Dental Surgery Prep

Nova has dental surgery in 12 days.. she's getting a cleaning and we're yanking some teeth..but won't know how many until the dental xrays that morning. She's somewhere between 9 and 12 years old they figure.. and still has all her teeth.. so it could be a big pay day for the tooth fairy.

So what's the typical plan.. We have discussed a reduced dose the night before and morning.. figured we would decide based on how she is doing closer to the date.. they will be monitoring her bg numbers throughout the surgery/day and managing with iv fluids and fast acting insulin if necessary.

What do other people typically do for dosing? Since she is generally quite low.. I am concerned about how things go without food (no food after PMPS the night before).. I don't have any data on how her body reacts to insulin in that situation.. I also don't expect her to be terribly interested in eating the night after the surgery.. would HC gravy or A/D be the better choice if I need to force feed a little bit?

She'll be going in 2 hours early so they can give her a full flush with fluids.. she struggles a lot coming out of general.. so we're hoping this helps..

Curious about pain killers and antibiotics.. I imagine things are pretty similar with her as they were for my heart disease cats dental surgery.. wanting to be aggressive with avoiding infection and pain.. but having limited choices as far as "safe" medications.. what are the drugs of choice? I would like to read about whatever I'm going shove down her throat before I do it . Apparently there's also a transdermal (inside the ear) gel option.. I'm hesitant to go that route.. I want her high as a kite and feeling as little pain as possible.. there is a lot of mixed information about how effective those gels are and I don't think it's really a good time for an experiment.

She'll be at the vet for most of the day.. I'll bring her home to the sicky cave (walk in closet armed with own litter box, food and water and snuggly warm places to sleep).. Are there any supplies I need to have on hand that I'm not thinking of?

Thanks!

 

This thread has been helpful to me.

viewtopic.php?f=29&t=5390

 

Hi there

there've been tons of recent posts about dentals recently, so I'd first suggest a search of the topic dental to see what has been written.

To address your specific comments, insulin dosing pre and during surgery is very individual. If she's a very low dose kitty it may not even be required much, so I'd go with a wait and see approach.

Re antibiotics, Dr Lisa recently posted that she doesn't support antibiotics unless really really really required...

Re pain meds and trouble coming out of anaesthesia, what does your vet typically use for induction, what is used for anaesthesia and what pain meds? We have lots of issues with Squeak.....I'd go with buprenex if there are no issues with opiates, otherwise you may be stuck with metacam which is fine short term if there are no kidney issues and the dose is low enough...

Finally, post surgery she may or may not have any issues with eating; only once that I can remember has Squeak not eaten as usual.

 

There are several posts on the general health forum on this topic - so you may want to check there for references.

 

Yeah her doctors really try to avoid antibiotics as well.. even with my heart disease cat we weren't going to give antibiotics after his dental surgery (the surgery ended up being a lot more involved then expected.. so we changed the plan).. but infections for him are a lot scarier then for Nova .. she's a lot more likely to be able to tough it out if it happens.

Local is lidocaine neat I believe.. As for general.. I don't actually know what it's called.. run of the mill normal stuff I imagine.. I know that they would use alternatives if they felt it was best.. the dentist is amazing.. wish he would look after my teeth . She doesn't have any life threatening problems coming out of general.. she just really feels like garbage.. took her a full day to be up on her feet after her last cleaning and she was pretty wobbly after that.. it was rotten for her . I had general for my first time last year.. and coming out of it was pretty rotten for me.. my brain was like scrambled eggs for 2 days..so I'm extra sympathetic about her struggles now..

Nova's kidneys are in good shape..but I know there was some concern about using metacam.. will discuss buprenex with them.. I know they listed a few alternatives..but I didn't write them down.. said I'd ask here and they were cool with that.

 

Lidocaine hmm.??? not sure if that is the standard anymore... for general, should be a gas like isofluorene as the effects start wearing off immediately...

 

Lidocaine is a local anesthetic and for dentals is sometimes used as a nerve block to reduce pain during specific extraction.

 

Yep its the local as I said.. general knocks you out..(she'll be under general as well) but it doesn't necessarily block the pain.. some people can feel pain while under, and some even wake up from it (yuuuuuck).. at least that's how it was explained to me before I was put under for dental surgery last year..

I assume kitties can have the same problems.. so they give a local just to make sure. It also makes waking up less scary... coming to is confusing enough.. with masses amount of pain as well it would really be unpleasant.

 

Interesting! I'm only used to lidocaine for us humans...Any sedative as well?

 

Lidicaine is a local not general anesthesia. It only effects the area where it is injected. For dentals it is injected adjacent to nerves to block impulses from going to the brain. See the following:
http://www.michvma.org/documents/MVC%20 ... ky%201.pdf