Q: I have an aging cat that seems to be drooling a lot more lately. I noticed that he is missing a lot of teeth and his front teeth are discolored and possibly infected. I am very hesitant about bringing him to see a vet only because I am afraid to put him under for work done on his teeth. He has a rapid heartbeat and a heart murmur and I am afraid he will not make it through the work done on his teeth. What should I do to help him?
A: I understand your concerns about anesthesia, but I really don’t think there’s much of an alternative. If your cat has an oral infection and a possibly painful mouth, it has to be addressed promptly.
Your cat’s age is not the concern. The suitability for anesthesia is not dependent on age. It depends on how healthy your cat is for that particular age. Your cat should have pre-anesthetic bloodwork before anesthesia, to make certain that the liver and kidneys are working and that your cat is not hyperthyroid, etc.
The presence of the heart murmur and rapid heartbeat pose a potential obstacle to anesthesia. A heart murmur is an abnormal sound that is caused by turbulent blood flow through the heart. The presence of a murmur is not necessarily something to be worried about, however, all murmurs should be investigated, as they may be the first sign of serious heart disease. Cardiac problems that can cause a heart murmur include cardiomyopathies (diseases of the heart muscle), disorders of the heart valves, and congenital defects. Murmurs are graded on a scale from 1 to 6, with one being barely audible and 6 being very loud, resulting in vibrations that can be felt by touching the chest. The intensity of the murmur does not correlate with the severity of the condition, and not all murmurs are indicative of heart disease. Heart murmurs can be the result of other systemic diseases or conditions, for example, anemia or high blood pressure. In some cases, a murmur may be completely benign and not be associated with any illness at all. Murmurs are common in older cats. Some kittens are born with murmurs, but they outgrow them.
To investigate the cause of a murmur, diagnostic tests are necessary and may include blood tests, blood pressure measurement, chest X-rays, an electrocardiogram (EKG), and an echocardiogram (ultrasound examination of the heart). If the murmur is deemed to be benign and the cardiologist feels that anesthesia would not be a problem, then you can have your cat safely anesthetized. Hopefully, this would be the last time your cat would ever have to be anesthetized for a dental procedure. You can help by brushing your cat’s teeth and giving dental treats once the teeth have been professionally cleaned.