March 22nd, 2006, 08:49 PM
A couple of weeks ago I had my 14 year-old cat teeth cleaned, with is done under anesthesia. Although she is old, her bloodwork was all ok and her heart too so it seemed safe. Coming back from the anesthesia was a slow process... The vet gave me back my cat the same day and she ( the cat) was extremely upset (never seen her so upset!). At first she would fall when she walked and it took 48 hours before she ate anything. The vet told me since it's an old cat, it was a little longer than usual before she processed the anesthesia.
Now she doesn't seem to be the same anymore. It's a cat I adopted and she has always rather distant with everybody, but she was quite nice and cuddly with me. But now she's distant with me, she meows in a more aggressive way, she doesn't seem to want to be pet as much and she seems afraid of me...:sad: it's just not the same cat. It was difficult to get her to act normal with me, I think her previous family wasn't all that nice, and we had achieved a great relationship over the years... now it's like we went back quite a few years to when she wasn't all that tamed. Also she is now eating a little less, drinking a little more and peeing a lot more (I'm afraid she might start kidney failure). I have an appointment with the vet in 2 weeks. Until then does anybody now why she would have changed her behavior since having her teeth cleaned?
March 22nd, 2006, 09:07 PM
Your instincts are enough to say there's something wrong, your kitty isn't responding and while I'm no expert, I'd say she's due for another trip to the vet. I don't know the full story, and perhaps you're normally thrilled with your vet, but the response you got "she's an old cat" makes my skin crawl. Perhaps there's another vet in the practice you can be seen by, but somethings clearly wrong :/ Keep us posted and good luck
March 22nd, 2006, 09:14 PM
Please go see another vet. My vet would never give my older cats an anesthetic, unless it was an emergency. The elderly (animals and people) have a difficult time with anesthesia, it's not healthy.
March 22nd, 2006, 10:14 PM
I am with Happycat I would see another vet. She may just be pissed off at you and is letting you know it. But I think a vet visit may give you more answers
March 22nd, 2006, 11:30 PM
I would contact your vet asap or if you prefer, contact another one BUT you need your cat's vet records so any other vet can ascertain what was used. Telling a vet your cat had anesthesia is akin to visiting your own family doctor and telling her or him that you took a pain killer and you think it might be affecting you. As you may well know, there are a plethora of medications on the market to assist pain - ASA (aspirin), acetaminophen, narcotics, NSAIDs stronger than ASA, muscle relaxants like flexeril, cox2 inhibitors. It is essential that any new vet you consult know exactly what your kitty was given and what her health conditions are and what else she might have eaten or done prior to the surgery.
I lead a research team that studies neoplasm medications (medications to help cancer and also to find adequate pain relief methods for children in particular though they have also worked with my cat postop tho as many of us know, cats tolerate narcotics extremely well and b/c they are a different species from us, their system processes medications differently and some (ASA and acetaminophen for example) are highly toxic and can be lethal. I am wandering off - sorry!!
I was leading to point out that I have colleagues doing the same thing for seniors because like children, they need less of a medication than adults typically do, not because like children their systems are developing and they are smaller. (Children are not just tinier people - their body needs and reacts differently to medications - I saw a child today in the ER (my rant for the day) who saw a GP in another ER and this doctor administered a medication not indicated for children (when all he had to do was to consult with another doctor or to consult a PDR or another med ref but he was in a hurry and negligent imho and this child may well now have a serious hematological disorder because of his stupidity and laziness!! He also attended a med school I am close top loathing because I see so many grads from there make the most obvious mistakes - I am ready to campaign to shut it down but given our severe lack of family doctors (We do not really lack doctors in Canada - we have more per capita now than we did 25 years ago but we do have considerably fewer who practice family medicine and thus the entry point for people is harder to access meaning the entire system is tougher to access and some of our politicians and even my own colleagues' methods of ameliorating this is to do the wrong thing but I soooooo digress and I am sorry - but if your vet is part of a similar problem and I do not know since I do not know that system as well, then you need to know what to do to help your kitty. Knowing some background info is not a bad thing.
Please do not take this as an indictment of your vet - I have no idea what he did. Or why he chose to use full anesthesia on an elderly kitty when there are other options available but they are more difficult - not costlier in terms of the cost of the medication but they require time and patience and more people, like vet techs to help - even the kitty's meomy. A recent research study demonstrated that when family members remained with a cat during a medical procedure and postop, the cats did much much better (I forget who published this - my vet will know, she was very keen about it) - I dislike anecdotal info yet I seem to use it on this site more often than anywhere (in fact, it is prob the ONLY place I use anecdotal info, lol) but I see the same thing in my work. A calm and helpful parent in a surgical suite or present during procedure helps immensely and the outcomes are so much better! Alas, some vets like some docs are insecure and also have this authority or white coat syndrome complex where no "civilians" incl family should be allowed anywhere near the procedure. As a result of this study, this vet has started a clinic that allows family to stay overnight with their pets - her recovery rate is faster and the cats do much better than those left alone postop. It is common sense when you think about it and I find it amazing in retrospect that no one has thought of this before!!
Anyway - sorry for the LONG rant and discussion. I apologize for that brief hijack. By all means, talk to your vet and if you are not satisfied - and ask him why he chose that alternative when more efficacious ones are available!!
It was noted that older kitties like elderly humans are at much greater risk from the use of anesthetics. Recovery time is longer, and the chance of complications is greater. Also, there are several age-related changes in lung, kidney and liver function that may directly result in decreases in med metabolism in older ppl.
