesthesiologist and our regular vet.

The dentist can do the bloodwork that morning, but I agreed to bring Kitty in a week ahead (next week), for this reason: Once I have withheld food, I want to be able to bring him in and get it all done early. I was concerned that if the doctor had to examine him, and then answer my questions, it would all cause too much delay for a hungry kitty who hasn't been given his regular insulin.

So I will get bloodwork next week, and the vet will look at his mouth, and hopefully answer my questions, and then we'll be all ready the following work for an easy dental.

Similar answers on these things:

AB in advance: Only if warranted by bloodwork and exam.
Pain relief: Regular vet said to ask for one dose during the anesthesia, unless there are extractions, in which case i should come home with it.
Monitor heart, oxygen, EKG, carbon dioxide. Catheter with fluids

Ketamine: I discussed with the regular vet that ketamine was recalled. She said all the good vets are aware of this and are not using the recalled manufacturer. i can ask to check.

Maybe we can support each other through this stressful event! I told my vet i wished someone would prescribe valium for ME!

 

Coupla thoughts --

PLEASE be concerned about this! You are NOT worrying for nothing!There are dental specialists for a reason -- it takes specialized equipment, training and experience. And it can make a huge difference in the life of your kitty.

My recommendation would be to take your kitty to the specialist an hour away and hang around there until the surgery is done. If they know you're driving a distance they will likely put a higher priority on your kitty's surgery.

*** Please Note: My vet is one of the very few in this area that specializes in dentistry:

Carolinas Animal and Dental Clinic in Charlotte, NC http://www.carolinasanimalhospital.com/at least contact them for a reference?

I just had Percy's teeth done -- more expensive than others, but it went very smoothly, unfortunately 2 teeth extracted, but he is a new kitten now -- for 9 years old!

I've been feeding raw chicken necks to all my kitties for a couple of months and when I asked my vet her thoughts she replied that recent studies confirm that feeding raw chicken necks does as good a job as brushing teeth regularly. So I"m sticking with that. I know people who have had their cats on the necks and have never had to have dentals done... so there is definitely an alternative to dental cleaning by a vet!

 

kathy, what you said about bringing in kitty a week before cleaning is a good idea. Two of the local vets suggested I bring in mocha before the actual cleaning, to do an oral exam. My local vet is free consultation, but I was also given the impression at my vets that they don't REALLY do a lot of dentals, which made us feel uncomfortable. The other vet I contacted is about a 20-25 minute drive away, and his consultation is 40.00 and pre bloodwork is another 40.00. We honestly cannot afford to take mocha to a vet for 80.00 and then not go through with the cleaning at that vet. It just is not financially in the budget. The second vet is less then half the price of the specialist, but he also wouldn't tell us what extractions cost and if she actually does need them, we might end up way over our budget. That is something we could discuss at the 40.00 consultation, but again, unfortunately it comes down to money for us.

Harryzmom, we are leaning towards the specialist for mochas cleaning. Even though she cost's quite a bit more then the local vets, she seems to be up on her game about what is needed, to make it nice and easy for mocha. However, she is over an hour away, and mocha really stresses in the car. REALLY stresses so that makes us nervous.

I wish this was so much more simple then what we are making it out to be. I am sure I am complicating things as I always do, but I just want to do what is best for mocha, we just don't have any experience with this so we don't know what that would be. I know I'm driving you guys crazy with this.

 

I think it is time to pick a plan and then stick with it and stop looking at more options and issues.... Just my two cents

 

I agree Jen. Just don't know which one to pick! As of right now, I really have two choices (because the third, my reg. vet, made us nervous about the dentals they do)

1. A specialist (an hour away, mocha stresses in the car) starting at $2-300 (not including any extractions, but did give us extraction price range) seems to be very up to date on all questions I asked about, and told me she has done this for 29 years, MSU vet school sends people to her (says a lot!)

2. A reg. vet (20 min away) starting at $117 (not including extractions, won't know price until we go in for $40.00 consultation, plus pre bloodwork is not included, but can be done for another $40.00) so right there we are close to $200.00. Answered most of my questions, but not as thoroughly as specialist, claims they do 2-4 dentals every single day, can set up a "plan" for us during consulation

are you guys seeing anything else in this 100 page thread I started that I should also factor in when deciding between the two vets?

