Dental disaster for my kitty

rphilip

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I am shattered. My girl who will be 11 in November, had displayed some lethargy starting late August. We had taken her to the vet who couldn't find any issue in her bloodwork. By the last week of September though, I noticed she was drooling from one side of her mouth and chattering without any noise and reduced vocalizing. Everything pointed to it being a dental issue which did not surprise me as the vet's general recommendation has been to give her a cleaning in the past although I never knew how extensively this could hurt her. What transpired since has been a nightmare.
She quickly stopped eating, and our regular vet got her an appointment and did a few extractions (Sept 30) he was comfortable with but needed her to go to a dental specialist for teeth resorption and root fragments that remained. The Specialists in a 60 mile vicinity are all booked out through end of November and into December. I begged and pleaded and found one specialist who showed compassion on my baby and took her in 8 days after her first extraction for a second set of extractions, with the goal of eliminating all source of pain. So, there were two procedures done under general anesthesia within a little more than a week. the specialist also mentioned that while performing the extractions, she noticed a lesion/sore under her tongue which she thinks was caused by an instrument during the first extractions (I'm beside myself learning this, btw !), and believes this will take longer to heal. We are past 1 week of the second extractions (October 8 - second extractions), and I feel like there is still no improvement. My baby has still not been eating and also stopped drinking water. The recovery time for dental procedures, I hear, is typically 1-2 weeks but the spot with the lesion may take longer. Still, they expected she would start eating again in 48 hours or so. They are surprised to hear she is still not eating or drinking water (today is Oct 19). For fluids, we take her every other day to give fluids under her skin to keep her hydrated. We are also syringe feeding her for three weeks now but she is not getting enough nourishment as it has been hard to syringe feed her. She gags a lot. Medication wise, we give her a mix of gabapentin, and buprenorphine for pain meds and she is on clindamycin (before and after extractions). We've stopped the buprenorphine recently since she has severe constipation now, and we stick to gabapentin alone. Earlier last week (about 4 days after her second extractions), I thought I saw a little improvement when she would walk around the house (as opposed to lie in her cat bed all day) and scratch her scratch post and groom her self a little. However, since the constipation started 72 hours ago, she seems to have lost any spark or brightness in her eye. She sits hunched, she barely moves. She is so uncomfortable, and she sometimes sits in her litterbox. Additionally, she just started grinding her teeth really hard when we syringe feed her (which she did a little before the extractions), and breathes slow and heavy, and is in bed all day. She wobbles over to the litterbox to pee.
I am so confused and I am going out of my mind. I now have two issues now I am dealing with: 1. Why does her mouth still seem to be in so much pain that she refuses to look at food or water, and related question, why is the teeth grinding back stronger than ever?? I thought any and all teeth issues would have ben resolved by now 2. How can I help my baby with her constipation naturally without subjecting her to more trauma than she has had with all the above pain and discomfort.
Also, as reference - she has lost 2 pounds since end of August. It's hard to see her become skin and bones though in front of my eyes. Her bloodwork so far is still normal. I am so worried the specialist did not remove all the problem teeth, and I get so mad thinking about it. I don't think my baby can survive another third set of extractions. Does anyone have any experience with these dental nightmares that you think may be helpful? We have a check up appointment with the specialist tomorrow, and I wanted to be prepared with any questions. I am losing my mind right now.
 

daftcat75

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At this point, I would strongly consider a feeding tube. It's much less stressful for you and her than syringe feeding by mouth and you'll be able to get all the nutrition and medicine in her while avoiding her sore spots. Most cats don't mind the tube. My Krista only minded it when I fed too fast or too cold. You get instant feedback on both. Learn and adjust. The feeding tube will take the stress of eating and drinking by mouth off of her giving the sore under her tongue and any other soreness in her mouth a chance to heal. You can still offer food by mouth. The tube doesn't prevent her from drinking or nibbling on her own when her mouth isn't bothering her as much. When she does start eating by mouth again, keep the tube in her long enough to know she won't backslide again. It's easier to keep the tube in her longer than you need it than to re-intubate her if you remove it too soon.

They do have to put her under briefly to insert the tube. But it's not nearly as long or as complicated as dental extractions. It is a fairly straightforward procedure. They may want to keep her overnight to do a tube feeding several hours after the tube has been inserted to make sure it all goes well before letting you pick her up.

