This is William, a lovely 12-year-old DLH ( Domestic Long Hair cat ) presented to us as his owner had noticed a lump in his mouth on his lower jaw. After careful examination we found a large collection of hair encircling William’s lower right canine, removal of the hair revealed a large defect in the tooth exposing sensitive tissues, part of a common cat dental issue called Tooth Resorption. His owner booked him in straight away for treatment.
Please note, William even with this very painful mouth appeared to be eating normally and apart from the lump was exhibiting no signs of pain. This is especially important in cats as they are exceptionally good at hiding all types of pain and so we have to be very diligent as owners to regularly examine our cats if possible.
William being admitted for the day
As dental procedures are often lengthy, we minimised the risks to William by performing general health blood sampling prior to the anaesthetic to ensure his kidneys and liver were functioning as they should. To protect his circulation and ensure blood pressure and hydration were adequate an intravenous catheter was placed prior to any medications and a fluid pump allowed us to regulate the fluids William received.
Drugs given before the anaesthetic include an opioid painkiller and a mild sedative. This was then followed with a short-acting injectable anaesthetic to allow a tube to be placed in his windpipe and allow oxygen and inhaled anaesthetic which the body can clear quickly direct entry to his lungs. His airway during the procedure was further protected with an absorbable sponge to stop fluids from the scaler and drill from gaining entry. Blood pressure was monitored so action could be taken if any concerns.
Dental radiographs are taken to assess the tooth roots. This is of paramount importance as a tooth can look healthy at the crown but has underlying root pathology that only an x-ray will pick up. (We perform dental radiography on all of our dental patients to ensure they receive optimal care and assessment.) The following radiographs show some of the pathology affecting William’s teeth – you can see the tooth looks mottled as if it’s being eaten away – this is a painful process but cats being cats tend to hide any outward effects of pain, so William’s owner never knew he was in discomfort as despite how awful these radiographs look, he was still eating! As we mentioned earlier. Can you imagine if this was a person….
Dental radiographs of William’s teeth
Tartar was removed by ultrasonic scaler and once the mouth was clean multiple extractions were performed after dental nerve blocks (this gives additional pain relief after the procedure and can allow the amount of anaesthetic given at the time to be reduced). William needed surgical extractions, so sutures are placed in the soft tissues with very fine absorbable material.
William’s teeth before extraction
William’s sutures following his extractions
As you can see, William ended up with further extractions than just the ones we thought on clinical examination, this is because the x rays showed tooth resorption starting in the other teeth (see green arrows) even though they looked normal from the outside.
His recovery was smooth, and we have seen him back for check-ups at 1 and 2 weeks after the operation. We always recommend ongoing pain relief and feeding of soft food until we are happy that the post-op check-ups are going well. William had a bit of infection evident at his first check but after a course of antibiotic, he had healed well by the second check. His owner is happy to continue ongoing dental prophylaxis if he will allow it and of course regular dental assessments.
We do hope William will enrol in our KISSCatCare Program, and do some WETs every month. In this program, we encourage once a month weight check, examinations and teeth checks (with images if possible). This can all be recorded in the pets own portal and is invaluable in helping your cat live a pain-free healthy life. Please ask for more information or go to https://kisscatcare.petstoreo.com for more information and our early Beta release.