Cat had dental now chewing air and pawing at mouth

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dreamingofdeltas

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Please let us know the results. No one can say that you are not trying everything to get to the bottom of this.
I sure will. ❤ Today Bentley seems okay for the most part but did grind his teeth once after grooming. I know I need to give the Prednisolone time, though. Thankfully he had not done it during or after eating and no pawing at the mouth so far.

Will certainly keep you all posted.
 
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dreamingofdeltas

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Hi all,
We got the results from the x-ray today and they said the report was completely normal.
Unfortunately, Bentley is still grinding his teeth (and of course did it a ton after I was messaging the vets office earlier.) This afternoon and evening he has done it mainly after chewing near plastic and after grooming. As I'm researching, I wonder if he also has pica (even though he doesn't swallow things, he has done the chewing near plastic before on and on throughout his life.) Regardless, he had a bad episode with pawing at the mouth Monday night and now seems to grind his teeth when eating a little bit here and there regularly and also randomly sticks his tongue out after eating as if saying "blehh that tastes bad".

But yesterday, he barely did it and I was so hopeful. So yesterday I thought the Prednisolone may be working but after today don't think so. Our vet wants us to finish the remaining days of the Prednisolone to see if there is any change. He also seems to be "twitching" a lot more, I am pretty sure he has FHS too because his back rolls frequently and always has and he sometimes chaes his tail and bites it but never self-mutilates. His back rolls have been happening much more. I'm unsure if that is related but I am paying extra attention to every little thing with him.

Nevertheless, the vet said if there isn't a change when we finish the Prednisolone, we will want to consider a CT (which the radiologist also recommended as a next step.) We, of course, will do whatever we have to for our boy but I dread the thought of him having to undergo more tests and more anesthesia as I was worried enough about his dental.

And am starting to worry could it be a brain tumor or something awful...

My husband thinks we should probably get a vet dentist to look at him just for a second opinion (we have one here in Columbus) and I don't think it is a bad idea - hopefully our vet will understand, we love them and trust them but I want to ensure we are looking at every angle to figure out what is going on.
I don't know if we should go with the CT first or dental consult. Or really, who knows who will be able to get us in first since I'm sure we will need a consult for the CT with a specialist anyhow.

I'm just so distraught and worried and have tears streaming down my face as I write this. My kitties are my babies and I am terrified something is really wrong with Bentley.

Requesting lots of hugs and love for my boy,
Tiffany
 

silent meowlook

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Go with the dentist first. Try to have him examined without anesthesia. It sounds like a tmj kind of thing. Probably soft tissue so it won't show up in radiographs. It could also be a bad tooth root.
Did they ever say if they use a gag during the dental? I find it hard to believe that this just popped up after the dental without it being related to the dental.
 

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I agree that consulting the dentist first is a good idea. Call right now, as those appointments can be hard to come by. I ask for referrals all the time for my animals and have never had anyone become offended. Vets are GPs, for the most part, and don't see a request for a referral as a lack of confidence in them.

One of my cats had a decent case of FHS, diagnosed by the vet. She never did anything in particular with her mouth during the episodes though.

Pica could be a possibility. I hope that you are not suddenly looking at some combination of conditions.
 
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dreamingofdeltas

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Yes, I did confirm that they didn't use a mouth gag.

I did call this morning and got a vet dentist consult scheduled for their next opening, May 31st!

I also did call the specialist who would need to do a CT scan so we could get that ball rolling, too, and was told he needed a consult first but they were not sure if this was internal medicine in nature or neurological. They had an internal medicine appointment cancellation today, which never happens and asked if I wanted the appointment and said they could do a neurology consult, too. We'd have to wait until June otherwise...so I snagged that appt and got him in to be seen today!

The internal medicine vet said he has no pain when pressing on his gums or anything but does highly think it is oral pain related since it started after the dental and also said seeing a dental specialist would be the next step (which I then told him I actually scheduled an appointment before coming to see them!)

