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4520139 tn?1355849169

Cat extraction - decisions to make

Hi everyone,
I've been reading some of the threads on this page and while I have learned a lot I am also very nervous about my 6-year old indoor male cat getting a dental cleaning + extractions under anesthesia. I was hoping for some advice from this community. I apologize in advance for the length but I make decisions based on a holistic assessment of a situation, so I've tried to include relevant information here.

1. 2011 annual appointment: vet noted "very clean teeth". I asked if I should be brushing his teeth - they said no. Exam not particularly thorough. I remember thinking they were talking more to each other than to me or my kitty, which is why I tried a new vet out this year (#2 below).
2. Took my cat for this year's appointment last week (Dec 2012). Vet recommended full blood panel ($189) including urinalysis. Justification: at this age, good to get a baseline on all measures so if he becomes sick at a later date, have something to compare. Also recommended dental cleaning ($200) and extractions (1 loose tooth definitely needs to be removed. Another is a 'maybe'. Was vague about price, but I think it was going to be $50-100 for the extraction of two teeth - said he would give me a minimal charge for the loose tooth which would probably come out easily). Vet was good until it came time for a simple administrative request - letter stating cat is healthy enough to fly in-cabin on upcoming trip. Insisted that he is not a "secretary" and does not write letters because then he would not have time to treat any patients, would spend all his time doing secretarial work. (? seriously?) BUT he was willing to answer my many questions and thorough with my cat (...or so I thought). Got the letter and the cat is on the trip with me now for 2 weeks. Vet said cat is probably experiencing some discomfort, but not to worry. This vet also told me that brushing teeth is unnecessary and Greenies are sufficient for future dental care. No medications given or recommended.
3. Took my cat for a second opinion. This vet found another two teeth to be extracted (root heavily exposed), as well as 2-3 more that might need extraction. Also noted an infection of the gums and recommended administration of antibiotics. Recommended basic blood panel ($90), but not the full blood panel unless indicated. Vet was very patient, willing to answer questions. Charged me for an annual exam in order to provide the consultation, but I don't think he did the part of the exam in which they manually feel the cat's abdominal area and glands throughout the body. Provided a detailed estimate of the costs. However, the cost is significantly higher than the previous vet (#2 above - around $200-300 for 2 teeth, not including blood panel), even if I take into account the different # of extractions (estimate was $580-$720, depending on whether he takes out 3 or 7 teeth, not including blood panel). I looked into the costs of some of the itemized supplies, and on the two I checked, the markup was 4x and 11x. (ex: Lactated Ringers Solution 1L = $22 on the estimate, but I found it for $2 on an online pet med supplies store). My "gut" feeling about the vet in #3 was more positive than about #2, but I am concerned about price gouging. Also, If I get the extractions done with this vet, my kitty will have 10 days to heal before the airline flight back home (which vet said is plenty) - if there are any complications I will have to delay travel. I am staying with my parents for the holidays, so this wouldn't be impossible, but changing my flight would be another expense on top of the already-higher estimate and I can't be gone too much longer. However, if I didn't take into account the much higher cost and the travel issue, I would probably choose #3.

I am a grad student (on financial aid), but will sacrifice other things to keep my cat healthy. However, I'm really torn about whether to do this procedure here (and pay about 2 - 2.5 times more, it seems) while visiting family, or wait another couple of weeks and go with #2. Both vets were kind to my cat. However, I don't know if I can fully trust either...

Please be positive or don't reply (I noticed some responses were very snarky and mainly focused on berating the guardian). I am open to constructive criticism and opinions/information. But I noticed some replies simply lecture or imply the owner is not committed enough. I ask my vet every year what more I can do to keep my kitty healthy. And to be clear, while I've listed prices above, I am in no way implying that price is the main/only factor in this decision.

I am trying to weigh several factors:
-trust in the doctor
-practical issues (I'm not in my own home right now and will need to travel soon. If there are complications like what I've read about, I would have a hard time extending my trip by more than a week or so)
-financial limitations (I will pay interest on this later when I start repayment on my loans, and while I am not 'cheap' when it comes to the important stuff, I strongly resent being 'taken for a ride' to pad the pockets of doctors)
-quality of medical care

Thanks so much in advance. If anyone with a similar question wants more info on the itemized costs (for comparison) send me a private message.
Best Answer
874521 tn?1424116797
ok....
I didn't want to go into this too deeply for starters b/c so many post than never return to read a reply..thus alot of time involved.

