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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.
Hi again, Opus!
Well Xmas is over and I'm back at home and ready to take Professor in for his surgery.
I found another vet (let's call them Vet #4!) and while they're considered one of the most expensive around here, they appear to be more reasonable than Vet #3... how about that!
Here are the drugs they discussed with me:
--Anesthesia cocktail: ketamine, domitor, duprenex
--Gas: isoflourane (spelling?)
--pain: Metacam and duprinex (I remember you said no to Metacam and I brought this up with them. They said they've had a good experience with it, except they wouldn't prescribe it in some cases based on the blood work... maybe they mentioned if there was a liver issue? I can't remember exactly what they said. I also asked if I could request another drug if I wanted. They said that's no problem.)
Any thoughts?
I will probably schedule for tomorrow morning, although the vet I prefer is not in until next Thursday.
Well Xmas is over and I'm back at home and ready to take Professor in for his surgery.
I found another vet (let's call them Vet #4!) and while they're considered one of the most expensive around here, they appear to be more reasonable than Vet #3... how about that!
Here are the drugs they discussed with me:
--Anesthesia cocktail: ketamine, domitor, duprenex
--Gas: isoflourane (spelling?)
--pain: Metacam and duprinex (I remember you said no to Metacam and I brought this up with them. They said they've had a good experience with it, except they wouldn't prescribe it in some cases based on the blood work... maybe they mentioned if there was a liver issue? I can't remember exactly what they said. I also asked if I could request another drug if I wanted. They said that's no problem.)
Any thoughts?
I will probably schedule for tomorrow morning, although the vet I prefer is not in until next Thursday.
lol Professor...like that:) you'll have to post photos....
we're all neurotic kitty mom's and dad's on this site so you'll fit right in:)
Merry Christmas and good trip home♥
we're all neurotic kitty mom's and dad's on this site so you'll fit right in:)
Merry Christmas and good trip home♥
Opus, yeah I feel guilty because I think my parents will be upset when I tell them I'm leaving on Xmas. But sometimes we need to accept that some people are not the right ones to support you through something they can't understand (they're not pet people, but they love Professor, my kitty).
I'm going to try to take him in on the 26th so he doesn't have to deal with the discomfort for too much longer.
And now, I'm going to do my own research on everything related to kitty health. I trusted his previous vet about the dental hygiene (the one who said brushing teeth = unnecessary and failed to recognize that a 'snaggle tooth' is a sign of a tooth dropping from the gum) and this is what happened. Time to be proactive! This forum has helped me to see that I need to do more.
I think despite the vet's advice, it's still my fault Professor has to get all these extractions. I could have still brushed his teeth even though they told me it wasn't necessary. Instead, I trusted them completely. Now my poor baby has to deal with my mistakes!
Hope you have a great Xmas too! Thanks for your support. :) I guess I'm a more neurotic kitty mom than I thought.
I'm going to try to take him in on the 26th so he doesn't have to deal with the discomfort for too much longer.
And now, I'm going to do my own research on everything related to kitty health. I trusted his previous vet about the dental hygiene (the one who said brushing teeth = unnecessary and failed to recognize that a 'snaggle tooth' is a sign of a tooth dropping from the gum) and this is what happened. Time to be proactive! This forum has helped me to see that I need to do more.
I think despite the vet's advice, it's still my fault Professor has to get all these extractions. I could have still brushed his teeth even though they told me it wasn't necessary. Instead, I trusted them completely. Now my poor baby has to deal with my mistakes!
Hope you have a great Xmas too! Thanks for your support. :) I guess I'm a more neurotic kitty mom than I thought.
awww I don't blame you....always best to do what you feel comfortable doing and when things feel right. besides I really do think its best that the convenia clear his system before the surgery!!!
And being back at home kitty will feel more comfortable during his recovery....also the Vet will be right there for follow ups.......you and kitty..btw whats his NAME?? you both have a great Christmas now no stressing for a few weeks :))
And being back at home kitty will feel more comfortable during his recovery....also the Vet will be right there for follow ups.......you and kitty..btw whats his NAME?? you both have a great Christmas now no stressing for a few weeks :))
Back to square one ... I decided to cancel the appointment and take care of this at home (it's too stressful on kitty and I to do this out of town). I'm going to go for another consultation with a new vet in FL - who will be Vet #4! - so you'll be seeing more of me on this forum.
From what I can tell after a brief call to the office, Vet #4 is all about client education (which I love) but is also quite expensive. I will speak with him personally tomorrow to get a clearer sense of his pricing. I just hope it won't be more than vet #3. Cross your fingers for me!
From what I can tell after a brief call to the office, Vet #4 is all about client education (which I love) but is also quite expensive. I will speak with him personally tomorrow to get a clearer sense of his pricing. I just hope it won't be more than vet #3. Cross your fingers for me!
Opus,
You were so right - I was up half the night... part of the reason was that my kitty was hungry and kept waking me up to ask for food.
I'm going to ask about the roots when I take him in this morning. I'll also find out what kind of gas anesthesia - not that I'll have time to research and make any requests, but I like how you and Ali are so informed and would like to keep similar records and post the information here to possibly help a future mommy with a kitty needing dental work.
I am so stressed out - it doesn't help at all that I'm not even at my own home (why did I plan a 2-week holiday visit???). Parents are great, but I'm so used to living alone. They just started an argument with me and I'm thinking about cancelling and heading home early to find a new cat dentist.
You were so right - I was up half the night... part of the reason was that my kitty was hungry and kept waking me up to ask for food.
I'm going to ask about the roots when I take him in this morning. I'll also find out what kind of gas anesthesia - not that I'll have time to research and make any requests, but I like how you and Ali are so informed and would like to keep similar records and post the information here to possibly help a future mommy with a kitty needing dental work.
I am so stressed out - it doesn't help at all that I'm not even at my own home (why did I plan a 2-week holiday visit???). Parents are great, but I'm so used to living alone. They just started an argument with me and I'm thinking about cancelling and heading home early to find a new cat dentist.
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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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