He said that we really wouldn't be able to get in for a CT until after the 31st anyhow and he wants to see what the vet dentist thinks first but agrees with our vet that a CT would be his next recommended diagnostic tool if the dentist is also unsure of what's going on. He said a CT would show if it is a bony tumor, nerve root damage, polyp, or something with the temporal mandibular joint. Another test we did was abdominal ultrasound today to check for pancreatitis (I was glad he brought this up as my research I saw that can cause teeth grinding, too. The ultrasound came back fine.)

He also said we can try a pain medicine, buprenorphine, too, to see if pain that is causing this. I know someone mentioned here to research it but I do recall he was on this after dental extractions years ago with no issue.

They did an in house neurological consult so I didn't get to speak with the neurologist since it had to take place in between the neurologists appointments...but I was just glad he got to be seen by both vets while there.

Th neurologist didn't see anything neurological wise but said they couldn't rule totally rule out FHS or unusual seizures, yet felt both were unlikely. The neurologist agreed the dental consult is the next step, however
And if we still are turning up with nothing after the vet dentist visit and a CT we can try a Keppra trial for unsual seizures or a gabapentin trial. So that is in our back pocket if all else fails.

The CT is tentatively scheduled for June 7th and they said we can cancel if the vet dentist finds something or wants to go a different route.

Any the intenal medicine vet does not think it is a brain tumor, he said we would see other presentations. So that was a relief!

I am so glad I could get him in today and that we have a good action plan for next steps!!

Thank you all for being here for us! ❤

Go with the dentist first. Try to have him examined without anesthesia. It sounds like a tmj kind of thing. Probably soft tissue so it won't show up in radiographs. It could also be a bad tooth root.
Did they ever say if they use a gag during the dental? I find it hard to believe that this just popped up after the dental without it being related to the dental.
 
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dreamingofdeltas

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I agree that consulting the dentist first is a good idea. Call right now, as those appointments can be hard to come by. I ask for referrals all the time for my animals and have never had anyone become offended. Vets are GPs, for the most part, and don't see a request for a referral as a lack of confidence in them.

One of my cats had a decent case of FHS, diagnosed by the vet. She never did anything in particular with her mouth during the episodes though.

Pica could be a possibility. I hope that you are not suddenly looking at some combination of conditions.
I did mention Pica too (forgot to add to the big update I just posted) but the internal medicine vet didn't really say anything about that...nor anything he passed along from the neurologist. So I'll just have to keep an eye on that and bring it up to my regular vet when he goes for his UTI recheck next Saturday!

And that is so helpful, you're right. It isn't a lack in confidence at all but rather specialty care! My vets office seemed completely okay with it and already got the records over to the vet dentist! I know they want Bentley well just as I do! ❤
 

fionasmom

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Great that you have been able to get those appointments scheduled as quickly as you did! You have all bases covered and will hopefully get to the root of this. I think that everything that was mentioned is probably on the table as a possibility which at least means that you might be narrowing down the field.
 
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dreamingofdeltas

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Great that you have been able to get those appointments scheduled as quickly as you did! You have all bases covered and will hopefully get to the root of this. I think that everything that was mentioned is probably on the table as a possibility which at least means that you might be narrowing down the field.
Thank you, I agree and was so glad to be able to get in yesterday and am happy we don't have to wait terribly long for the dentist's appointment. ❤❤
 
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dreamingofdeltas

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Hi all, I just wanted to give an update as we had our dentist specialist visit today.

While the dentist vet didn't see anything visible upon examining his mouth, she said there could be some tiny amount of tooth resorption that could have gotten disturbed from the cleaning. This is unlikely and would be rare but still in the realm of possibility. Or perhaps a minor hole in a tooth or something that could have have been instigated by the dental, a subdermal lesion that you cannot see by just looking, or perhaps maybe his teeth rubbing together causing an issue.

She brought up that if it is none of that, it could be FOPS (she brought up FOPS before I could even ask about it.)

