Complete Care for Your Aging Cat - Amy Shojai [94]
One of the best ways to keep your cat healthy is to keep the teeth healthy. When problems have already begun, a professional dentistry by your veterinarian is the best choice.
Cats won’t hold still for dentistry. “Everything must be done under anesthetic,” says Steven E. Holmstrom, DVM, a dentist in San Carlos, California. “They won’t say Ah.” Geriatric cats should be screened to make sure the safest anesthesia is used. For cats that also have heart problems, for example, special care needs to be taken, says Dr. Holmstrom. A screening profile checks blood chemistry, electrolytes, liver and kidney function, blood cells and platelet status, and urinalysis. A heart test such as an electrocardiogram (ECG or EKG) may even be run. These pre-anesthetic evaluations not only help the veterinarian choose the best tools to do the job, they may also identify hidden problems.
Most veterinarians offer routine dental care, such as cleaning and extractions when necessary. Veterinary dentists have the benefit of additional training and more specialized equipment. “As a veterinary dentist I probably do at least one root canal a day,” says Dr. Gengler. “We also do crowns and orthodontia not for cosmetic purposes, but for medical reasons.” For example, teeth that are misaligned may cause damage as the pet chews, and need to be realigned to prevent serious injury.
Those practicing at specialty practices or teaching hospitals have an added advantage of having access to veterinary anesthesiologists. Typically, once the cat is cleared for dentistry, an anesthetic such as isofluorine or sebofluorine is administered. With older patients, Dr. Holmstrom says fluids are also helpful to counteract potential hypotension (low blood pressure) that may result from the anesthetic.
“The next step is evaluating all the teeth with a periodontal probe. Dental X-rays are extremely beneficial to detect lesions below the gum line, and getting an idea of bone loss,” says Dr. Holmstrom. Sometimes tartar is all that holds bad teeth in place. Once the teeth are cleaned, those with severe damage almost fall out on their own.
“Active periodontal disease probably cannot be cured in one treatment,” says Dr. Gengler. Antibiotics often are required following a dentistry to fight any infection and counteract new problems that may develop from the open wounds (pockets).
Stomatitis associated with bartonella in otherwise healthy cats may be treated effectively with antibiotics. For cases of chronic gingival stomatitis in which antibiotics don’t help, removal of all the teeth will be necessary. “Fortunately, we don’t have to do it often,” says Dr. Gengler. This condition probably results from an upper respiratory infection (calicivirus) and prompts a malfunction of the immune system, which attacks the gums and teeth.
For stomatitis, a variety of treatments may be offered after the cat’s teeth have been thoroughly examined and cleaned. Dr. Rochette says owners of these cats should be prepared for a long battle. “Aim for comfort and control, not a cure,” she says. “These cats have been very painful for a very long time. They need their pain addressed.”
Veterinary dentist Judy Rochette, DVM of Burnaby, British Columbia, says treatment often includes combinations of antibiotics, a hydrolyzed protein allergy diet trial (such as Hills z/d or Waltham-Royal Canin HP23), antihistamines, lactoferrin,