Dental for an old cat - which anaesthetic in uk?

[molly_the_tortoise]

Hi,

I'm trying to do as much research as I can prior to booking in my 13.5year old for a dental (no issues with her eating or smelly breath, but the vet has said she has some gingivitis as well as plague/tartar) . We've had a young cat (9 months) pass away unfortunately recently, from something unrelated to dental (but its sort of changed my mind on how I view some vets).

From reading online, it seems like sevorflurane is the safest GA, as its short acting and administered by gas. Is this something licensed here in England? Ketamine injections seem to be much more frequent here, and from reading alot of (USA) forums this seems to have the most side effects - most people recommend a gas based general anaesthetic.

Would someone be able to shed some light on this please?

Many thanks

[fjm]

I think the best thing may be to ask your vet what they recommend and use - as mine said to me recently, better to rely on her 35 years of training and experience than random unqualified people online. Once you know what they use you can research its pros and cons, and if necessary consider asking for a second opinion. There are ways of improving anaesthetic safety - pre-op blood tests, ensuring constant monitoring during and after anaesthesia, etc, and it is worth ensuring your chosen vet provides these services.

[booktigger]

I would ask your vet what they use, but I didn't think they used Ketamine in the UK any more, I remember about 15 years ago my old vet having a big sign up when they changed to a different anaesthetic. With her age, I'd have pre-op bloods done and a drip, it makes it more costly, but also safer.

[Mollycat]

More things vets do differently!

My vets routinely do pre-op bloods regardless of age and health, and I don't know about age but both mine had dentals after diagnosis of very early renal issues and had a night in before on IV fluids, and one had a second night after as well.

Can I ask, your young cat that you lost, was this anaesthesia-related? Only, it's an unusual thing for owners to be concerned about so I wonder if you had a bad experience. If so, anaesthesia always carries a small risk but anything licenced for use should be safe for all but the smallest number of patients.

[molly_the_tortoise]

I think the best thing may be to ask your vet what they recommend and use - as mine said to me recently, better to rely on her 35 years of training and experience than random unqualified people online. Once you know what they use you can research its pros and cons, and if necessary consider asking for a second opinion. There are ways of improving anaesthetic safety - pre-op blood tests, ensuring constant monitoring during and after anaesthesia, etc, and it is worth ensuring your chosen vet provides these services.

Thank you all for your replies. I did ask on the phone today actually (reception staff) but they didn't know and said they weren't medically trained. Not sure how I would go about speaking to the vet themselves..

I would ask your vet what they use, but I didn't think they used Ketamine in the UK any more, I remember about 15 years ago my old vet having a big sign up when they changed to a different anaesthetic. With her age, I'd have pre-op bloods done and a drip, it makes it more costly, but also safer.

I will try and find out, from forum posts in the last few years I did read Ketamine was used, but of course all vets will have different ones. Cost isn't an issue, I'm all for pre bloods, xrays, IV, monitoring etc as long as she is fine during and afterwards. Some GA's can cause renal issues in the weeks / months after administration which is very worrying. My Molly was sprayed around 12 years ago approx, so I assume that was under GA also (no idea which one as it was with another vet whose closed shop).

More things vets do differently!

My vets routinely do pre-op bloods regardless of age and health, and I don't know about age but both mine had dentals after diagnosis of very early renal issues and had a night in before on IV fluids, and one had a second night after as well.

Can I ask, your young cat that you lost, was this anaesthesia-related? Only, it's an unusual thing for owners to be concerned about so I wonder if you had a bad experience. If so, anaesthesia always carries a small risk but anything licenced for use should be safe for all but the smallest number of patients.

It wasn't anaesthesia related. He and his litter brother had had just been introduced into going outdoors few weeks prior. He came in one night with a cut on his belly (about 2 inches long, not much blood) but kept licking at it as cats do. (My Molly has had several cuts from fights et over the years, she's always been fine and never had Loxicam - only antibiotic and steroid injections). Initial vet visit they put staples on the cut and prescribed Loxicam (Meloxican). Over the next few days his appetite gradually decreased, still licking at his wound. Took him vets again, vet just put a cone on him that was all didnt really check him out. Over the next 48 hours his appetite had dramatically decreased (we took cone off to help him eat etc) and he was quite stationary - not his playful normal self. Had to take him to emergency vets in the evening, he was kept in overnight. Had to be put on oxygen, passed away 12 hours later - one week after his initial vet visit. Vets seem to think it was sepsis, they said he had a low platelet count from a blood test. We think it was the Loxicam. Retrospective research on this, Meloxicam seems to be blacklisted in USA apart from exceptional circumstances, with renal side effects most common. This seems to correlate to what happened unfortunately.

