Pain, difficulty eating one week after multiple tooth extraction

KJIA

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Hello All! My dear Juliette (15 yo, Ragdoll) had a dental cleaning a week ago, and unfortunately, had six teeth extracted. I have a very difficult time brushing her teeth, but I've been able to use dental rinses, gels, water additives -- no such luck. Poor kitty, I feel like I've let her down, but alas on to more immediate issues.

My concern is we are a week out from the procedure, and she does not have much appetite and still appears to be in pain. We were sent home with Onsior (2 days) and buprenorphine (enough for a week). I am able to get her to eat small amounts, but likely only 1/3 to 1/2 her normal intake. A few days ago, I reached out to our vet as she was not eating well and had noticed that the buprenorphine made her lethargic and generally out of it. She would sniff food, but walk away. The vet said we could try another pain medication (metacam), but we would only be able to use that for three days. Since the metacam, she is no longer lethargic and seems to be partially interested in food, however, yesterday was our last day of metacam. Today I have seen her jerk her head and paw at her mouth while eating, so I know she is still having some pain. On the bright side, she does seem to be perking up a bit and getting back into her normal routine, so I'm hopeful she is recovering.

Any thoughts on where to go from here? Do we simply need to tough it out until the pain subsides? Any previous experience with how long that could possibly be? I think I would be able to get her to eat better if it were not for the pain. I have tried blending her food (she looked at me like I was crazy), attempting to syringe assist (it was stressful and messy for us both), warming food, different types of food, flavors, gravies, soups. Currently, the winners are wet food with fortiflora sprinkled on it (thank you to other posts for that tip!) and moistened dry food. Even so, it's still much less than her normal daily calories, which worries me because I read kitties can easily go into liver failure if they don't eat. She means the world to me, and I'm so worried. Any help would be greatly appreciated!
 

Antonio65

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Buprenorphine is well known for giving cats very bad reactions. You'll find a few threads in this forum on the subject, and from my experience, one injection only was more than enough for having my cat stoned for nearly two days!

After reading your post, I imagined that your cat may still be feeling pain from the extraction. Multiple or total tooth extraction is not uncommon, but generally cats recover quite quickly, a couple of days and they're back to their life.
What comes to my mind is that the procedure didn't go well. I mean, probably the vet should have extracted one more tooth, that is they left a bad tooth behind and this is giving your cat pain. Or that there is an ongoing inflammation/infection on one of the extraction spots, you should inspect her mouth and see if there is any redness or swelling. Or the vet didn't do a very good job and left a fragment of root in place and this is giving your cat pain.

I would have your vet look at her again.
 

daftcat75

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It depends on why the teeth were extracted, which teeth were extracted, and yes, the skill and experience of the vet who performed the extractions. Some teeth come out easier than others and some vets who are not dentists do stupid things like drill out the teeth and leave the (probably still painful) roots. 😿 🤦‍♂️

I would recommend finding a dentist or dental specialist. If the teeth were removed because of a developing chronic condition like tooth resorption (resorptive lesions) or stomatitis, conditions like these are best handled by dental professionals rather than a general vet. Except. These specialists are usually few and far between and have very long wait times. So go ahead and call around and make a few appointments (if you can find a few in your area) and be prepared for a two to six month wait time. That's your long term plan.

In the short-term, I would ask the vet if she could do another dental exam with x-rays. It's possible she missed something. Or it's possible that the extractions left her bite unbalanced in such a way that eating is causing her pain or discomfort. General vets aren't in the habit of pulling healthy teeth even if such an extraction would fix this kind of an issue. That's what you need a dentist for. I'm hoping your regular vet can help because it's going to be a long time until you can see a dentist.

If you're in US or Canada, you can find a board-certified dentist here:
Find A Veterinary Specialist | AVDC.org

But there are non-AVDC accredited dental specialists out there as well. If you have an animal specialty hospital, I would start your search there. Or you can call a nearby veterinary school to see if they know how to find a dental specialist for you.

And by the way, teeth issues are common in senior cats. Many of them are not preventable with regular hygiene. You could have been a faithful tooth brusher her whole life and she still might have gotten tooth resorption. 🤦‍♂️ Don't beat yourself up over that.
 

