2nd and 3rd opinions

[jmacintosh]

I have a 13 YO lilac lynx point siamese. She was dropping weight and getting fussy about eating. She was always small, around 6 pounds now down to 4.5. Vet suspected she needed a teeth cleaning as her gums were inflamed. Cleaned teeth, got her back, ate great for about a week.

Continued dropping weight and being fussy. She started "side chewing". making these movements with her mouth deliberately "chewing" with nothing in her mouth. We also noticed something else rather peculiar. She wouldn't extend her tounge to lap up things when eating or drinking. Vet suspected Gingivitis stomatitis, recommends pulling her otherwise healthy teeth. We were told the condition is common in siamese and maine coon cats. We go ahead and have everything removed from the upper and lower fangs back. Vet didn't want to touch the fang teeth for fear of breaking her jaw. She wants us to administer Metacam. It helps a little to reliever her pain enough so she would eat the bare minimum to keep her going. now we are reduced to feeding her Gerber baby food. I haven't seen her drink for sometime now, but the baby food has so much moisture in it it seems to be keeping her somewhat hydrated. had to keep rotating food choices because we figured that she would eat a particular flavor until she associated it with whatever discomfort. feed her something else until she associates it with the discomfort again, Gerber to the rescue.

I suspected that maybe, like myself, had a tooth removed and there were bits left behind. Brought her back for an x ray and sure enough, ligaments and tooth fragments were left behind from the last procedure...Their error... Back in she goes. They put her under again, this time with an opioid as well as the isoflourane. We get her back, and she is eating everything in sight... for three days

Continued fussy eating, now just under 4 pounds. vet says keep giving her Metacam and now Clindamyacin. Vet says she thought her tonsils were a little inflamed and the cycle continues. Gave Clindamyacin for 10 days, and nothing has changed. Now she is doing something similar to the side chewing but different. Now she shakes her head and sticks her tongue out like she has a popcorn hull stuck somewhere.

I have a link to the video of her doing this... Marina's video

Took her to another vet for a second opinion. they suggested to continue with the Metacam while giving her Atopica, which will suppress her immune system. The 2nd vet believes what you can see in the video is a pain response, and Marina may get some relief from Atopica. was told it will take 10-14 days for it to kick in and do it's job. Meantime, she is eating less and less if that is possible. I am now giving her 50cc's of ringers lactate subcutaneously to keep her hydrated every other day.

All of this can be fixed by simply fixing whatever she is doing with her mouth. The 1st vet claims there is no other obstruction. she suggested a sinus issue, but at this point, we are 9k into this, and think she is grasping at straws. A vet with 25+ years of experience and she has no clue, and she thinks we have a money tree in our backyard. This poor girl has been through so much, and I know there is an answer.

 

[jmacintosh]

One thing I would like to add...

When she came back from the vet to have the tooth fragments removed, she was polishing her plate during those three days, indicating that she could in fact use her tongue. So I have no reason to believe there is a jaw/hinge issue. As each day went by however, she cleaned the plate less and less effectively.

 

[FeebysOwner]

Hi. I think at this stage, consulting with a vet who specializes in dentistry and/or internal medicine is the next step. You can take all of her records to them for review to see what they think. Most vets are familiar with such specialty groups in their area, and most of these groups do want a referral from a vet for the consult. So, you can ask your vet about who they would refer you to. I see no reason why your vet would object given they appear to be out of ideas on their own.

Specialty groups are not cheap, but they tend to carry a level of expertise, experience, and knowledge that your average vet does not.

 

[jmacintosh]

It is my hope that someone has experienced something similar with their cat. I am already in contact with several local vets to try to address the issue. If there is anyone viewing this thread that would like to provide more insight other than "go call a vet", it would be greatly appreciated!

 

[Robyn5678]

How old is your cat? My parents cat did something similar and she had a tumor under her tongue. I’d have hoped your vet would have looked under her tongue with all shes had done

 

[jmacintosh]

Thanks for replying! She is 13 years old. The last time she was in the vet was to remove the fragments. we had asked that they checked for anything abnormal while they had her under. They claimed they didn't find anything unusual other than the mildly inflamed tonsil, but if they were fixated on the fragments as the cause they may have overlooked it, and just said everything looked fine figuring they had found the cause in the fragments.

 

[FeebysOwner]

If there is anyone viewing this thread that would like to provide more insight other than "go call a vet", it would be greatly appreciated!

Until such time that other members with similar experiences come along and see your post, perhaps you would like to look through previous threads to see if you can find some that are in alignment with your situation.
Search Results for Query: stomatitis | TheCatSite

 

[jmacintosh]

Until such time that other members with similar experiences come along and see your post, perhaps you would like to look through previous threads to see if you can find some that are in alignment with your situation.
Search Results for Query: stomatitis | TheCatSite

I will do that... thank you!