[Mollycat]

I'm so sorry, how awful. I do understand your caution with drugs though.
Perhaps not so much with pet drugs but you have to remember pharma companies are extremely powerful and drugs are not always given or refused licences entirely based on science. Take the campaign against the Oxford Covid vaccine for example, even the media managed to grasp the idea in the end, that a vaccine costing a quarter of the price of the others because of an ethical condition imposed on its manufacture was always going to struggle, when scientific testing found no more problems with it than any other. And when you add that its manufacturer and distributor successfully fought off a hostile takeover bid by the manufacturer of its main competitor very recently, that tells you all you need to know if not the whole story of why the negative press and licence delays on the other side of the Atlantic.
Meloxicam is Mexican - no further comment on that. But it can be and is used cautiously long-term even with renal failure patients.

Vets do have the benefit of many years training, but they do also have the pharmaceutical (and pet food!) industries knocking on their doors with promotions. I would treat this as any other pet care decision - get the vet's point of view, check it out for yourself, but do be careful of your sources and their sponsorship.

[booktigger]

I'm surprised the receptionist couldn't tell you what anaesthetic they use, you don't really have to be medically trained for that. I would ring them back and ask if they can either ask the vet, or get the vet to ring and tell you what they use. I'm sorry about your other cat, it might not have been Metacam, I had a 20 year old on it for arthritis, she did go in early stage renal failure but we kept her on it, with a diet change her numbers improved and she had nearly 12 months with both renal failure and metacam, and it was her arthritis that forced the decision. I wouldn't compare the UK to the US too much

[fjm]

Loxicom got a bad reputation when the only formulation was the 1.5mg/ml for dogs - cats need a much lower dose, and it was very hard to get it right. Since the .5mg/ml has been available it is much safer - like booktigger I had an elderly cat on a daily dose for many years, and it made a great difference to his quality of life. Any medication that is effective can have side effects, of course, but I would not jump to the conclusion that it caused the sad death of your cat, when sepsis is a more probable explanation. Think of paracetamol - an overdose causes liver failure in humans, but that used correctly it is so safe it is available over the counter.

I would book a pre-op appointment to discuss your worries with the vet who will be doing the op - they may have a range of anaesthetics and choose the one best suited to your cat's condition, and should be able to explain both that and the monitoring available and post op care. Write down a list of your questions, so that you don't forget anything. It may mean standing in the carpark, or they may be able to do it by phone or online, but by making it a paid for appointment you should get a block of time when the vet isn't dashing to get to the next patient.

[molly_the_tortoise]

Loxicom got a bad reputation when the only formulation was the 1.5mg/ml for dogs - cats need a much lower dose, and it was very hard to get it right. Since the .5mg/ml has been available it is much safer - like booktigger I had an elderly cat on a daily dose for many years, and it made a great difference to his quality of life. Any medication that is effective can have side effects, of course, but I would not jump to the conclusion that it caused the sad death of your cat, when sepsis is a more probable explanation. Think of paracetamol - an overdose causes liver failure in humans, but that used correctly it is so safe it is available over the counter.

I would book a pre-op appointment to discuss your worries with the vet who will be doing the op - they may have a range of anaesthetics and choose the one best suited to your cat's condition, and should be able to explain both that and the monitoring available and post op care. Write down a list of your questions, so that you don't forget anything. It may mean standing in the carpark, or they may be able to do it by phone or online, but by making it a paid for appointment you should get a block of time when the vet isn't dashing to get to the next patient.

Thanks, yes that a good point, I dont mind paying for the vets time, although the vet may think who is this strange animal coming in

I've taken some photos of her mouth whilst giving her a treat. Does it look quite bad? (She hates me opening her mouth so this is the best I can do) She is eating and drinking with no issues, that's why I am in 2 minds about this.

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