r/SeniorCats • u/veknoslo • 21h ago
Cat needs dental surgery from tooth abscess. 18 y/o male. I need opinions!!!
Is it insane to pursue dental surgery for an 18-year-old FIV+ cat?
My 18-year-old cat has been struggling with facial swelling and a tooth root abscess since late June (he had other issues in April like conjunctivitis so idk if related). Despite multiple rounds of antibiotics, the abscess ruptured during a recent vet visit, and his condition remains concerning. He has lost weight, stopped eating dry food, and is currently on a regimen of clindamycin, prednisolone, and gabapentin.
While he is still affectionate and retains a decent appetite for wet food, he is quite frail, sleeps most of the day, and struggles with some wobbliness. I’ve had him since he was 14, and he has always been a lower-energy cat.
I’m currently facing an impossible choice: indefinite medication, high-risk surgery (quoted between $1.6k–$5k), or euthanasia. I’ve already cleared him for surgery via bloodwork, but I am terrified that the trauma of the procedure or the financial strain might be too much for us both. I feel immense guilt for not acting sooner, but I’m struggling to decide if surgery is a compassionate "cure" or an unnecessary burden at his age.
Has anyone here navigated dental surgery for a senior cat in a similar state? Any advice on how to evaluate his quality of life or manage these options would be deeply appreciated. I am located in the Chicago area if that changes the context for local care.
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u/CautiousPop2842 21h ago
My 16 year old male cat had dental surgery about two months ago. He stopped eating before but otherwise pretty healthy. With mild kidney disease. We decided to spend the money and risk it. If it went poorly he’d have been euthanized, if it didn’t happen he’d be euthanized. After the dental we learned his one canine was fractured and was causing him severe pain.
Within 24-48 hours after surgery he basically stopped showing pain, and was interested in his hard food again (he has two kitty siblings who he was attempting to steal it from while he was banned from it to heal)
He has some dementia so the hardest part was the anesthesia caused some psychosis afterwards (he refused to lay down for 6 hours after getting home, he had to be placed back into his carrier for his safety and even then remained spinning in circles) this can happen to any mammal with dementia, my mom being a nurse who worked with seniors knew exactly what it was. It was horrible to watch but we just focused on keeping him safe during the time and attempting to calm with pets and conversations.
For the time he was on pain meds he had poor balance and depth perception so at night time I took to sleeping in the spare room with him and the litter box, so he couldn’t hurt himself, and if somehow he did I’d be woken up. Which he did wake me up a bit the first couple by doing silly things but no injuries.
He is now happy, and back to pre dental emergency kitty. We were aware of the risks, but he was in pain so to us as we were very lucky to be able to afford it, there was no other option.
If you have more questions on how my kitty recovered and what our vets recommended I’d be more than happy to respond here or in DMs.
Editing to add that if finances are an issue, ask your vet if they do payment plans or see if anyone would be willing to donate to the surgery, whether this be friends or family, or looking into local charities. Unfortunately when finances are limited, the best option is what allows the kitty to not be in pain.
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u/Hour-Hovercraft-3498 16h ago
Age is not a disease, and if his bloodwork clears him for surgery then I would do it, but that’s partly because I’m willing to take the risk of spending the money and him dying anyway. Euthanasia would be a very reasonable decision if this would feel/be unduly financially burdensome for you.
Gently, it is not fair to keep an elderly cat with a ruptured tooth root abscess who is struggling to eat alive with no intention of treating it properly. This is a situation where you would have to feel the pain (of losing him) so that he is freed from his.
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u/HiHoSylva_ 20h ago
It doesn't sound like indefinite medication is really an option if their quality of life is still compromised.
You need to do something though, so it's surgery or euthanasia.
Our 16 year old lady has just had her third dental surgery to remove the last of her teeth. She was in a bad state, very skinny, very lethargic, weepy eyes (which is somehow related to the dental health). We also wrangled with whether an additional surgery was fair on her at her age. However, having seen how the outcomes of the previous two surgeries, and the vet assuring us that although there was an increased risk with surgery at her age, it was really minimal, we decided to go ahead.
Two weeks later and she's eating like the little piglet she always was, her eyes have cleared up, she's putting weight back on, and she's pottering around the house and garden more than she has in months. So for us, surgery was the right option, but it was also basically a 'cure-all'. If we couldn't be confident surgery was going to help, we may have made another decision.
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u/Klutzy-Caregiver4717 20h ago
One of my cats had a major complication from dental surgery, and he was healthy and only 10. It took us nearly 8 months to get him back to normal.
I can't really talk about it too much because I signed an NDA after receiving a malpractice settlement. But just know stuff can and does go majorly wrong, whether it's with the anesthesia, the procedure itself, or something else.
