Tooth Extraction for senior cat with HCM?

nartyteek

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So my 16-year-old cat has had just about everything on him examined in the last half year except his teeth. He has kept us distracted with other problems, so who knows how long this has gone on. He's been reluctant to do much in the past three days. He will probably have to get a top canine removed, maybe a few others. I'm not too worried about that, and at his age it's bound to happen. I happen to live right down the road from a specialist who does very cheap surgeries and is highly rated. People travel from other cities to go to this place, so that all looks great. And the whole package will cost $355 unless we get xrays, so I can swing that. I'm wondering if anyone has had to deal with oral surgery and HCM? Is it even relevant? His only medication right now is plavix (blood thinners). How about senior cats and post-op care? Any tips? To be honest, my family made me put my cats outside growing up, and they never lived very long, so this is a brand new territory for me.
 

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I don't have any cats with HCM. And in fact had to look it up to even know what it was. But after reading, has your vet said it's safe?
Teeth are the last thing I thought of, as I have so many (rescues) and they have so many other issues. But 4 had to have dental cleanings due to big plaque build up and each had a few teeth removed with one so bad he had 17!:( For the last big guy, she said he had a heart murmur and had him tested for anything else such as diabetes that would add to the complication of putting him under. Mine told me that if there's a heart condition, they typically don't put the cat under (which they have to of course for this) due to worries of bringing them back out.
If it's safe, all mine were over 10 that had work done, and whether 2 teeth removed of 6, they have to be on soft food for at least the week. Vets will give meds for pain which I had a 5 day supply for, just once a day. And just peak at their mouths if allowed. To ensure you don't see any massive inflammation or discoloration for infection. All four of mine did great and were back on their feet in no time. Oh, and don't give them anywhere to jump while on pain meds. They can topple easy on them. Especially that first day of anesthesia. They're way dizzy and out of sorts that day. Best of luck. Sorry I couldn't say much with the HCM though.
 

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Jamie was just dxed with HCM, although he is only 4. He is on plavix and atenolol for blood pressure. Jamie is not facing any surgical procedures and is much younger than your cat so the only advice I have is to make sure that the vet you are using is quite skilled in surgery/anesthesia in older animals with heart conditions. When my dog, who was 11 at the time, was dxed with melanoma and had to have surgery I specifically took him to a referral clinic although his vet could have performed the surgery. He had a few preexisting conditions, one of which had caused a previous dog to die as a result of surgery, so I did not want to take any chances.
 
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nartyteek

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We haven't done the necessary testing to make sure he's safe yet, for now he's just getting palliative care until the surgeon is available. But he got the same testing before he was being assessed for a broken hip last year and he didn't need surgery after all but he was deemed healthy enough if need be. I guess my thinking is, I don't see an alternative? I don't think they can remove teeth without anesthetic, much as I'd prefer that, but he can't live like this. If I had my way, I'd just keep putting it off until he died of something else.
 
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nartyteek

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Jamie was just dxed with HCM, although he is only 4. He is on plavix and atenolol for blood pressure. Jamie is not facing any surgical procedures and is much younger than your cat so the only advice I have is to make sure that the vet you are using is quite skilled in surgery/anesthesia in older animals with heart conditions. When my dog, who was 11 at the time, was dxed with melanoma and had to have surgery I specifically took him to a referral clinic although his vet could have performed the surgery. He had a few preexisting conditions, one of which had caused a previous dog to die as a result of surgery, so I did not want to take any chances.
I am lucky enough to have a surgial clinic just down the road that often does surgeries like this. Judging by the reviews, people come in from other states and cities just to go there. I got on the wait list, so at this point I have to choose to wait with all the risks that go with that, or go to a generalist (don't know if that's even a word lol) and get it over with sooner. Two months is a long wait, even with painkillers!
 

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It sounds as if you have a good doctor lined up for the procedure. The cat needs anesthesia for the procedure itself and to insure a good look around his mouth while he is out. No, he cannot live with painful teeth for the rest of his life and something has to be done. If you can, probably sticking with this doctor is a better bet than going to the general practitioner. If you are able to be flexible, tell them you will come in if they have a cancelation.
 

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I am lucky enough to have a surgial clinic just down the road that often does surgeries like this. Judging by the reviews, people come in from other states and cities just to go there. I got on the wait list, so at this point I have to choose to wait with all the risks that go with that, or go to a generalist (don't know if that's even a word lol) and get it over with sooner. Two months is a long wait, even with painkillers!
Hello nartyteek nartyteek and sweet cat! Other posters have good thoughts, to which I can't add except to offer *Prayers* and best thoughts for successful surgery for your cat. Thank you so much for being so caring and for giving your cat excellent care, as every cat deserves! I hope you can go in on a cancellation and that it helps him. Of course the surgical team will be informed ahead of time of his HCM and of what other medical conditions he has, along with the medications he is on, and will discuss with you the best (and other) options. Is he eating well?
I have had experience of HCM in two of my cats, both of whom have passed on, unfortunately before they reached age 16. My cats now are 16 and 13, and both are healthy.
Sixteen really isn't "old" for a cat these days, especially one who is well cared for. Please keep us informed, won't you? And we love pix here at TCS.
 
