Dental surgery for a senior cat with serious, chronic health issues (and potentially cancer)

goholistic

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Hi all.  
  I've been out of touch, having to put most of time into focusing on work, my kitties, and trying to take care of myself.

As many of you know, Sebastian is my "special" kitty with chronic GI issues and now potentially small cell lymphoma.  
  He's hanging in there and doing relatively okay considering.....well.....everything.

We have a new problem. He has more FORLs that are causing him pain. At least two affected teeth are visible to the naked eye, and are pretty bad. Six teeth were taken out two years ago because of FORLs. The vet recommends dental surgery. She says she doesn't expect anything bad to happen, but, knowing Sebastian, it IS a risk. His issues all started right after his last dental in 2013, so he is potentially one that is sensitive to the emotional and systematic stress of surgery. 


He blood work from last month showed normal kidney and liver values. Glucose is also normal. His RBC is on the low end, but not a cause for worry according to the vet. His lymphocytes were low and monocytes were high, which can be a result of stress and/or steroid administration. He was both VERY stressed at the last visit and also on prednisolone. It's possible that these numbers are a result of his illness, as well.

I've considered pain management. He gets Buprenex (buprenorphine) as needed, which isn't very often, but it makes him sleepy/lethargic and takes away his appetite. As a result, administering buprenorphine daily would not be ideal. I do not have any experience with Tramadol and the side effects it has. The vet said there is no safe cat version of lidocaine that I could give.

Someone told me that it is the sedative they administer before anesthesia that is hard on the body, and it could be skipped. I don't know much about this. It was suggested to search specifically for a dental surgeon from the AVDC and they might be able to only put him partially under (not completely out). I don't know anything about this either. I have a call into our vet to discuss further.

To put him through dental surgery scares the heck out of me. But I also don't want him to live with the pain. I don't know how much longer he'll be around. I just don't know what to do.

Anyone have any thoughts?
 

mollyblue

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That is a difficult decision.  Nutrition is important and its hard to eat well if your mouth hurts.  Not to mention that infection from the mouth can spread to other parts of the body.  I am not familiar withi Sebastian and if you mentioned how old he is, I missed that part, but I think that would come into play here as well.

With our Siamese, when she was diagnosed with CRF, she had a bad tooth also, but her blood levels were horrible and the vet expected her to pass any day so surgery was not an option.  Over the next year we did several rounds of antibiotics to combat infection, she had the buprenorphine, but we only administered as needed and she didn't need it daily.  We did change her diet so for the first time in her life she became a wet food kitty.  Looking back on it all, the vet didn't do the surgery because he was afraid it would kill her (the bad tooth is why we took her in).  But, every appointment over the next year, he would suggest it was time to euthanize.

I'm sorry I can't be of more help. Im not sure what FORL is, but if the teeth are infected, and money for the surgery is not a factor, I think I would go ahead and have it done.  One and done, vs. all the cost and special care required to manage the condition...
 

2catsandadog

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Sorry you're facing such a difficult decision. I know just how you feel as my 14 year old Oliver had terrible dental disease and was having difficulty eating and appeared to be uncomfortable whenever he ate. Oliver has a heart condition and early stage crf. I discussed surgery at great length with my vet who is cats only vet and specializes in dental surgeries. We agreed that it was worth the risk as ultimately it's their quality of life that matters.

Oliver was kept on an iv drip throughout the surgery and his vitals were monitored. He ended up having most of his teeth removed. That was 2 weeks ago. The first week after he appeared to be very uncomfortable and then came down with a uri due to the stress we suspect. He stopped eating and I have been syringe feeding him most of the past 2 weeks.

I am cautiously optimistic Oliver is finally coming around. He is still stuffed up but is much more mobile and alert and asked for some food today and ate for the first time in a long time. He still has a long way to go but I am doing everything I can to help him recover.

I have asked myself since the surgery would i do it again and the answer is yes.
 
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goholistic

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@MollyBlue, thanks for your thoughts. His exact age is unknown, but he's estimated to be about 14 years old. FORL is feline odontoclastic resorption lesion. Here's an info link: http://healthypets.mercola.com/sites/healthypets/archive/2012/01/17/teeth-resorption.aspx

@2catsandadog, thank you for sharing your story. It is helpful to hear from someone going through the same thing. I'm sorry Oliver is having a tough time with recovery, but glad he made it through. I think it can be expected that Sebastian would also have a difficult time with recovery.

I almost have to go into this accepting that I may lose him.   
  It's so difficult. He is the feline love of my life. I just spoke with the vet to express my concerns. Ugh... I don't want him to live with pain. The dental is scheduled for Monday and I'm scared to death.
 

castle cat

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I pray that everything goes well with your lovely Sebastian. Keep us posted. Wishing Sebastian good health.

Castle Cat (devoted servant of late Jethro)
 
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goholistic

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I pray that everything goes well with your lovely Sebastian. Keep us posted. Wishing Sebastian good health.

Castle Cat (devoted servant of late Jethro)
Thank you so much. We really could use everyone's good wishes and vibes.
 

2catsandadog

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Best of luck to dear Sebastian. You are putting his needs first which shows how much you love him.
 
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goholistic

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Best of luck to dear Sebastian. You are putting his needs first which shows how much you love him.
Thank you.

If I'm going to change my mind, I have until 2:00 p.m. tomorrow to cancel the appointment. I probably won't. But just worried sick.
 
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