Cats Community
Cat extraction - decisions to make
About This Community:

This forum is for questions and support regarding your pet cats!

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

Cat extraction - decisions to make

Hi everyone,
I've been reading some of the threads on this page and while I have learned a lot I am also very nervous about my 6-year old indoor male cat getting a dental cleaning + extractions under anesthesia. I was hoping for some advice from this community. I apologize in advance for the length but I make decisions based on a holistic assessment of a situation, so I've tried to include relevant information here.

1. 2011 annual appointment: vet noted "very clean teeth". I asked if I should be brushing his teeth - they said no. Exam not particularly thorough. I remember thinking they were talking more to each other than to me or my kitty, which is why I tried a new vet out this year (#2 below).
2. Took my cat for this year's appointment last week (Dec 2012). Vet recommended full blood panel ($189) including urinalysis. Justification: at this age, good to get a baseline on all measures so if he becomes sick at a later date, have something to compare. Also recommended dental cleaning ($200) and extractions (1 loose tooth definitely needs to be removed. Another is a 'maybe'. Was vague about price, but I think it was going to be $50-100 for the extraction of two teeth - said he would give me a minimal charge for the loose tooth which would probably come out easily). Vet was good until it came time for a simple administrative request - letter stating cat is healthy enough to fly in-cabin on upcoming trip. Insisted that he is not a "secretary" and does not write letters because then he would not have time to treat any patients, would spend all his time doing secretarial work. (? seriously?) BUT he was willing to answer my many questions and thorough with my cat (...or so I thought). Got the letter and the cat is on the trip with me now for 2 weeks. Vet said cat is probably experiencing some discomfort, but not to worry. This vet also told me that brushing teeth is unnecessary and Greenies are sufficient for future dental care. No medications given or recommended.
3. Took my cat for a second opinion. This vet found another two teeth to be extracted (root heavily exposed), as well as 2-3 more that might need extraction. Also noted an infection of the gums and recommended administration of antibiotics. Recommended basic blood panel ($90), but not the full blood panel unless indicated. Vet was very patient, willing to answer questions. Charged me for an annual exam in order to provide the consultation, but I don't think he did the part of the exam in which they manually feel the cat's abdominal area and glands throughout the body. Provided a detailed estimate of the costs. However, the cost is significantly higher than the previous vet (#2 above - around $200-300 for 2 teeth, not including blood panel), even if I take into account the different # of extractions (estimate was $580-$720, depending on whether he takes out 3 or 7 teeth, not including blood panel). I looked into the costs of some of the itemized supplies, and on the two I checked, the markup was 4x and 11x. (ex: Lactated Ringers Solution 1L = $22 on the estimate, but I found it for $2 on an online pet med supplies store). My "gut" feeling about the vet in #3 was more positive than about #2, but I am concerned about price gouging. Also, If I get the extractions done with this vet, my kitty will have 10 days to heal before the airline flight back home (which vet said is plenty) - if there are any complications I will have to delay travel. I am staying with my parents for the holidays, so this wouldn't be impossible, but changing my flight would be another expense on top of the already-higher estimate and I can't be gone too much longer. However, if I didn't take into account the much higher cost and the travel issue, I would probably choose #3.

I am a grad student (on financial aid), but will sacrifice other things to keep my cat healthy. However, I'm really torn about whether to do this procedure here (and pay about 2 - 2.5 times more, it seems) while visiting family, or wait another couple of weeks and go with #2. Both vets were kind to my cat. However, I don't know if I can fully trust either...

Please be positive or don't reply (I noticed some responses were very snarky and mainly focused on berating the guardian). I am open to constructive criticism and opinions/information. But I noticed some replies simply lecture or imply the owner is not committed enough. I ask my vet every year what more I can do to keep my kitty healthy. And to be clear, while I've listed prices above, I am in no way implying that price is the main/only factor in this decision.

I am trying to weigh several factors:
-trust in the doctor
-practical issues (I'm not in my own home right now and will need to travel soon. If there are complications like what I've read about, I would have a hard time extending my trip by more than a week or so)
-financial limitations (I will pay interest on this later when I start repayment on my loans, and while I am not 'cheap' when it comes to the important stuff, I strongly resent being 'taken for a ride' to pad the pockets of doctors)
-quality of medical care

Thanks so much in advance. If anyone with a similar question wants more info on the itemized costs (for comparison) send me a private message.
Blank
874521_tn?1375890587
ok....
I didn't want to go into this too deeply for starters b/c so many post than never return to read a reply..thus alot of time involved.

Yes by #2 choice I do mean the last Vet as I didn't even consider the first one as even being in the running, how blind can a person be to not see what you are describing...very incompetent!!!!...

I am like you, money is short however I do not skimp on this when it means the diff between what I feel is the best choice for my kitties:) however the est. Vet #3 gave you is not out of range IMO...except for the ringer sol cost, but thats minimal...

I will try to address all your questions quickly as your decision has to be today and I too have plans for a bit later.

-yes xrays can only be done under anesthesia...and please insist on these being done!! its mainly only with an xray that FORL's can be dx'd..b/c as with my boy they were all beneath the gums and not showing on the surface. thus is why he needed a dental surgeon, and the absolute need to extract the roots and not just the tooth....he had 4 extractions and under gum work done...cost $1800. yikes. but it was done well.

-I agree the cost of the ringer sol. is very high, I would question this, on my bill it was $12

-I am assuming your kitty has extensive gingivitis and this was the case with my boy too...and the forls that were found while xrays were done during an annual cleaning...what my Vet never found and the specialist did is the PERIDONTAL DISEASE that he also had...and thus the need for extensive work on the roots for his front teeth, still need a follow up to see if this worked along with the oral care I do at home(now) if not than he'll need more extractions.

