Feeding a cat with dental pain

[Twylasmom]

Anyone have any tips for feeding a cat with chronic dental pain? Twyla has a painful tooth but extraction is too high risk due to her multiple health conditions, which include stage 3 kidney disease and a heart murmur, among other things.

She will be starting twice daily gabapentin to see if that will help some. Because she has kidney disease the foods she eats need to be lower in phosphorus (I am adding binder, but still better to start lower if possible.) which is a challenge because those are not the food she prefers!

The big challenge is she prefers dry food but has gone off it as the tooth pain has increased. I am planning to grind up her dry food and distribute it throughout her wet meals in order to get her to meet calorie goals. Also making sure that wet food is room temperature or slightly warm.

 

[daftcat75]

I suspect Betty has constant tooth pain because the last time she saw the vet for her teeth, I was told that she had some resorptive lesions on a few teeth that were not yet in a condition to remove.

She takes gabapentin twice daily. She's a real trooper. She used to take her own meds--whatever I could pack in capsules, dip in Hills A/D, and drop on the carpet for her. But I think maybe either her teeth don't like this anymore or she caught a taste of something she didn't like and never trusted this again. In any case, she takes 1 mL of the liquid (50 mg at 50mg/mL) twice daily. I have a bigger syringe than the one they send home the medicine with which pops the 1 mL dose into her all at once rather than asking her to come back for the second half of the 1 mL syringe after she's already fled. I know she doesn't like taking the medicine or the taste. But she doesn't try very hard to hide or otherwise get out of it. I think she realizes it helps even if she doesn't like it.

For her food, I give her a mix of Hills A/D, which I call her fudgy crack, and Hills I/D, her digestive food. Both pates. She's always down for A/D. But it's too rich for her to eat enough of it. That's why I mix it with the I/D. I also give her a few drops of hemp oil with each meal. I don't know if it helps. But it doesn't seem to be hurting. I can see she also has arthritis so I'm sure it will be helpful for that. I suspect she was a former kibble addict before I adopted her. Once we got her early GI issues handled, she seems okay with just a little bit of kibble in each meal. Because I suspect she has dental pain, I don't mix it in but rather top it. This way if she's feeling particularly painful, she can choose to eat around it if she wants. I cut up two pieces of I/D kibble in a pill cutter. These four pieces each get a drop of CBD oil (when my aim is good.) I grind up three more pieces in an herb grinder and sprinkle that kibble dust over my CBD halves.

Because Betty doesn't always visit the food plate when it's plated, I don't mix hot water in. Instead, to make it easier on her mouth, I warm up her fridge portions in a hot water bath before portioning them out. I have two shallow dishes that I fill with hot water and a plate that weights down the covered cans in each of their dishes. Then because the water and food want to come to a middle ground, I run a small stream of hot water over the plate to keep the water hot and ask the food to catch up to the water instead of the other way around. It takes about five minutes to get her food up to "prey temperature" (luke warm to the touch.) Seeing her able to eat her plate when I serve it makes the little amount of water I waste for this worth it.

Because the labels inevitably come off in the bath, I use different colored lids to tell them apart.

Finally, whether it's because of her sensitive tummy issues or her dental pain, she's never been a big eater. Instead of trying to get all her calories into two meals, I feed her four times a day. I chose 5am and 5pm for her med schedule. We go right back to sleep after 5am breakfast for another couple of hours. She gets lunch at noon and a second dinner before our bedtime around 9:30 pm.

 

[Twylasmom]

I suspect Betty has constant tooth pain because the last time she saw the vet for her teeth, I was told that she had some resorptive lesions on a few teeth that were not yet in a condition to remove.

She takes gabapentin twice daily. She's a real trooper. She used to take her own meds--whatever I could pack in capsules, dip in Hills A/D, and drop on the carpet for her. But I think maybe either her teeth don't like this anymore or she caught a taste of something she didn't like and never trusted this again. In any case, she takes 1 mL of the liquid (50 mg at 50mg/mL) twice daily. I have a bigger syringe than the one they send home the medicine with which pops the 1 mL dose into her all at once rather than asking her to come back for the second half of the 1 mL syringe after she's already fled. I know she doesn't like taking the medicine or the taste. But she doesn't try very hard to hide or otherwise get out of it. I think she realizes it helps even if she doesn't like it.

For her food, I give her a mix of Hills A/D, which I call her fudgy crack, and Hills I/D, her digestive food. Both pates. She's always down for A/D. But it's too rich for her to eat enough of it. That's why I mix it with the I/D. I also give her a few drops of hemp oil with each meal. I don't know if it helps. But it doesn't seem to be hurting. I can see she also has arthritis so I'm sure it will be helpful for that. I suspect she was a former kibble addict before I adopted her. Once we got her early GI issues handled, she seems okay with just a little bit of kibble in each meal. Because I suspect she has dental pain, I don't mix it in but rather top it. This way if she's feeling particularly painful, she can choose to eat around it if she wants. I cut up two pieces of I/D kibble in a pill cutter. These four pieces each get a drop of CBD oil (when my aim is good.) I grind up three more pieces in an herb grinder and sprinkle that kibble dust over my CBD halves.

