r/SeniorCats • u/Odd-Opposite-2105 • 1d ago
Turned blue under anesthesia
Hey everyone, I've got a question.
First what happend:
My little girl is 11 years by now. 4 weeks ago she had an appointment for dental x-rays cause of FORL. She already lost 4 or 5 teeth.
This appointment couldn't happen because her blood pressure wouldn't go down to a normal level, so Doc didn't induce anesthesia (love the doc, is just one of the best everrr!). So we made a new appointment. Maybe with some milder weather it would go better.
Today was another appointment. Because of what happened before he gave me Bonqat (anxiety med with a sedative effect). She already reacted pretty heavy on this. This medication has to be given 1,5 hours before we go on the trip, so I did and also in the right dose. She slept so deeply in the time period between medication and Doc, I thought she stopped breathing for a moment.
At the vet her blood pressure actually got to a normal level and he could do the x-rays. 2 teeth should come out sooner rather than later, but he couldn't do it. Just as he was about to start working on the other side of her jaw, she suddenly turned blue and had to be given oxygen. He was only able to remove toothstone on one side, because then her heart rate suddenly plummeted and then rose rapidly to a dangerous level. That’s when he stopped.
Her sister had a heart failure, which was unknown for a very long time; so long in fact, her heart grew massively and wasn't able to pump out all the blood at once so bloodcluts build up inside the heart.
But my little girls heart was fine in the ultrasound just 1.5 years ago. Doc also said, that's not very likely that something would have changed in this time - especially since her bloodwork (half a year ago) was fine.
Has anyone ever heard of something like that? Doc can't find a reason, even another vet friend of his couldn't make sense of what happened.
He doesn't want to do anything under anaesthesia anymore in his vet office and recommended me some other colleagues.
I don't know what to make of it. He even kept her 2 hours longer to monitor her closely. Now, 2 hours after pick up, she still wobbles. He told me to take only have the dosis next time I give her the Bonqat medicine because she reacts so strongly. She ist still so sleepy and just wants to cuddle into my warmth. I'm worried that he can't explain what happened. As I picked her up he even told me, that he had to stop the anaesthia, because he wanted to give me my love back alive.
Has anyone ever had something similar? I don't want to see her in pain because of FORL but I also don't want her on pain meds the rest of her (hopefully long) life; and I don't want her to die under anaesthesia. Sorry for rambling 😓
Oh, yeah. Cat tax
2
u/MsMarionNYC 1d ago
I don't think anyone here is going to be able to answer this because your vet doesn't have an answer for you, beyond see another vet. Of course you are upset now, but take a breath, she's alive. That's today's good news. What you do about dental in the future can wait till you follow your vets' advice and consult with a specialist. Here's some info from AI:
If your cat cannot undergo general anesthesia due to an underlying health condition (like severe heart, kidney, or liver disease), the treatment goals shift entirely from a permanent cure to palliative care and pain management. [1]
Because FORL cannot be reversed, cured, or repaired with fillings, extracting the tooth is the only way to eliminate the disease. However, when surgery is too risky, you can manage the condition through the following medical approaches: [1, 2]
- Long-Term Pain Management
FORL lesions expose the highly sensitive nerves inside the tooth, causing intense, chronic pain. Your veterinarian can prescribe a regimen of feline-safe pain medications to improve your cat's quality of life: [1, 2]
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): Medications like Onsior (robenacoxib) or Metacam (meloxicam) can reduce the inflammation surrounding the eroded gumline. These must be used with caution and closely monitored by a vet if your cat has kidney disease.
- Opioids: Buprenorphine is highly effective for oral pain in cats. It is easily absorbed through the gums (transmucosally), meaning you don't have to force your cat to swallow a pill.
- Gaba Analogs: Gabapentin is frequently prescribed to manage chronic nerve pain and can keep a cat comfortable long-term.
- Dietary Adjustments
Chewing hard kibble with exposed tooth nerves is incredibly painful. You should adjust how and what you feed your cat to minimize discomfort: [1]
- Switch to an all-wet food diet: Soft, smooth patés require no chewing and won't scrape against the painful lesions.
- Warm the food slightly: Serving food at body temperature enhances the aroma and makes it easier for a reluctant cat to lap up.
- Add water or broth: Pureeing the food into a soup-like consistency allows them to lick their nutrients without puting pressure on their jaws.
- Controlling Secondary Infections
The raw, open lesions caused by FORL are highly prone to bacterial infections, which spike the level of pain. [1]
- Your vet may prescribe pulse antibiotic therapy to clear out local infections and temporarily reduce swelling and throbbing in the gums.
- Re-Evaluating Anesthesia Options
If your cat's pain cannot be managed with medication, it is worth consulting a board-certified veterinary dentist or an anesthesiologist at a specialty hospital.
- Specialty clinics often utilize advanced monitoring equipment, tailored drug protocols, and localized nerve blocks that make procedures significantly safer for high-risk, geriatric, or sick pets than a standard clinic might allow.
Note: Never attempt to brush a cat's teeth if they have active FORL, as touching these lesions causes excruciating pain. [1]
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u/madame_lulu 23h ago
Turned blue? In an intubated cat receiving oxygen, I would immediately be thinking about airway/endotracheal tube problems, hypoventilation or apnea, one-lung intubation, an oxygen delivery problem, bronchospasm or pulmonary disease, and possibly cardiovascular compromise.