 

I think both look fine. There are some unknowns with number 2 but they state that they will do up a treatment plan with you prior to the dental so you should be able to address all of your concerns at that time. The fact that they do that number of dentals should give you some comfort level.

The fact(s) is:

1. you do not have a personal relationship with either, so there is a bit of an unknown that you won't be able to overcome until you develop one
2. things can and do go wrong sometimes regardless of whether someone does 2 or 20 dentals a day...

You have to decide for yourselves and I don't think more facts are going to help you with this. Pick one, set your mind to it and get it done when you can afford it. I'd book the appt(s) now if I were you so you have that part off of your mind.

You cannot control everything, remember?

 

re: stressing in car -- not sure if you have tried the pheremone spray before, but 4 out of 5 of my cats respond very well to that -- it's not cheap, but you can get it on the internet cheaper -- you would spray her toys, blanket, inside of carrier, etc. that she comes in contact with before traveling -- coupla days to get started;

Also, my Harry is a very High Maintenance kitty, but calms down really well when I give him his brush -- he LOVES to be brushed, so i leave it in his crate with him while traveling and give it to the vet techs -- he gets totally distracted and starts rubbing on it and they can pretty much do whatever they want with him for 20-30 minutes. there might be something that would have the same effect for you. Also make sure you take away in toys that might have catnip in them well before traveling...

also, NEGOTIATE with the vet!!! Like everyone else, they are facing a money crunch. Ask them if they can knock some off the top and if you can work out a payment schedule, pay half up front, etc... They are a Business, and will work something out.

 

up front quotes -- it's fair to ask for an exact breakdown of all possible fee ranges, -- if they don't have that available, I wonder about how they come up wih their final figures, and if this is a serious part of their business where they have not broken it down for themselves. Just as when you bring your car in to be fixed, there should be a range available over the phone. If not, they may just trying to get you in the door, then since you have invested the initial consultation fee, you'll feel compelled to finish it out.

FYI, to give you an idea of the price you are getting with the specialist you are dealing with, my total bill for Percy with full blood work (including senior panel for wellness check), 2 extractions, x-rays etc. was $823.14 -- blood work done the week before.

 

Devon, I'll offer my impression, since you and I are both digging into this subject right now. For myself, I would choose the specialist if at all financially possible. From what you've said, she seems like an expert who can prevent after-the-fact problems -- which would also cost money.

As far as riding in the car is concerned: None of want to put our kitties through ANYTHING, but sometimes, for their health, we have to. So maybe this should not be the deciding factor.

By the way, how do you carry Mocha in the car? I used to hold him in my arms, and he stressed out, gasping -- it was horrible. Then I put him in a carrier large enough for him to stand up and turn around in, tucked into the he back seat so that it was stable, and opened the windows a crack -- and he sat down through the whole trip. Not happy, but not panting either.

I've made my pre-appt for next week. Let me know when YOU are going. We can stress together!

 

looking back over your thread, there doesn't seem to be a compelling reason to be doing a dental cleaning NOW. May I recommend trying to self-clean the teeth for a month or two with the chicken necks, then get another eval?

... you're feeding Fancy Feast? (gulp) -- is there any way you could switch to a better food? I've got 5 cats, and the only one that's had teeth problems was the only one eating FF -- anecdotal, but ... (he's now on Natures Variety frozen raw Rabbit]

 

Harryzmom, are your cats diabetic, or are you in the General Health category? FF is a great option for diabetic cats.

 

Harry is diabetic, the rest are civvies. Percy is gluten allergic, so i had them all on gluten free FF for awhile -- including Harry. I switched to Wellness canned for awhile, and was amazed at the difference. Percy wouldn't eat the Wellness, so he stayed on FF gluten free/ low carb. Then i started on the NV frozen raw chicken, and OMG! new kitties! and cleaner teeth! Percy still wouldn't eat anything but FF, which gave him constipation, he was still throwing up almost daily (down from 3-4 times a day with other foods). Now that he's on the NV Rabbit, he's doing GREAT! unbelieveable difference

many varieties of FF are low carb for sugar kitties, but that doesn't make it nutritionally or dentally beneficial -- better than dry, and cheap, but many other brands are much better choices for sugar and civvy kitties alike -- there's a reason it's cheaper

 

Interesting. I'll look into it. Kitty is doing so well on FF, though -- lovely BG -- I hate to change anything. Maybe I'll try it once and see how he does.

