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-   -   Feline Dental Disease / Stomatitas - Complication with Anesthetics (http://www.pets.ca/forum/showthread.php?t=85159)

jon2008 February 17th, 2014 11:19 AM

Feline Dental Disease / Stomatitas - Complication with Anesthetics
 
We have a beautiful rescue cat that has been part of our family for 6 years. We are unsure of his age or breed. On the basis of some health complications that have occurred and the opinions of a couple of vets we now think he may be around 13 years (several years older than we had previously thought). As far as breed, he certainly has some Burmese and we think probably Siamese and Himalayan also.

In the first year we had him it was necessary for him to have a tooth extracted, but he reacted badly to the anaesthetic and we nearly lost him shortly after he came out of the operation. We have moved on from the original vet, but have always been very reluctant to put him through any treatment requiring a general anaesthetic again. The vet themselves recommended avoiding a general anaesthetic if at all possible. Since they never fully figured out what the problem was, it is very difficult to assess the actual risk however.

Anyway moving on from that, a few years back he was diagnosed with thyroid problems. And we have him on a special diet for that, which he has responded well to.

However, in the past few months he has developed problems with his teeth, and it is evidently causing him discomfort and getting worse. His breathing has been gurgly, and he wheezes quite a bit (especially at night). His breath has a strong odor. He is evidently irritated particularly on the left side of his jaw and taken to scratching that a little too vigorously, causing soreness under his ear on that side.

We have made many visits to the vet over the past few months. Under normal circumstances they would have tried to give him a general anaesthetic and do some dental work, but because of the risks in his case we tried a different route through antibiotics and anti-inflammatories.

The meds are Prednisolone 5mg, and Clamavox 62.5 mg.

The first course of those back in early December seemed to work really well. He was noticeably improved after only 2 days. No odor, no apparent discomfort. Things went well until he finished the course, and then after only a few days he deteriorated again.

Since they didn't want to start on the anti-biotic (Clamavox) again right away the vet suggested trying just the anti-inflammatory (Prednisolone) to control the inflammation and pain. That seemed to help a bit, but then one night he got violently sick, so we backed off that for a while.

The most recent thing we have tried is another course of both meds. The Clamavox has been replaced by Clavaseptin, but we are told that it is a brand name for the exact same thing. But we have reduced the amount of Prednisolone to 1/2 tablet (i.e. 2.5mg), on approximately a 36 hour cycle.

If anything we think that his condition is either holding steady or deteriorating slightly. And of course when he comes to the end of this course of antibiotics (today) then probably things will get worse again.

So we have a very difficult choice. We can schedule him for surgery with the knowledge that he did not do well last time. Or we can keep trying these “pulse” course of anti-biotics and anti-inflam's that seem to be steadily reducing in effectiveness.

The vet says that even if he makes it through surgery then the outcome will depend on exactly what is going on. She mentioned that it may be dental disease or stomatitas. If the latter then the operation may still not fix the problem, and we will be back to some sort of management.

Are there any other options that we could consider? We would be so deeply grateful for any advice, however minor. I don't think we've had a good night's sleep for quite some time worrying about this on top of life's usual problems.

marko February 17th, 2014 02:35 PM

Welcome to the forum and so sorry u are going through this - :grouphug:

I too have a cat with bad bad teeth. She only has 4 left (canines) and they will need to be removed eventually. Vet thinks it's stomatitis in our case...but this is a general word as far as I know, as is dental disease. In our case, 'stomatitis' was determined by blood work which suggested an immune problem - and the lay conclusion is that she is allergic to her own teeth or rather the plaque that forms around her teeth. She has had about 10 teeth extracted thus far.

I can tell you that our cat gets regular abscesses on the 4 teeth that she has left and that it is painful. As the abscesses grow, she sleeps more and is less playful. (vet thinks that's pain). We do have been trying 'pulse' antibiotics and they do help for a short while. But they are a band-aid solution in our case.

I really don't know what i would do in your situation. 13 isn't young for a cat but many cats live to 20 years these days. The bad breath is a classic symptom of stomatitis, and the cat rubbing on the left side of the jaw may well indicate pain in that area.

If money is no object, then I might look for a feline dental surgeon and get an opinion there. It may well be that your cat needs additional extractions. And if that is the case, from recent personal knowledge about my own cat, the techniques for extraction by a vet surgeon are far superior to the techniques done by the average general vet. (Surgeons pull the harder to extract teeth via a cut they make in the gums, general vets pull from the top and hope the teeth don't break and when they do break they hack away at the remaining teeth).

If you do go that route, perhaps they might also have additional experience with anaesthetics.... and if they did and suggested a decent outcome, I think I'd take the risk.

One thing you didn't mention is the type of 'operation' the vet is considering.

Hope this experience was of some help and hope members have additional suggestions.

Good luck! :goodvibes:

lindapalm February 17th, 2014 07:22 PM

Did your vet think that if all the teeth are pulled it would cure the stomatitis? Two of our cats were diagnosed with stomatitis, and both had all their teeth pulled, not all at once. They have had no problems since then, but were much younger when they had the work done. I would do like marko said, look for the best person to do the work, and chance it, since nothing else seems to be helping. It doesn't sound like he's getting any long term help from the meds, I would risk the surgery, knowing if something happened I at least tried to help him be pain free. Its so hard when their old to know whats best, I wish you luck.

jon2008 February 18th, 2014 08:24 AM

Thank you so much for the replies.

As far as what the existing vet is proposing, they were going to anesthetize and then take x-rays and assess what could be done. So unfortunately we don't even know a likely course of action or prognosis, even if he manages to hold up to the anaesthetic.

We think we might get a second opinion from another vet that has been recommended to us, and appears to have some additional facilites to deal with assessing the dental situation.

jon2008 March 1st, 2014 12:50 PM

We thank you so much for all your advice.

Sadly Ted didn't make it. While he was under anaesthetic the vet found another complication – a growth that was interfering with his breathing. It wasn't operable, and we had to make the incredibly hard decision to say goodbye while he was still under anaesthetic.

We are devastated, but appreciate the advice that was given.

Jonathan

Lynne&Co. March 1st, 2014 02:41 PM

I'm so very sorry for your loss.

lindapalm March 1st, 2014 09:20 PM

I'm so sorry to hear that, you were so concerned about Ted and tried to help him, he was very lucky to have been rescued by you.

hazelrunpack March 1st, 2014 09:28 PM

I'm so sorry to hear about Ted, Jonathan. My heart aches for you. :grouphug:

You and your family were angels for adopting him when he needed you...and now he's your angel, watching over you.

:candle: Ted


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