Yes by #2 choice I do mean the last Vet as I didn't even consider the first one as even being in the running, how blind can a person be to not see what you are describing...very incompetent!!!!...

I am like you, money is short however I do not skimp on this when it means the diff between what I feel is the best choice for my kitties:) however the est. Vet #3 gave you is not out of range IMO...except for the ringer sol cost, but thats minimal...

I will try to address all your questions quickly as your decision has to be today and I too have plans for a bit later.

-yes xrays can only be done under anesthesia...and please insist on these being done!! its mainly only with an xray that FORL's can be dx'd..b/c as with my boy they were all beneath the gums and not showing on the surface. thus is why he needed a dental surgeon, and the absolute need to extract the roots and not just the tooth....he had 4 extractions and under gum work done...cost $1800. yikes. but it was done well.

-I agree the cost of the ringer sol. is very high, I would question this, on my bill it was $12

-I am assuming your kitty has extensive gingivitis and this was the case with my boy too...and the forls that were found while xrays were done during an annual cleaning...what my Vet never found and the specialist did is the PERIDONTAL DISEASE that he also had...and thus the need for extensive work on the roots for his front teeth, still need a follow up to see if this worked along with the oral care I do at home(now) if not than he'll need more extractions.

-so be prepared for this as well, b/c its not until a Vet does xrays that the total extent of kitties issues will be seen..if there VISIBLE evidence that he needs that many teeth extracted than there could be many more that are not visible. I would caution that you speak with the Vet and he not do more than whats necessary for kitties comfort at the moment....its a very extensive surgery if forls are present...
but thats up to you and if the Vet feels kitty is healthy and strong enough to have many extractions done at one surgery...

-please please tell the Vet you don't want Metacam (a common anti-inflamatory) used...
NOR any convienia injections....(antibiotic injection that has proven very dangerous) use only ORAL antibiotics and the best one for kitties undergoing dental surgery is ANTIROBE AQUADROPS..(clindamycin hydrochloride)

http://www.drugs.com/vet/antirobe-aquadrops-liquid.html

re: pain med buprenorphine hcl...an excellent choice esp for safety and nerve pain following extractions...good

NO I am not a Vet, only a pet parent like yourself, however have lots of experience the last year with dentals in kitties and spent alot of time researching this recently....so all the suggestions are IMO and always follow what you believe to be right at the time..:)
the research I have done is with holistic cat people, who have dealt exclusively with the care and treatment of cats esp. where medication dangers are concerned.

-
54 Responses
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7052683 tn?1392938795
You Bet!!!!

Can't agree with you more, Opus!
Helpful - 0
874521 tn?1424116797
thank you CML for posting all that valuable advice, I was hoping you'd pop in..I wasn't sure but I thought Meezy had the total extraction....poor baby
Like Pip mentioned we all know what an abscessed tooth feels like :(

I am glad you are seeking out a dental surgeon,  especially when a kitty needs extensive work there is NO comparison in the knowledge and treatments that these specialist have in comparison to a regular Vet

expensive yes for sure, but with the care credit CML mentioned it is doable.

good luck to Sam and please post after the consult....♥
Helpful - 0
7052683 tn?1392938795
Hi Mak,

YES!!!!  I know exactly what you are going through. Sam has what is called Stomatitis, an immune mediated disease. This is so VERY painful.

I got my cat Meezy from the Rescue where I worked, because she had this disease and was in so much pain they would have put her to sleep or someone who did not understand this terrible condition would have unknowingly allowed her to suffer everyday --not eating, grooming ,playing...UGH!

Even with all the pain she was in you could tell she had so much love to give. I had ALL her teeth removed when I adopted her and she was 5 then. The difference is REMARKABLE!!!  She IS just as loving as I thought she would be and now is so devoted to me we are inseparable.

Having a total removal of ALL teeth and the roots is a must in order to cure them of this pain. I had this surgery done by a Specualist--A Dental Veterenarian who worked with all the Big Cats at the Arizona ZOO.

It cost a pretty penny $3,500.....but that included total removal , 4 day stay at the clinic.feeding tube, fluid and med IV, before and after x-rays , and all the bells and whistles that go along with surgery including a complete Blood work-up. Unfortunately she also had to have her sinuses flushed due to the mouth issue infecting her sinuses. She went in a total mess , I visited her twice daily , and she has been the best little cat I have ever had.

