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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.
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.
I was willing to do the full blood panel (when I go to my human dr, I generally like them to be comprehensive, so I take the same approach with kitty), but I got the basic panel yesterday according to vet #3's recommendation.
I am surprised about the costs of your kitty's dental cleanings. The dental cleaning itself (if my calculations are correct) at vet #3 is $250-300. The extractions are priced out by tooth AND by additional anesthesia costs.
Vet #2 quoted $200 for the cleaning, including costs of anesthesia and additional for the extractions. Why would the price be so different?
Vet #1 never discussed the dental issues with me, but I think you are referring to #2 instead, who I saw last week in FL where I live. He did give me a rough breakdown that it would be under $100 or so for the extractions (he noted 1 definite extraction and 1 possible extraction).
When you say "IMHO I would probably go with #3 if only because you may be able to go longer without kitty having to have another cleaning." ... do you mean kitty wouldn't need a cleaning for awhile because he'll have fewer teeth? Or did you mean that #3 will be more thorough in the cleaning than #2?
I am surprised about the costs of your kitty's dental cleanings. The dental cleaning itself (if my calculations are correct) at vet #3 is $250-300. The extractions are priced out by tooth AND by additional anesthesia costs.
Vet #2 quoted $200 for the cleaning, including costs of anesthesia and additional for the extractions. Why would the price be so different?
Vet #1 never discussed the dental issues with me, but I think you are referring to #2 instead, who I saw last week in FL where I live. He did give me a rough breakdown that it would be under $100 or so for the extractions (he noted 1 definite extraction and 1 possible extraction).
When you say "IMHO I would probably go with #3 if only because you may be able to go longer without kitty having to have another cleaning." ... do you mean kitty wouldn't need a cleaning for awhile because he'll have fewer teeth? Or did you mean that #3 will be more thorough in the cleaning than #2?
By the way, the vet tech told me that the intravenous anesthesia would be Propofol.
My kitties have both had quite a few teeth pulled. One is 14 and his teeth are going bad and the other was sick when he was little and I think the meds I had to give him may have weakened his teeth. Each time they have had some of the bigger molars removed which are the more expensive ones since they are harder to get out and they usually use a stitch or two to close the gums.
I just remembered that they did xrays which added to the cost, so it would have been less without them.
With the fewer cleanings I meant that the vet would be more thorough and possibly not leave anything that should have been taken out minimizing the risk and uncomfortableness for kitty.
I just remembered that they did xrays which added to the cost, so it would have been less without them.
With the fewer cleanings I meant that the vet would be more thorough and possibly not leave anything that should have been taken out minimizing the risk and uncomfortableness for kitty.
Thanks once again, Opus.
A couple of things:
-the med supplies are several items in the bill (I gave the fluids as an example, but when you add up all the markups I am guessing the profit from supplies alone will be over $100). I realize human doctors do this, but maybe I don't mind it so much then because my insurance covers that but my research on kitty insurance showed it was not nearly as useful. Maybe I just have to accept that they're going to make money off of IVs, fluids, sutures, fluid drip set, anesthesia, etc.
($12.54 for IV catheter, $32.50 for "Catheter Placement, I.V.", $12 for fluid drip set, $12 for "T-Port Connection, I.V., $22 for Lactated Ringers Solution 1L). Also it seems they are charging per tooth for x-rays, is that normal?
-unfortunately (now that I have read your post recommending against this) they recommended an antibiotic injection yesterday, which my kitty DID receive. They said it would cover him for 2 weeks and with the dental discomfort this would be preferable to jamming something down his throat (my words, not theirs).
I am hesitating a lot right now because all the extra charges are making me question whether I can trust the doctor .... is that illogical of me?
I haven't called them yet for the blood test results, which they told me should be available at 10am (it's now 2pm). I was hoping to know whether to take him in now, or just wait to get home (and feed him soft food to keep him comfortable in the meantime). They haven't reached out to me either ...
A couple of things:
-the med supplies are several items in the bill (I gave the fluids as an example, but when you add up all the markups I am guessing the profit from supplies alone will be over $100). I realize human doctors do this, but maybe I don't mind it so much then because my insurance covers that but my research on kitty insurance showed it was not nearly as useful. Maybe I just have to accept that they're going to make money off of IVs, fluids, sutures, fluid drip set, anesthesia, etc.
($12.54 for IV catheter, $32.50 for "Catheter Placement, I.V.", $12 for fluid drip set, $12 for "T-Port Connection, I.V., $22 for Lactated Ringers Solution 1L). Also it seems they are charging per tooth for x-rays, is that normal?
-unfortunately (now that I have read your post recommending against this) they recommended an antibiotic injection yesterday, which my kitty DID receive. They said it would cover him for 2 weeks and with the dental discomfort this would be preferable to jamming something down his throat (my words, not theirs).
I am hesitating a lot right now because all the extra charges are making me question whether I can trust the doctor .... is that illogical of me?
I haven't called them yet for the blood test results, which they told me should be available at 10am (it's now 2pm). I was hoping to know whether to take him in now, or just wait to get home (and feed him soft food to keep him comfortable in the meantime). They haven't reached out to me either ...
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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.
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