 

Im nearly 95% certain we will be going with the specialist. Like kathy said, no one likes to put our cats through the stress of going to the vet, but sometimes we have to do what is best for them. I have a cat carrier that mocha fits in, but it is not big enough for her to stand up and walk around in. Peter is thinking of somehow making a home made carrier, just for the car, that she will be able to move around a little more freely in, as well as maybe a cat box. Since the specialist is over an hour away, we will just stay at the vets or in that town until she can come home. Peter plans to take the day off as I will be to much of a nervous wreck to go at this on my own. Kathy, I wish you the best of luck with kitties dental. I will be thinking of you guys!!!

Harryzmom, we have tried mocha on the wellness canned food, but she shunned it. She seems to really like the FF so I think we will stick with that. There is no immediate need for a dental, just hopes it might help regulate her numbers. She is far from regulated at this point.

I am wondering how the day of the dental would go for mocha. Say she gets her PM insulin the night before, and then the vet says she should not eat after X time, then no insulin the morning of, and no food still, then the hour drive, plus whatever needs to be done BEFORE the actual dental, then recovery, that might be a really long time for mocha to go without food or insulin. I like kathy's idea of going the week before to get all of that stuff taken care of. I should ask the specialist if that is possible.

 

Devon, I was also concerned about how to manage the dosing the night before and day of.

Jill has said her vet recommended one-half to no dose the morning of the procedure, depending on numbers. Remember there is what Jojo has called the "nom nom" feature of anesthesia: it tends to eat up glucose, somehow, so the kitties seem not to miss that morning dose.

I hate to leave him without food overnight, but when he had anesthesia last fall for the biopsy, he did not starve. :smile:

 

definitely relate with good numbers -- i will say, though, that once i switched harry over (and started adding taurine) his levels are steadily dropping -- last august was 3.6 bid, today he's at 0.9, still dropping, so it still might be worth slowly transitioning -- or substituting a meal... it would probably take more than 'once' to see any difference

remember cats are carnivores, so the closer we can get to their 'natural' prey food the more likely their system will heal itself

all my kitties LOVE FF! but i don't let my kids eat nothing but ice cream, either

 

If she has a dental issue (abcess, etc.) that would definitely affect her numbers. You are feeding her the FF on the "list" right? Not all FF is low carb -- just to check...

Cats are carnivores, closer to prey food is best, unless there are underlying issues. Also may i suggest adding Taurine (really cheap stuff) to help regulate

What insulin are you on? the basal insulins (lantus/levemir) have the highest rates of remission...

 

yes, we are feeding her LC turkey and giblets FF. I don't have any idea how mochas teeth and gums are. Last year at DX time, her then vet said teeth and gums looked good, but that was all she said, and it was said after a mere glimpse in her mouth. Mocha has never had a dental done.

Mocha is currently on lantus.

 

Harryzmom, why are you suggesting taurine to regulate?

 

taurine is necessary for general health and healing for kitties; recent studies regarding taurine amts concluded previous requirements were 1/4 what they should be; taurine is an absolute necessity for cats, so if a sick kitty isn't getting enough in their food their will likely have a hard time healing / getting over the hump of surviving and moving toward recovery

from tillydiabetes.net:

http://www.tillydiabetes.net/en_6importantfactors.htm

"Prolonged deficiency over a period of several months or even years is required before clinical symptoms appear in most healthy cats. Supplementing a diabetic cat's diet with taurine would seem to be beneficial, for reasons described in the articles referenced below.

Here the most important points:

• Taurine has been found to affect blood sugar and insulin levels favorably in humans and other animal models.
• Supporting kidney function with taurine: kidney cells do not require insulin to take up glucose. The high plasma glucose levels caused by diabetes result in high intracellular levels of glucose. Via a chain of events this leads to a decrease in the taurine quantity in kidney cells. Organic osmolytes - such as taurine - play an important role in the regulation of cell volume.
• The clinical state of diabetes is often accompanied by elevated blood levels of cholesterol, triglycerides, and free fatty acids. Taurine is important for the formation of bile acids. The formation of bile acids represents the most important route for the elimination of cholesterol. Too little bile acid can entail increased cholesterol values. In studies of diabetic rats, taurine also lowered plasma triglyceride values. As many diabetic cats have elevated cholesterol and triglyceride values, taurine may help to lower them. Additionally, according to the lipotoxicity hypothesis, chronic exposure to high concentrations of lipids contribute to deteriorating beta-cell function in diabetic patients.
• Taurine has been shown to reverse neurological damage in diabetic rats.