You will not be sorry having the full removal--there is no other choice accept tones of steroids for pain. Find a Dental Specialist who takes CareCredit--it is a credit card backed by GE that allowes you to pay off your bill with no interest if you pay the minimal amount you agree to each month. So my bill was $3,500 I took out a 24 month payment plan and it worked out to about $148 a month. I also just paid it off before the 24 months were up.

If you have Pet insurance that may cover the surgery with your 20% c0-pay for specialized services----each insurance plan is different.

Lastly I will advise you if you do not have Pet Insurance after this procedure, I would get it. Cats that have Stomatitis are considere3d special needs cats. They will usually have the Herpes virus which will cause them to have many Respiratory symptoms. No biggy though, they will just get colds and you have to watch them for asthma. I have insurance and it has been a blessing.

There is also a Forum on Yahoo called FELINE STOMATITIS which helped me really understand this condition and you can speak with people who all have cats like yours and mine.

Good Luck to you and Sam....I know he will feel 100% better once this surgery is done. Just make sure you get the Before and After x-rays to be sure they have gotten ALL the roots. If even 1 root is left it will continue to cause pain.

PLEASE let us know how it goes.
Sincerely,
CML
Helpful - 0
506791 tn?1439842983
I have had kitties over the years who have either lost teeth or had them extracted.  All of them did just fine with fewer teeth.

Knowing the pain I had with an abscessed tooth, I will hope that this total extraction will relieve your little guy's pain and give him the good years he deserves.
Helpful - 0
Avatar universal
Hi and thx so much for your reply.

Like you, I would not consider NOT doing what is necessary to get this baby pain-free. As I said, he is just 3.5 yrs old, hopefully, with many more years to live.

I appreciate your feedback on post-op ability to eat. It is helpful.

I have to travel a few hours out of town to see a Vet Dentist for a consult, but will post here again as things progress. Say a prayer for Sam and all his brothers and sisters. I pray no one else has to endure this painful condition.
MA
Helpful - 0
874521 tn?1424116797
poor kitty.....can only imagine the pain he is in:(

I can't speak for total extraction experience....but I do deal with a Veterinary Dental surgeon b/c my Sami..has forls...and has had many extracted, perhaps more to come as he ages.

I have been told cats can do very well without their teeth and on a soft food diet, it would sure be much better alternative than leaving him suffer and waste away due to not eating nor enjoying life..

good luck, let us know your decision and how he fares please....we value all this info and care very much abt each these kitties in distress here
Helpful - 0
Avatar universal
Can anyone speak about the experience of having a kitty undergo total mouth tooth extractions?

My kitty Sam is a very young (3.5 yrs) guy who has a  severe inflammatory allergy to the bacteria in his mouth. Because eating has become so painful for him, he has lost weight despite our many efforts to medicate his condition and offer him food that is more palatable. This has not been adequate, and his mouth remains painful, and his body remains frail. He no longer grooms himself or plays, and his apparent discomfort is heartbreaking.

My Vet has spoken with a Veterinary dentist, who both recommend total extraction. I do not disagree, but would like to hear the experiences of cat parents who have gone this route with their kitties.

Thanks for your thoughtful replies,
MA
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874521 tn?1424116797
Hiya, nice to see your post and hear Gabsters continues to be doing well....
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4520139 tn?1355849169
Hi Wilma,

Thanks for your post. This thread is a little old, actually. I had done all the recommended extractions (in two separate surgeries, because the "borderline" teeth at the time of first surgery became infected and needed a second surgery to remove). Kitty is doing fine. He only has one of the long teeth remaining (lower). Most of his teeth are gone now, and he seems to have no trouble eating. I feed him BLUE - in addition to the quality of the food, it has very small sized food pieces that seems to make it easier for him to swallow without biting first. One issue that has come up since my last post is that it's difficult for him to keep his fur groomed. He used to use his teeth as a sort of "comb" and now he gets more mats than before. I brush him often, but he needs to get a haircut a couple times a year to keep his fur from being knotted. I'm sure you are familiar with this, since you have Maine Coons as well - they have a coat of fine fur close to the skin that is prone to tangles.
Hope this helps.