-so be prepared for this as well, b/c its not until a Vet does xrays that the total extent of kitties issues will be seen..if there VISIBLE evidence that he needs that many teeth extracted than there could be many more that are not visible. I would caution that you speak with the Vet and he not do more than whats necessary for kitties comfort at the moment....its a very extensive surgery if forls are present...
but thats up to you and if the Vet feels kitty is healthy and strong enough to have many extractions done at one surgery...

-please please tell the Vet you don't want Metacam (a common anti-inflamatory) used...
NOR any convienia injections....(antibiotic injection that has proven very dangerous) use only ORAL antibiotics and the best one for kitties undergoing dental surgery is ANTIROBE AQUADROPS..(clindamycin hydrochloride)

http://www.drugs.com/vet/antirobe-aquadrops-liquid.html

re: pain med buprenorphine hcl...an excellent choice esp for safety and nerve pain following extractions...good

NO I am not a Vet, only a pet parent like yourself, however have lots of experience the last year with dentals in kitties and spent alot of time researching this recently....so all the suggestions are IMO and always follow what you believe to be right at the time..:)
the research I have done is with holistic cat people, who have dealt exclusively with the care and treatment of cats esp. where medication dangers are concerned.

-
47 Comments Post a Comment
Blank
874521_tn?1375890587
hi and welcome, good for you for searching for some answers before proceeding...I am surprised you are getting such different assessments of kitties teeth, tell me were xrays ever done? why is he needing so many extractions? Were FORL's every mentioned....re exposed root, this kitty is in alot of discomfort. and all of them didn't recommend brushing..that is very very surprising, greenies will NOT keep the teeth clean. I have just gone thru extensive dental work with a cat dental specialist....and what a surprise I got compared to the routine cleanings and findings from my regular Vet...post back if you are still looking for some help with a decision and I will be glad to help...if I understand correctly you are at your parents now and seeing a Vet in that city, when would the procedure be if you decide to have it done there? Is there anyone you know whose used this Vet and is he highly recommended? to tell you the honest truth this second one sounds more competent/caring despite the costs difference...however I will say for that many extractions...it is much better for kitty to be under the care of a dental specialist...but than that raises the cost again...
post back and I'll go  into more detail....♥
Blank
874521_tn?1375890587
If possible also tell me what EACH Vet is planning on using for anesthesia and pain control following, that will give me a good indication of which Vet I would recommend...
Blank
152660_tn?1291759171
With the blood panel, my vet did the "senior" blood panel which was about $180 as a baseline when they were around 6 or so.  But, that doesn't have to be done now, maybe in the future when you don't have the teeth issue to think about.  

I have had all 3 of my cats in for cleanings and they have been around the $500 - $700 range.  One was more because of the number of extractions they did because the cost of each ranged from $50-$200 depending on the tooth.  

IMHO I would probably go with #3 if only because you may be able to go longer without kitty having to have another cleaning.  

I wouldn't go with #1 just because he wouldn't give you a straight answer on cost.  They should be able to give you a cost breakdown of each tooth that they think may need to come out and all of the anesthesia and equipment costs as well.  He also seemed a little too "I'm too good for that" with your request which would make me think that he may not be as gentle and loving with kitty as he should be especially with him being under anesthesia and vulnerable.
Blank
4520139_tn?1355852769
Hi Opus88, and thank you for your quick response to my post from last night.

--When: I need to make a decision TODAY (surgery is tentatively scheduled for tomorrow morning if I proceed with #3). I will call them sometime in the next couple of hours to discuss the blood test results. I can bring up any issues then. Yes, I am in my parents' home now (in CO) - where vet #3 is located. I live in FL, which is where vets #1 and #2 are located.

--Xrays: no, never done by any of the three vets. #2 and #3 said this would be done under anesthesia.

--Why so many extractions: receding gums, gums not healthy. Canines have started to protrude out of the mouth, hanging outside his bottom lip (this actually started more than a year ago, but when I mentioned one protrusion to vet #1 from 2011, they did not see it as a problem. The second canine has started to protrude in the last couple of months or so). Vet #3 says protruding canines due to the extreme gum recession. Infection in gums around molars. No mention of FORL (and from my research, his gums look nothing like the photos I've seen of FORL).

--recommendations from clients of vet #3: I don't know anyone who goes to him. I can ask my neighbors - it is possible they use this dr.

What did you mean by this, Opus88? How were you surprised?
"I have just gone thru extensive dental work with a cat dental specialist....and what a surprise I got compared to the routine cleanings and findings from my regular Vet"

And when you say "this second one sounds more competent/caring despite the costs difference" you are referring to #3 with the higher price? (not #2 that was fussy about the airline note, right?)

I'd also like to hear your opinion about the markups - a sign of the vet's priorities? Correct me if I should not make this connection (but a former teacher of mine used to say, "a person never cheats in just one area of their life") --> Fair pricing and integrity go together. A lot of people would see this price tag and decide not to pay for treatment of their pets. I am not one of those - I see this price tag and question whether it's fair. I can understand charging more for the services rendered (if he is a rock star dental surgeon), but $22 for a liter of saline?
Blank
4520139_tn?1355852769
Here is the info you requested on anesthesia and I've included the duration and price if it was listed on the quote. (By the way, are you a vet?)

Pre-anesthetic medication ($26.13)
Intravenous anesthesia ($47.03)
Anesthetic monitoring (electronic) per hour, 45 min ($37.23)
Gas Anesthesia 45 minutes ($66.68)
Gas anesthesia additional minutes, 45-85 depending on final decision about extractions ($59.85-$113.05)
Local anesthesia ($30)

Pain: buprenorphine HCL ($52.50)



Re: Vet #2, I did not get a written estimate from him (and obviously no estimate from vet #1 who didn't even notice gum recession at all). I guess he assumed we'd go over that when I brought my kitty back after the holidays to do blood work. All the info above pertains to the estimate from vet #3.
Blank
4520139_tn?1355852769
I was willing to do the full blood panel (when I go to my human dr, I generally like them to be comprehensive, so I take the same approach with kitty), but I got the basic panel yesterday according to vet #3's recommendation.

