One very swollen cheek

[syzygycat]

TLDR: One of my cats has a very hard swollen left cheek. Antibiotics havent helped. Curious if anyone has had experience with this and how did it get resolved?

My 13+ y/o male cat had some mild upper respiratory infection symptoms and a swollen cheek. Went to the emergency vet hospital who said its gum infection. Got 3 different antibiotics, 3 vet visits in 9 days (the only 2 local Animal hospitals that will don't 4 weeks to see them).1st cheek sample had too much blood in it to identify anything. Got blood work and another cheek sample on the last hospital. (2-5 more days for results).

He's only getting worse. Supposedly cant do a steroid injection will make it harder to identify. Can't do anything with anasthesia til the cheek sample comes back and blood work shows he doesnt have an infection (which it might).

I've noticed he's got thick vicious drool coming his mouth 5mins after any oral medication, IDK if anything we've given him is getting in.

I don't think the cheek has gotten much bigger but everything else is going downhill a little more each day. He's having a very hard time eating, specially the last 3 days, keeps trying to claw at his mouth and giving up after a few bites/licks. He's grooming & getting out of bed less and less. And getting very stressed with the meds. I'm worried by the time they figure out what to do itll be too late.

He has had occcasionally eye/mouth watering issues in the past, I know he has an allergy to certain foods (causing watery drooling and overgrooming) we think its carrageenan and or wheat-gluten (fancy feast classic resolved it), we've avoided most other foods for years. He also has hip issues and has been getting cosequin for the past 2-3 months (I stopped giving it to him when I noticed his swollen cheek).
But my other cats have had health issues in the past 6mos, one needs RX kidney food that has carrageenan, the other licks her stomach bald with purina foods been getting weruva brands exclusively for her.
Maybe he got into thier food and has an abscess PLUS its been aggravated by an allergy to one of the foods or cosequin. The vets just say it's possible.

 

[Antonio65]

So sorry to read that your cat is experiencing such a bad issue.
My first thought, when I read this, was that some tiny sharp foreign object pierced his inner cheek and the cheek got infected.
I don't know if there's a specific test or scan to detect such a thing in a tissue, though.

 

[FeebysOwner]

Hi. I honestly think you need to wait for the test results to come back before taking much more action. If the test results come back inconclusive, then all bets are off about what to try, including further testing.

Liquid medications are often bitter and can cause excessive drooling on their own. I don't know how you are administering them, so there may be solutions depending on what they are and how you are giving them to him,

Baby food meat (Gerber Stage 2 or Beechnut Stage 1) are often used to get a cat to eat when they can't/don't want to eat other foods. Antibiotics always need to have food given shortly before or after to help avoid digestive/stomach upset.

 

[syzygycat]

...lquid medications are often bitter and can cause excessive drooling on their own. I don't know how you are administering them, so there may be solutions depending on what they are and how you are giving them to him,

Baby food meat (Gerber Stage 2 or Beechnut Stage 1) are often used to get a cat to eat when they can't/don't want to eat other foods. Antibiotics always need to have food given shortly before or after to help avoid digestive/stomach upset.

Thank you, this is helpful.

So, after reading your post and some cat health sites about meds causing drooling: On the rare occasion I've seen a cat drool, it's watery. The post-medication "drool" is almost as viscous as jelly (but clear). if I saw him swallow most of it. Then 5-10min later thick slimy discharge comes up... It's probably does not mean the meds are coming back up, right?
(I was thinking he's regurgitating it because it's so thick, but now I'm thinking it's drool).

2nd point: I've looked at a half dozen sites about tooth abscesses causing severe, 3+cm swelling. All of them required the abscess to be lanced, rotten tooth removed, or surgically drained. None of them just "went away" with antibiotics like the vet led me to believe it would.
The original clindomyacin Rx was for 4 days, since the swelling didn't go away I thought he has a life threatening allergy or tumor.


He's eating less but he is eating. So he always has a little food (like 10cal) in his stomach 15min before his meds; watered down pate.
He's gone from 250+ cal a day to 40-60cal/day.
I went to the local pet store 2 days ago, Bought every pate & liquid food/treat that didn't have carrageenan. So far no luck with new foods but we added a 1/4 dose of Benadryl to his meds yesterday (couldn't hurt) he at the same time amount of pate but also ate a tube & a half of tiki stix every few hours, and didn't claw at his mouth eating it. not ideal but it's the first time he gotten 100cal in a day.

