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Jennifer Thompson-Fleet
February 8th 07, 08:24 PM
Hello all,

I haven't posted here in quite a few years. I have two cats, Sylvester
and Bonnie, ages 17 and 18 - the same two I used to post here about.
I've had them since they were kittens.

My 17 year old, a very large DSH male, is my concern at the moment.

His teeth are VERY dirty - his back molars are covered in tartar and his
breath his horrible. However, he eats his dry food just fine and is of
good weight so I don't think they are bothering him - yet.

I want to get his teeth cleaned, but he has some health issues that make
it very risky. My previous vet (I recently moved) was always of the
opinion that health issues made it too risky to warrant cleaning his
teeth - but the teeth are much worse now. His health issues are:

1) He has heart disease. Hypertrophic cardiomyopathy. Over 10 years
ago, he was given 1-3 years to live. He is still very much alive,
active and happy. He has a moderate murmur. I had him ultrasounded
yearly for several years and his heart disease had stopped progressing
and he was doing fine. We took him off his heart meds because they were
causing daily vomiting (see below under IBD)and he continued to do fine
without them. But his heart is still enlarged, and he does have a
murmur. This concerns me in regards to putting him under for the teeth
cleaning.

2) He has IBD. Inflammatory Bowel Disease. He has had it since he was
about 2 years old. If he eats anything besides his special food, he
gets very bad, bloody diarreah and vomits. As long as he stays on the
one food that has worked all this time, he is fine and has normal
digestion (my carpets are very relieved). Oral medication also triggers
his IBD - and for a dental, they will want him on antibiotics. I'm
afraid this will trigger the IBD and we will begin that horrible process
all over again. I guess I can ask about an injectable antibiotic..?

3) He has diabetes and gets insulin twice a day for it (I swear I'm not
a troll - this cat actually has all three of these diseases!). I'm not
sure though that this is of concern when it comes to anesthesia or teeth
cleaning, other than if his IBD flares up and he starts vomiting up his
food, it will make regulating his blood sugar a nightmare.


So....here is this beautiful 17 year old cat that should be dead by now.
Instead, all of his conditions are well controlled, he is sleek,
shiny, fat, active and an affectionate goofball. He looks and acts in
much better shape than Bonnie, who is a year older and has no real
issues except for low thyroid (she takes meds for that). He runs around
the house at night, still chases things, is a huge pest for attention,
etc. Basically a happy cat.

I'm am SO afraid to rock the boat, so to speak, by putting him through
the trauma of a teeth cleaning. His heart could fail, his IBD could
flare up, etc. I'm really in limbo over whether it's worth it. But
then I look at his teeth....and..YUCK. I'm worried that he might
develop some infection and at his age, it could be serious.

My vet is pretty torn also....he said he'd do the cleaning but I have to
understand that he might not do well, could even die if his heart fails.

Any advice for someone in my shoes?

Thx,
Jennifer
Sylvester
and
Bonnie

cindys
February 8th 07, 08:48 PM
"Jennifer Thompson-Fleet" > wrote in message
...
snip for brevity
>
>
> So....here is this beautiful 17 year old cat that should be dead by now.
> Instead, all of his conditions are well controlled, he is sleek, shiny,
> fat, active and an affectionate goofball. He looks and acts in much
> better shape than Bonnie, who is a year older and has no real issues
> except for low thyroid (she takes meds for that). He runs around the
> house at night, still chases things, is a huge pest for attention, etc.
> Basically a happy cat.
>
> I'm am SO afraid to rock the boat, so to speak, by putting him through the
> trauma of a teeth cleaning. His heart could fail, his IBD could flare up,
> etc. I'm really in limbo over whether it's worth it. But then I look at
> his teeth....and..YUCK. I'm worried that he might develop some infection
> and at his age, it could be serious.
>
> My vet is pretty torn also....he said he'd do the cleaning but I have to
> understand that he might not do well, could even die if his heart fails.
>
> Any advice for someone in my shoes?
-----------
Since you asked...look at the thread about Madeleine. She was a presumably
healthy, happy, bouncy 14-year-old cat. There was ostensibly no medical
condition that contraindicated [went against] doing the dental in her case
(unlike your cat's case), at least not that her owner mentioned. Madeleine
had a bad reaction to the anesthesia or some other issue (the doctor wasn't
sure), but after the dental, she was barely eating, stopped using her
litterbox, and was unable to stand up. Despite pain meds and forced feeding,
and the veterinarian's best efforts, he was unable to save her, and she died
in her sleep at her owner's side a few days later. I vote no dental for
Sylvester. While it is true that the bacteria teeming in his mouth could put
him at risk for making his heart condition worse or bacteria invading his
bloodstream and affecting other organs, you could consider
on-again-off-again antibiotics (i.e. ask your vet about giving him
antibiotics for one week out of each month to keep down the bacterial
count). This is what I did for the last few months of my cat's life (she was
dying from CRF, her teeth were a mess, and she was obviously not a candidate
for a dental). If you go ahead with the dental and your cat dies, you will
never forgive yourself. Good luck.
Best regards,
---Cindy S.

