Should My CKD Cat Get a Dental?
Q: My 16 year old cat has had at least two dental cleanings and one tooth extracted. Should he continue to have his teeth cleaned with the risk of anesthesia? He does have kidney disease that is stable right now with weekly sub-q fluids.
A: Let me answer this two ways: first, just for you (you lucky duck), and then for everyone else.
For You:
You’ve got a good thing going.
SQ fluids, and attentive care. Without knowing anything else, let me make a few guesses: a cat who’s probably over 6.6 lbs (3 kg) and not shrinking like a wool sweater in the dryer. I’m going to go out on a limb and say he’s eating well, holding his weight, and has had thoughtful, kidney-friendly anesthetic choices.
Did I guess right?
If so, let me tell you what you’ve built:
A mouth that’s not a war zone. A cat whose comfort isn’t held hostage by inflammation. A veterinary team that knows what they’re doing and doesn’t treat your cat like a set of teeth on a conveyor belt.
The benefits?
Less body-wide inflammation.
Less mouth pain.
Fewer future problems.
No “domino effect” where one bad tooth infects the neighbours.
It’s working. Keep going.
So, what is your mission now?
Keep your cat in this sweet spot—where the kidneys don’t become the reason you have to start declining dentals or reconsidering anesthesia.
That specifically means continuing to reduce kidney fibrosis. What the heck is that? I lay out that plan in my latest book.
You're already doing it, probably without knowing it. SQ fluids help. Maintaining body weight helps. Dentals done right also help.
But when do you pause and ask: Wait—should we still be doing this?
Easy. You be cautious when:
Your cat is unintentionally losing weight, especially under 6.5 lbs.
The pre-anesthetic bloodwork shows the kidneys aren’t just holding steady—they’re starting to slide. Which is increasing fibrosis.
At that point, the question isn’t “Can we?” but “Should we?”
What’s the benefit? What’s the risk? What’s the plan B?
For Everyone Else:
Let me tell you about a classmate of mine. He’s now one of the top veterinary dentists in North America. Salt-of-the-earth guy. Bit of a sarcastic dude, but in a good way. He used to spar with the professors for fun. Later in life, he’d say:
“You’ve got a better chance of getting into a car accident on the way to the dental than having an anesthetic complication at the dental.”
And he wasn’t wrong.
The risk? Very small.
The heartbreak when it does happen? Enormous.
I’ve had it happen once. It was awful. We did everything right. But medicine isn’t a guarantee—it’s a probability. Ugh.
Still, 99.9% of the time, dentals help.
Your cat wakes up and boom—a new mouth, a new lease on life.
I once met a cat stationed on a military base. His military daddy adored him—but his cat’s gums? Total warzone. This cat would flinch and chatter just thinking about someone looking at his mouth. It was a classified no-go zone. That poor guy didn’t just need a dental—he needed a full tactical extraction. Black ops for molars.
That said—dentals aren't always the priority.
If your cat has mild tartar and zero gingivitis, and there are bigger fish to fry (say, unstable kidneys or untreated pain elsewhere), I’m not rushing to the dental table.
Also: I don’t believe in dental factories.
You know the ones. Checkbox clinics. Same recommendation, no matter the cat. Tartar! Bad! Must remove!
Nah.
Dental recommendations should be tailored. Not about making the teeth sparkle for a glam shot—but about improving your cat’s quality of life.
So ask:
Will this dental reduce pain?
Will it lower inflammation?
Will it help my cat eat, stay stable, and stay with me longer?
If yes—shine up those dental instruments.
If no—pause. Reassess. Let’s make a better plan.
And if you want the full scoop—including what fibrosis really is and how to outsmart it to keep your CKD cat doing well, —check out the book.