 

[di and bob]

Try to find some Delectable Lickables in the stew flavors, i guve meds in that and cat really like it. It is in a box or a pouch in the treat section. Im so sorry you are going through all this, you are trying to help and he knows that......

 

[syzygycat]

Try to find some Delectable Lickables in the stew flavors, i guve meds in that and cat really like it. It is in a box or a pouch in the treat section. Im so sorry you are going through all this, you are trying to help and he knows that......

Yeah I started with those, whichbis how I figured out the smoother the texture the better. He didn't like it any more or less that watered down pate. The tiki stix he seems to like are very very similar and way more expensive.
This cat is super calm never hisses, or hides, runs away. Let's anyone hold him. Even when the vets draws blood from his face he just laws and purrs. But the oral meds freak him out and I have to give it to him 3-5x a day. It's heart breaking.

 

[FeebysOwner]

My cat's post med drool is pretty much immediate, which means she probably isn't getting much of the meds. If you cat has a period of time between the med and the drooling, it is possible he is getting some of it anyway. The lag between the med administration and the drooling could very well be from how bad of a taste is left in his mouth, which causes him to salivate. Think of you eating something that tasted horrible, but not rinsing your mouth out afterward - I bet you'd salivate too.

I don't think 4 days of any antibiotic is enough to eradicate an infection. But, if it is an abscess, it won't go away, antibiotics or not. And just because it didn't go away certainly doesn't point to a tumor or allergy. I also think it is weird for an allergy to cause swelling in a specific area, but maybe - hence some success with Benadryl. At any rate, there is a cause for an infection and/or an abscess and until the cause is removed the problem isn't solved. So, maybe he as both an allergy and a dental issue?

I give my cat several different lickable treats in order for her not to tire of any of them. In addition to Delectable Squeeze Ups and Tiki Cat Stix, she also eats Temptations Puree, Churu, Vitakraft, Catit, and Fussie Cat. There is another one - Nulo - but they are a bit more expensive too. The texture is about the same for all of them. Speaking of texture - you might try Tiki Cat Mousse, which is similar - actually any of the mousse products are and most are nutritionally complete.

What meds are you giving now that have to be administered 3-5x a day?

 

[syzygycat]

...maybe he as both an allergy and a dental issue?

I give my cat several different lickable treats in order for her not to tire of any of them. In addition to Delectable Squeeze Ups and Tiki Cat Stix, she also eats Temptations Puree, Churu, Vitakraft, Catit, and Fussie Cat. There is another one - Nulo - but they are a bit more expensive too. The texture is about the same for all of them. Speaking of texture - you might try Tiki Cat Mousse, which is similar - actually any of the mousse products are and most are nutritionally complete.

What meds are you giving now that have to be administered 3-5x a day?

I gotta turn on my push notifications, I spent 90min researching foods to land on tiki mousse/ tiki mousse 'after dark', ordered a variety pack of each for same day del., then read your post recommending it.

I'll order an assortment of those wet treats. TY.
Had some luck with Weruva Classic chicken lunch/dinner once they were watered down enough... Texture is EXACTLY like Jell-O (comes out in a perfectly smooth jiggly cylinder it's super weird).

He had his dental cleaning last fall, but his breath smells like a hot dumpster. Diphenylhydramine is sold as an allergy med (benedryl) but also as a sleeping pill (Sominex/unisom), as anti-nausea (Dramamine), nasal decongestant (every other cold&flu med). Could be helping for a multitude of reasons besides allergies or just a coincidence that he's eating better after.

His original RX was zithromax 1.5ml a day til the 12ml bottle is done.clindomyacin 4.8ml a day til the 20ml bottle is done. Gabapentin 1.8ml a day til he's back to normal. The 2nd round was another bottle of clindomyacin now 3.6ml a day til the 20ml bottle is done. He gags if I do more than 0.6ml at a time max and freaks out more and more if I do it multiple times. 2x0.6ml in a row is tough but doable. Won't do 3. So we have to brake up those doses into 1.2mL. Even the good gabapentin could do isn't worth how badly he panics.