Jennifer Thompson-Fleet
February 8th 07, 09:16 PM
cindys wrote:

(snip)

> I vote no dental for
> Sylvester. While it is true that the bacteria teeming in his mouth could put
> him at risk for making his heart condition worse or bacteria invading his
> bloodstream and affecting other organs, you could consider
> on-again-off-again antibiotics (i.e. ask your vet about giving him
> antibiotics for one week out of each month to keep down the bacterial
> count). This is what I did for the last few months of my cat's life (she was
> dying from CRF, her teeth were a mess, and she was obviously not a candidate
> for a dental). If you go ahead with the dental and your cat dies, you will
> never forgive yourself. Good luck.
> Best regards,
> ---Cindy S.
>
>

Thanks Cindy. I've been leaning that way...in fact for the last few
years....I've kept putting it off, perhaps forever...but the fact that
his teeth are so bad keeps bugging me...but you're right - I'd never
forgive myself if he died on the table, or shortly thereafter, when he's
been doing so wonderfully for all this time, depsite his various
maladies. My old vet used to call him the miracle cat. My new vet
can't even believe he's 17, let alone a 17 year old with three major
diseases.

I'll ask about the antibiotics - maybe I can inject them on some sort of
schedule...oral won't work - his digestive tract will go crazy.

Thanks again,
Jennifer

Jennifer Thompson-Fleet
February 8th 07, 09:17 PM
I also wanted to add how sorry I am to read about Madeline. :(

You just never know, even with so-called routine stuff. You try to do
what's best and this kind of thing happens. It's just heartbreaking.

-Jennifer

Rene S.
February 8th 07, 09:45 PM
> My vet is pretty torn also....he said he'd do the cleaning but I have to
> understand that he might not do well, could even die if his heart fails.
>
> Any advice for someone in my shoes?
>

Wow, what a tough decision. Is it possible to give him a mild sedative
and do a quick cleaning vs. putting him out? (I don't know if this is
done, but it might be worth asking about in your case.) I'd opt for
no, and see if you can brush his teeth once per day instead. It won't
remove plaque, but it will help with his breath a little.

Lynne
February 8th 07, 10:04 PM
on Thu, 08 Feb 2007 21:45:36 GMT, "Rene S." >
wrote:

> Wow, what a tough decision. Is it possible to give him a mild sedative
> and do a quick cleaning vs. putting him out? (I don't know if this is
> done, but it might be worth asking about in your case.) I'd opt for
> no, and see if you can brush his teeth once per day instead. It won't
> remove plaque, but it will help with his breath a little.

I don't know... I think brushing at this point would be risky. Dislodging
some of that bacteria incorrectly could send it directly to his heart. He
already has a murmur, so that puts him at an even greater risk for
bacterial endocarditis. I wouldn't risk ANY dental care at this point.
Not under anesthesia, and not brushing at home.

--
Lynne

cindys
February 8th 07, 10:47 PM
"Lynne" > wrote in message
m...
> on Thu, 08 Feb 2007 21:45:36 GMT, "Rene S." >
> wrote:
>
>> Wow, what a tough decision. Is it possible to give him a mild sedative
>> and do a quick cleaning vs. putting him out? (I don't know if this is
>> done, but it might be worth asking about in your case.) I'd opt for
>> no, and see if you can brush his teeth once per day instead. It won't
>> remove plaque, but it will help with his breath a little.
>
> I don't know... I think brushing at this point would be risky. Dislodging
> some of that bacteria incorrectly could send it directly to his heart. He
> already has a murmur, so that puts him at an even greater risk for
> bacterial endocarditis. I wouldn't risk ANY dental care at this point.
> Not under anesthesia, and not brushing at home.
--------
Lynne, what do you think about my idea about the antibiotics?
Best regards,
---Cindy S.

Lynne
February 8th 07, 10:57 PM
on Thu, 08 Feb 2007 22:47:56 GMT, "cindys" >
wrote:

> Lynne, what do you think about my idea about the antibiotics?

I meant to say that I think it's a very good idea to give him antibiotics,
assuming the vet agrees. And via injection, given the existing IBS. What
I don't know, though, is if injected antibiotics can still cause gastro
problems. This will be key to find out.

When humans are at risk of bacterial endocarditis (which is a major risk
with the dental issues combined with existing heart murmurs), long term
prophylactic antibiotics are frequently prescribed.

