I can well understand your dilemma – on one hand, your older cat has a health problem that would benefit from treatment yet on the other hand, performing the necessary care poses potential health risks.
Let me begin by commenting that, based on your description of your cat's dental disease, the severity suggests you have very little choice – something needs to be done to address the problem. Conceptually place yourself in your pet's paws – consider how you would be affected by such severe dental disease. As most of us know from personal experience, dental disease can be painful and I suspect that your cat is currently experiencing discomfort and hence, a reduced quality of life that, for many people, is often more important than quantity of life. In relaying to you the potential risks involved with the recommended procedure, your veterinarian is simply living up to his/her responsibility of providing you full disclosure so that your ultimate decision is based on true, informed consent.
However, while there are risks involved (as with any anesthetic procedure although heightened due to age), these risks can be controlled and minimized. First and foremost, if it has not already been done, have a full diagnostic blood profile (including assessing for thyroid gland disease) and, if deemed necessary, radiographs and an EKG done on your cat. This will help identify any potential age-related illnesses or organ deficiencies that, regardless of electing for the dental procedure or not, are important to address in your pet's routine healthcare. This will also help to better define and manage any potential illnesses that could heighten the anesthetic risk. In preparation for the procedure, discuss placing your cat on prophylactic antibiotics with your veterinarian. While this won't cure the dental disease, it will reduce the associated bacterial population (which often gain access to the body through the circulation) thereby reducing the additional health risks that these organisms can pose.
Also in preparation for the dentistry, discuss the anesthetic protocol to be used, including intravenous fluids to help support blood pressure during the procedure and the use of monitoring equipment to alert the anesthetist of impending problems before they become critical. Many different anesthetics exist with a number of the newer ones, especially when used in combination at lower concentrations, effectively minimizing and managing anesthetic risks. While it is impossible to eliminate all the potential risks, through appropriate preparation, anesthetic protocol selection, and monitoring, the majority of animals can undergo anesthesia safely thereby allowing them to receive the necessary treatment.
Dr. Walt Ingwersen is Chief Veterinary Officer at PetCare Insurance Brokers Ltd. He is a 1982 graduate of the Ontario Veterinary College. Board certified in Internal Medicine, he has the distinction of being the first Canadian editor of the Journal of the American Animal Hospital Association, a position he currently holds.
Involved in many aspects of the national and international veterinary community, "Dr. Walt" is the recipient of the President's Award for outstanding contribution to the veterinary profession awarded by the Canadian Veterinary Medical Association (CVMA). He is also Chief Veterinary Officer and Chairman of the Veterinary Advisory Board at PetCare Insurance Brokers Ltd. -- Canada's leading provider of insurance for dogs and cats.