Dental, FORL and pain

[Daphne and Aida]

Hi there!
I think I just want to vent.

Feloro went in for a dental yesterday, had one extraction and a lot of tartar removed.
The vet also mentioned that 2 of his teeth were resorbed and that 2 others had to be monitored - although didn't say how exactly to do that.

I asked her about the resorbed ones, she showed me on the x-ray that only the roots had remained. She was adamant that it isn't painful for cats, and that they typically leave them be. And that when a tooth is in the process of resorption, they just cut it off and leave the roots in.

It goes so against all the guidelines that I've come across! Aida is due for a dental in 2 weeks and, although they take great care with the anesthesia with elderly and kidney cats (Feloro is CKD), I don't believe that they are really up to date with the dental procedure. It's a cat-friendly clinic, and they leave them with what must be horrible pain!!!

There is no specialised feline dentistry in the city I'm in.

Like I said, just venting.

 

[Suzanne & Darcy]

Hi. Here’s an article on resorptive lesions from Today’s Veterinary Practice. It’s long and detailed, and if you scroll down to the section on treatment, they do discuss extractions versus crown amputation.
https://todaysveterinarypractice.com/dentistry/feline-tooth-resorption/

 

[Daphne and Aida]

Suzanne, thanks!

Like many other super interesting articles on the topic, all tend to say the same things.
Anyway, from another group I was told that it is rather reassuring that she's not doing something she's not confident enough to do - like a complicated extraction.

What pains me is that Feloro is still having a painful side in his mouth, and he went through the ordeal of anesthesia…
The good thing is that he starts letting me brush his teeth - not the painful side obviously! After years of trying!

I'll keep trying it with Aida, maybe she'll let me do it one day…

 

[Clarence & family]

My non diabetic cat has (had) FORL. I was hesitant to have him put under anesthesia as he has a lot of medical issues. He’s epileptic and even ‘normal’ vet visits can cause lots of bad grand mal seizures.
He had both kinds of lesions, some teeth had the crown resorbed and the root intact, and some destruction of the roots with nearly intact crowns. I couldn’t leave him with the pain it was causing, he was drooling, losing weight and just very uncomfortable. Vet even said either take you chance with surgery or euthanasia is the only other humane option, and he was right (please know this was an extreme case! Nearly all his teeth were affected). His jawbone was so inflamed and enlarged they first thought he had cancer.

I was told the exact opposite from what your vet said, the teeth with the intact roots were easiest to pull, and the ones where only the crown remained and roots were gone would have the crown amputated and the gums stitched closed so there weren’t any exposed nerves which is what’s causing the pain! My kitty is nearly toothless now, he has a couple front teeth remaining and two canines, but he eats hard foods and raw meat now that he wasn’t able to with his rotten teeth.

 

[Daphne and Aida]

Oh he must have had so much pain!!! You did the good thing, pain alleviation is the number one criteria to risk anaesthesia, there is no point in living more time in pain…

Aida has had real pain at some point in my life when I could hardly afford to buy food. There was no humane clinic, and I asked a vet (it was another clinic) if they could offer me a special price, which they did fortunately (but I was in dept for a while).

I think that my vet is really good and dedicated, but not really up to date. We’re in a small town, people here tend to live their lives without looking much further, once they’re established. The fact that she is in continuous education is in itself incredible. But yeah… Weird that we know some things that we cannot perform, and she has the training to perform but doesn’t know…
Many thanks for your testimony!!

 

[tessa's mom]

If you can afford it and can travel, I highly recommend seeking out a veterinary dentist. Tessa had recurring gingivitis and a history of developing FORLs and that's the route we took.

We had a few teeth removed in April at a normal vet's office but she still had signs of pain so we took her to a specialist last month. We had to drive ~3 hours one way and it was very expensive but worth it IMO. They removed all but her incisors (the little tiny teeth in the front). They did x-rays and also CT imaging so they could see a lot more detail and make sure they were getting everything. There were a few teeth that were healthy like her lower canines (the big pointy teeth) but that would have left her with a pointy tooth that would keep hitting her lip (she had one canine removed in April and the lower one kept hitting her lip and hurting her) so we opted to remove them. I also think that they eventually would have developed the lesions in those teeth as well and it would have been additional cost and stress at some undetermined time in the future.

If a veterinary dentist isn't possible, ask your normal vet if they are affiliated with any other vets with more expertise in dental work. My home vet referred me to a vet about an hour away from my home to do the extractions in April. This vet has additional dental training but isn't a board certified veterinary dentist. It was a good option between the two though and she did a great job.

 

[Daphne and Aida]

Hi Jess,
Thanks for your advice!

For us, we would have to travel to Paris, the problem here so far being that I would then need to ask the pet-sitter to come for Feloro, and she costs a fortune! She asked last time 100€ daily because she's a trained vet assistant and can pill him.
Plus, we're moving by the end of the month, so it would be so stressful for Aida to 1) go to Paris, get her teeth cleaned, and come back here, followed by 2) take the train and the subway and the plane and the car to a new place…

For now, I'll bring her in for her dental at the regular vet, ask to get the x-rays, and later check with the referral clinic once we're settled in Athens.

I suspect that there is something with the vet dentistry in France that is really weird. I've read in the vet online magazines some advice that a vet was giving that if you have a client present a senior cat with bad teeth, the best is to give pain medication. The rationale behind it is, I think, that the pet will die soon, so why bother with the costs and the additional work.
The previous vet I went to was very reluctant to do dental care for my cats, they were 11 and 12 at the time.

Which then makes me say that I truly believe that the vet I've found now is truly exceptional. For first, SHE READS ENGLISH! and… SHE UNDERSTANDS IT! Like woah!!! But yeah, France… She has a whole collection of the Journal of Feline Medicine and Surgery, and like I said previously, I think it was in this post, she's in continuous education, in a very small town.

I hope that she'll pick up with the international guidelines soon!