 

[Robyn5678]

Thanks for replying! She is 13 years old. The last time she was in the vet was to remove the fragments. we had asked that they checked for anything abnormal while they had her under. They claimed they didn't find anything unusual other than the mildly inflamed tonsil, but if they were fixated on the fragments as the cause they may have overlooked it, and just said everything looked fine figuring they had found the cause in the fragments.

Have you noticed her drooling? That was one big thing that my parents cat did.

 

[jmacintosh]

i have not noticed any drooling. she's been kind of dehydrated so that may be the reason.

 

[BellaBlue82]

Hi there, my kitty Casper has stomatitis and he's going on 18. We could not figure out why he was drooling, grinding his teeth (at least that seemed like what he was doing) and consistently licking at nothing. He would also act hungry, but then when we put food down he'd turn away from it. While he had teeth removed, he was still doing this. Our vet indicated pulling teeth for stomatitis isn't always the full remedy for some cats, as stomatitis is a reaction to the bacteria in their mouths. She recommended monthly pulse dosing of antibiotics (Clindamycin tabs) 5 days, once a month. This seems to be working quite well for our little guy, as he has gotten his appetite back and is eating well again. Maybe it's worth the ask on what more the vet could do if they believe it's stomatitis?

 

[jmacintosh]

Hi Bella, Thank you very much for taking time to offer some insight!

Clindamycin in liquid form (0.7cc 2x daily) was being given in conjunction with the Metacam. Prior to that was Mirtazapine and Cerenia. While I am going through the two week phase of Atopica for immune suppression, we needed to stop the Clindamycin for the time being. To see which is having an effect, plus we can't just keep her on an antibiotic 24/7/365.

After reading more about this, I have come to two conclusions...

First, the 0.7 dosage was on the low end of the scale and can be adjusted upwards next time we use it, and when we do use it, we need to accept that there will a slight reduction in the effectiveness of the Atopica while using the Clindamycin during that "pulse" period as you call it. As far as I am concerned, I have two main goals. Relieving her pain enough that it doesn't impede her ability to eat. She definitely wants to eat, that much we know.

Second, to be able to get her off the Metacam, because that will eventually fry her kidneys, and we are already in the territory of off label use at the suggestion of our vet. I amy be repeating something many people already know, so forgive me, but Metacam is not something intended for any kind of long term use. Another thing about Metacam... upset stomach and nausea can be a side effect. That is kinda counterproductive when you are trying to put weight back on a poor little girl like Marina who is under 4 lbs as we speak. We may also increase the amount of Ringers Lactate we are administering, (currently 50ccs or mls?) to keep her hydrated. I took this step on my own because I believe nothing good can come from the combination of Metacam's possible side effects, and dehydration when her weight is so low.

 

[BellaBlue82]

Hi Bella, Thank you very much for taking time to offer some insight!

Clindamycin in liquid form (0.7cc 2x daily) was being given in conjunction with the Metacam. Prior to that was Mirtazapine and Cerenia. While I am going through the two week phase of Atopica for immune suppression, we needed to stop the Clindamycin for the time being. To see which is having an effect, plus we can't just keep her on an antibiotic 24/7/365.

After reading more about this, I have come to two conclusions...

First, the 0.7 dosage was on the low end of the scale and can be adjusted upwards next time we use it, and when we do use it, we need to accept that there will a slight reduction in the effectiveness of the Atopica while using the Clindamycin during that "pulse" period as you call it. As far as I am concerned, I have two main goals. Relieving her pain enough that it doesn't impede her ability to eat. She definitely wants to eat, that much we know.

Second, to be able to get her off the Metacam, because that will eventually fry her kidneys, and we are already in the territory of off label use at the suggestion of our vet. I amy be repeating something many people already know, so forgive me, but Metacam is not something intended for any kind of long term use. Another thing about Metacam... upset stomach and nausea can be a side effect. That is kinda counterproductive when you are trying to put weight back on a poor little girl like Marina who is under 4 lbs as we speak. We may also increase the amount of Ringers Lactate we are administering, (currently 50ccs or mls?) to keep her hydrated. I took this step on my own because I believe nothing good can come from the combination of Metacam's possible side effects, and dehydration when her weight is so low.

Aw, poor sweet kitty. I know what you mean, our fur babies being on some of those medications can be scary. I think your goals are very reasonable!

That's very possible the Clindamycin dose may need adjusted. It took us a few trials with our vet to find out the dosage that worked best for Casper, while ensuring we weren't giving him too much. He gets 50mg a day in the pulse period, split into two 25 mg doses - Am and Pm.

Casper went through some weight loss himself while we were trying to figure all of this out, 9lbs down to just shy of 7lbs. It's so scary when they lose weight. I can see you are doing everything in your power for your little girl. I'm sending good vibes your way, keeping sweet Marina in my thoughts and hopefully you see some progress soon!