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19 Year-old Cat Needs Emergency Dental Surgery

September 30, 2009

Cleo was a skinny orange tabby cat who had not eaten for 3 days.  Normally, I’d perform the physical examination, make my testing and treatment recommendations, and that would be that.  In Cleo’s case, emotionally-charged decisions abounded because Cleo was born before my new kennel assistant.  She was 19 years old!

“I don’t know if we should put her through blood tests.  She’s so old,” her mom ventured.

“Old age is not a disease,” I countered.

“But I know she’s needed dental care for years, how could she survive anesthesia?”

“First of all, we’re talking about her mouth.  This is central to her every waking thought.  Can she eat without pain?  Cleo deserves to be happy and comfortable.”

“But I heard that old pets die under anesthesia.”

(Here’s the deal–and I’m talking to you– yes, the statistical odds of an “adverse anesthetic event” go up with age.  But, with proper, thorough patient selection: meaning bloodwork, stable underlying conditions like thyroid or kidney disease, heart screening, and careful delicate use of anesthesia.  And with fastidious nursing care and monitoring meaning: a dedicated anesthetist, body temperature and blood pressure regulation, and all the rest of the usual monitoring, with an experienced and practiced anesthesia team, your pet has every expectation of a wonderful outcome.)

Cleo underwent dental surgery.  She needed 11 rotten teeth removed.  She woke up from her anesthesia within 20 minutes and actually ate right away!  At her 2 week post-op check-up, she had already gained a pound!  She could potentially live for years longer, and now she is comfortable to do so.

17 Comments leave one →
  1. kristy lee permalink
    March 14, 2012 7:18 pm

    hi… my 13 year old siamese chloe was operated on for mammary cancer just over a year ago, she has been on chinese herbs and has been doing fairly well until the tumors grew back a few months ago… for the past 3 days she has not eaten or drank anything but i have her on fluid injections and she has had 2 shots of short and long acting quarterzone… her mouth is so swollen and sore and black looking at the moment and she had had teeth problems for a while but the vets told me they didn’t want to operate… however i have her booked in for surgery with another vet tomorrow and i am wondering with all of her cancer problems if it is still safe for her to have major dental surgery?

    • March 15, 2012 7:35 pm

      Wow! Good luck, Kristy Lee.
      Without being your veterinarian and seeing your kitty for myself, I cannot tell you how risky the operation is. That is part of the art of veterinary medicine. While there is risk, the mouth problems may be so harmful to her quality of life that it is worth the risk.
      Good luck,
      Doc Truli

  2. November 29, 2011 7:20 am

    My cat went for a routine dental cleaning. No teeth extracted – just a lot of tartar was removed. When she came home, she tried to eat, and as she chewed, she made a loud cracking sound with her teeth and shook her head. She became afraid to eat. Took her back to the vet, and he sedated her, and put her under anaesthetic to remove the tooth that he suspected was causing the problem. Than means she went under twice in 3 days. I brought her home, and she still has the same problem – she goes to eat, takes a bite, shakes her head and the cracking starts – this is 6 days since original procedure. She only does this when she tries to eat. She can drink water without trouble. My vet has no idea. Taking her to a specialist today. My question – do you know what could be causing this? And – if she needs a third procedure, do I dare risk another anesthesia again? She is nearly 18 – before the procedure she was early CRF, but otherwise fine – eating well, good normal weight, happy. Right now I’m syringe feeding with soft food, because she is so hungry but cannot eat enough to satisfy her appetite.
    I have searched high and low, but cannot find anything related to this following surgery.

    • November 29, 2011 5:26 pm

      Dear Marie-Ora,

      First, did she have dental x-rays? If not, they will significantly increase your chances of finding the problem. The specialist will probably check her tempomandibular joint, too.

      If she has IV fluids, good monitoring, and does not become hypotensive (low blood pressure) during her procedure, she should do fine (of course, depending on the hands-on evaluation of your vet at home.)

      If the problem persists, a temproary feeding tube can be placed if she resents syringe feeding.

      Videotape the behavior (if she will do it again) for your vet and the specialist.

      I have seen this before. It was a tooth that did not line up properly with another tooth, so it was not obviously loose on the initial exam. It can be hard for a veterinarian to tell how the teeth line up when your cat is under anesthesia. A trick a specialist taught me is to remove the endotracheal breathing tube at the end of the procedure in order to close the jaw and check that everything lines up right. Then, quickly and gently replace the tube to finish the anesthetic procedure.