A typical quantity of taurine that many people give their diabetic cats is 500 mg per day. No scientific studies were found to support this dosage in cats and the guidelines used by the pet food industry vary widely."

about 6 months ago i asked my vet about this, he did some research and found a brand new article recommending 2000 mg per day...

since it is CHEAP and tasteless and can be mixed in with any food, no reason not to ...

 

follow up on the food:

http://www.catinfo.org/commercialcannedfoods.htm

 

Well....I have seen little to no mention of taurine in posts on this board, and after reading Dr Lisa's page which I'm very familiar with but haven't read for awhile, I see 50mg supplementation for those feeding a specific dog food to their cats, but no mention of what is appropriate for cats on a commercial cat food.

 

hmmm, looking at your spreadsheet, may i suggest you *****may***** be over-dosing?

I was overdosing for about 6 months and my numbers were very similar -- apparently overdosing is common amongst those of us who home-test

your numbers look better back at 2.75 or 3.0; perhaps drop back there and leave her there for 5-7 days, see what happens

imho

i don't have the article links in front of me now but if you're interested i can get them to you -- give her system time to get all the compensatory systems back to normal, then see what happens...

also, you can probably cut back testing for ketones to once a week (i don't test anymore at all)

 

the links to the articles are on the tillydiabetes.net page -- but i agree, regretfully, that not enough attention is paid on this board to taurine; i've seen marked improvement from giving taurine in my kitty's numbers...

 

well, will be interested to see more :smile:

 

summary: taurine is ESSENTIAL to cats, and is found in raw muscle meat. it is easily synthesized and if you look at cat food cans it will be listed as an added ingredient. it has to be added because cooking the meat degrades the taurine. adding additional amts makes up for previous unmet needs and assures the kitty is getting enough to repair. not possible to overdose ( also, taurine is in most energy drinks, and can be added to water or juice for your own enjoyment .

 

ok. I cannot comment on the taurine issue, as this I think is the first time I have ever even heard of it. I have e mailed the specialist back with a few more questions, regarding the day of the dental and insulin questions. This is what she wrote to me.

Funny you should ask about the diabetes, we did a teeth cleaning and root canal on a diabetic dog today!
Diabetics should be given one half their normal dose of insulin the morning of the procedure and NOT fed. They receive Dextrose in their fluids and then have a blood sugar drawn a number of times to be sure they are okay, then get fed here asap once they are awake.
IV fluids only for kidney problems? My belief is everyone goes on fluids, as keeping the vasculature open, blood pressure up and urine flow going helps to protect the kidneys! I can't say I ever heard anyone say to only use them for kidney; some vets may only use them when there are kidney issues, but that doesn't mean they should only be used at that time.
Cat dentistries can take 1 - 2 hours depending on the teeth involved. Xrays require anesthesia, so taking the xrays and delaying the procedure doesn't help you that much.
hope this helps, I know it can be nerve wracking to travel with a cat; mine is not very good on trips

I asked about the IV fluids again because after reading another series of questions on this site that Jill had written up for someone else, I was confused. I asked her if it was better to take mocha in a week earlier to do the X rays and the oral exam, that way on the day of the dental, there was less to do. But it seems it would be best to do it all on the same day? I am nervous about mocha being without food for so long! Does all of this sound good? I mean, is dextrose a common thing to have in their fluids? Im so sorry I keep bombarding you guys with these questions!!

 

That vet sounds very good to me. Not infrequently dextrose is added to IV fluids. Insulin dosing and eating seems to vary between vets. One of my vets says 1/2 meal and 1/2 normal dose of insulin morning of dental. She allows feeding she has never experienced a cat vomiting due to anesthesia (based on emergency surgeries where fasting not foreseen) and her experience with diabetic cats and that densities are done starting at about noon. I really like his position on IV fluids - always uses them.