Because Betty doesn't always visit the food plate when it's plated, I don't mix hot water in. Instead, to make it easier on her mouth, I warm up her fridge portions in a hot water bath before portioning them out. I have two shallow dishes that I fill with hot water and a plate that weights down the covered cans in each of their dishes. Then because the water and food want to come to a middle ground, I run a small stream of hot water over the plate to keep the water hot and ask the food to catch up to the water instead of the other way around. It takes about five minutes to get her food up to "prey temperature" (luke warm to the touch.) Seeing her able to eat her plate when I serve it makes the little amount of water I waste for this worth it.
View attachment 477383
Because the labels inevitably come off in the bath, I use different colored lids to tell them apart.

Finally, whether it's because of her sensitive tummy issues or her dental pain, she's never been a big eater. Instead of trying to get all her calories into two meals, I feed her four times a day. I chose 5am and 5pm for her med schedule. We go right back to sleep after 5am breakfast for another couple of hours. She gets lunch at noon and a second dinner before our bedtime around 9:30 pm.

Thanks!
This sounds similar to what I am planning. I am fortunate that Twyla is unbelievably easy to pill - I kneel on the floor with her between my knees, dip her filled gelcap of multiple meds into a little bit of Temptation purée and pop it in. Her gabapentin tablets are chicken flavored and go in without a gel cap. Then she gets her inhaler and then she can finish the purée. I try to keep a 7am/7pm schedule

She also gets fed a series of smaller meals (including one at 4 am, because that’s when she wants it! Because I have to add phosphorus binder to her food I am planning to mix up a daily batch that contains a lower phosphorus pate (some prescription, some not) and a higher phosphorus food she likes in about a 70/30 mix and add in the requisite amount of binder. That way I can keep track of how much binder she gets across all meals. Today I have been putting a few pieces of dry on top without grinding and she has eaten them, so I may not need to grind. But she also has bupe and a B12 shot on board today so probably not feeling the pain as much. I aim for about 200 calories a day to keep her at a good weight (12 pounds). She’s a nibbler, so I periodically add a little more water and pile up everything that has been scattered across the bowl.

If she comes up short a couple of days in a row I supplement with finger feeding a little baby food.

 

[ailish]

Anyone have any tips for feeding a cat with chronic dental pain? Twyla has a painful tooth but extraction is too high risk due to her multiple health conditions, which include stage 3 kidney disease and a heart murmur, among other things.

She will be starting twice daily gabapentin to see if that will help some. Because she has kidney disease the foods she eats need to be lower in phosphorus (I am adding binder, but still better to start lower if possible.) which is a challenge because those are not the food she prefers!

The big challenge is she prefers dry food but has gone off it as the tooth pain has increased. I am planning to grind up her dry food and distribute it throughout her wet meals in order to get her to meet calorie goals. Also making sure that wet food is room temperature or slightly warm.

I might want a second opinion about the extraction or another treatment if my cat had constant tooth pain, but I'm a feline dental health zealot. Maybe someone more specialized would have the skill to make it work. I realize you don't want to harm (or worse) your cat, but constant tooth pain? I want to hear alternatives, even if just pain medication.

 

[Twylasmom]

I might want a second opinion about the extraction or another treatment if my cat had constant tooth pain, but I'm a feline dental health zealot. Maybe someone more specialized would have the skill to make it work. I realize you don't want to harm (or worse) your cat, but constant tooth pain? I want to hear alternatives, even if just pain medication.

The gabapentin is for pain relief and she had a cleaning and extraction one year ago. Believe me I would love to have the tooth gone but another dental is very risky for her. She is 17 or 18 years old, has stage 2/3 kidney disease, high blood pressure, heart murmur, mild HCM, hyperthyroidism, arthritis and asthma. Right now she is eating really well and transitioned to an all wet food diet with ease. The vet and I will continue to monitor the situation. It’s not ideal, but that’s where we are.

 

[jman_in_mn]

I've got a vet appointment scheduled on Thurs 6/20 for Marvin to include a dental exam (because I want to rule out dental for a current medical issue), but what are some of the symptoms folks are seeing with a dental issue when it comes to eating? Food dropping to floor? Drooling? Are you observing some vomiting from pain? Just curious.

 

[Twylasmom]

I've got a vet appointment scheduled on Thurs 6/20 for Marvin to include a dental exam (because I want to rule out dental for a current medical issue), but what are some of the symptoms folks are seeing with a dental issue when it comes to eating? Food dropping to floor? Drooling? Are you observing some vomiting from pain? Just curious.

For me, the things I have noticed are dropping food, tilting the head as if attempting to eat from one side of the mouth and an aversion to certain foods. In this latest instance, which is isolated to one tooth, pain management seems to be working and she has started eating dry food again.