      Good Luck! I hope you can report a happy ending after the specialist visit.

      Doc Truli

      • November 30, 2011 5:45 am

        Doc Truli – thank-you so much for your reply, and thank-you for providing this type of service for desperate pet parents.
        The specialist checked her – she has a slight infection, and seems to have pain in very specific back teeth. I had videoed her, and it helped him to understand what I meant. When he poked the painful teeth gently with an ear bud, she immediately started cracking and grinding. He said she is in excruciating pain. Because she was slightly dehydrated, and hadn’t eaten well for nearly a week, he has put her on nasal feeding, a drip, antibiotics, and opiates for the pain. She has to stabilise before he can do Xrays and attend to the problem teeth.
        This morning he called to say she has perked up tremendously. Bloods showed that although her kidneys are slightly compromised, she is in VERY good health for a 17 year old cat. The only reason she wasn’t eating was because of pain.
        I must add that I am infuriated by all the people who kept insisting that I was being cruel, I should put her down, perhaps it was her time….I would never keep an animal who is truly suffering lingering, but to just throw in the towel and end her life because of her age is out of the question. I wonder how many other animals stop eating after a dental because of pain, and this is misinterpreted to mean they didn’t do well under anaesthetic.
        Thank-you again, and all the very best to anyone here who is battling with these issues.

      • December 4, 2011 5:23 pm


        You wondered how many animals stop eating because of pain after a dental and people misinterpret and think they did not do well with the anesthesia. That is such an insightful comment! I hope more people consider this when they decide for further care for their pet.

        “Old age is not a disease!”

      • December 5, 2011 1:14 pm

        My cat had 2 resorbtive lesions removed on Friday – the crowns had long since disappeared, and it seems the dental cleaning somehow caused the roots to become inflamed and painful. The grinding was a response to pain. Mitzi has been home since yesterday. She ate well enough then, but today her appetite is down. She still appears to be in pain when she eats, but it is not as bad as before (I think). She is on pain meds which I give her every 8 hours. Wednesday will be 3 weeks since the original procedure, and she is still struggling to eat. Despite nasal feeding, she has lost a ton of weight (relatively), and her water consumption is down. I’m not sure if she is drinking less because she was on a drip for 5 days, and not needing to drink, and has become less aware of the need for water
        She is eating very tiny amounts of raw minced beef (maybe a tablespoon in total today), and she gobbled a little lump of buttter, but that is about it. I have every kind of cat food available, along with tuna etc. She is catnip responsive, and only ate the second portion of her mince because I pulled it out in desperation. The veterinary nurse said to avoid syringe feeding because she has so much mouth pain.
        I don’t know if she can still have substantial pain 3 days after having these roots removed, or if I will ever be able to get her to eat properly again. Any advice will be very much appreciated.

      • December 8, 2011 3:58 pm

        Just a quick update. Mitzi seems to have developed FOPS (more common in Burmese – she is a Himalayan) as a result of the dental. She paws at her mouth, and shakes her head when she tries to eat. With lots of tiny feedings, she is maintaining her weight, but not regaining the weight she lost. Her CREA count is up since the last anaesthetic – it’s now 240, so she has been put on a low dose of Fosekor for her kidneys. She is on Temogesic, and will stay on it for the next 5 days or so. Metacam is out of the question because of her kidneys. She has also been given cortisone, but I’m reluctant to add it in.
        The pain does seem to be improving slightly, although I noticed that after her check-up today (and the vet is VERY gentle) her discomfort is higher than yesterday. I think the nerves are so tender that anything sets them off. I believe that FOPS often goes into spontaneous remission. Other than mealtimes, she has been quite bright, walking around, purring when she is awake.
        I’m sure this prolonged set of interventions has added to the syndrome – it is difficult to get painful nerves to stop firing after they have been irritated for so long. I’m heart-broken she is suffering like this.
        If Doc Truli or anyone else has any advice for this problem, I would very much appreciate it. I would never have thought a routine dental could go so wrong – I think the lesson is you MUST have Xrays when doing a dental on an older cat, just in case your miss problems, because repeat treatments are very hard on the cat’s stress levels and kidneys.

