Older cat and dental treatment

[Grandmaw]

Thomas is 16 and is on Vidalta for hyperthyroidism.
His teeth are not good but the vet has been concentrating on getting the dosage correct for his thyroid problem.
Thomas was at the vet this week for blood tests to check his levels and the vet suggested that now is the time to deal with his dental problems.
This would involve a ga and, as well as cleaning the teeth, the vet has said that it is possible that some may need to be removed.
I am concerned about Thomas having a ga - as well as his thyroid problem he has a raised heart beat and a heart murmur.
Please tell me about your experiences of an older cat and a ga.

Seniorboy had a big GA dental at 16. Previous vets had commented on his teeth needing treatment but had demurred about doing the necessary work. His then new (and now current) vet commented that his mouth was now 'horrible' - and I saw the vet nurse reel back from his mouth when she opened it.

I discussed the risks with her (he had (and has) a little heart murmur and was, after all, 16) but the vet felt reasonably confident that she and her team could take him through. Despite the risks of a GA - which do exist - her crunch thought was that the teeth simply weren't going to improve with age and that bad teeth are potentially very dangerous to any cat, but particularly an old boy, so that we might as well go for it while she still felt reasonably fine about a GA. (I don't think she would do one, nor would I probably allow one, now that he's 19.)

It was a fairly lengthy procedure due to his horrible mouth with, if I recall, an extra team member there to monitor his vitals real carefully - he certainly went through a lot of fluids. (I was given a detailed post-op breakdown) and he wasn't allowed out of the practice until about 17.30 at night when they were happy he was fine. He hasn't looked back though. They removed most of his remaining teeth so I think he now has 5 left and while he occasionally has a touch of gingevitis still, that's now controlled by ABs. He's been pretty fine ever since.

I'm afraid that I don't know about the risks associated with hyperthyroidism but that aside, I think I would go for it if I were you - if the vet is happy to proceed with a GA. Bad teeth can have very serious effects on cats: not only the effect of poisons from rotting teeth/possible abscesses on the whole system but just the pain and discomfort of bad teeth (think how you would feel yourself) and the possible effects on future eating.

Yes, there's always a risk from GA so it's one to discuss with your vet thoroughly. (And with your bank manager re the second mortgage!)

PS - he'd just had a full blood screening undertaken as well. I think that the results from that underpinned the vet's view on the GA.

Personally I wouldn't put a cat of my own that age through a general anaesthetic. However I'm a vet nurse and have anesthetized many elderly animals without incident. Dental disease can affect animals systemically so you have to weigh up the pro's and con's. If his liver and kidneys are showing no sign of disease then that is a good indicator, however it would be unusual for a 16 year old cat.

I would disagree with Min. He as a heart murmur so actually dealing with his teeth is more important than it would be in a cat without a murmur. Animals and people with murmurs are more at risk of bacteria that have crossed the mucosa into the blood stream attaching to the heart valves and causing an endocarditis.
Nearly all cats we anaesthetise for dentals are teenagers and whilst there are risks with the anaesthetic with the correct precautions these can be minimised. The vast majority of the time these cats have significant improvement in quality of life.
I have anaesthetised my own cats as this age.

My own old cat had hyperthyroidism and had a GA at 16 years old to remove part of the thyroid. It was a higher-risk op as the thyroid disease was not stable (he had reacted badly to the tablets & so there was no alternative treatment for him) - the main risks were that his blood pressure and heart rate were high compared to normal so there was a greater risk when having an anaesthetic. However he came through it fine. The vet had no issues with his age & the GA as he was otherwise in good health for his age. We now have a dilemma over his dental issues as he has gingivitis, very bad breath and a lot of tartar. However he is nearly 18 now and although to look at him he is quite plump & sleek, he is less well overall. He is blind and on blood pressure treatment (high BP being the cause of his blindness) and although surgery has been mentioned I think we all accept it would be extremely high-risk and he might not come through the op as most if not all of his teeth would have to be removed, so a fairly long procedure. For the time being we are doing symptom relief (he had antibiotic & steroid injections a couple of weeks ago and is going back to the vet on Monday for a review) which has worked ok but is not a cure and the tooth problems will get worse again, we know that.

So if the vet thought an op would be a reasonable option for your cat I would go for it, as in a couple more years it may well be too late (as it is for me)

did they actually say they would GA? what would they use? propofol? any done at my last practice with health/ age issues would normally be monitored under ketamine only. Dental doesn't take that long so usually you are waiting around to bring them round after because you have to wait 40 mins between knocking them out on keta and bringing them round on anteseden again. talk to your vet about the various options and the risk of each of them

Mine had this at about 15 with heart murmur. she was fine and apparently some sort of blood poisoning maybe so the teeth (vast majority apart from fangs and side/front teeth) had to come out.

she did prefer pate food afterwards.

and she had GA I think too.

In case you were wondering, Seniorboy, with his 5 remaining teeth, has no problem eating at all. He's always been on wet food but he started noshing again on the evening of his GA and hardly seemed to notice he'd had most of them out. I think cats do pretty well indeed with only a few (or no) teeth.

thank you for your replies.
have just had a chat with the vet - blood test back and thyroid levels pretty normal so to continue with Vidalta. Some query re kidneys but vet will keep an eye on this.
As for teeth - still undecided as worried about ga. Have said I will think about it further. Thomas is eating fine, can eat crunchies and doesn't seem to be in any discomfort.

Of course you'll need to think about it - but bear in mind that all of that good eating behaviour can change in a moment and you already know that Thomas's teeth are 'not good'. Cat teeth aren't designed by nature to last for 16 years after all: how long will a cat live in the wild - 5 years, maybe?

I'm glad, despite the risks of GA (which my vet controlled well), that I gave Seniorboy a full dental at 16. I wouldn't want him to have a lengthy procedure now that he's 19 and at least I know that I've spared him major dental problems now that he's really a bit too old for an op.

Best of luck to him anyway - whatever decision you make.