Feeding Tubes For Cats

The other recommendation I have is that if she does have tooth resorption, it often doesn't stop at whatever teeth were just extracted. You should discuss with the specialist the possibility of proactively removing all her remaining teeth rather than waiting for them to go bad individually. Krista went through hell having to get extractions every few months until her regular vets said, "She needs a dentist. We don't feel comfortable doing any more work in her mouth." I told the dentist to, "make this the last dental procedure she'll ever need." She was eating again that very night. She was also doped up from the procedure. The recovery did take about two weeks. But she was eating better even during this recovery than she did before the procedure. She was about a week away from getting a feeding tube (again) if we didn't have such amazing luck finding a dentist who would see her in two weeks instead of the two to six MONTHS that other dentists were booking.
 

StanAndAlf

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I second all of the above advice. Especially the feeding tube, it may be that some proper nutrition will pick her right up. She can't have energy without fuel. It may also be that the medication is making her nauseous, and not just the pain in her mouth, that is making her reluctant to eat. I would also look at some Nutripet or Hills A/D, as both are full of essential nutrients and sugar, and easily digestible, so it shouldn't cause any constipation.

I usually recommend raw egg yolk to ease constipation, but I wouldn't want to risk upsetting her belly further while she is sick. You may be able to get an over the counter laxative from your vet clinic though. Laxapet gel is one that comes to mind, which formulated for cats and dogs and you may be able to get it online or at a pet store.

As for the specialist, yes, ask about the reabsorption and formulate a plan from here. IMO, I think priority should be getting her back on her feet before even considering another set of extractions, even if that means a week or two with a feeding tube in. But at the consult I would want to create a timeline of where you need to go from here to end her dental issues, hopefully for good.

I know this all seems so horrible, and I am sorry you are going through this. But just take solace in the fact that if you had done nothing, its likely her dental issues would have killed her. If you have other cats I would seriously advise you to get them checked as well. Please keep us updated, we truly do care.
 

daftcat75

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For constipation, I second the recommendation for egg yolk. My Krista loved egg and I would let her lick the scrambled egg bowl clean after I poured the egg in the pan. In fact, she became classically conditioned to come running to the kitchen when she heard the fork in the bowl. 😻🤦🏼‍♂️ Since you’re already syringe feeding her, you can put a small amount of egg yolk (a half to a 1 tsp until you know how it affects her) in with the food you’re syringing. You can also offer her some unsalted, unseasoned (no milk added) cooked scrambled egg. You can experiment with texture by how long you cook it. If she likes scrambled egg, you may be able to see which texture works better for her right now. Cats with mouth/teeth issues will develop texture preferences based on what causes them the least discomfort. Some cats may like a chewy texture because they can more easily avoid teeth that bother them. While others may like a pate because it requires less chewing. And still others may like a runny pate or stew texture that can be slurped up. Egg can take on many textures depending on how you cook it which makes it easy to eggsperiment with texture.

One note about egg: while you can offer it raw or cooked, you don’t want to offer raw egg white alone. Raw egg white has an anti-nutrient that can be cooked away. But it’s thought that there is more than enough of the nutrient in the yolk compared to the anti-nutrient in the white, that as long as you scramble them together, you can offer raw scrambled egg if that’s how she likes it or you need to put some in the syringe.

Also, I don’t know if gabapentin alone is strong enough pain relief. I would try the buprenorphine again to see if the teeth grinding lessens. If so, then keep giving the bupe and address the constipation as well.
 
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rphilip

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Thank you, Daftcat and stan&Aif. My dental specialist called about 30 mins ago to check on her, and I gave her the details. She can't figure out why she is still chattering. She thinks the open sore can take weeks to heal and while that is happening, it can be a very sensitive area :(
I have my check up appointment with her in the morning tomorrow. She suggested leaving my cat with her so she can sedate her and look into her mouth and under the tongue to see what might be going on/ how things are healing.
She also mentioned that my baby could be constipated or she could have a urinary infection, especially when I told her she sits in her litterbox and pees a lot. She asked me to take her to the emergency to get both of those checked. Interesting information on the egg yolk ! I will have to check that out once the vet confirms whether it is constipation or a urinary infection.
I was hoping to not go the feeding tube route because I was hoping she would take a turn and recover. She hates anything touching her body even collars. One time, I thought it is just safer with a collar so I left it on her for 6 months. I really thought she would be over it in 2 weeks, but for 6 months, she was such a muted personality. She would just sit and not move too much. It was so strange how a little collar affected her so much. When I removed the collar after 6 months, she was back to herself in a second !!! This is why I am weary of the feeding tube since I feel like she'll just give up. But I know it's definitely something I should keep in mind. Do you have any suggestions on which type of tube, as I know there are at least three types?
So, the plan for now is to meet the dental specialist tomorrow morning to see what's going on in her mouth that is still causing her pain, and then, if my cat is up for it, a trip to the emergency to check out her constipation/ urinary infection, and then with each of the vets, understand what is the plan and timeline to recovery. I will keep you posted.
 