I am surprised about the costs of your kitty's dental cleanings. The dental cleaning itself (if my calculations are correct) at vet #3 is $250-300. The extractions are priced out by tooth AND by additional anesthesia costs.
Vet #2 quoted $200 for the cleaning, including costs of anesthesia and additional for the extractions. Why would the price be so different?

Vet #1 never discussed the dental issues with me, but I think you are referring to #2 instead, who I saw last week in FL where I live. He did give me a rough breakdown that it would be under $100 or so for the extractions (he noted 1 definite extraction and 1 possible extraction).

When you say "IMHO I would probably go with #3 if only because you may be able to go longer without kitty having to have another cleaning." ... do you mean kitty wouldn't need a cleaning for awhile because he'll have fewer teeth? Or did you mean that #3 will be more thorough in the cleaning than #2?
Blank
4520139_tn?1355852769
By the way, the vet tech told me that the intravenous anesthesia would be Propofol.
Blank
874521_tn?1375890587
ok....
I didn't want to go into this too deeply for starters b/c so many post than never return to read a reply..thus alot of time involved.

Yes by #2 choice I do mean the last Vet as I didn't even consider the first one as even being in the running, how blind can a person be to not see what you are describing...very incompetent!!!!...

I am like you, money is short however I do not skimp on this when it means the diff between what I feel is the best choice for my kitties:) however the est. Vet #3 gave you is not out of range IMO...except for the ringer sol cost, but thats minimal...

I will try to address all your questions quickly as your decision has to be today and I too have plans for a bit later.

-yes xrays can only be done under anesthesia...and please insist on these being done!! its mainly only with an xray that FORL's can be dx'd..b/c as with my boy they were all beneath the gums and not showing on the surface. thus is why he needed a dental surgeon, and the absolute need to extract the roots and not just the tooth....he had 4 extractions and under gum work done...cost $1800. yikes. but it was done well.

-I agree the cost of the ringer sol. is very high, I would question this, on my bill it was $12

-I am assuming your kitty has extensive gingivitis and this was the case with my boy too...and the forls that were found while xrays were done during an annual cleaning...what my Vet never found and the specialist did is the PERIDONTAL DISEASE that he also had...and thus the need for extensive work on the roots for his front teeth, still need a follow up to see if this worked along with the oral care I do at home(now) if not than he'll need more extractions.

-so be prepared for this as well, b/c its not until a Vet does xrays that the total extent of kitties issues will be seen..if there VISIBLE evidence that he needs that many teeth extracted than there could be many more that are not visible. I would caution that you speak with the Vet and he not do more than whats necessary for kitties comfort at the moment....its a very extensive surgery if forls are present...
but thats up to you and if the Vet feels kitty is healthy and strong enough to have many extractions done at one surgery...

-please please tell the Vet you don't want Metacam (a common anti-inflamatory) used...
NOR any convienia injections....(antibiotic injection that has proven very dangerous) use only ORAL antibiotics and the best one for kitties undergoing dental surgery is ANTIROBE AQUADROPS..(clindamycin hydrochloride)

http://www.drugs.com/vet/antirobe-aquadrops-liquid.html

re: pain med buprenorphine hcl...an excellent choice esp for safety and nerve pain following extractions...good

NO I am not a Vet, only a pet parent like yourself, however have lots of experience the last year with dentals in kitties and spent alot of time researching this recently....so all the suggestions are IMO and always follow what you believe to be right at the time..:)
the research I have done is with holistic cat people, who have dealt exclusively with the care and treatment of cats esp. where medication dangers are concerned.

-
Blank
874521_tn?1375890587
propofal...another good choice.
Blank
152660_tn?1291759171
My kitties have both had quite a few teeth pulled.  One is 14 and his teeth are going bad and the other was sick when he was little and I think the meds I had to give him may have weakened his teeth.  Each time they have had some of the bigger molars removed which are the more expensive ones since they are harder to get out and they usually use a stitch or two to close the gums.  

I just remembered that they did xrays which added to the cost, so it would have been less without them.  

With the fewer cleanings I meant that the vet would be more thorough and possibly not leave anything that should have been taken out minimizing the risk and uncomfortableness for kitty.




Blank
874521_tn?1375890587
good post ali....thx for the input and info♥
Blank
4520139_tn?1355852769
Thanks once again, Opus.

A couple of things:

-the med supplies are several items in the bill (I gave the fluids as an example, but when you add up all the markups I am guessing the profit from supplies alone will be over $100). I realize human doctors do this, but maybe I don't mind it so much then because my insurance covers that but my research on kitty insurance showed it was not nearly as useful. Maybe I just have to accept that they're going to make money off of IVs, fluids, sutures, fluid drip set, anesthesia, etc.
($12.54 for IV catheter, $32.50 for "Catheter Placement, I.V.", $12 for fluid drip set, $12 for "T-Port Connection, I.V., $22 for Lactated Ringers Solution 1L). Also it seems they are charging per tooth for x-rays, is that normal?

-unfortunately (now that I have read your post recommending against this) they recommended an antibiotic injection yesterday, which my kitty DID receive. They said it would cover him for 2 weeks and with the dental discomfort this would be preferable to jamming something down his throat (my words, not theirs).

I am hesitating a lot right now because all the extra charges are making me question whether I can trust the doctor .... is that illogical of me?