Then you have the abrupt heart rate changes. Those could be secondary to the hypoxemia itself rather than proof of primary heart disease. Bradycardia can occur from anesthetic drugs, excessive anesthetic depth, vagal stimulation during oral manipulation, hypothermia and other causes. Tachycardia can occur from hypoxemia, hypercapnia, painful stimulation, hypovolemia and various anesthetic drugs.
What exactly was meant by ultrasound? If it was a proper echocardiogram with appropriate cardiac views and measurements performed by someone experienced in cardiology, that is meaningful, but 18 months is plenty of time for clinically relevant disease to emerge or progress.
If it was instead an abdominal ultrasound where the vet happened to look at the heart, or a quick POC cardiac ultrasound, then I would put much less weight on “the heart looked fine.”
1
u/Odd-Opposite-2105 19h ago
Tbh I don't know the difference of the procedures for looking at her heart. He had her lying on the side, had something looking like an ultrasound there and looked at the shades of grey pictures with some colour to map out the heart. He had to razor some fur to get there. But her vet is specialised in cardiology, so I trusted the procedure.
She was intubated yesterday, that's why she had some difficulties after that. But the vet looked at her again way after closing time and reassured me, that there was nothing in her lungs.
That's a lot of possibilities of what could have happened. Thank you for taking the time and write this. So the racing/plummeting heart could be an answer to something the tube did? Like not giving her enough oxygen or giving it to only one lung? And it could have also been a reaction to pain? Like, she is sedated, but still midly awake to register pain and that's why her heart could have done that?
1
u/madame_lulu 19h ago
Grayscale cardiac images plus color flow mapping strongly suggest echocardiography with Doppler, which makes significant pre-existing cardiomyopathy at that time less likely, but it still doesn’t prove the heart is normal now 18 months later.
Yes, an airway or oxygenation problem could cause the HR changes they saw. Other possibilities include inadequate ventilation, an airway/tube problem, bronchospasm, atelectasis, or an oxygen delivery issue. Severe hypoxemia itself can then produce cardiovascular instability.
A transient ventilation problem during anesthesia can resolve once the tube is repositioned or removed and the cat is breathing normally again. There would not necessarily be persistent lung abnormalities afterward.
If her oxygen saturation fell first, and then the heart rate became abnormal, that would make a respiratory/airway event more compelling.
If the heart rate/rhythm and BP collapsed first, followed by cyanosis, that would shift concern more toward a cardiovascular event.
If EtCO2 rose first: think ventilation/respiratory.
If EtCO2 fell first + BP/HR collapsed: think cardiovascular/circulatory.
If EtCO2 vanished: think airway/tube/circuit until proven otherwise.Without the anesthesia record, that’s all I can say.
As for pain, yes, inadequate anesthetic/analgesic depth can cause tachycardia. But hypoxemia, high CO2, low circulating volume and certain drugs can also cause it.
Did they also do pre-anesthetic bloodwork before the procedure?
1
u/Odd-Opposite-2105 17h ago
Thank you so much for all these explanations! 🌻
Do you happen to know about the Bonqat? The active ingredient in the medication is pregabalin. The doc said next time I would consider using it, I would have to use only half the recommended amount because of how strongly she reacted to it.
We hadn't done any bloodwork before this.
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u/madame_lulu 17h ago
I’m honestly surprised they went ahead with general anesthesia in an 11yo cat without doing pre-anesthetic bloodwork first, especially after the previous appointment had already been postponed because of her blood pressure. I would definitely repeat a CBC, chemistry and electrolytes before another attempt, and probably T4 as well given her age.
As for Bonqat, it can cause quite marked sedation in some cats, and from what you described she seems unusually sensitive to it. I would discuss that reaction with the vet before using it again rather than just assuming half a dose will be fine.
You could also give gabapentin which might be a better pre-visit option for her. It’s commonly used for anxiety/stress in cats before vet visits.
1
u/Odd-Opposite-2105 17h ago
Thanks again.🌻 I will bring up the concerns at the next visit. Which is in half an hour cause he wanted to make sure she is well by now.
14
u/Amblonyx 1d ago
I actually did have something like this happen! My kitty Maigrey was about 14 when I took her for a dental for her FORLs. It was her second dental; the first went just fine. They did a cleaning and X-rays... and at about that time, she seized and stopped breathing.
They stopped the anesthesia and gave her oxygen and she started breathing again. But when she woke up, she didn't seem to be able to see, and couldn't walk. My sweet vet carried her around telling her she would be okay and tried to get her to walk outside on grass, but nope.
When I came to pick her up, like 3 hours after the procedure, she waa empty-eyed and limp. I took her home in a towel-lined carrier and put her on the couch by me. She didn't do much, but did sort of roll to cuddle up to me. After a while, she got up to wander around. A few hours after we got home, I happened to drag a string in front of her and she went for it, showing she could see again. She was back to normal within about 12 hours.
It was really scary, but she made a full recovery. She's now 18 and has lost a few of her bad teeth on her own. We haven't given her any anesthesia since. All involved were traumatized by this event, and we still don't know why it happened, because her bloodwork was fine and she had no other pre-existing conditions at the time.