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nartyteek

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So we had his evaluation for surgery scheduled in two days and uhh. I just found his tooth on the floor. Wow. I guess that's why he's been eating so much quicker today. I just checked around, and of course everything is closed today! So we talked to the emergency vet and he's on antibiotics and pain killers, but other than that, we're just going to stay the course until he goes in for his appointment. When I talked to the surgeon, she did float the possibility of him getting priority on the schedule if he was deemed worthy. No idea if this qualifies him, but at least I'm not bored. Jeez. Why is he such a wild old man.
 

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He was just telling you you didn't need to bother with a vet, he can perform the procedure himself! 🤣

I had a cat of similar age who had to have a dental as well, though he did not have HCM (he had thyroid issues instead), and he was so much happier for it.

The main issue I would worry about is the blood thinners. Tooth extractions are normally bloody business, but if you have a qualified vet then they should hopefully know how to work around it so he doesn't lose too much blood.

It's standard procedure for older patients at my vet, but I would just double check and make sure they put your boy on some intravenous fluids during and after the procedure, for a few hours at least while he recovers from the anesthetic. I found this really helped my guy bounce back, and the extra fluids supports their organs while they are unconscious.

Also, stock up on chicken. My vet said to stay away from wet food (especially pates) for a few days after the teeth were removed, as it can get stuck in the places where the teeth were. Boiled chicken is great, as he probably won't want to eat dry food and the sometimes anesthetic can cause an upset tummy, which the chicken will also help.

Oh, and as mentioned above, they are often very groggy and unbalanced for a day or two afterwards, so be sure to accommodate for that. Regular water changes are required too, as you will probably find a little blood in there from time to time for the first week afterwards.

And of course, preanesthetic bloods are a great idea.

Best of luck, would love to here some updates, especially after the procedure!
 
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nartyteek

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He's going to get testing (echocardiogram, bloodwork) on the state of his heart condition, and maybe if he's alright he can temporarily go off the blood thinners. That would make this a lot easier. There's some great practical advice in your thoughtful response, and I was going to simply thank you for it, but my cat interrupted me just now by bringing my shoes up the stairs. He hasn't done that in DAYS, but usually he wakes me up by bringing me shoes. Not necessarily the shoes I need. He just just kind of picks a pair and than waits for treats and praise. Always a matched set, though.
 

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He's going to get testing (echocardiogram, bloodwork) on the state of his heart condition, and maybe if he's alright he can temporarily go off the blood thinners. That would make this a lot easier. There's some great practical advice in your thoughtful response, and I was going to simply thank you for it, but my cat interrupted me just now by bringing my shoes up the stairs. He hasn't done that in DAYS, but usually he wakes me up by bringing me shoes. Not necessarily the shoes I need. He just just kind of picks a pair and than waits for treats and praise. Always a matched set, though.
How do his other teeth look? Sometimes it’s just one bad tooth. Is the gum swollen? Of course the vet will tell you that you have to worry about the root (he’s not wrong) BUT sometimes the root is just resorbed by the body and is gone. Is the end of the tooth broken. Like it left some behind? X-rays would tell you the whole story but that also requires sedation.
 

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When Icky was about 5 years old he was diagnosed with HCM. And his murmur was quite significant!! Needless to say, I was gutted. So I did a little bit (really, a lot a bit) of research and I read that some cats cannot absorb taurine when it has been cooked. It just passes through unutilized and then they poop it out. SO..... I started my cats with raw diet. And I put Icky on Vetri-science cardio-support. As well as Standard Process Feline Cardiac Support (that is rx only but I was able to get it thru my vet. I also got it online via a chiropractor) One can do a taurine blood level sample, but it is really not an accurate test because the body actually compensates for the lack of taurine availability by robbing taurine from the organs and tissues so that it flows in the circulation system. So while the circulating blood has enough taurine to give you a normal reading, vital organs are deficient. That can this lead veterinarians into thinking all is well with the taurine level. Not all vets want to take it any further than the blood level being fine. He is now 11 (or 12?). (Or 3!! I think he’s 3!!!!) and has NO DETECTABLE MURMUR. Now I’m definitely not saying that is the case with all cats because obviously that would be very unrealistic. What I am saying is that it works for my cat. As a matter of fact, during my research, I learned that vegetarians are notoriously low in taurine because is not available through most avenues a vegetarian eats. 😳 So I now supplement!
 