 

vet's recommendations sound very reasonable -- lantus is much more flexible re: feeding schedule (i used to free feed until i switched to raw), and as long as they're monitoring everything should be fine -- going without food for this short duration shouldn't be a problem at all...

blood work is usually less expensive if you have it done beforehand (no rush charges); the only other reason to make two trips is to make sure the cleaning is necessary -- otherwise x-rays can be done at time of cleaning -- no real benefit to getting them done ahead of time, down side sometimes they have to sedate kitty to get the xrays

 

Actually it has been mentioned quite a bit over the years. I became interested when Tigger was having all his liver problems a couple of years ago. I also wonder if it is why he seems to be a pretty well regulated diabetic after over six years. He gets it added to his raw food twice a day even though his raw is already supplemented ( I used to add it to his canned food too). I have always wondered about whether or not freezing the food might diminish its efficacy somewhat so I just add extra when I feed him (like you said, we know that warming/heating food does). Here are some links I have posted before:

http://www.thehealthierlife.co.uk/natur ... 00284.html
http://www.bluecross.org.in/petcare-taurine.html
http://www.hdw-inc.com/healthtaurine.htm
http://www.healingdaily.com/detoxificat ... aurine.htm
http://www.ncbi.nlm.nih.gov/sites/entre ... s=11747139

Thank you harryzmom for bringing it up again.

P.S. I always wanted to try the chicken necks for cleaning teeth but it seemed it would be so messy. I have heard of people putting their cats in the bath tub...not sure if Tigger would go for that.

Sorry for hijacking the thread.

 

Good to hear the word is at least out there about Taurine!

So far I haven't had to resort to the bathtub, though that sounds like a good idea. Though there's a bit of growling going on, pretty much it's just crunching . not too messy, i cut in a few pieces before hand so they're not dragging it around

 

wow this discussion has really progressed into new territory (at least for me).

I was and maybe mistakenly so, under the impression that the proper amount of taurine is added to commercial food and it is not necessary to add extra. I feed a buffet of choices - friskies SD, EVO 95 and NV raw. I'm also waiting to learn how to make raw.

Not everyone is eating the evo and NV, and well the friskies (I guess that like eating junk for dinner) everyone wants and eats.

When I get some time, I'll read the links about taurine, so I can be more educated.

I did schedule Maui's appointment - Friday is the pre-visit and I need to make the question list, and Feb 15 is the dental. I feel ok about taking her to the regular vet, as I do have a relationship, will get the questions/concerns addressed. But I'm still nailbite_smile

I don't see anything particularly bad or wrong in her mouth. But I do see lots of tartar buildup and think she just needs a cleaning.

Now Sydney, is the other issue - I've decided to take her to the specialty place for a consult. That's as far as my action plan is with her. If after the consult the dentist feels she should come in, then I'll need the questions answered and decide. I'm concerned that it may be too much for her, yet I'm concerned that she does need attention.

 

hillary, good luck with mauis appointment! I will be sending positive thoughts your way!!

 

anecdotally, the vet that recommended Percy get a dental cleaning (we were in for another issue) saw him about 3 weeks later to draw blood for his dental, did a triple take on her notes and his teeth because they were so much cleaner -- because he had clear tooth loss i went ahead with the dental, but i wouldn't have put him under anesthesia just for a cleaning; the three weeks in between i had really made the effort with the chicken necks, now that he was off the bad food, and apparently he had knocked off the tartar / plaque himself :mrgreen: just something to consider, or even plan on for after the cleaning

there is also a tablet that you can put in the water that keeps the tartar from forming once the teeth are clean; apparently it works but i've not tried it myself...

if you're going to learn how to make raw, let me know if you're interested in purchasing a gently used high-end meat grinder

 

Gosh, am I the only one who isn't getting sent notices when there are new replies? I do have the "notify me" checked. I've been out of the loop!

Devon, on that issue of the pre-visit, the suggestion was not to have the x-rays done during the pre-visit, just the basic visual exam and the bloodwork.

I'm really intrigued by the Taurine discussion, and the FF discussion. I don't think Kitty ever had dental issues until we started FF last year.

I don't think raw chicken necks will work in this house, though!

Hillary, my appointment for Kitty's dental is just a few days after yours. I'll send you vines, then send them to me when you're done, okay?? :mrgreen:

 

My girls aren't drinking water, probably since I add enough to their food.