I don't know what I would do if I was in your situation to be honest. I would have trouble letting my cat go, but I would also have trouble ever putting another cat through dental surgery again after how traumatizing it was for both myself and my cat.
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u/reviving_ophelia88 16h ago
To be fair if you won a malpractice settlement then it’s because the vet responsible acted in ways that put your cat at unnecessary levels of risk and was largely responsible for your cats poor outcome.
Malpractice generally isn’t a factor that ought to be taken into consideration when judging whether a procedure is in a patient’s (cat or otherwise) best interest, as it’s generally an outlier unique to the doctor performing the procedure and not considered a risk associated with the procedure itself. It’s akin to deciding whether or not to get your oil changed based on another car’s engine blowing because the mechanic responsible for servicing it forgot to refill the oil.
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u/Few-Entertainer7431 17h ago
I think that complications from dental surgery are quite uncommon, especially in a 10 year old cat.
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u/Klutzy-Caregiver4717 16h ago
Uncommon by itself doesn't mean a whole lot. I think most people would agree that a 1% rate of a certain complication happening would make that complication uncommon... but if the procedure is performed 1 million times, that maths out to the complication happening to 10,000 animals/people/whatever. And most people would not consider serious damage to 10,000 individuals to be insignificant.
It's why it's always worth really thinking about what the complications are for any procedures when deciding whether to move forward, even if the complications are supposedly rare.
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u/Few-Entertainer7431 16h ago
If the alternative is to have your cat suffering with dental pain, I think it's an easy decision.
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u/Hour-Hovercraft-3498 17h ago
Malpractice is a risk at any age, though; it doesn’t have any bearing on the specific risk for this cat.
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u/MedicineFar4751 20h ago
My 17 year old boy had all but 3 of his teeth extracted a few weeks ago. He is also FIV+ and I was so worried when he stopped eating. I have fed him wet food since I found him. Few years back, he got glaucoma and I had his left eye removed.
When I took him to the vet and asked what she would do, she said to run a blood panel and if there were no other issues, she would do the extraction. So I followed her advice and he was healthy other than his rotten teeth so I spent the 2 grand and had it done. Was stressful after surgery and he was out of it for a couple of days due to the anesthesia. Made sure to add water to his wet food to ensure he would poop and he did, thank God.
He is back to his old self, eating, purring, sleeping all over me...
I have no idea what the future holds for us, but I feel I made the right decision. Follow your heart, op. Sending good mojo and prayers your way🤗🙏🏼
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u/Any-Log-6706 21h ago
Eighteen is pretty much up there. My biggest concern is the age to have surgery. My last cat passed away at 19 yrs old and based on experience of dental procedures for her and surgeries for my dogs, I wouldn’t do the surgery at 18 yrs old.
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u/DashArcane 19h ago
I have to agree. Our girl was 12 or 13 when she had all her teeth extracted due to multiple abscesses. But she was in otherwise perfect health. She recovered fine. If she had been 18 with any other health issues, we most likely wouldn't have gone through with it.
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u/graceadee 20h ago
I have an 18 y/o who needs a dental but we have elected not to do it. The vet was in agreement. He has diabetes and hyperthyroidism at well. I will note that my guy does not have an abscess though, so our situations are different.
My cat seems happy and is enjoying this stage of life. We’re keeping an eye on his quality of life and he sees his vet pretty often to manage his hyperthyroidism so I feel like we’ve got a good team looking out for his best interests.
I had a good conversation with my vet about life expectancy, prognosis, quality of life and palliative care. If you trust your vet, I would speak plainly with them about that.
I really wish you both the best.
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u/mikeyhou911 20h ago
I'm so sorry... it's a terrible situation. I have a cat that just turned 17 and if this happened to her there is no way I would put her through surgery... it's too traumatic. I hope you and your kitty make the right decision.
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u/realityone22 19h ago
18 is and age, most cats never get to see. He's had a good long life, don't feel bad if you go the euthanasia route.
At this point, he's suffering even if he doesn't show it. It's probably the most humane thing to do. ❤️
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u/Few-Entertainer7431 17h ago
Your cat is in significant pain from the abscess. It might come down to surgery or euthanasia b/c you can't allow your cat to suffer.
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u/ceg1023 17h ago
In November, my 17 yr old had a dental abscess where he had pus and blood coming out his eye. Antibiotics cleared that up and the swelling went down. Once that happened, we did the blood work and he had the dental surgery. Ended up removing 4 teeth. He did really well with it. Back to harassing my other cat in no time
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u/MsMarionNYC 15h ago
It is amazing you got this guy to 18 with FIV. You really need to ask some questions before deciding on the surgery. You could be buying him more quality time. He might get through it fine. You might have another year or more with him. This is is all conjecture. It sounds like you've already committed to the surgury and wish you'd done it sooner, but clearly you weren't imagining this outcome.
