Hi - I'm quite confused. It cat has something going on with it's mouth - looks like neck lesions. Our regular vet said that they cannot take him until late next week. A vet on Just Answer told me we needed to get him to a vet right away or he could die from sepsis. We took him to another vet this morning who said they could do the surgery, but after we went there this morning and the vet examined him - she said yes he would need surgery but that they did not have the time today after all, and that it would have to be next week. Now I am concerned that something could happen to him by the time we bring him in. I have phone all emergency clinics and they have said they don't have the dental specialists on staff to care for him until next week. Should I be concerned that he could die?
Pet's Gender: Male
Pet's Age: 6
Name of Cat: Leo
Hello and thanks for trusting me to help you and your pet today. I am a licensed veterinarian and would be happy to provide answers your questions.
Can I ask you if Leo is acting sick or has a fever? Did the vet that saw him this morning take his temperature? Did they do any bloodwork?
DId they mention anything about his mouth looking infected? Or was it primarily that inflammation and redness from the neck lesions?
Did they dispense any medications until the surgery?
They said his ears felt warm - which I would agree, but when they took his temperature they said he didn't have a fever although they said that can go up and down. They did not do any bloodwork - because when they said they would not have time to do the surgery we decided to look elsewhere. The vet didn't say anything about the mouth looking infected - she ran her finger along his gums and teeth and said she didn't notice any chattering but that the gums looked really red and based on his history of neck lesions 2-3 teeth would probably need to be extracted. They offered to give him some pain meds and antibiotic but said that the pain meds could very well make him nauseus and groggy.
It can be very deceiving to judge body temperature by anything but a thermometer. I have been fooled many times by a cold nose or warm ears. (his ears were probably warm because he was nervous and flushed about being in a vet office).
Without the benefit of examining him and evaluating dental xrays, I cannot tell you anything for certain about his case, but there are a few statements I can make that may help. If he has a history of neck lesions (also called FORLs), there is a very good chance he has more of them. The often affect other teeth as time goes by. They can be difficult to identify in the early stages without the benefit of xrays as all you may see are reddened gums. These are most often not a bacterial infection or decay problem and our goal in treatment is to provide pain relief by extracting them.
That being said, red gums can also be a sign of periodontal disease which can involve bacteria and lead to localized infection of the mouth. These are usually easier to at least tentatively diagnose by appearance and involves loss of teeth, receded gums or gingival pockets that often contain pus. These mouths can smell bad and are painful as well. While they are not healthy, they are usually fairly localized to the mouth and it is not common to see systemic spread of infection or sepsis. If that were to occur, we would also expect a fever and increased white blood cell count. If the pet were septic, most likely they would be feeling poorly or at least lethargic. A root tip abscess is another form of infection in the mouth, but is more localized to one tooth and even less likely to lead to sepsis (not impossible, but rare).
So based on your description, I would say there is a very good chance it is not something that can wait until next week, other than the pain factor. If he is still eating, chances are he is not too painful or has been able to adapt. Unfortunately, I cannot tell you for certain, but I would find it hard to believe that if the vet you saw today felt it was severe enough to lead to sepsis, they would have made arrangements in the schedule to do something today or would not have let him leave without antibiotics. I think the previous expert may have been trying to illustrate a "worse case scenario" example to you, but I would tell you that sepsis from an infected mouth in a cat is not common.
I hope this is helpful. If you would like any additional information or have additional questions please don't hesitate to ask!
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Thank you - just want to clarify something. You stated "So based on your description, I would say there is a very good chance it is not something that can wait until next week, other than the pain factor." So we need to find him a vet somewhere right away? Or did you mean it is not something that can't wait? Beginning with yesterday he is only eating about 1/3 of what he normally eats in the day and is lethargic.
I am sorry, I didn't proofread well enough and missed that. Let me take out the double negative. What I meant to say was, " there is a very good chance it is something that can wait until next week, other than the pain factor."
I did not know however that his eating is down that much and he is lethargic. Again, without seeing him and reviewing his medical history, I can only comment in general statements. It's possible the pain is getting him down. You could try soft foods and see if it helps. The person who can best answer your questions about waiting would be the vet who saw him today. They could possibly prescribe an appetite stimulant and or pain meds (use lowest dose so less likely side effects) or even run bloodwork to make sure nothing else is going on while waiting. He will most likely need preanesthetic bloodwork anyway, whoever does the procedure, so why not run it before the weekend to make sure we are not missing something else unrelated to the teeth as a cause of his symptoms.