As for the necks, only one eats raw and that's hit or miss lately. Nobody seems interested in raw chicken pieces, let alone the necks. While they are discovering their inner carnivore, they're not fully there.

The person who makes raw does so with someone else and they will teach me and maybe it'll just be easier to join their party, rather than do on my own. But time will tell.

I looked at Maui's teeth and thought she ought to just have a general cleaning. It's been a few years and in wanting to keep her health at optimum levels, teeth cleaning is a good way to go. And yes, I hate the idea of anesthesia, but what choice do I have currently? (And no neck bones! :lol: )

 

well I will be sending both of you guys positive dental cleaning vines! We still haven't made mochas appointment yet. I never really noticed mocha having bad breath before we put her on FF either, but like I told peter, we probably were not paying much attention to it. But I do know that when we had cheddar, his breath was BAD! And it was bad right from the start, so I'm thinking if we noticed his without any problems, wouldn't we have noticed mochas?

 

Why not take advantage of the free consultation to see if she even needs a dental in the first place?

Also, make sure you budget for more than the estimate. When my vet got Sweetie under anesthesia for her dental, he got a much better look in her mouth than he could during the regular exam. She had stomatitis and it was worse than he had thought. Our routine dental turned into a nearly full mouth extraction and really drove the cost up.

Luckily, I have a savings account for these sort of surprises.

 

I have a feeling the local vet would not do more then just a mere glance inside her mouth. They already told me they don't do a lot of dentals, and when I asked a few questions about it a few months back, they were pretty baffled by them. I dont know.

We will have a little extra for mochas dental, but not much. As most of us do, we live paycheck to paycheck and there really isn't a back up savings.

 

this vet sounds fantastic to me. the places that i've taken my cats to, vet techs do the cleaning and a vet supervises; the vet does any extractions but the rest is done by techs.
the vet i take my kids too now is great, she does the fluids and monitors BP during the dental, most here only do a pulse oximetry, and my vet said that a potential problem will show up in the blood pressure first, before the O2 drops, so this is a safer way to monitor the cat while it's under anesthesia. the sooner you know about a potential problem, of course, the faster you can do something to fix it.

Feb is dental health month- ask if they have any specials. a lot of vets take 10% off the cost for a dental during Feb!!
i want to take my boy shelly in this month.

all of my cats have had at least one dental- Raven's had two, Nell has had four? or five? she has resorptive lesions, which are painful, so she has to go in every year pretty much and Sheldon has had 3 dentals.

Snoopy, my diabetic boy had a dental when he was unregulated and quick sick, actually, and did so much better afterward
The other diabetic cat i had never had a dental because our vet at the time just didn't 'believe in them'. and Mickie didn't have a dental because her vet never thought she needed one, but by the time she was 16 or so, she did need one, but her kidneys were in bad shape and the vet didn't want to risk it.

however, if i had THEN the vet i have NOW, i am fairly sure she would have felt confident enough to go ahead and do the dental on MIckie.

my vet does pretty much what is outlined here (this is NOT my vet's website, but it says pretty much everything she told me about how they do dental there- except my vet has some sort of cat bed that they use that has circulating warmed water going thru it to keep the cat warm afterward)
http://www.southarundelvet.com/site/view/99746_Surgery.pml

it's got a nice checklist you can use, if you still have any questions left

good luck with Mocha's dental! i am sure she'll be fine and that specialist sounds really good.
i have a cat who gets so upset when i have to take her in the car, she pees, poops, and throws up!
what helps is keeping the cat carrier covered so she can not see outside

cat's vision is very specialized, their eyes are meant to track motion, esp horizontal motion (the kind a lot of prey would make) so things going by outside the car at such a rapid speed, it really really upsets many cats because they can't make out what it is that they are seeing.
it's easier on many cats to be in the carrier covered with a towel or blanket that blocks their view of the outside.

talking calmly to them sometimes helps too.

hope this helps some.
i don't like having my cats' "put under' but when you have a good vet that you trust, it makes a big difference.

all the best
althea

 

nadlemgarcia,
this actually is NOT a dental forum, it is a feline diabetes forum. this site is populated by those who do like, do own or have owned cats, and especially diabetic cats.

i see the dentist link in your signature. are you studying dentistry or something? i ask because i see you are replying on all the really old dental posts here so i'm just curious.

ETA: This is Venita. I removed the advertising post that Cindy is referring to.