She said the next step would be doing an exam and their CT under anesthesia and they will very carefully looking at his mouth. Before treating as FOPS, she said it is best to rule out anything wrong in the mouth first before making a FOPS diagnosis and given their speciality equipment for dentals, she wants to examine his mouth fully. I mentioned our vet did do dental xrays and a head xray but she said their equipment is different and they like to look at different angles.

She said if she finds any problems at all, even something tiny that she would not worry about during a normal dental, she will take care of it on the spot.

They are booked through August but they were able to squeeze us in late next week for this, given he clearly is having some discomfort.

He was supposed to have a CT at the specialists office who we saw on the 19th but she said if she finds something she can treat it right away. The only bummer is the dentsits CT does not check the brain or for any nasal or brain tumors, polyps, etc, just the teeth, jaw, and mouth areas. So I'm worried if it could be that vs dental, are we wasting time. But I'm trying to rationally think what is most likely and both the specialist we saw on the 19th and her think it definitely seems to resemble oral pain the most and other causes would probably show other symptoms.

So we rescheduled the full head CT at Medvet for early July just to have it on the books (if needed and I could always move it up if I want but want to also give him time in between all of these stressful events)

Also, the buprenorphine that the specialist prescribed on the 19th did not work for the teeth grinding, so we stopped that after a few days of trying it. Our vet called in transdermal gabapentin that we will be getting delivered from a compounding pharmcy to try (he takes it for stress before vet visits but has been spitting out the liquid/frothing at the mouth with it...and the capsule mixed with food or water he just pukes up. We know transdermal is possibility less effective but hopefully he'll absorb some.) We will try that for the pain/discomfort...I saw it is also a potential treatment for FOPS, as well, so it is worth a shot.

So no real new answers but hoping this gets us closer to helping him feel better. I'll certainly keep you guys posted, especially if this maybe will help a future kitty parent with a similar issue down the road. Thank you all for all of the good vibes and prayers. ❤
 
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dreamingofdeltas

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Just an update Mr. Bentley had his dental CT and exam under anesthesia at the vet dentists today.

Unfortunately, we didn't get "good news" that anything was found causing this so the vet dentist does suspect FOPS since we ruled everything else out, as nothing was found on the dental CT either today.

They gave him an NSAID injection for today and Onsior NSAID to try for the next 6 days in conjunction with the gabapentin we are already giving him, I'm glad it isn't metacam as I've heard warnings on that med. She said in the US it is prescribed for 3 days but longer in Europe and she wants to give it some time to see if it works. The prednisolone didn't work before so I'm unsure but we will see with this.

If that doesn't work, they'd look at phenobarbital... and the dentist is consulting with an internal medicine vet who knows about FOPS to get her thoughts.

The transdermal gabapentin came Monday and does seem to lessen the episdoes he gets when grooming but not while eating, so maybe we need to up the dose.

The only diagnostic test we haven't done yet is the full head CT (today's was just of the teeth - she is going to see if the specialist vet Medvets will look at it as she said it will show the sinus area too but not the brain as it shows hard tissue not soft.) She recommends seeing if the meds work and trying medical management first before deciding to do the head CT and honestly, I don't want to put him through more stress now and know a brain tumor or something of the sort is unlikely so we will try this route for now.

Still rooting for my sweet boy (who is currently staring into space, loopy from the anesthesia!)

Thank you all for the head bunts, love, prayers and good vibes. ❤
 

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Wow. That’s disappointing, to not have an answer. Maybe it’s been mentioned, but they ruled out muscular skeletal pain right? They didn’t use a mouth gag right? I think you had said they didn’t.

I find it hard to believe this isn’t related to the dental. It started right after didn’t it?

Be careful with the Onsior. This is the link to FDA it’s boring but read to the end where it mentions Onsior.

How long has it been since the Prednisolone? You can’t use them together and there is a wash out period.

I am sorry you and your cat are going through this. It must be so frustrating. I wouldn’t be doing more diagnostics if it were my cat. He’s been through so much.
 
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