All his bloodwork was normal, but the doctor could see a "kitty cavity" (called a resorptive lesion) on that one tooth. These lesions occur when the body starts reabsorbing the root of the tooth and moves up the root into the crown of the tooth, causing a painful hole in the tooth (which is the red spot we saw). The treatment is to remove the tooth - or more specifically - perform a crownectomy, where only the top (or crown) of the tooth is removed, leaving the root since the body reabsorbs it.
Dr. Brown (the cardiologist who comes every other week to do echocardiograms) pronounced him a good anesthetic risk, so I scheduled his dental cleaning for the following week.
Titus was not happy to be going back to The Cat Practice again, especially after only a very tiny breakfast since he was to be sedated later. I put him up front in our hospital cages where our surgery patients wait and recover. We decided to put his IV catheter in after he was asleep to minimize his stress and discomfort.
We put him in our clear tank which allows him to breathe in the gas and fall asleep, which he did very smoothly. After he was sedated, Laura the dental technician intubated him and placed his IV catheter in one of his front legs. We hooked him up to the anesthesia monitors, which reads blood pressure, pulse ox, heart rate, and body temperature. All readings were very good and normal.
Before starting, Laura add pain medication to Titus's IV bag, and also gave Titus him a bolus of pain meds through his IV line. This continuous rate of pain medication throughout the procedure and for 2-3 hours afterward will ensure he is not painful at all. She also shaved a spot on his back foot and placed a pain patch, which delivers pain medication transdermally through the skin for the next several days.
After that Laura took all the dental xrays. Since most of the problems with cat teeth occur under the gumline, a feline dental cleaning MUST include xrays. She found that not only was that one tooth bad, but the same tooth on the other side was affected, as well as another lower molar. Dr. Houlihan studied the xrays as well and concluded that those 3 teeth should be removed. The affected areas are shown circled in red:
Laura cleaned up the rest of the teeth, hand scaling as well as using the ultrasonic scaler, then polishing. After she was finished, Dr. Houlihan performed crownectomies on the 3 bad teeth - which didn't take as long as I expected. It was very quick, and the tiny incisions were neatly closed with very fine stitches that dissolve on their own.
She turned off the anesthesia, letting him just breathe oxygen for a minute, then when he started to wake up, she removed the endotracheal tube from his throat. Laura already had his recovery cage waiting with a warm heating pad and towels. Titus woke up gradually over the span of a couple minutes, and was soon sitting up. He didn't seem to mind the IV still in his front leg at all. His pupils were dilated from the pain medication, so I knew he was feeling good!
He stayed on the IV for the next 2 1/2 hours to ensure he got enough fluids and pain medication. We offered him a litterbox (which he didn't want to use!) and some baby food (which he very much enjoyed!) in the meantime. After the time passed, we removed his IV catheter and he was ready to go home.
He was very happy to go back in his carrier - I think he knew he was going home! I expected him to hiss at his brother when we got home, like he did last week after having all his preanesthetic bloodwork and exam, but he didn't. All he wanted to do was clean himself up - licking his arm where the IV was, licking his foot where the pain patch was... he promptly removed the wrap that covered the pain patch!
Then he was back to his old self! Much better than I would have done after having anesthesia and 3 teeth removed! He wanted dinner (gave him just canned food) and ate all of it. He was pleasant to his brother and was acting completely normal and chatty.
The next morning, I noticed the pain patch was gone off his foot. My husband ended up finding it later on the floor, half-chewed. But even without the ongoing pain meds, Titus was active and happy, and eating completely normally, back on his mixture of dry and canned food after only 3 days. I honestly think he feels better not having those painful teeth in his mouth!
I'm really glad we got him taken care of - I would never have known that he had sore teeth before because he never acted or ate any differently, but I can tell he feels better now!
Thanks for Laura and Dr. Houlihan for taking such good care of him and doing a wonderful job on his teeth. Even Titus says it wasn't that bad, and is happy his teeth don't hurt anymore :)
~Tabitha