It is also well known that it takes older ppl longer - sometimes significantly so - to recover not just from the surgery itself but that cognitive problems are also an issue, ie elderly ppl tend to be more confused postop than younger ones. No definitive study stands out b/c there are so many other risk factors with elderly folk like pain management (which is not usually a prob with cats since they tolerate narcotics so much better but in an older kitty with diminished liver and kidney metabolism, it may very well be a significant concern!), the interaction of various medications, the stress that accompanies surgery, the disorientation that accompanies being away from familiar surroundings, and infection that sometimes sets in after an operation.
My own grandfather lapsed into serious neurological deficits postop while fighting Hodgkin's Disease (a type of lymphoma). He was at an age when some oncologists refuse to operate or aggressively treat the disease but his GP said to the oncologist I insisted he call (one of the best in the biz - who will simply not treat anyone over a certain age), "Wait until you see him!". He did well for two years but after the final surgery, he was fine initially but then completely lapsed into confusion and delirium - even what we sometimes call ICU psychosis but this seemed to have come to stay. It was emotionally devastating for me but I was amazed to also see it in younger children who become so stressed with the whole trauma - they however typically bounce back, grandpa did not.
I know I am back to anecdotal info but his was an almost classic case of Acute Confusional State (ACS), usually seen in the hospital setting - and I am wondering if there is a feline version of this. If your cat had any problems before - you know how older cats will sometimes begin to howl at night or wander and cry or develop neurological issues - these could have been exacerbated by the surgery and if she did not exhibit anything like this, anesthesia may just be making it much longer for her to overcome or recover from the procedure. What might be normal in a young cat (say a day ir 2) might be a week in an older cat.
I had a geriatric bunny who had a very serious case of Ileus (A serious GI condition - an obstruction essentially). Untreated, this can be deadly - and surgery was the only option recommended by the vets at the Vet College in Charlottetown where like a mad woman, I had taken him, desperate and upset for my baby!! However, he was 12 and the avg age domestic rabbits with good care tend to live is about 8. I knew instinctively - never mind medically - that while there were some pain meds he might have tolerated, anesthesia would have been putting him to sleep for good!! After consulting with a Miami biologist with experience in rabbits in the US (Dana Krempel, you are a bunny angel!!), I opted to come up with own plan and admittedly the vets at the College were most unhappy with me. "We are not in New York or LA here", one of them acerbically informed me, as if I was not aware that of that salient fact! I won't go into detail but with Dana's expertise and my own medical abilities and the grudgingly provision of the facilities at the vet school and a student vet who offered to help and hoped to learn from the experience, my bunny lived!! We did use IV's and lower amts of pain meds that bunnies usually can tolerate well , Lactobacillus acidophilus which in powdered form can actually assist rabbits in crisis tho no one knows why and some other trial and error ideas.
The vet profs there never operated on geriatric cats either. Depending on the cat, they were trying -either a local anesthetic, low level laser with lower levels of pain meds - and cats tolerate narcotics so need less anyway or a combo of meds to both relax the cat and the use very decreased levels of the newer fast acting Anthiathia meds. the. I myself did my own "experiment" when my YY had her spay surgery and gave her .1 mg/kg IV,IM and SQ of hydromorphone - my own vet tried that in comparison with her usual meds for cats requiring pain relief (usually more serious than spay surgery tho) and compared to her routine of 0.02 mg/kg of buprenorphine routinely in cats at least for the first 12-24 hours then often decrease if if they were kept on it. She uses IV access or but she was in a quandary of using multiple IM injections because they hurt. The hdromorphone
IV dosing had the fasted onset, greatest intensity of effect and longest duration of action and fewest side-effects (vomiting, nausea). She was a kitten tho and my vet has not attempted it in elderly cats!!
At any rate, I would ask your vet all these questions and make sure you find out of this is a temporary neurological defecit or did something else happen there?
I do wish you luck and apologize for my lengthy treatise!!!
March 23rd, 2006, 02:08 PM
Thank you all for your answers. Although this might not sound responsible to many, I must say my cat has never seen a vet on a regular basis. The reason being she was quite healthy and never goes outside so i was told that the vaccine were not necessary in that case. So the vet is new. I have a friend who's a vet but her clinic is far from my place so I went to a clinic closer to my home and affiliated with my friend's clinic. My friend recommended the vet who has been a vet for about 20 years. We had her blood checked and the vet strongly recommended to have her teeth cleaned because she had a lot of tartar and since it looked like she was going to be around for a couple more years it seemed a good idea. I did voice my conern about having an old cat under anesthesia but the vet said since everything was perfect with her tests, there wasn't more dangers for her than any other cat. They never said there was an alternative. When I called after the anesthesia because my cat wasn't walking straight they told me it was rather normal that it took longer because she was old. They did say to bring her back if all didn't look good after 48 hours. Since she started eating again I thought all was normal.
So, since my friend referred that vet I thought I could trust her. I'll call them again and see what they say.
After I posted my message last night my cat came to watched TV with me, which she hasn't done since the anesthesia... yeah! :) Maybe she felt betrayed by me and didn't know if she can trust me again?
Thank you all for your inputs and I'll keep you posted!
March 28th, 2006, 11:40 AM
I'm posting an update in case it happens to other people. I contacted the vet and they suggested that she was probably just upset about the whole experience. As a matter of fact, her behavior has been improving since I last posted and she is now back to her normal self! :) So Mastifflover was right. What was not normal is that she has been drinking a lot more. The vet suspects kidney failure because her urine is too diluted. We'll have result of bloodwork shortly to comfirm this. Again, thank you to everyone who offered advises!