      • December 11, 2011 3:41 pm

        I agree X-Rays are awesome to prevent prolonged treatment. Also- little known to pet parents – a veterinarian who can remove teeth without resorting to lots of “drilling the roots out” will cause far less damage to your kitty’s nerves. It’s better to “elevate” the roots out, instead of pulverizing them and having the drill bit fling micro sized bits of tooth into the surrounding jaw tissue. It’s just so hard to assess the competence, skill, or quality of a doctor (in general). It sometimes boils down to trust…

      • December 11, 2011 10:21 am

        Mitzi is still in pain – after she takes a few bites of food, she starts shaking her head and moving her mouth around. Occasionally she paws at her mouth. The vet has given me the option of having all her back teeth removed, just in case on of them has a small defect no-one can spot which is causing pain, the other is just to leave it for a while in the hope it resolves. I’m really not sure what the right thing is to do. She is doing better, but she is not recovering as hoped. If it is a tooth, it seems terrible to leave it. On the other hand, if it is FOPS it may make it worse. Aside from mealtimes, she is quite bright, enjoys a slow walk around and being cuddled. I desperately want to do the right thing for her, but I’m not sure what it is…….

      • December 11, 2011 3:35 pm

        Oh! THat’s unfortunate! It sounds like you are doing everything right, and yet you still have a problem.

        Have you tried Buprenex opiod painkiller?

        Have you gotten a good acupuncture referral from your veterinarian?

        Just some ideas…

  3. Janie permalink
    April 16, 2010 8:53 am

    Have just read this having left my 19year old boy at the vets today for a dental. I’ve had him since he was 6 weeks so he’s very precious. I am nervous but his comofort and wellbeing are my priorities so I feel I have to take the risk. Here’s hoping I have my baby home tomorrow and he’s tucking into something lovely to eat.

    • April 18, 2010 10:02 pm

      Dear Janie and Steve,
      How did your boy do? Is he back to eating and feeling happier?
      Doc Truli

      • Joyce Holden permalink
        May 7, 2010 5:26 am

        I have a 19yr old persian, who has been on medication for a heart complaint and high blood pressure for the past year, her eye sight and hearing are very poor, however she eats well and is of good weight and seems fine in herself and we feel she still has quality of life. Last week we took her for a check up and to get more tablets and her blood pressure was up, we were referred to the cardiologist who had treated her a year ago and were told that she would need the full bood profile done and also some of her teeth needed removing as they said she would have a sore mouth, (she has no problem eating her food and always enjoys her food) if her teeth were that bad would it not put her of eating? My fear is putting her through the aneasthetic and the stress of the blood tests etc at her age, also the fact that she is virtually blind and can`t hear very well, there is also tha fact that they may find something else in the blood tests.
        Having read the previous letters i am wondering if it is worth putting her through the aneasthetic!!!

      • May 8, 2010 7:17 am

        Dear Joyce,

        You have fantastic, relevent questions. Spot on.

        Consider these ideas:
        If your veterinary surgeon felt teeth needed removing, then we’re not discussing preventative care “just to be good.” Those teeth hurt your Persian lovely. Do not fear the further blood tests. She certainly needs them. The knowledge they give you will either ease your mind or give you some data to act upon. The cardiologist can assess better than anyone if her heart should be able to take the anesthetic. Of course, we cannot know for certain, but please do not underestimate the discomfort and distraction that loose or damaged teeth cause your little girl.

        To your question about “if her teeth were that bad would it not put her off eating?” A veterinary dentist, Dr. Jan Bellows, once explained it this way,”If you lived on a desert island and you had to eat to survive, you’d eat. Our houses are like that desert island for our pets. They have no choice.” The pets that stop eating are in soo much pain that they prefer death to the disease. Your Persian companion still loves life, loves eating, and wants to live. If you follow your veterinarian’s advice, that will give her the best chances to keep living the wonderful life you have provided for her.

        Good luck!
        Doc Truli

  4. October 19, 2009 10:45 pm

    Congratulations on a successful operation, and you are so lucky to have your old friend with you after 19 years! A good diagnostic procedure before anesthetic or other treatments is key to getting the balance right and avoiding any post op complications.

    • October 20, 2009 10:04 pm

      Hi Samantha! I hope more people will realize their 19, 20, or even 25-year-old pets can have the operations they need without undue fear of dying. Our older pets are even more precious (if possible) than the hope-filled day when we found them! And you are absolutely correct, proper patient identification before surgery helps tremendously to set up a good outcome!

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