The vet left the steroid injection be my choice but advised against it til we know what's going on. The hospital's visitation fee is a bit higher than a normal vet. But the itemized tests are outrageous. Am a little weary they're dragging this out to charge for as many tests as possible. $800 for the 1st cheek swab $680 just for the visit to do the blood test $550 the next day redo the cheek swab. No tests done on the 1st visit but that one was a "walk in" emergency visit $400 + $35 for the meds. I'm fine with whatever they charge as long as he gets better but the prices are crazy

 

[syzygycat]

So sorry to read that your cat is experiencing such a bad issue.
My first thought, when I read this, was that some tiny sharp foreign object pierced his inner cheek and the cheek got infected.
I don't know if there's a specific test or scan to detect such a thing in a tissue, though.

Specificalty hospitals can do imaging under anesthesia but the won't do that if theirs an active infection. Had to do it once for a hip issue. Afaik their nearest ones are both 2hours away. That's the option if the blood work, pathology, and biopsy are inconclusive.

 

[syzygycat]

Got results tonight. Its a malignant tumor no infection/abscess. Squamous Cell Carcinoma.
Going to an oncology vet hospital tomorrow but it seems pretty bleak even if surgery is an option.

 

[FeebysOwner]

I am so aorry to hear this. I never would have imagined. I will hope to hear of some helpful news after you see the oncologist.

 

[syzygycat]

I guess heads up for other cat owners. Oral S.C.Carcinoma is a very common cancer in cats.
The skin version is pretty common too and usually from the UV, ie hanging out in sun shine by window.
If you're cat starts drooling/dripping. Or weird looking scab on their skin that doesn't go away. Figure out why ASAP.
It's the few early signs of these cancers. Once therevis something noticabley wrong it's already very advanced. "with surgery/radiation" most cats live 4-6mos. >10% make it to 1 year.

He was perfectly normal but dripping for a few months. Even the pet dentist didn't notice an issue. I have video of him from March 7th, no swelling at all. This thing grew very fast. his blood work was perfect 6mos ago, still perfect now.

ps. Tiki Cat Mousse I nothing like Tiki Cat Stix. All 5 of my cats loved the Stix immediately. None will eat the mouse (I opened every flavor) Even when I put a tube of the Stix on a teaspoon of mousse, the won't go near it. At best you need to very slowly get them used to it over a few weeks like any other cat food.

 

[Antonio65]

My cat, in my avatar, had oral squamous cell carcinoma, she had it under her tongue.
I had her quickly and promptly booked for a complete course of radiotherapy followed by chemotherapy.
You will find a few cases in TCS of members who had to deal with this, and yes, it seems one of the most common types of cancer in cats. The skin type that you are mentioning is common in white cats who sunbathe a lot. It generally hits their ears and nose, but other parts of the body might be involved too. It seems that cats with their coat other than white are immune to this.
I'm sorry to read this, very sorry

 

[syzygycat]

My cat, in my avatar, had oral squamous cell carcinoma, she had it under her tongue.
I had her quickly and promptly booked for a complete course of radiotherapy followed by chemotherapy.
You will find a few cases in TCS of members who had to deal with this, and yes, it seems one of the most common types of cancer in cats. The skin type that you are mentioning is common in white cats who sunbathe a lot. It generally hits their ears and nose, but other parts of the body might be involved too. It seems that cats with their coat other than white are immune to this.
I'm sorry to read this, very sorry

How well did the treatment work?

We did the CT and PT scans today.ctumorvis massive. Most of my kitties left jaw, sinus , cheek tissue, nerves, part of the pallette is all destroyed by the tumor. Didn't spread to the bone, destroyed it

Surgery not an option, chemo not an option. Gotta go to a Radiation oncologist tomorrow to find out if that is an option, if it is it's just to help keep him comfortable won't do much long term. He's got weeks to a few months before we'll have to take the final action.
They also found a lung tumor, different form of cancer but at this point the face tumor will definitely kill him before that becomes a problem.

 

[orangie]

I can’t imagine the shock this must be, I’m sorry you’re going through this.

 

[Antonio65]

We did the CT and PT scans today.ctumorvis massive. Most of my kitties left jaw, sinus , cheek tissue, nerves, part of the pallette is all destroyed by the tumor. Didn't spread to the bone, destroyed it

I'm so sorry. Please consider the pain that your cat must be feeling and his quality of life.