Jcatbird

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A friend just went through some tough dental stuff with their cat. An appetite stimulant made a world of difference when it came to eating again. Along with everything else, you might inquire about that while you are getting her checked. I am so sorry you are both going through this. Hoping for much better news soon.
 

daftcat75

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If you choose to go with the feeding tube, and I recommend that since syringe by mouth is very stressful and not so effective, I would go with the e-tube. Inserts in the side of the neck and goes into her esophagus. I would recommend a Kitty Kollar. It slides on over the tube and helps keep the insertion site protected and the tube out of the way. Best of all, my Krista who hated collars didn’t mind this at all.
Kitty Kollar - Special Hugs for special kitties & kanines
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LTS3

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Do you have any suggestions on which type of tube, as I know there are at least three types?

The vet will determine which feeding tube type is best for your cat's situation.

Another thing you can try to feed your cat with to get nutrients in, either by mouth or watered down through a feeding tube is Oxbow Animal Health Your vet may sell the product or be able to point you to a local retailer. Technically you can buy it online from Amazon and other place but none are authorized retailers so there's no guarantee you're getting the actual genuine product.

Your dental vet can consult with a veterinary school or other dental vets to get more suggestions on why your cat is still having issues.
 
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rphilip

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Hello all - thank you all for your input. I have a sad update. My baby had her follow up with the dentist and she sent us to emergency right away when she started checking her and felt a huge swelling in her throat on the left side. Emergency did a an X-ray and found a very large swelling and then followed with procedure to check whether it was fluid or a mass by inserting a needle there and analyzing it. Turns out it is an aggressive cancer - squamous cell carcinoma. My heart was broken. The open lesion was a sign. We decided not to pursue with surgery or radiation because she cannot eat anymore, drink water or take meds orally since she gags. The mass is constructing her throat significantly. She suffered so much already. She perked up in the car in our way home, standing like a dog, looking out the window, watching all the lights of the cars. She was peaceful. She is at home right now and she wants space. She has not eaten in more than 24 hours and I’d hate to keep her hungry for much longer. Doc suggested no more force feeding as it will make her gag. So the sooner, the better. I’m heartbroken that my little furry companion, my best buddy, my shadow, will not be around anymore. I’ll miss seeing her little face and snuggling with our arms around each other every night. She was a gift from God for 10 years. Attaching my little baby’s pic here when she was well - Praying for strength tomorrow and the coming days.
 

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rphilip

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If you choose to go with the feeding tube, and I recommend that since syringe by mouth is very stressful and not so effective, I would go with the e-tube. Inserts in the side of the neck and goes into her esophagus. I would recommend a Kitty Kollar. It slides on over the tube and helps keep the insertion site protected and the tube out of the way. Best of all, my Krista who hated collars didn’t mind this at all.
Kitty Kollar - Special Hugs for special kitties & kanines
View attachment 399259View attachment 399260View attachment 399261
Lovely Krista. ❤
 

Jcatbird

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I am so sorry about the findings. I am so grateful she has you. She is absolutely beautiful. We will all be here for you anytime you feel the need. I loved your description of how she perked up in the car and enjoyed watching the lights. I will hope that every minute will be like that for you both. Our hearts are with you both.
 

daftcat75

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I’m sorry to read this update. My cat before Krista, Cabernet, developed oral squamous cell carcinoma. It’s very aggressive and the prognosis is poor for chemo or radiation. From diagnosis to her final appointment wasn’t more than a week or two. She declined that quickly. 😿 Wishing you strength and serenity.
B0DCBFC7-C026-4370-A177-5982640FE37F.jpeg
 
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