I haven't called them yet for the blood test results, which they told me should be available at 10am (it's now 2pm). I was hoping to know whether to take him in now, or just wait to get home (and feed him soft food to keep him comfortable in the meantime). They haven't reached out to me either ...
Blank
4520139_tn?1355852769
Ali, I 100% agree with you about being more thorough to avoid leaving teeth in that will cause my kitty discomfort. I think we both tend to the safe side!

Do you remember if x-rays were charged per tooth? I know for my human dental x-rays, they do something like 4-6 to to cover the entire mouth.

Thanks so much for your time and advice... I'm hoping I'm nearly there in terms of making a decision.
Blank
152660_tn?1291759171
For the x-rays, they charge per x-ray to a point, then just all it the whole mouth which ends up less.  

The cost breakdown always makes me cringe, but then I think about the fact that they have to pay for their equipment, staff, rent, their own salaries etc.  For example:  Lactated Ringers Solution 1L = $22 on the estimate, but I found it for $2 on an online pet med supplies store).  We don't think about the tubing and needles etc that go with it.  :)  
Blank
4520139_tn?1355852769
I went ahead and scheduled the appointment.

One final question (and thanks again for all your advice): should I confirm that the roots will come out for every extraction or does this not make much difference?

Wish me luck! :)
Blank
874521_tn?1375890587
I don't find the prices totally out of line with what i paid at the specialist clinic(in the city)....while the #2 clinic is more in line with what I pay at my regular Vet clinic here. Are the same anesthetic gases and medications being used?.  bottom line is I guess you just need to go with your 'gut' feeling on this....if you felt more comfortable with Vet #3 than don't let price be a barrier....but if you'd feel just as comfortable with your Vet at home for less money...((make sure the gas (either propofal or isorflurane) is what they are using.... )) got to compare apples to apples.
And buprenorphine for pain...this Vet is right on with what he uses, other than the convenia injection..I will post a long write up another member just made on convenia on Dec. 16 at the bottom of this page....

there can be side effects from this....and now to be going into surgery with MORE meds added and theres always the chance of side effects with ANY medication....kinda seems like a whole H of alot to be throwing at this kitty all at once...again my opinion.
I tend to trust the #3 Vet the most(other than the convenia) b/c of the more indepth diagnosis he gave you and noticed more issues with your kitties teeth than did either of the other 2. but again if your just as  comfortable with one where you live and thats your decision....

I assume you've made your mind up by now given you had to let the clinic know and of course had to take all food and water away from kitty....nothing says you can't phone and cancel in the morning tho if you get second thoughts...just needed to say that so you would lie awake all night thinking and rethinking like I do...lol.

go with your best instincts....let us know what you decided, if kitty does have morning surgery we send our prayers with him...let us know how he makes out ok...♥

angiesmom posted this Dec 16th abt her thoughts on convenia..please read.

My cat Angelina also had a reaction to Convenia, I did a necropsy at Cornell Hospital Pathology Dept. They found that they think she had liver adenoma/ cholangio carcinoma as well as acute myeloid leukemia. In spite of the fact that she had an end stage liver cancer, it seems, nothing to that effect showed up in her blood work until 4 days after the Convenia shot. At that point her AST was elevated but now tremendously and they thought she had an infection. 4 days after that she had become severely anemic, there was no sign of anemia in any of her blood work before this. She also had a 4 minute claw test, which means she took 4 minutes to stop bleeding.

The findings at Cornell said that they did not believe Convenia caused the anemia, not because it wasn't possible, but because Convenia hasn't been reported to cause anemia. This isn't true, read Dr. Pierson's website, read Pfizer's own foreign market results which state it has caused hemolytic anemia- I have also communicated with someone else whose cat developed hemolytic anemia and who passed away after 4 blood transfusions. So this drug does cause anemia as well as many other severe effects.

When Angie received Convenia she had what seemed to be a cold which wasn't going away, she didn't seem that ill. She had had some weight loss in July, but her blood work was normal. We did a thyroid panel in September which was fine. Then she had some hair loss for which I never got the results of, an expensive test for ring worm.

After Convenia, she developed a high fever, she became extremely doped, she was hiding a lot and she stopped eating. Throughout this she kept seeming to revive as if her body was trying to fight off the reaction. She was given Orbax and her fever lowered and she ate three dishes of food, but then she regressed and started hiding again.. it was at this point I believe the anemia began... I had given her fluids at home and the next day when I brought her for an ultrasound of her abdomen, they thought from an xray that she had possible pancreatitis and had given her more meds for that, she had a large bruise at the site of the fluids.

That day her dvm told me she was severely anemic and she thought Angie was dying... the dvm was very upset- she was crying. I took Angie to a speciality hospital where she was given iv fluids, pain killers and tested. They told me that night they were considering Convenia as a cause of her anemia, I had just read all about it, not having been warned of any of the severe side effects, and I called them to tell them about that. I decided to take her home and try to treat both the cancer and the FeLV( see below) with steroids and other drugs, but I knew the next day she was in too much pain and I had to let her go.

Now that it has been determined that she had cancer, as well as acute myeloid leukemia, which could or could not have been caused by FeLV, she had one inconclusive and one positive eliza test but no IFA test, which I was finally informed of the day she left the speciality hospital, I fear that both Pfizer and dvm societies will not believe that Convenia played a role in her death.

I still plan to file reports with Pfizer and with the FDA as well as warn everyone I can not to use Convenia. I will never use this drug again- I had already refused it once in July when Angie developed a cold after receiving two vaccinations. I had stopped vaccinating my cats due to health issues and I decided to do a rabies which I was still doing as well as a distemper. I think that was the trigger for her FeLV, assuming she really had this, because it stimulated her immune system too much. Angie was one of two kits of a feral queen  who was put to sleep in a shelter, I believe that she may have contracted felv from her mom and then fought it off, but the virus hid in her bone marrow to later resurface.