How well did the treatment work?

The treatment probably gave us some more weeks. At first, it seemed it worked a miracle, but a few weeks later I had to face reality.
My cat survived 6 months and a half since diagnosis, and about 5 months since the end of the treatment. I am sure they were the worst months of my life.
My best wishes to you and your kitty.

 

[Antonio65]

The treatment probably gave us some more weeks. At first, it seemed it worked a miracle, but a few weeks later I had to face reality.
My cat survived 6 months and a half since diagnosis, and about 5 months since the end of the treatment. I am sure they were the worst months of my life.

I think I have to make a correction to my post.
I realized my cat Lola had a mouth issue in the third week of September 2016, I was scared because I thought it was a carcinoma, the vets said it was a mouth infection/inflammation so they gave the cat a long course of antibiotics which didn't work, of course.
So two or three weeks later I asked for a thorough test of the tissue and the result was oral squamous cells carcinoma. So we quickly started the radiotherapy the following week, and then ten weeks of chemotherapy. My sweet Lola left me at the end of March 2017, so, yes, 6 months and a half since I realized that something was wrong, but only 5 months and a half after the official diagnosis, and only 2 months and a half after the last chemo injection.

 

[syzygycat]

I'm so sorry. Please consider the pain that your cat must be feeling and his quality of life.

"Luckily" the tumor also destroyed the nerves there too. The cancerous region shouldn't be in much pain. Aside from chewing, he should Just be in slight discomfort from pressure in the surrounding area

 

[syzygycat]

I think I have to make a correction to my post.
I realized my cat Lola had a mouth issue in the third week of September 2016, I was scared because I thought it was a carcinoma, the vets said it was a mouth infection/inflammation so they gave the cat a long course of antibiotics which didn't work, of course.
So two or three weeks later I asked for a thorough test of the tissue and the result was oral squamous cells carcinoma. So we quickly started the radiotherapy the following week, and then ten weeks of chemotherapy. My sweet Lola left me at the end of March 2017, so, yes, 6 months and a half since I realized that something was wrong, but only 5 months and a half after the official diagnosis, and only 2 months and a half after the last chemo injection.

I'm guess based on some of your other posts. They were trying the more aggressive curative treatment

The Drs keep answers or vague. Wont give rough odds on anything. With a tumor this big (3x5cm)
The of 2 palliative and a curitive radiation options "despite thier name" all could significantly reduce the size of his tumor or do nothing. Could cause mild to severe mouth/skin ulcers.
They have a similar chance of working but each dose increases the side effect risks.
IF they shrink the tumor it usually takes 1-8 months for the tumor crop back up
Benefit of Curitive daily doses for a month is if it does shrink the tumor its the average is again "usually",closer to the higher end of the 1-8mos.
But the "increased" risk of needing a permanent feeding tube.



It's seemed like once a week for 4weeks was the way to go.
It's 90min each way, fewer trips also means less stress.

They're doing the prelim CT scan and making the RR cast now. Saw the estimated for the 1st time.
The prelim cast is the same $3k. The 4(once a week sessions) is $4800, the other palliative options was slight lower doses 6days in a row $11k+ (didn't see curitive therapy's cost).

I'm a little worried I made the wrong choice. If the 2 palliative therapies are comparable the cost should be comparable. If they charge a flat fee per appointment it should still be a smaller difference.

I hate this.
This kitty isn't even my oldest cat.

 

[Antonio65]

In my cases, the casts from the CT scan were included in the cost of the radiotherapy treatments.
I'm in Italy, all prices are in euro.

The CT scans were around €900 each.
The curative treatment for the nasal carcinoma was around €5,000.
Daily sessions, actually four days a week (Mon and Tue, then Thu and Fri), 15 minutes each, for four weeks, 16 sessions.
The treatment for the oral carcinoma was €2,500. Two sessions a day, morning and late afternoon (hence, two deep sedations a day) for a whole week, 10 sessions.
And this was just three months after the surgery for her adrenal gland carcinoma that cost me nearly €10,000.

On both occasions the cat was held at the facility for the whole time (4 hour's drive from home) and I would visit her on the weekends. I would book a room at a pet-friendly hotel and I would stay with her for two days each weekend.

I know that you will do your best for your kitty. There is no wrong choice, there's only the best choice, what our heart tell us to do.