Gabsters
Helpful - 0
Avatar universal
I have young Main Coons  - 3 cats about 1 year old.  Two are ok but 3rd one had severe gam infection, as you did, I looked for several vet opinion, but unfortunately all diagnosis come the same - I will have to extract almost all cat teeth.  We check with specialists and veterinary school by major A&M University and unfortunately extraction is necessary.   So far my Main Coon cat had deep teeth cleaning and gum trimming (infected gum grows over the teeth) all under anesthesia.  So far it was better for couple of months, but gums are again very red.   My final option will be extract almost all teeth.  I want to enter him in the FICA show in November in Houston and after that I probably extract the  teeth.  It is very painful for the cat to eat with gum infection or any other teeth problem - teeth extract will not bother cat at all.  It sound very drastic and on the beginning I can't bear that I have to do it, however,  I will help my cat.  Cats after extraction have a normal life. My outdoor cat already had most of back teeth removal and it healed in the couple of days.  We had to give him some pain medication and antibiotic for couple of days and later vet give him antibiotic shot for two weeks. Now he eats dry food and everything else without a pain. He is healthy and happy now.  Unfortunately I can't give you a price, but it is worse it - it's a member of your family.  Other issue - you probably do not see that your cat is in pain - cats hide it very well....

Wilma     .
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Avatar universal
Dear cat lover......The Univercity of Penn animals at 3600 spruce in Philadelphia...Is the finest animal vet to go to...They are intense and treat an animal as if it were a person....I highly recommend that you go their with your pet......Trust me they are the finest...They save animals that are on their death beds..and the dentists are the best.....
Helpful - 0
Avatar universal
Dear cat lover......The Univercity of Penn animals at 3600 spruce in Philadelphia...Is the finest animal vet to go to...They are intense and treat an animal as if it were a person....I highly recommend that you go their with your pet......Trust me they are the finest...They save animals that are on their death beds..and the dentists are the best.....
Helpful - 0
874521 tn?1424116797
thank you so much for the update...I am so glad its all over with and you had a good experience with the new Vet (sure can make a difference)....I hope she will now bounce back quickly and be pain FREE....nothing worse than a sore mouth as we ourselves know:(
I'm glad you will be using the EFAC....I think this will make a huge difference for her.
glad you found us too....your welcome to post any old time, doesn't have to be a problem going on..we love members with just plain old kitty tales too...
be sure to tell us her name next time you drop in...:)
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Avatar universal
All the information was so helpful. The new vet's office was so much more conducive to caring information. My cat didn't freak at all. I felt informed. She had 4 teeth pulled and has bounced back so well. The vet thought she had probably been in pain as the pulling was necessary. Glad to be done with it. Will be using the EFAC. The vet I changed to charged $300 less than the one I left. So glad I found this website. Thanks all!
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874521 tn?1424116797
I know its almost impossible to brush some kitties teeth b/c of their character &/or background, especially when their mouths are so tender anyway.  My Vet told me one of his patients was like this and the owner just squirted the capsule into the cats mouth, or he mentioned even just putting it on the paw and naturally the cat will lick it off.....:)

good luck with this......give it a trial for a month or two, if there isn't a drastic improvement than unfortunately the kindest thing you can do for your kitty is to have the teeth removed, especially if there are FORLs present. be sure you get a dental surgeon when looking at extensive extractions....:(

keep us posted♥
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Avatar universal
Yes!  I'm going to try the EFAC capsules. The pamphlets were at the new vet's office, so that was a good sign. Thank you for that.
Helpful - 0
Avatar universal
ugh ... there's no way my 13 pounder is letting me brush her teeth. She was a rescue cat and is a very sensitive, respectful soul but has very strong opinions about how, where, and how much she's touched!  After 3 years + of trust building I still get nipped... tho it's gotten gentler over time. I'm considering discussing getting all the possible teeth pulled as I don't want to keep stressing her heart and my pocketbook. As a sr citizen it's too expensive to do this every year or so, especially as she gets older and I do too!
Meanwhile I decided to go to a different well recommended vet so at least it will be a more personable staff. and maybe she'll be less freaked out. She's been under the bed since we got home yesterday. Now I'm worried they poked and prodded and aggravated her poor gums. I'll take her to the new vet tomorrow. Thanks for your input, really!!
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874521 tn?1424116797
hi and welcome, I am sorry your kitty is facing so many more issues with his teeth, that care gets terribly expensive. My Sami has also faced extensive dental work.
I would like to tell you of something I've been using for his oral care. In Oct. 2012 he had several more extractions done this time by a Veterinary Oral Surgeon, he found lots of peridontal disease....also did some repair work under Sami's gums and added a gel antibiotic to hopefully permanently fill in the huge pockets he found. he also of course gave his teeth a good cleaning.

