Teeth cleaning for diabetic cat

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KRSAAA

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Hi All,
Just wanted to know whether teeth cleaning/x-rays for a diabetic cat is a relatively safe procedure and if anyone has had any experiences with this.

My cat has been on 2.5 units insulin for about a year now and is doing very well. The vet recommended a teeth cleaning because he said she had gingivitus and inflammation in her gums. Said it's better to do it now before it gets worse. Delays might result in the inflammation affecting her diabetes. Currently she has no problems eating Hills DM kibble which is the only food she likes.

- Would there be any issues if she had to fast prior to the proceduer which is done under anesthesia ? I'm guessing she will not be getting an insulin dose because of the fast.
- After the cleaning will she have issues eating ? That would mean no insulin again if she didn't eat.
- How long does it take to recover and she can eat normally again ?
- Would it be better to do it at a specialty clinic ($$$) than a regular vet in case things don't go as planned? In case she has to stay overnight.

Thanks for any information.
 
Can you tell us what insulin you are using please?
A lot of kitties have their teeth cleaned and taken out here.

Normally a half dose of insulin is given on the morning of the procedure.
I have not had a cat who had to have teeth cleaned but I will tag a few people who might have experience
@Wendy&Neko @Suzanne & Darcy @tiffmaxee
 
- Would there be any issues if she had to fast prior to the procedure which is done under anesthesia ? I'm guessing she will not be getting an insulin dose because of the fast.
My vet starts the procedure at about noon and says to give ½ insulin and ½ food if BG is as expected in the morning. Some vets say no food after midnight or some 10PM. Water is never withheld.
After the cleaning will she have issues eating ? That would mean no insulin again if she didn't eat.
How long does it take to recover and she can eat normally again ?
None of mine had problems eating the evening after the dental.
- Would it be better to do it at a specialty clinic ($$$) than a regular vet in case things don't go as planned? In case she has to stay overnight.
I depends upon how much confidence you have in your vet. All mine were done at their regular vet. Some animals have problem with the anesthesia even w/o diabetes. I worked at a vet and had one dog go into seizures during the cleaning. He never recovered:(
 
My girl went to a dental specialist a couple times, who always did xrays. She was complicated with extra conditions and the specialist did extra monitoring during the procedure. Plus one time she had to have a growth removed from her jaw so the specialist was the place to go. Food was 1/3 of meal up to 6am and half dose insulin. I believe he started procedures late morning. Neko ate as soon as she got home, but just small amounts as anaesthesia can mess with the GI system. How much they feel like eating depend on whether they have multiple extractions. Neko ate after her major jaw surgery. She liked food! She never stayed overnight.
 
Would it be better to do it at a specialty clinic ($$$) than a regular vet in case things don't go as planned? In case she has to stay overnight.
This depends on how complicate the dental procedure is and how much confidence you have in your vet. Has your kitty had pre-anesthetic blood work to make sure that it is safe to administer anesthesia (checking liver, kidney function, etc.) Also, I am assuming that your cat has not heart problems such as a heart murmur (which would require further investigation to determine if anesthesia is safe for your cat.) Even an "uncomplicated" dental procedure frequently involves extractions because the vet often finds "resorptive lesions" and those teeth need to be removed. I have had cats though that simply had some tartar and gingivitis and needed nothing more than a good teeth cleaning. Usually, if the vet finds suspicious teeth, then will x-ray the tooth to determine if it needs to be extracted.

As far as how soon they can eat again, that probably depends on how many (if any) teeth are extracted and also on how swiftly they clear the anesthesia from their bodies. Many of my cats have been hungry. Of course, they only eat wet food so it would be easier for them to eat that after a dental procedure. I only allow small amounts of food that evening, due to the possibility of GI upset (vomiting) because of the anesthesia, as Wendy pointed out. However, some cats have been so insistent that they have gotten more a few hours later and they've all been fine.

As to insulin, like Elise, my vet said no food after midnight and to skip the morning insulin shot. It depends. If you had a spreadsheet, we could look at it and see what his numbers usually are, etc., and be in a position to advise on what would be a safe course of action.

Your cat should most likely be started on a course of Antirobe (Clindamycin) for a few days prior to the dental procedure (or at least after) because there's a lot of bacteria that is released during the dental procedure.

As to pain, if there are extractions, your kitty may be in some pain. Do not let them give you Metacam for pain. Metacam (Meloxicam is the generic name) is harmful to the kidneys of cats. Refuse that if they try to give it to you. Onsior for three days maximum is a little better (but I still don't like it.) This, of course, is all dependent upon the status of your cat's kidneys anways -- which is why I asked about the bloodwork. The safest pain medication for a cat is Buprenorphine. I have had some cats (most in fact) come home from a dental with just a few extractions (1-2) and they've done well without any pain medication at all.

Sorry if I'm repeating things here, but I'm trying to cover a lot of the basic bases when a dental procedure is going to be performed. If I think of more things, I'll post here.
 
Also, what kind of insulin does your cat receive. This actually would make a HUGE difference in any recommendation as to whether or not you would give insulin at all, give a half dose, etc. Also spreadsheet data with your cat's blood glucose numbers.
 
Another key decision maker for where to do dentals is if the vet has dental xray capability. As I had experience with Neko, there can be things below the gum line that don't show up without xrays.
 
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