Photo by Cel Lisboa via Unsplash

Dear Most Esteemed and Knowledgeable Kitties:

My family’s 18-year-old cat has come into my care in the past couple of years and I’ve noticed her teeth are quite bad. The plaque is very visible and recently her gums have turned red and she swallows her kibble whole. I’m sure they’re causing her pain. She is too old to go under anesthetic, have multiple teeth removed and possibly recover (or not) if she makes it through the op. The vet told me she had early kidney disease and slightly raised liver levels, she is quite old and likely on her way out. Is there anything else I can do, such as a continual course of antibiotics? I already put cat teeth cleaner in her water. She vomits from pain medication. Back when I was a child, what we now know about cat tooth infections wasn’t known and it wasn’t the done thing to put them under for a clean.

~ Scarlet

Thomas: You’re certainly in a tricky situation, Scarlet. The thing about dental disease is that it certainly can do harm to the vital organs, including the kidneys. But then, if her organ function isn’t up to par for anesthesia, how can you treat the dental disease?

Bella: We did some research on treating dental disease in very old cats and found a great article by Dr. Sandra Mitchell on the benefits of doing dental work on old cats.

Tara: In the article, she tells the story of a 17-year-old cat with advanced dental disease. The cat’s caretaker was reluctant to put the cat under anesthesia because of concerns about her general health …

Thomas: After all, the kitty already had kidney disease and hyperthyroidism…

Bella: But the thing is, all those diseased teeth were causing the cat a lot of pain and were showering her blood with harmful bacteria that would affect her kidneys and other organs.

Thomas: Ultimately, the guardian decided to have the vet treat her cat’s dental disease with an anesthetized cleaning and extraction of teeth that had resorptive lesions (which are like “kitty cavities”).

Bella: Because the vet did a thorough physical, monitored the anesthesia carefully, and made sure that all the cat’s diseased teeth were removed, the cat came through the operation just fine and was like a new cat once she recovered.

Tara: The moral of the story is that it is possible to anesthetize an old cat, even one with kidney disease and other organ problems, and have everything turn out okay.

Thomas: If your vet isn’t comfortable doing surgery on your cat–and we should add that’s totally okay and actually a good thing for a vet to say they’re not equipped to do a procedure like that!–maybe you can consult a dental specialist.

Bella: Believe it or not, there are veterinarians who specialize in dentistry. They have lots of experience with anesthesia on cats of all ages, in all stages of health, and they’ll be able to give your cat the best possible chance of making a full recovery.

Tara: If the dental specialist says it’s not in your cat’s best interest to do surgery, they’ll certainly be able to recommend things to help ease your cat’s pain and treat the infection in her gums.

Thomas: You’ll probably be surprised at how different your cat acts once her mouth doesn’t hurt anymore!

Bella: When Siouxsie (bless her furry little heart, we still miss her and it’s been two years since she passed) had a dental at the age of 15 and had four teeth removed, her whole demeanor changed and she started acting about five years younger!

Tara: Whatever you decide to do, though, we know you’ll be doing it with your cat’s best interest at heart. When you approach your cat’s care that way, there is no wrong thing to do.

Thomas: While you’re figuring out what to do for your kitty, we’d recommend feeding her soft food rather than kibble. It’ll be easier for her to eat, and it’ll help her stay hydrated, which is really important for a cat with kidney disease.

Bella: And Thomas should know–he has kidney disease, and you should see how much water he drinks! And that’s even when eating wet food! My goodness, he leaves lakes in the litter box!

Thomas: Bella, that’s not nice. I’m doing the best I can, and at least I’m going in the litter box.

Bella: I know, Thomas. I’m just trying to help Scarlet understand that she’s not alone in dealing with a kidney kitty.

Thomas: Okay. Can we snuggle now?

Bella: Oh yeah, let’s snuggle!

Tara: I wish I could snuggle.

Thomas: You’re always welcome, Tara.

Tara: Thank you. I’m not quite ready yet, but I’m getting there.

Thomas: In any case, Scarlet, please talk to your vet about the possibilities for treatment. He or she may agree that a long course of antibiotics could help with the gingivitis (gum swelling), or possibly refer you to a dental specialist who could help you and your cat.

Bella: That soft food should do wonders for your kitty’s ability to eat, and help manage her kidney disease as well.

Tara: Dental disease is really common in cats. In fact, most cats show some signs of dental disease by the time they’re three years old!

Thomas: Best of luck to you and your cat, Scarlet. Thank you so much for taking care of her and wanting the best for her remaining years.

Bella: What about you other readers? Have you had a really old cat who had dental disease? What did you do about it? Please share your thoughts in the comments!