I had never heard of Convenia before that but I rejected it on the basis that it stays in the system too long. I will always regret giving her Convenia, but had I been warned about the severe side effects reported in foreign market studies I NEVER would have allowed it. I think it is crazy that DVM aren't required to warn us about all of this.   Please see my video Just Say NO to Convenia at youtube.

Please inform yourself because no one else is going to unless this drug is removed from the market, which is my goal. Don't risk the health and lives of your beloved fur babies. There are plenty of safe alternatives to Convenia. I would avoid Baytril also as I have read that it causes blindness and possibly other effects.

http://www.youtube.com/watch?v=yk4MnjGUCGo
Blank
874521_tn?1375890587
guess our post crossed .....yes indeed we wish kitty good luck and hugs to you!!!

the roots I believe normally come out with the extraction......its only when FORLS are involved and the reabsorption process has begun that it means digging into the calcified bone to remove, some Vets aren't qualified to do this thats why my local Vet sent Sami to a specialist....if root fragments are left it can lead to many problems down the road not to mention the continued pain....
Blank
4520139_tn?1355852769
Ali, so true about the cost estimate! I looked at it and definitely cringed.
But they did charge me for EVERYTHING, needles, sutures, fluid drip kit, IV tubes, etc. Just didn't charge me for the scalpels, table, and surgical gloves!

If they would have put the real price of the supplies and charged higher rates for the extractions themselves instead... I think I would have had a different reaction. Nobody wants the medical expertise to cost less than the equipment! I'd rather get the equipment on sale and pay a premium for the skills of the vet. You know what I mean?

Thanks for the info about x-rays! Maybe that will be less in the end than they estimated.

I am dropping him off shortly. Will keep you posted. Really appreciate the info and support.
Blank
4520139_tn?1355852769
Opus,
You were so right - I was up half the night... part of the reason was that my kitty was hungry and kept waking me up to ask for food.
I'm going to ask about the roots when I take him in this morning. I'll also find out what kind of gas anesthesia - not that I'll have time to research and make any requests, but I like how you and Ali are so informed and would like to keep similar records and post the information here to possibly help a future mommy with a kitty needing dental work.
I am so stressed out - it doesn't help at all that I'm not even at my own home (why did I plan a 2-week holiday visit???). Parents are great, but I'm so used to living alone. They just started an argument with me and I'm thinking about cancelling and heading home early to find a new cat dentist.
Blank
4520139_tn?1355852769
Back to square one ... I decided to cancel the appointment and take care of this at home (it's too stressful on kitty and I to do this out of town). I'm going to go for another consultation with a new vet in FL - who will be Vet #4! - so you'll be seeing more of me on this forum.
From what I can tell after a brief call to the office, Vet #4 is all about client education (which I love) but is also quite expensive. I will speak with him personally tomorrow to get a clearer sense of his pricing. I just hope it won't be more than vet #3. Cross your fingers for me!
Blank
874521_tn?1375890587
awww I don't blame you....always best to do what you feel comfortable doing and when things feel right. besides I really do think its best that the convenia clear his system before the surgery!!!
And being back at home kitty will feel more comfortable during his recovery....also the Vet will be right there for follow ups.......you and kitty..btw whats his NAME?? you both have a great Christmas now no stressing for a few weeks :))
Blank
4520139_tn?1355852769
Opus, yeah I feel guilty because I think my parents will be upset when I tell them I'm leaving on Xmas. But sometimes we need to accept that some people are not the right ones to support you through something they can't understand (they're not pet people, but they love Professor, my kitty).
I'm going to try to take him in on the 26th so he doesn't have to deal with the discomfort for too much longer.
And now, I'm going to do my own research on everything related to kitty health. I trusted his previous vet about the dental hygiene (the one who said brushing teeth = unnecessary and failed to recognize that a 'snaggle tooth' is a sign of a tooth dropping from the gum) and this is what happened. Time to be proactive! This forum has helped me to see that I need to do more.
I think despite the vet's advice, it's still my fault Professor has to get all these extractions. I could have still brushed his teeth even though they told me it wasn't necessary. Instead, I trusted them completely. Now my poor baby has to deal with my mistakes!

Hope you have a great Xmas too! Thanks for your support. :) I guess I'm a more neurotic kitty mom than I thought.
Blank
874521_tn?1375890587
lol Professor...like that:) you'll have to post photos....
we're all neurotic kitty mom's and dad's on this site so you'll fit right in:)
Merry Christmas and good trip home♥
Blank
4520139_tn?1355852769
Hi again, Opus!
Well Xmas is over and I'm back at home and ready to take Professor in for his surgery.
I found another vet (let's call them Vet #4!) and while they're considered one of the most expensive around here, they appear to be more reasonable than Vet #3... how about that!

Here are the drugs they discussed with me:
--Anesthesia cocktail: ketamine, domitor, duprenex
--Gas: isoflourane (spelling?)
--pain: Metacam and duprinex (I remember you said no to Metacam and I brought this up with them. They said they've had a good experience with it, except they wouldn't prescribe it in some cases based on the blood work... maybe they mentioned if there was a liver issue? I can't remember exactly what they said. I also asked if I could request another drug if I wanted. They said that's no problem.)

Any thoughts?
I will probably schedule for tomorrow morning, although the vet I prefer is not in until next Thursday.
Blank
874521_tn?1375890587


so Vet #4 it is....glad this is alll settle and Professor is ready to get this done and over with..

