(I’ve modified this question to keep everything anonymous.) Dear Dr. Chandroo, I'm hoping I haven't killed my previously healthy cat, Lynx, a 3 yr. old Devon Rex. I am told at examination, she needs teeth cleaned then later teeth pulled. Next day, give her her pill & pain med. Then, next dose. She seems worse/dehydrated. Bring her back- they say her kidney, etc test is ok but keep her 2 more days on IV. She's terrified there & won't eat. Bring her home & she eats. Now it's 14 days & she's still not right. I'm afraid to bring her back there. Her papers shows this: gas anasthesia/acp injection group methadone, temgesic .15, amoxycillin-clavulonic Acid injection .2, meloxicam injection .2, meloxicam oral per ML 1.75 (1 per day), clinicin tabs 25MG (2 per day). Does this look right? I know you can't say with certainty- I'm just beside myself guilty now.

This is the worst? Isn't it? That feeling when you have done something with the best interests of your cat in mind, but then, things don't work out. In fact, things seem to be worse. You feel bad. Your cat feels bad. On the vet side of things, it can feel like the rug got pulled from underneath you. You have promised and supported someone through something you believe in, but then it all goes pear shaped. Ugghhh. People often think euthanasia is the toughest thing a vet has to do. It's hard, but this type of situation is even harder.

I could tell you that this is a rare event, but that isn't going to help you or make you feel better. I could tell you that the risk rates with modern anesthetics and medication techniques are exceptionally good - but this is useless information when you are sitting at home teeming with guilt.

I did Zack’s dentistry when he was 19 years old. I didn’t want his golden years to be fraught with dental issues, infections or oral pain. I knew going into the anesthetic that at 19, with a heart murmur, kidney issues, hyperthyroidism (and the list goes on) that his level or risk was higher. And even though I could rationalize every singe medication and anesthetic gas that touched his body, as well as the procedure we performed for him, how do you think I would feel if he never recovered from the anesthetic? Or was worse off than when I began?

Guilty. I would feel just the same as you do.

So I want you to know that at the end of the day, don’t change being that person who is looking out for the best interests of your cat. I see mountains of quality of life destroying dental disease every week. And these guys can’t fix their issues alone - it takes people willing to see the good of what they are doing as outweighing the potential risks.

So it’s obvious that something unplanned has happened here. Even with multiple extractions, the expectations I have of my dentistry patients is to be chowing down food an looking great very fast. This is the norm. If not when they go home the same evening, but in 24 hours at least. It really could be anything - reaction to something in the anesthetic, an antibiotic, medication, pain from extractions etc. Sometimes the physiological stress of an anesthetic reveals something that was hiding beneath the surface.There will be people telling you that it must be this medication or that medication that caused it. But I find the truth is often in the details and may be revealed by fresh eyes. If you can’t imagine going back to the same clinic, it may be a good idea to get a second opinion. If there is something I can’t figure out for a patient, I will actively offer people second opinions via specialists or other clinics. The more eyes on her and people thinking about her, the better.

Dr. Kris