Complete Care for Your Aging Cat
Page 25
them other than extraction.”
Defects develop at the gum line, or “neck” of the
tooth, and form a tiny entry hole (or may start from the inside)
to ultimately erode the tooth from the inside out. That leaves
literal y a hol ow, fragile shel of tooth that can easily fracture,
and cause severe dental pain. Lesions occur with a
frequency of up to two-thirds of cats seen for dental
problems.
Veterinarian researcher Dr. Alexander Reiter, studied
TRs at the University of Pennsylvania, School of Veterinary
Medicine, and found some interesting links. The condition
was uncommon before the 1960s, suggesting that
something that changed at that time—such as commercial
diets. Blood tests of cats with TRs were found to have
ingested higher levels of vitamin D, and when various
commercial foods were tested, about one-third were found
to contain excessive amounts of this vitamin. The diet
represents the only source of vitamin D in cats because they
are unable to produce vitamin D in the skin. Although further
research is needed, Dr. Reiter concluded that dietary intake
of excess vitamin D over several years may lead to dental
changes that lead to TRs.
“People think that because an animal has been eating
wel , a broken tooth doesn’t bother them,” says Dr. Gengler,
but that’s not the case. Painful teeth can affect your cat’s
behavior in subtle ways. For instance, your cat may become
irritable, refuse petting, and stop cheek rubbing when the
teeth hurt. Typical y, though, behavior changes are so
gradual owners don’t attribute them to a painful mouth. “Just
like us, a broken tooth doesn’t ache al the time,” says Dr.
Gengler. When there’s a flare-up the cat may simply hide
under the bed.
Cats do their best to hide discomfort and usual y eat
through the pain. “In the later stages when the teeth start to
get mobile, there’s pain. That’s usual y what makes them
stop eating,” says Dr. Gengler. People tend to think behavior
changes are just due to normal aging, and are surprised
when treatment returns the cat to the normal behaviors and
activities of a much younger cat.
Comfort Zone
A variety of products can help control plaque.
Chlorhexidine and zinc ascorbate are available in
topical gels or rinses.
Cats rarely indulge in recreational chewing the way
dogs do, but some treat products are designed to
benefit dental health. For example, the Wysong
Dentatreat and Hartz Crunch N Clean Cat Treats are
helpful. Also, C.E.T. Chews for Cats, made from
freeze-dried catfish, are soft, chewing treats with
enzymes added to help stop plaque from forming. They
also include a natural abrasion that cleans teeth as the
cat chews. C.E.T. products are available from
veterinarians or pet products outlets.
Some cats benefit from being offered a smal
piece of very lean cooked beef or other firm meat
once or twice a week. The size and flavor induces
them to chew, especial y on the rear molars, which
helps natural y abrade these teeth clean. Check
with your veterinarian first to be sure this wil not
upset the cat’s normal diet.
Treatment
Dental disease isn’t limited to the mouth, though.
Mouth bacteria from diseased teeth and gums can spil into
the bloodstream and travel to damage organs in the body.
Plaque and calculus may contain up to a bil ion bacteria per
gram, and is 1,000 to 1,500 times more resistant to
antibiotics than free-living bacteria.
The inflammation of the oral tissues that al ows the
body’s defenses to attack the invaders also al ows these
bacteria access into the body. Brook A. Niemiec, DVM, a
veterinary dentist practicing at San Diego Veterinary Dental
Training Center notes that recent animal studies indicate
these bacteria affect kidneys and liver potential y leading to
decrease in function over time. It’s thought the bacteria can
also attach damaged heart valves, and studies have linked
oral bacteremias to brain and myocardial infarctions. Human
studies have linked periodontal disease to increased
incidence of chronic respiratory disease (COPD) and
pneumonia.
Periodontal
disease
increases
insulin
resistance, resulting in poor control of diabetes mel itus, and
the two have an interrelationship where one worsens the
other. Periodontal disease can increase in inflammatory
lipids—a state of overal body inflammation leading to
chronic disease processes and an abnormal immune
response.
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 stil 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 cel s 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. Typical y, 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 al 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 al that holds
bad teeth in place. Once the teeth are cleaned, those with
severe damage almost fal out on their own.
“Active periodontal disease probably cannot be cured
in
one treatment,” says Dr. Gengler. Antibiotics often are
required fol owing 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 al the teeth wil 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 al ergy diet trial (such as
Hil s z/d or Waltham-Royal Canin HP23), antihistamines,
lactoferrin, and interferon. Curcumin, zinc and lysine also
may help. Some of these act as immune stimulants and/or
simply help cats feel better. Dr. Rochette says prednisolone
works better than prednisone, but wil require three months
before seeing improvement.
“Sixty to 80 percent of cats do much better if we remove al
their teeth,” says Dr. Gengler. The pain is removed, and
because cats don’t tend to chew food much anyway, they
typical y do very wel . “They’re pretty amazing. They kind of
gum it down and swal ow it. A lot of times they don’t even
have to have a special diet.”
Whenever possible, Dr. Holmstrom tries to keep the
canines (fang teeth) and carnassial teeth (big molars), which
do most of the chewing. “The lower canine teeth act as a
guide for the tongue and the upper ones keep the lip away
from the gum tissue,” he says. Without these teeth, the cat
may have trouble keeping his tongue in his mouth.
Bottom Line
Cost for professional dental care for cats varies, but the
anesthetic, antibiotics, and basic cleaning combined usual y
starts at $80.
Prevention
Some cats have more problems with tartar than others.