I really don't know much abt Ketamine, other than being told its old school protocol and there are safer drugs available....however IMO also and with my own Vet I sometimes think its safest to go with the drugs they are used to working with and not demand an alternative(some cases)...know what I mean? for instance propofol is a safer induction agent BUT it must be administered by a skilled Vet otherwise if injected too quickly can lead to respiratory arrest.
so if your Vet commonly uses this and is comfortable with it and you trust him....
one word of warning it can cause major hallucinations...so if Professor acts really weird following that is very likely the cause....of course this would reverse when the med has cleared his system.

I am not at all familiar with Domitor,
I think this is medetomidine(?) a pain med. buprenex(bupronorphine) is a safer med. also butorphanal.

duprenex....do you mean buprenex? that is the best choice in pain meds for a cat especially for the nerve pain associated with dentals..
that is absorbed orally via a dropper....and tolerated well.

I'm not sure why 2 pain meds would be required?

for an antibiotic Clindamycin is best for dentals and is very well tolerated by cats. if required.

Metacam is a non steroidal anti-inflamatory (NSAID) and is not a good drug, but from what I've read none of the anti-inflamatories are. they are very hard on the kidneys.....I can't suggest any alternative there. but I would request an alternative if an NSAID is absolutely necessary.

http://www.metacamkills.com/

sorry I can't be a whole ton of help to you. Go with what you've read and your best gut feeling, thats all we as parents can do....I wish you and Professor tons of luck tomorrow...update us afterward okay. sorry but I have to rush off the forum tonight, but will check back tomorrow for an update...♥

Blank
4520139_tn?1355852769
Opus,
You won't believe what this vet did to me on pricing today. I got a quote yesterday that put the services (without seeing him) under $500. I padded this estimate based on additional costs I could anticipate. This already felt like a lot (remember, I've already spent $300 on 2 physical exams, antibiotics, and blood work). But I specifically asked for information on pricing so I wouldn't bring him in for another exam and then find out I couldn't afford the services at this facility.
Then this morning I bring him in for the surgery and the estimate they gave me at the last second was $200 more than yesterday. They said the girl from yesterday had made a mistake and was not authorized to price it out the way she did. I asked for a few minutes alone to think about it (in the exam room) and could not get a hold of myself. I had already kept Professor without food for two different nights. And I figured they'd charge me for the (THIRD) physical, even if I took him and left the office. They completely cornered me. An already stressful situation became so much worse when they hit me with a bill substantially higher. It made me more uneasy than I already had been.
Then they called during the surgery to get my approval for an antibiotic gel. The vet said it "would not change the price much" but it turned out to be another $90. So in 24 hrs the bill went from $500 to $800, even though I had accounted for basically the same number of extractions (I thought 7, but they took out 8) and was confident that I had anticipated it properly.
I am so upset at how they have handled the cost. I know they are a business and need to cover their costs, but they should understand that I also have a budget and need to cover my costs too!
On a more positive note, they said he was doing fine and after the antibiotic gel they'd wake him up.

Is this how all vets are? I am so disappointed ...
Blank
874521_tn?1375890587
well this is an unfortunate thing with 'estimates' they are only an estimate and as with all we do need to be prepared for more...however that is quite a jump from $500 to $800...I can't blame you for being upset, when finances are an issue(as with most of us) that is a terrible increase.

but I will say if they did this antibiotic gel...than this Vet must also have done some under the gum work as my Sami had...and thus Professor also has peridontal disease....Sami only needed 4 extractions(thus far) and his bill was $1800. so this Vet is not out of line.

this under gum antib gel that Sami got was to TRY to prevent more root detachment from the peridontal disease, he has to return to see if this gel treatment was successful or not, if not then more extractions will be needed....so as it will be for your kitty.

the specialist also sold me some oral cleaners and told me Sami had to have daily dental care...including a brushing for prevention....so be prepared for that also. also a product called EFAC an essential fatty acid that I was told they've seen great success with.

You tried so hard to find a Vet and a price you were comfortable with and I'm so sorry this had to happen to you. I would ask if this includes a follow up..
main thing now for Professor is that he comes thru the anesthesia fine and heals well with no problems....feed him soft canned food for a few days, he will have a very sore mouth.....thats alot of extractions at one time.

its over!!!! now the healing for both him and YOU...((hugs))


Blank
874521_tn?1375890587
I forgot....did he also get x-rays done? and NO sign of FORL's????
Blank
4520139_tn?1355852769
Thanks for your support - it's been a hard process for Professor and I. More so for him of course, and only financially and emotionally for me.

They did do dental xrays. Gave me a printout, but for some reason they only included the bottom xrays in that printout. I asked about this and they said it would be difficult to provide the top xrays (?? no idea what that means).

However, the vet DIDN'T EVEN COME OUT TO TALK TO ME when I came to pick up Professor. Only the vet technician. So I did not get a recap of what happened. All I know is that 6 were level 1 extractions and 2 were level 2 extractions. No info on FORLs, although the doctor discussed them in the consultation before the surgery. I expected her to come out and greet me, but maybe they warned her that I wasn't happy so she stayed in the back room until I was gone. I was 100% polite, but considerably less cheerful and friendly than I had been in previous interactions. Also my eyes are pretty puffy from the stress of the morning and I am sure I looked really anxious while I was handing over my credit card.

Regarding the estimates, I had accounted for 7 extractions at the level 2, which was conservative (vet #2 said 2 maybe 3; vet #3 said between 3 and 7 extractions). Based on the information I had, the eighth extraction should only have increased the price by another $30... so it's the other stuff that they got me on (changing the price of the dental cleaning, the antibiotic gel, and different meds from those in the first estimate). Although I had asked the first tech at this office what other optional meds or supplies might be given, she failed to mention this antibiotic gel. The vet did not say anything about it this and it wasn't on the estimate from this morning either.