He sent us home with some oral care gel to apply following each daily brushing...do you brush your kitty's teeth?
he also prescribed a fairly new product, an esterfied fatty acid called EFAC I will include the link for this product. I have been cleaning Sami's teeth daily since that appointment and opening one of the EFAC capsules and rubbing the gel like substance on his gums, hates the taste but he doesn't fight me...:)

anyway, we had his 6 month check up 2 weeks ago and the Oral Surgeon just could NOT believe the difference this has made to his gums...they are in beautiful condition, nice and pink and healthy..he also probed under the gum line with one of those steel picks and Sami didn't even flinch, he was amazed at the complete turn around...won't say cure, but darn near. We now only need to apply it every second day:))

Please ask your Vet to order you some of this. After my local Vet learned abt it he has been prescribing it for all the kitty's with dental issues and he said he's seen remarkable transformations too...

http://hopesciencevet.com/cat-perio-home/
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Avatar universal
It's now May 1 2013 and I am so glad that you posted your whole experience and got the feedback from so many others. Invaluable to me as I was stressing about the news that my 5 yr old Maine Coon would need a few more extractions. I spent $1000 on extractions a few years ago plus a few hundred for a pre-op heart ultrasound thru a UC Davis clinic here in San Diego as Maine Coons can have some heart issues. Now we're back and in the $1,100 range. It has really helped me compare the various inputs re: prices, meds, xrays as I could see on my detailed printout that prices were within range and that the protocols (full xray, periodontal cleaning, oral flap, meds) were in line with the recommendations. Even if there's some padding, I'm willing to deal with the cost now just knowing that the place is spotless and people are very caring. I realize from the input that peace of mind is worth the extra few buck when it comes to feeling my kitty best friend is safest and best cared for.  Thanks to all!
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874521 tn?1424116797
well we do have to trust in the knowledge of these Vets at times too, its just good to be up on everything ourselves at the same time:)

I agree Gabster you're slowly switching that doctorate over to Veterinary Medicine......sure could use ya!!!!

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4520139 tn?1355849169
The vet said the temp could be in part due to the stress of being there, but there was at least a minor fever either way. He prescribed:
1. Buprenex for pain
2. Metacam for pain/inflammation (I addressed my concerns about this and he responded by explaining that the low dosage he is using makes it safer than what the studies have shown. He seemed to know exactly which literature mentioned the risks and was confident he had accounted for that)
3. Clavamox for antibiotic

I'm becoming a veterinarian one day at a time... administering meds, checking gums, etc. :) Maybe I should give up on the doctorate and switch to a veterinary medicine program.

Thanks for the good vibes! I am crossing my fingers that this is just side effects of an infection and will be solved with the Clavamox after a couple of weeks.
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874521 tn?1424116797
I am so glad you got Prof back to the Vet....with a temp of 103 he definitely has a serious infection going on.
I hope the Vet rx'd the same buprenex for pain and antirobe for the antibiotic?
I am certainly hoping and praying that this works out well for the poor little guy....no wonder he wasn't playing and acting normal...sending some good healing {{{{vibes}}}} to our boy♥
Helpful - 0
4520139 tn?1355849169
Update:
I took Professor back to the vet today.
-Some inflammation in gums where one canine that was removed. Periodontal gel still in place.
-103 degree fever
-his breathing has been shallow and rapid, not in the extreme but noticeable enough that I caught it.
-he has been quiet and sleeping a lot since I stopped giving pain meds. (The last 2 days on pain meds he seemed to have had a lot more energy and was playing - the kind of behavior he used to have in the past but had been missing these last couple of months)

Next steps:
-started him on a pain management regimen to test whether his behavior changes if his pain is removed.
-started antibiotics (expecting a 2-4 week course) to treat the deep bone infection in his teeth.
-will call the vet Friday to discuss progress
-follow-up visit in 2 weeks

Helpful - 0
152660 tn?1291755571
How is your little one today??
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