“There’s certainly a genetic predisposition with animals,”
says Dr. Gengler. Young cats may get away with a yearly
professional veterinary cleaning, but more frequent attention
usual y is required as the cat ages. “Once the animal loses
its natural defense mechanism and pockets are formed and
bone is lost, that is not regained. It doesn’t heal natural y,”
says Dr. Gengler. “That animal is going to be a much higher
maintenance animal.”
Brushing the cat’s teeth every day is the best possible
answer. Starting when the pet is a baby is ideal, but you can
begin brushing at any age. Start slowly, find a toothpaste
flavor the cat likes, and use it like a treat, suggests Dr.
Holmstrom. “Avoid human toothpaste. They often don’t like
the flavor, and also there’s detergents in it that shouldn’t be
swal owed,” he says. Cats can’t spit; the foam makes them
mad, and can upset the stomach if swal owed.
Commercial cat toothpastes in seafood, poultry and malt
flavors are safe for animals to swal ow. These pastes may
include the enzymes glucose oxidase and lactoperoxidase,
which have antimicrobial activity and aid in plaque control.
Kitty toothbrushes are available, or choose a preschool-size
human toothbrush with the softest bristles. Some cats more
readily accept the finger toothbrushes that slip over your
finger.
Put the paste on the brush, let them lick the brush three or
four times a day without making any effort to brush the teeth
for several weeks, until the pet’s coming to you to beg for
treat time,” says Dr. Holmstrom. Gradual y progress to
handling the cat’s mouth until he’s more comfortable. Final y,
he suggests putting a toy or a pencil in his mouth to prop it
open, put your hand around his muzzle to hold him steady
and keep the object in place, and then brush the teeth.
Age-Defying Tips
Proper dental care throughout his life provides a positive
impact on his total health, improves quality of life as he ages,
and may prolong longevity. In addition to brushing your cat’s
teeth, a dental diet may help prevent dental disease.
Look for sodium hexametaphosphate (sodium HMP)
listed in the food. This helps to prevent plaque from
attaching to the tooth surface. More and more “regular”
pet diets contain sodium HMP as a part of the formula.
Some diets with dental claims include polyphosphate
crystals to help prevent the mineralization of plaque
into calculus.
Some diets have unique fibers that offer a scrubbing
action to clean the tooth as the cat chews.
Look for the “Veterinary Oral Health Council (VOHC)
Seal of Acceptance.” That means the product has
passed a rigorous and objective review of
effectiveness from representatives from the fields of
veterinary dentistry and dental science along with
representatives of the American Dental Association,
American Veterinary Medical Association, and
American Animal Hospital Association.
Although these diets can help with dental care, be sure
the diet itself is appropriate for your cat’s total health
needs. The need for a therapeutic kidney diet may
override dental concerns, for example.
Golden
Moments:
Baby
Kitty’s
Toothache
Sandi Maltese of Pueblo West, Colorado, has always
loved black cats. She knew that adopting Baby Kitty (BK for
short) would save his life. He returned the favor at age 13
when he alerted her to a fire in the basement. “I was working
in the kitchen last year and he started meowing at me,” says
Sandi. “I thought he was hungry. His food was downstairs
and usual y he leads me downstairs. This time he stopped
halfway down.”
Smoke was everywhere, and she found a cigarette
butt smoldering in the wastebasket that could have grown
into a tragic fire. “I was done for the day and wouldn’t have
found it otherwise,” she says.
BK is skittish around strangers and even hides from
the doorbel . But he enjoys being an indoor/outdoor cat and
loves keeping Sandi and her husband, John, company in
their home offices when they work. “He’s very loving with us,
and a terrific pet.” She trained the 10-pound cat to come
inside from his hunting expeditions with a special voice cal ,
and bribes of cocktail shrimp.
; The next year, she noticed the 14-year-old cat wasn’t
feeling wel . “He was drinking way too much. I used to hardly
ever seen him drink,” says Sandi. She decided to take him
to the Best Friends Animal Hospital for a checkup.
“He was running a temperature of 103,” she says. Other
tests, including an X-ray and blood screening, indicated BK
was in kidney failure. “I lost it there in the vet’s office.” She
knew the condition was very serious.
The first recommendation was to slowly switch his
food to a therapeutic kidney diet. “He hated it, wouldn’t eat
it,” says Sandi. She worked hard to change BK’s mind for
over two weeks. But when he began to stay under the bed al
day and even ignored his wicker sleeping “cat house,” she
took him back to the vet.
“I left him overnight, they sedated him, and found three
teeth so bad they needed to come out,” says Sandi. They
started him on antibiotics immediately and planned dental
surgery for that weekend to remove the decayed teeth and
clean up the abscesses. Sandi would need to give him
antibiotic pil s twice a day for a couple of weeks after the
surgery as wel . “The cat must have been in horrible pain,”
says Sandi. “The vet said the infection was so bad it had to
start months ago. Intel ectual y, I know he hid it from me, but I
stil feel guilty.”
The recovery from the surgery has been a slow, rough
process. “My three vets—Dr. Cynthia Lopez, Dr. Roger
Mauer and Dr. Cantchaola—have been absolutely
wonderful,” she says. “The surgery cost about $525, but I’ve
been in there four or five times since then and they’ve not
charged me.”
She’s noticed a big improvement in BK in just the past two
or three days. “He’s feeling better, drinking better, and he’s
already eating good.” She knew he was on the road to
recovery when he began demanding his shrimp bribe each
morning and reminding her if she’s late.
Dr. Mauer explained that dental disease sometimes leads
to kidney problems, and BK’s kidney test might have been a
false reading due to his tooth problems. Sandi hopes so.
She plans to have another kidney evaluation once he’s ful y
recovered.
“He always gets a yearly check up. And they always
checked his teeth,” says Sandi. “He gets better care than
me, but he’s my baby. And from now on, he’s going in every