Elderly Cat & Tooth Pain / Resorption

ermentrude

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I have posted about my little lady Catherine before, she's about 19 (guess) and I found her about 9 years ago.  This past summer she stopped eating and started hiding, leading me to get her to the vet and a diagnosis of Kidney disease.  Her numbers are still within the normal range but they are on the borderline.  Since then she's been moved to an all wet diet, plus roasted chicken and a weekly application of 100 ml sub q fluid.  Overall she's been OK.

In about 2009 she had her teeth cleaned and found that she had multiple resorption lesions.  She also had a very hard time coming out of the anesthesia from the teeth cleaning, her body temp kept falling.  They took her outside in the 105 degree heat to try to get her body temp up.  It worked, eventually, but it was rough on everyone.

I did notice a week ago that she was rubbing her face on things very roughly.  I had noticed it before but hadn't given it much thought until last week when she finally sort of stared me down and wiped her face across a sharp corner multiple times, so hard her back leg did the air scratching thing.  Clearly, her mouth hurt and I had been too stupid to understand.  (Humans can be so stupid...)

This time at the vet (my usual vet is on leave, so I'm with her replacement right now), he more or less told me the only thing we could do was grind out her teeth.  That there was no other solution.  The specialty dentist will be here in about 3 weeks and in the interim, she could be on pain meds.  She had one dose of buprenex on Thursday and reacted very poorly (vet called it a bad trip) - could not sit still and howled all night.  Neither of us slept.  Then on Friday the vet gave me a script for gabapentin.   So far no bad trips on the gabapentin, she's eating like a pig but she is lethargic and unbalanced about an hour after her dose.  I'm going to ask the vet if I can split the dose or lower it, to see if that minimizes being unbalanced.  

I spoke to the assistant to the dental vet today and she was ready to schedule a consultation and the procedure.  I explained, as I had to the vet, that I only wanted to do this if it was for her, not for me.  I was concerned about the previous issues with anesthesia and wanted to be conservative.  She said she'd talk to the dental vet but saw no issues with the kidney values, age or prior anesthesia to prevent the procedure.

I love this cat to bits and do not want her to be in pain.  I would love her to be with me as long as she is able.  But ultimately I have to be fair to her, because she is a fantastic cat.  My local vet and the dental specialist seem so confident.  But she has such quirky responses to sedatives - almost not coming back from the teeth cleaning and the bad trip on the buprenex.  I feel like they're rushing in and not listening to me when I ask if there is any other option.  It would break my heart but I'd rather she have a dignified, peaceful departure at home (traveling vet) than try to push this dental work and have her pass away on a cold operating table, all alone.  But then again, I don't want to deny her surgery that could give her a new lease on life, since we have no idea how old she really is.

So I'm here to ask for any advice.  The dental vet isn't here until Oct 21, so I have some time to see how the gabapentin works and affects her.  Has anyone had their cat on gabapentin long term and were there any ill effects?   Is there really no other option but surgery for tooth resorption pain?  
 

red top rescue

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I have an old cat who has had that problem.  Some of the teeth have been removed, but she has the rest of them and she has stomatitis as well.  She gets injections of depo-medrol for the stomatitis and that controls the pain of that for about a month.  Fortunately she does very well with buprenex and gets 0.4ml. underneath her tongue every 12 hours when that happens.  I am not sure what dose your cat got, but pain control is important.  If the gabapentin is working for the nerve pain, I would just leave her on that and not risk the anesthesia.  Obviously she is very sensitive to drugs.  Mine had no problem with anesthesia last time her teeth were done, and she's about 17 years old.
 
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