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