--
Lynne

cindys
February 8th 07, 11:29 PM
"Lynne" > wrote in message
m...
> on Thu, 08 Feb 2007 22:47:56 GMT, "cindys" >
> wrote:
>
>> Lynne, what do you think about my idea about the antibiotics?
>
> I meant to say that I think it's a very good idea to give him antibiotics,
> assuming the vet agrees. And via injection, given the existing IBS. What
> I don't know, though, is if injected antibiotics can still cause gastro
> problems. This will be key to find out.

In general, they don't AFAIK.
>
> When humans are at risk of bacterial endocarditis (which is a major risk
> with the dental issues combined with existing heart murmurs), long term
> prophylactic antibiotics are frequently prescribed.

My father, of blessed memory, developed emphysema after years of smoking. In
his final years, he was landing in the hospital every winter with pneumonia.
Finally, the doctor prescribed continuous prophylactic antibiotics for the
winter months, and my dad stopped developing pneumonias. Unfortunately, he
then started having frequent visits to the hospital emergency room because
of severe stomach cramps, which interestingly never occurred in the summer.
It took two years for everyone to figure out that the antibiotics were
causing the cramps. The doctor switched his antibiotic regimen to a
one-week-on, one-week-off regimen (rather than continuous). That seemed to
work, as he no longer suffered with stomach cramps and also avoided
pneumonias. (Of course, what applied to my father would not necessarily
apply to Sylvester. I understand that Sylvester could not handle oral
antibiotics at all.)

I hope things work out for Sylvester and Jennifer reports back. I noticed
that as soon as we started the week of Molly's antibiotics (my baby, now
deceased from CRF), her breath would improve considerably within 24 hours.
Then, after the week was over, the bad breath would return gradually.
Best regards,
---Cindy S.

>
> --
> Lynne

Buddy's Mom
February 9th 07, 01:34 AM
Funny - having cats for the past 50 some years, and having them live
to be 20 - they all had their teeth cleaned every two to three years -
until they were 16 and then the vet said no.

On Feb 8, 6:29�pm, "cindys" > wrote:
> "Lynne" > wrote in message
>
> m...
>
> > on Thu, 08 Feb 2007 22:47:56 GMT, "cindys" >
> > wrote:
>
> >> Lynne, what do you think about my idea about the antibiotics?
>
> > I meant to say that I think it's a very good idea to give him antibiotics,
> > assuming the vet agrees. *And via injection, given the existing IBS. *What
> > I don't know, though, is if injected antibiotics can still cause gastro
> > problems. *This will be key to find out.
>
> In general, they don't AFAIK.
>
>
>
> > When humans are at risk of bacterial endocarditis (which is a major risk
> > with the dental issues combined with existing heart murmurs), long term
> > prophylactic antibiotics are frequently prescribed.
>
> My father, of blessed memory, developed emphysema after years of smoking. In
> his final years, he was landing in the hospital every winter with pneumonia.
> Finally, the doctor prescribed continuous prophylactic antibiotics for the
> winter months, and my dad stopped developing pneumonias. Unfortunately, he
> then started having frequent visits to the hospital emergency room because
> of severe stomach cramps, which interestingly never occurred in the summer.
> It took two years for everyone to figure out that the antibiotics were
> causing the cramps. The doctor switched his antibiotic regimen to a
> one-week-on, one-week-off regimen (rather than continuous). That seemed to
> work, as he no longer suffered with stomach cramps and also avoided
> pneumonias. (Of course, what applied to my father would not necessarily
> apply to Sylvester. I understand that Sylvester could not handle oral
> antibiotics at all.)
>
> I hope things work out for Sylvester and Jennifer reports back. I noticed
> that as soon as we started the week of Molly's antibiotics (my baby, now
> deceased from CRF), her breath would improve considerably within 24 hours.
> Then, after the week was over, the bad breath would return gradually.
> Best regards,
> ---Cindy S.
>
>
>
>
>
> > --
> > Lynne- Hide quoted text -
>
> - Show quoted text -

Rene S.
February 9th 07, 02:58 PM
On Feb 8, 4:04 pm, Lynne > wrote:
> on Thu, 08 Feb 2007 21:45:36 GMT, "Rene S." >
> wrote:
>
> > Wow, what a tough decision. Is it possible to give him a mild sedative
> > and do a quick cleaning vs. putting him out? (I don't know if this is
> > done, but it might be worth asking about in your case.) I'd opt for
> > no, and see if you can brush his teeth once per day instead. It won't
> > remove plaque, but it will help with his breath a little.
>
> I don't know... I think brushing at this point would be risky. Dislodging
> some of that bacteria incorrectly could send it directly to his heart. He
> already has a murmur, so that puts him at an even greater risk for
> bacterial endocarditis. I wouldn't risk ANY dental care at this point.
> Not under anesthesia, and not brushing at home.
>
> --
> Lynne

Lynne, I didn't think about this. You have a valid point.

Rene