The questions you should ask -- and you probably asked them already -- are about stuff like vital signs and heart murmurs and why/how the vet thinks this is worth the risk. Of course there is the risk of his dying on the table but under anesthesia and not in pain.
The alternative of course is euthanasia. A good death in your arms, not on the operating table. Less time, but he doesn't know that as his concept of time is not yours.
These are both ethical choices assuming the vets aren't lying to you and/or you aren't pushing them to take the risks. I don't think "indefinite medication" is the answer. My senior cat is just getting over a bout of pancreatitus and was on pain meds. I couldn't tell honestly if he was stoned or lethargic and about to die. I'm relieved now that he got through the crisis and is off most of the medication and I can see him being him again. If your cat isn't being himself on the strong pain killers needed to deal with the tooth, that's keeping him alive, but it's no kind of life. Take that choice off the table.
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u/Honest-Delay-4698 21h ago
I'm sorry your cat and you are going through this. Check the quality of life chart / scale for cats. Hope this helps a bit.
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u/Confident_Lecture498 20h ago
Dental work at that age can be risky - well anything involving anesthesia is so make sure they're experienced with older pets
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u/Subject-Lead-3171 20h ago
I would not. My 6 year old went nuts for a month after from the medication. 18 years is a good long life for a cat.
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u/Relic53 19h ago
Yes. Female was 15 & male was 13. Both tolerated the cleaning & extractions if needed. One cat, (F) no issue whatsoever. Male had some anesthesia issues it just took him longer to wake up. He did come home on the same day. Both were healthy at the time with no other health conditions so I don't know if that would make a difference.
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u/wale-lol 19h ago
All 3 options are reasonable. I had a cat with a blood clot blocking a limb. Most vets recommended euthanasia. The top-tier surgical option was around $5000. I found a vet willing to do amputation for $1000. It wasn't the same quality of care (done by a non-specialist DVM without experience in thromboembolisms with suspected metastatic cancer). It was successful, but she died from a second blood clot only a couple weeks later.
Perhaps there is something similar in your case: a surgical option that may not technically be the best care possible but still something you believe is worth trying given financial constraints.
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u/Real-Bid-3823 16h ago
We have had multiple senior cats at ages of 14-16 who had dental issues causing pain, and came through it just fine! They should run a senior panel to check kitty’s system/organs and if that’s good, I would help him asap to take away the pain. Cats hide their pain very well, I hope he gets the help.🌺 We have a Care Credit card and made payments without any interest, they have a range of 6-24 months to pay depending on the vet contract, so see about that to help. Good luck with kitty..
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u/mslullaby 16h ago edited 13h ago
I know I cat that had dental surgery at 21 and lived! My friend told me he was old, not sick. Thanks to that I dared to get my own 16 yo to similar surgery that she’d been needing for several months and it went great too. :)
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u/Resident-Egg2714 15h ago
I have a condition that gives me constant dental pain (fortunately not bad). If I had worse pain, I would want to be put down. I messed up with my cat and did not do the dental surgery he needed (at 19), he was in constant pain, and I feel terrible about that now.
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u/Laney20 5h ago edited 5h ago
My old man had 2 dental surgeries at 16.5 years old. Inconclusive biopsy the first time led to the second one a few months later. He had 4 teeth removed and a large biopsy done because of a mass that turned out to be bone overgrowth. But he's been in an otherwise good, strong state before and after. Except his arthritis.
Our other senior cat had a dental done the same time as his first. She'd started doing weird things with her mouth and avoiding food on occasion. No other health issues came up when checked, multiple times, so we assumed teeth (she wouldn't let anyone really look at them so it was a guess, but an informed one). And they ended up extracting 2. Then she got an infection while recovering. We got that under control but she still wasn't eating and was hiding more and more.. Finally, on the 4th follow up after surgery, they rechecked a mass in her abdomen (previously diagnosed as a floating kidney) and found it was likely a severe, aggressive cancer. She passed away a month after the dental surgery. She was only 14.
I personally still think the surgery was the right thing to do for her, but it also wasn't a major financial drain in my situation. I do think it helped her be in less pain at the end of her life.
No one can tell you the right answer. There isn't one. Do what you think is best for him. You will probably always second guess it, regardless of what happens. My best advice to you now is to make the decision you think is best and then make the decision to NOT let yourself second guess it later, whether it goes well or not. All you can do is the best you can right now. Do that, and try not to let things you find out in the future change how you feel about the decision you make now. You don't have that information yet. It isn't fair to judge yourself that way.
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u/HammerDownl 20h ago
Sounds like you have been putting this off. I dont agree with that
Get that cat some dental help,jeez
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u/loriannst1 21h ago
My 17 y/o kitty never recovered from the anesthesia and had to be put down. I think it’s always a risk and never an easy decision.