They said they wouldn't charge me for the follow-up. I think this was their last-ditch effort to save face on Yelp. I haven't decided whether I will bring him back again but if I do it would be after discussing these issues with the owner, who is the primary vet (the one I was supposed to see when I came back from my trip early).
Blank
874521_tn?1375890587
hows Professor doing today??
Blank
152660_tn?1291759171
How is your little one today??
Blank
4520139_tn?1355852769
Update:
I took Professor back to the vet today.
-Some inflammation in gums where one canine that was removed. Periodontal gel still in place.
-103 degree fever
-his breathing has been shallow and rapid, not in the extreme but noticeable enough that I caught it.
-he has been quiet and sleeping a lot since I stopped giving pain meds. (The last 2 days on pain meds he seemed to have had a lot more energy and was playing - the kind of behavior he used to have in the past but had been missing these last couple of months)

Next steps:
-started him on a pain management regimen to test whether his behavior changes if his pain is removed.
-started antibiotics (expecting a 2-4 week course) to treat the deep bone infection in his teeth.
-will call the vet Friday to discuss progress
-follow-up visit in 2 weeks

Blank
874521_tn?1375890587
I am so glad you got Prof back to the Vet....with a temp of 103 he definitely has a serious infection going on.
I hope the Vet rx'd the same buprenex for pain and antirobe for the antibiotic?
I am certainly hoping and praying that this works out well for the poor little guy....no wonder he wasn't playing and acting normal...sending some good healing {{{{vibes}}}} to our boy♥
Blank
4520139_tn?1355852769
The vet said the temp could be in part due to the stress of being there, but there was at least a minor fever either way. He prescribed:
1. Buprenex for pain
2. Metacam for pain/inflammation (I addressed my concerns about this and he responded by explaining that the low dosage he is using makes it safer than what the studies have shown. He seemed to know exactly which literature mentioned the risks and was confident he had accounted for that)
3. Clavamox for antibiotic

I'm becoming a veterinarian one day at a time... administering meds, checking gums, etc. :) Maybe I should give up on the doctorate and switch to a veterinary medicine program.

Thanks for the good vibes! I am crossing my fingers that this is just side effects of an infection and will be solved with the Clavamox after a couple of weeks.
Blank
874521_tn?1375890587
well we do have to trust in the knowledge of these Vets at times too, its just good to be up on everything ourselves at the same time:)

I agree Gabster you're slowly switching that doctorate over to Veterinary Medicine......sure could use ya!!!!

Blank
Avatar_m_tn
It's now May 1 2013 and I am so glad that you posted your whole experience and got the feedback from so many others. Invaluable to me as I was stressing about the news that my 5 yr old Maine Coon would need a few more extractions. I spent $1000 on extractions a few years ago plus a few hundred for a pre-op heart ultrasound thru a UC Davis clinic here in San Diego as Maine Coons can have some heart issues. Now we're back and in the $1,100 range. It has really helped me compare the various inputs re: prices, meds, xrays as I could see on my detailed printout that prices were within range and that the protocols (full xray, periodontal cleaning, oral flap, meds) were in line with the recommendations. Even if there's some padding, I'm willing to deal with the cost now just knowing that the place is spotless and people are very caring. I realize from the input that peace of mind is worth the extra few buck when it comes to feeling my kitty best friend is safest and best cared for.  Thanks to all!
Blank
874521_tn?1375890587
hi and welcome, I am sorry your kitty is facing so many more issues with his teeth, that care gets terribly expensive. My Sami has also faced extensive dental work.
I would like to tell you of something I've been using for his oral care. In Oct. 2012 he had several more extractions done this time by a Veterinary Oral Surgeon, he found lots of peridontal disease....also did some repair work under Sami's gums and added a gel antibiotic to hopefully permanently fill in the huge pockets he found. he also of course gave his teeth a good cleaning.

He sent us home with some oral care gel to apply following each daily brushing...do you brush your kitty's teeth?
he also prescribed a fairly new product, an esterfied fatty acid called EFAC I will include the link for this product. I have been cleaning Sami's teeth daily since that appointment and opening one of the EFAC capsules and rubbing the gel like substance on his gums, hates the taste but he doesn't fight me...:)

anyway, we had his 6 month check up 2 weeks ago and the Oral Surgeon just could NOT believe the difference this has made to his gums...they are in beautiful condition, nice and pink and healthy..he also probed under the gum line with one of those steel picks and Sami didn't even flinch, he was amazed at the complete turn around...won't say cure, but darn near. We now only need to apply it every second day:))

Please ask your Vet to order you some of this. After my local Vet learned abt it he has been prescribing it for all the kitty's with dental issues and he said he's seen remarkable transformations too...

http://hopesciencevet.com/cat-perio-home/
Blank
Avatar_m_tn
ugh ... there's no way my 13 pounder is letting me brush her teeth. She was a rescue cat and is a very sensitive, respectful soul but has very strong opinions about how, where, and how much she's touched!  After 3 years + of trust building I still get nipped... tho it's gotten gentler over time. I'm considering discussing getting all the possible teeth pulled as I don't want to keep stressing her heart and my pocketbook. As a sr citizen it's too expensive to do this every year or so, especially as she gets older and I do too!
Meanwhile I decided to go to a different well recommended vet so at least it will be a more personable staff. and maybe she'll be less freaked out. She's been under the bed since we got home yesterday. Now I'm worried they poked and prodded and aggravated her poor gums. I'll take her to the new vet tomorrow. Thanks for your input, really!!
Blank
Avatar_m_tn
Yes!  I'm going to try the EFAC capsules. The pamphlets were at the new vet's office, so that was a good sign. Thank you for that.
Blank
874521_tn?1375890587
I know its almost impossible to brush some kitties teeth b/c of their character &/or background, especially when their mouths are so tender anyway.  My Vet told me one of his patients was like this and the owner just squirted the capsule into the cats mouth, or he mentioned even just putting it on the paw and naturally the cat will lick it off.....:)

