It appears that
dental problems may be linked to an increased risk of other health issues.
Although the precise mechanism is not known, scientists believe that in
humans there may be a link between the oral bacteria associated with poor
dental hygiene and heart disease.
The National Institute of Dental and Craniofacial
Research reports on studies to date.
A similar link
is thought to exist in cats.
The American Animal Hospital Association
states that "Dental disease doesn’t affect just the mouth. It can
lead to more serious health problems including heart, lung and kidney
The majority of
cats have some degree of periodontal disease, and dental problems
can arise or worsen because of CKD.
Conversely, dental problems may seem to trigger CKD, in that a cat with
periodontal disease who undergoes dental treatment under anaesthesia may
develop CKD shortly afterwards. It cannot be proven that the CKD has been
triggered by the dental disease, and it is also possible that the anaesthetic played a role; but dental procedures do appear to carry some
degree of risk, although the risks can be greatly minimised if precautions
are taken (see below).
feel that it is important to keep a
close eye on your cat's dental health, as indicated by our own small
survey of two CKD cats - Tanya was very healthy apart from
the occasional dental abscess, and when we trapped Thomas, he had three
badly abscessed teeth.
Cats are prone to a particular dental condition called Feline
Odontoclastic Resorptive Lesions or FORL (also known as neck lesions).
This condition is so painful that, as shown in a video from
Beach Animal Hospital, even cats under anaesthesia may react
when an affected tooth is touched, yet often it is completely undetectable
except via X-ray.
There is no treatment for FORL other than removal, so if your cat is to undergo a dental
under anaesthesia, I would always ask for x-rays to be taken to check for FORL, so any affected teeth can be removed.
Just like humans, cats benefit from having their teeth cleaned regularly
at home with a toothbrush. You can buy special small toothbrushes for cats
and special toothpaste in various flavours. I tried this on my Indie and
must confess it wasn't a great success but I do know of quite a few people
who clean their cats' teeth regularly with no problems. If you decide to
try this, start off gradually, and let your cat get used to the toothbrush
first, before you add the toothpaste.
Antioxidants mop up free radicals in the body, which
are associated with aging and disease. Co-enzyme Q10 (CoQ10), also known
as ubiquinone or ubiquinol, is an
antioxidant that is used by the body in energy production. Human research
indicates that it may be helpful in the treatment of periodontal disease.
Effect of topical application of coenzyme Q10 on
adult periodontitis (1994) Hanioka
T, Tanaka M, Ojima M, Shizukuishi S & Folkers K Molecular aspects of
medicine15 Suppl pp241-8 found that the topical application of
CoQ10 appeared to improve periodontitis in humans. Sugano, N, et al. There
were similar findings in more recent research by Nihon University School
of Dentistry presented to The 63rd Meeting of the Vitamin Society of
Japan, Hiroshima, Japan on 4th and 5th June 2011.
I don't know
anybody who has tried this in a cat, but if you want to try it, check with
your vet first. More information on CoQ10 can be found
If your cat has
dental problems which are not too advanced, or if your vet is reluctant to
perform a dental under anaesthesia because of your cat's CKD, a course of
antibiotics may be prescribed instead. Even if your vet is prepared to
perform a dental under anaesthesia on your CKD cat,
antibiotics should be given for several
days in advance, and continued for 5-7 days afterwards.
The best choice
in most cases is an antibiotic called clindamycin (Antirobe), because this is particularly good at killing anaerobic
bacteria which are often found in the mouth. When my PKD
cat had a dental, this was the antibiotic which both the veterinary dentist and
kidney specialist recommended for him.
Pfizer, the manufacturer of Antirobe,
provides some information about it.
Some vets and
groomers offer teeth cleanings performed while the cat is awake.
Unfortunately it is not possible to perform a proper dental cleaning on a
conscious cat, because the problem area is under the gumline, which can
only be reached if the cat is unconscious. Therefore this sort of
procedure is largely cosmetic, however it may be of some use for cats who
have had a dental performed recently, though tooth brushing (see above)
Eventually you may find that your cat needs dental surgery under
anaesthesia, to clean under the gumline to help fight periodontal disease
and/or to remove unhealthy teeth, perhaps because of FORL or abscesses.
Many people are terrified of having their cat undergo a dental, but if
your cat is suffering severe dental problems, you probably have little
choice because it becomes a quality of life issue. Dental
problems can be extremely painful! And since cats instinctively try to
hide pain, your cat could be suffering chronic pain without you realising
it. Americans are famous
for their standards of dental care so probably don't know how bad
toothache can be; but I'm English, so, as night follows day, I have bad
teeth (though in my defence I would like to point out that they are
naturally beautifully straight - no orthodontist necessary for me!). Therefore, yes,
I have had toothache, and I can tell you it is absolutely horrible,
and a dental abscess is unbelievably painful. If your cat has FORL, a
dental condition unique to cats, it is so painful that even cats under
general anaesthesia may react when an affected tooth is touched.
If your cat does need a dental,
there are ways to minimise the risks, as follows:
Preparing for Surgery
If you are
in the UK or the USA, consider using a veterinary dental specialist.
You should always have a physical exam and bloodwork done and blood
pressure checked before surgery, so any problems can be addressed. If your
cat has heart issues,
you may also wish to see a veterinary cardiologist prior to surgery.
If your cat
is on blood pressure medication such as amlodipine (Norvasc) or benazepril
(Fortekor), ask your vet if you need to stop the medication a couple
of days before the surgery (since anaesthetics may reduce blood
Antibiotics should be given to the cat, ideally starting a day or two
before the procedure and continuing for 5-7 days afterwards.
Policy statement: the use of antibiotics in
veterinary dentistry (2005)
American Veterinary Dental College mentions that antibiotics are
recommended for cats with kidney disease who are having oral
should be placed on
IV fluids for a few hours before, during and after
any dental procedures. All cats should be placed on IV fluids during and after any dental
procedures. This is to avoid reduced blood flow and falls in blood pressure during the
procedure, which may damage the kidneys.
develop a low temperature following anaesthesia, so ensure that your
cat's temperature will be monitored afterwards. Your cat might benefit from a
immediately following surgery.
anaesthesia has been used, your cat will have a tube down the throat
during surgery (intubation), which can cause the throat to feel a
little sore for a day or two afterwards.
pressure should also be monitored for a week or so afterwards because
surgery and anaesthesia may cause increases in blood pressure
following the procedure.
may be able to come home a few hours after surgery, or may have to
stay in the hospital overnight or for a day or so. If you bring him or
her home soon after surgery, keep him/her in a warm, quiet place. Your
cat may be a little wobbly at first, but this should soon improve. If
you have any concerns, contact your vet.
If a lot of
work is done,
may be necessary. My Indie (non-CKD) had
extensive extractions, and was given a
Fentanyl patch on her back leg
to help her oral pain.
is also used for many cats following dentals with few problems. Make sure your vet does not give
to your cat.
Most cats do cope with dental surgery; but it is still surgery, and problems
may occur in some cases. Some cats will start
eating immediately following a dental, but may then worsen a day or two
later as the painkillers wear off. Many cats take a while to
regain their appetite. Our Indie, non-CKD, was given a dental at the age
of nine because she simply stopped eating because of dental pain. Although
she recovered relatively quickly from the surgery, she still went through an extended
period of not eating afterwards, which had me at my wit's end. If your cat
does not resume eating and also seems to be gaining weight following a
dental, check with your vet because occasionally more serious problems can
Harpsie, even though we followed all the