So, there are two ways to look at anesthesia in geriatric patients. One, is heck no, I don’t want to risk putting an old, frail pet under and take the chance that they won’t wake up. Two, is remembering that age is not a disease. If the patient is otherwise healthy, then they shouldn’t be at much more risk under anesthesia than any other patient. A vet’s course of action will be influenced by which end of the spectrum they’re on. Personally, I’m extremely resistant to putting anyone, including myself, under anesthesia unless there’s no way around it. I’m probably too paranoid about it, TBH, but anesthesia always comes with risks and I’ve seen perfectly healthy patients unexpectedly die while under and blah, blah, blah. At the same time, there needs to be serious thought given to an animal having to live life in constant pain. If the dental disease is bad enough that it’s negatively impacting the cat’s quality of life, then I would say something needs to be done to correct it even if the treatment carries risk. Because the only other option is to keep the cat on pain meds around-the-clock and I don’t consider that a good option.
The beginning-of-the-month course of antibiotics in lieu of a dental procedure is something that’s frequently done with cardiac patients. As in, there’s some mild-to-moderate dental disease, gingivitis, inflammation, etc. that would benefit from a good cleaning but the patient has some compromising health condition that means they wouldn’t be a good candidate for anesthesia, so instead of putting them under for a dental we’ll use antibiotics to try to keep it in check. It’s not something I’ve seen done in lieu of surgical treatment when the patient has severe enough dental disease as to actually cause some level of suffering, like an abscessed tooth, for example. In that case, I expect most vets would recommend treatment, even if anesthesia was required, with the understanding that it may be a riskier-than-normal procedure based on the patient’s age.
I will also say, there’s a difference between renal
insufficiency and renal
failure. I don’t know how bad your cat’s values are, but that’s something to consider when weighing the risks of anesthesia. Just
how bad are the values, does the cat otherwise act like a healthy cat, is she in good body condition...?
Hopefully her teeth will be just fine and you won’t have to make any tough decisions.