good luck with this......give it a trial for a month or two, if there isn't a drastic improvement than unfortunately the kindest thing you can do for your kitty is to have the teeth removed, especially if there are FORLs present. be sure you get a dental surgeon when looking at extensive extractions....:(

keep us posted♥
Blank
Avatar_m_tn
All the information was so helpful. The new vet's office was so much more conducive to caring information. My cat didn't freak at all. I felt informed. She had 4 teeth pulled and has bounced back so well. The vet thought she had probably been in pain as the pulling was necessary. Glad to be done with it. Will be using the EFAC. The vet I changed to charged $300 less than the one I left. So glad I found this website. Thanks all!
Blank
874521_tn?1375890587
thank you so much for the update...I am so glad its all over with and you had a good experience with the new Vet (sure can make a difference)....I hope she will now bounce back quickly and be pain FREE....nothing worse than a sore mouth as we ourselves know:(
I'm glad you will be using the EFAC....I think this will make a huge difference for her.
glad you found us too....your welcome to post any old time, doesn't have to be a problem going on..we love members with just plain old kitty tales too...
be sure to tell us her name next time you drop in...:)
Blank
Avatar_m_tn
Dear cat lover......The Univercity of Penn animals at 3600 spruce in Philadelphia...Is the finest animal vet to go to...They are intense and treat an animal as if it were a person....I highly recommend that you go their with your pet......Trust me they are the finest...They save animals that are on their death beds..and the dentists are the best.....
Blank
Avatar_m_tn
Dear cat lover......The Univercity of Penn animals at 3600 spruce in Philadelphia...Is the finest animal vet to go to...They are intense and treat an animal as if it were a person....I highly recommend that you go their with your pet......Trust me they are the finest...They save animals that are on their death beds..and the dentists are the best.....
Blank
Avatar_f_tn
I have young Main Coons  - 3 cats about 1 year old.  Two are ok but 3rd one had severe gam infection, as you did, I looked for several vet opinion, but unfortunately all diagnosis come the same - I will have to extract almost all cat teeth.  We check with specialists and veterinary school by major A&M University and unfortunately extraction is necessary.   So far my Main Coon cat had deep teeth cleaning and gum trimming (infected gum grows over the teeth) all under anesthesia.  So far it was better for couple of months, but gums are again very red.   My final option will be extract almost all teeth.  I want to enter him in the FICA show in November in Houston and after that I probably extract the  teeth.  It is very painful for the cat to eat with gum infection or any other teeth problem - teeth extract will not bother cat at all.  It sound very drastic and on the beginning I can't bear that I have to do it, however,  I will help my cat.  Cats after extraction have a normal life. My outdoor cat already had most of back teeth removal and it healed in the couple of days.  We had to give him some pain medication and antibiotic for couple of days and later vet give him antibiotic shot for two weeks. Now he eats dry food and everything else without a pain. He is healthy and happy now.  Unfortunately I can't give you a price, but it is worse it - it's a member of your family.  Other issue - you probably do not see that your cat is in pain - cats hide it very well....

Wilma     .
Blank
4520139_tn?1355852769
Hi Wilma,

Thanks for your post. This thread is a little old, actually. I had done all the recommended extractions (in two separate surgeries, because the "borderline" teeth at the time of first surgery became infected and needed a second surgery to remove). Kitty is doing fine. He only has one of the long teeth remaining (lower). Most of his teeth are gone now, and he seems to have no trouble eating. I feed him BLUE - in addition to the quality of the food, it has very small sized food pieces that seems to make it easier for him to swallow without biting first. One issue that has come up since my last post is that it's difficult for him to keep his fur groomed. He used to use his teeth as a sort of "comb" and now he gets more mats than before. I brush him often, but he needs to get a haircut a couple times a year to keep his fur from being knotted. I'm sure you are familiar with this, since you have Maine Coons as well - they have a coat of fine fur close to the skin that is prone to tangles.
Hope this helps.

Gabsters
Blank
874521_tn?1375890587
Hiya, nice to see your post and hear Gabsters continues to be doing well....
Blank
Post a Comment
To
MedHelp Health Answers
Recent Activity
242912_tn?1402547092
Blank
Jade59 commented on mclovin
10 mins ago
5347058_tn?1381192026
Blank
ariley13 commented on 'You Would Know&...
2 hrs ago
2020005_tn?1404435525
Blank
mhv, and KTowne commented on TinaR10's status
2 hrs ago
Top Cats Answerers
874521_tn?1375890587
Blank
opus88
Canada..., SK
7052683_tn?1392942395
Blank
CML2014
highland beach, FL
587315_tn?1333556383
Blank
zodiacqueen
VA
242912_tn?1402547092
Blank
Jade59
CA
134578_tn?1404951303
Blank
AnnieBrooke
OR
506791_tn?1350343103
Blank
Piparskeggr
Saint Mary's County, MD
Cats Community Resources
RSS Expert Activity
469720_tn?1388149949
Blank
Abdominal Aortic Aneurysm-treatable... Blank
Oct 04 by Lee Kirksey, MDBlank
242532_tn?1269553979
Blank
The 3 Essentials to Ending Emotiona...
Sep 18 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank
Top Cats Answerers
874521_tn?1375890587
Blank
opus88
Canada..., SK
7052683_tn?1392942395
Blank
CML2014
highland beach, FL
587315_tn?1333556383
Blank
zodiacqueen
VA
242912_tn?1402547092
Blank
Jade59
CA
134578_tn?1404951303
Blank
AnnieBrooke
OR
506791_tn?1350343103
Blank
Piparskeggr
Saint Mary's County, MD