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nartyteek

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How do his other teeth look? Sometimes it’s just one bad tooth. Is the gum swollen? Of course the vet will tell you that you have to worry about the root (he’s not wrong) BUT sometimes the root is just resorbed by the body and is gone. Is the end of the tooth broken. Like it left some behind? X-rays would tell you the whole story but that also requires sedation.
When we're done with the echo, if his tests all look good and his risk is about average (even a perfectly healthy cat of a couple thousand or so will just mysteriously die from anesthesia) then I think we're still going ahead with a full dental anyway. His tooth was a bit incomplete, either from reabsorbtion or breakage we can't say yet, but the socket looks lovely so far. At the very least, this will push his schedule back so it's not as urgent (or as expensive tbh!!), and maybe his antibiotics will have more time to calm things down a bit, too. If he's perfectly alright otherwise, I might just be tempted to wuss out and put it off again, but I think the right thing to do is to strike while the animal is healthy. Another year at his age, he might not tolerate surgery as well.
 

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When we're done with the echo, if his tests all look good and his risk is about average (even a perfectly healthy cat of a couple thousand or so will just mysteriously die from anesthesia) then I think we're still going ahead with a full dental anyway. His tooth was a bit incomplete, either from reabsorbtion or breakage we can't say yet, but the socket looks lovely so far. At the very least, this will push his schedule back so it's not as urgent (or as expensive tbh!!), and maybe his antibiotics will have more time to calm things down a bit, too. If he's perfectly alright otherwise, I might just be tempted to wuss out and put it off again, but I think the right thing to do is to strike while the animal is healthy. Another year at his age, he might not tolerate surgery as well.
I agree. Dental infection takes a big toll on their health, particularly with cardiac disease. Your plan makes sense. You have a good head on your shoulders. 😻
 
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nartyteek

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When Icky was about 5 years old he was diagnosed with HCM. And his murmur was quite significant!! Needless to say, I was gutted. So I did a little bit (really, a lot a bit) of research and I read that some cats cannot absorb taurine when it has been cooked. It just passes through unutilized and then they poop it out. SO..... I started my cats with raw diet. And I put Icky on Vetri-science cardio-support. As well as Standard Process Feline Cardiac Support (that is rx only but I was able to get it thru my vet. I also got it online via a chiropractor) One can do a taurine blood level sample, but it is really not an accurate test because the body actually compensates for the lack of taurine availability by robbing taurine from the organs and tissues so that it flows in the circulation system. So while the circulating blood has enough taurine to give you a normal reading, vital organs are deficient. That can this lead veterinarians into thinking all is well with the taurine level. Not all vets want to take it any further than the blood level being fine. He is now 11 (or 12?). (Or 3!! I think he’s 3!!!!) and has NO DETECTABLE MURMUR. Now I’m definitely not saying that is the case with all cats because obviously that would be very unrealistic. What I am saying is that it works for my cat. As a matter of fact, during my research, I learned that vegetarians are notoriously low in taurine because is not available through most avenues a vegetarian eats. 😳 So I now supplement!
I'll ask about the taurine. I know he's had all sorts of tests but if it's difficult to test for specifically, I should go ahead and ask. I will say his internal organs, heart issue aside, seem to be in great condition
 
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nartyteek

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I agree. Dental infection takes a big toll on their health, particularly with cardiac disease. Your plan makes sense. You have a good head on your shoulders. 😻
I mean, I'm trying to keep my cool, considering I'm pretty damn scared tbh! But that's just how it goes with a senior cat.
Edit: SUPER senior, actually! I forgot that. Dang, he's old.
 
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Xena44

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I mean, I'm trying to keep my cool, considering I'm pretty damn scared tbh! But that's just how it goes with a senior cat.
Edit: SUPER senior, actually! I forgot that. Dang, he's old.
I'll ask about the taurine. I know he's had all sorts of tests but if it's difficult to test for specifically, I should go ahead and ask. I will say his internal organs, heart issue aside, seem to be in great condition
I hear you. Any malady with my little loves terrifies me too. Tough to keep your head in check when the heart is sooo involved. 😻😻😻😻 Like i mentioned, testing taurine level doesn’t rule out low levels. And it is a specific test. And it’s pricey!! And supplementing with something like vetri science cardiac support only would help. And the research I’ve read supports that you can’t overdose your kitty on taurine. Obviously you wouldn’t give her a point a day but the levels in a supplement were more than she actually needed, her kidneys would just flush it away. Do your own research on it. Feel comfortable before you do anything. 😉😻
 
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