TardisDance

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I’m in the same boat with my cat who had only 1 tooth extracted (an upper premolar) on April 5th, so about 11 days ago. She’s only 4 years old. Her tooth was infected so within 3 weeks of being checked and having her tooth removed, her appetite was reduced and she lost almost a pound (from 9.7 lbs. down to 8.9 lbs) and also had a resulting upper respiratory infection. The vet gave a Convenia shot (a long lasting antibiotic) and 3 Onsior tablets. She’s semi-feral so I only managed to sneak 1 Onsior in a pill pocket. The vet said I had to give her wet food and/or dry food moistened with water for 10 days. She was a hoarding rescue and has had trouble adapting to wet so I tried wet food and moistened dry food. She was okay for 2 days but then she hunger striked, so I had to give her some dry food without moistening and then she finally ate some wet food. She‘s been okay and hasn’t broken her sutures.

Only by around day 9 or so, she’s getting better about eating more but it’s been a struggle. I have to give a lot of treats to encourage her to eat and then she’ll eat more of her food. She’s always been a grazer though.

I will say that with the tooth removal, she’s become a huge cuddler. I’ve only had her a little over a year and she’s always been shy and hiding. Since the extraction, she’s become a total lap cat which is the most cutest thing ever. She’s on my lap now as I’m typing. I also feel terrible though, because I had her examed multiple times by vets at the same office and they never noticed a tooth issue. The latest vet actually told me she had really bad gingivitis and an infected tooth. I’m on a waiting list to go to another vet office, by the way.
 
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KJIA

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Thank you everyone for your thoughts so far. I do know that my vet did x-rays after the procedure, so I hope we aren't dealing with any roots or fragments left behind. I did try to take a look in her mouth, and in the brief glance I was able to get the tissue doesn't look overly red and seems to have formed a scab where teeth were extracted. In the mean time, my vet suggested I try half doses of the buprenorphine. It seems to have taken a bit of the edge off so she can get some nibbles in without making her completely zoned out, so we're just trying to find a balance between reducing pain without suppressing her appetite too extremely. We have a follow up appointment later this week.

TardisDance TardisDance , I'm sorry to hear the struggles with your kitty, but I'm glad to know some kitties just take longer to heal. I can't imagine a respiratory infection on top of this, so you (and your kitty) are a trooper! We are at day 9 tomorrow, so I hope things begin to improve. Even though we're having difficulty eating, it still makes me feel better that she has begun to greet me at the door again and snuggle in bed. I hope your kitty continues to improve. Sounds like she is very lucky to have been rescued by you.

Thank you all again!
 

david68

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My vet has switched to using gabapentin for pain control in cats, and I think it's the best thing I've used. In fact, my cat was also having oral pain, and we were treating him with gabapentin to help him eat prior to getting him in for surgery to correct the problem. It did not affect his appetite. I would give him a dose of gabapentin, wait an hour, and then give him a can of wet food. He would eat the whole thing. I know buprenorphine can affect appetite.

In fact, earlier this year, I had a muscle spasm in my back, and my own doctor prescribed meloxicam and gabapentin for me. It was like magic. It seems like gabapentin augments the pain relieving effect of meloxicam.
 

di and bob

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Cats are known to have severely reduced appetites on pain meds. I would go a couple of days and see if it gets worse or better. if it gets worse take her to someone who could check her out and see what is wrong. Call the vet who did the extractions and see what they recommend, she should NOT be in pain this long. It is logical to think that if she is still in pain, it is the pain meds or something is still wrong.....I have had two cats with tooth extractions, not to that extent though, and had NO meds, they ate fine from day two on. Even hard food.
 
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KJIA

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Thank you all so much for your advice. I think today we have turned a corner! Today she ate about 70% of her food all on her own, with just pets and praise (no syringe assist), which is a huge improvement from earlier this week. I also didn't see a need to administer pain medication. I think she's still learning to work her new mouth, but I didn't see any head jerks or pawing at her mouth so I hope she is feeling more comfortable. Hooray!
 

daftcat75

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Great update! Hopefully she continues to improve.

Please schedule a consultation with a dentist for long-term and proactive maintenance. Depending on which teeth were removed and especially if canines were removed because of their structural role, asymmetrical extractions can change her bite and lead to long-term irritation like lip entrapment and gum ulceration. Additionally, if these teeth were extracted because of a developing chronic condition (and senior kitty dental issues are often chronic) like resorption or stomatitis, these conditions almost always require more extractions and are often best managed with expert hands and sometimes full mouth extractions. A general vet only has so much training in basic extractions.

Dentists have long wait times for consultation appointments—typically two to six months. If the dentist decides there is work that needs to be done, procedure appointments are much easier to come by. Usually two to four weeks after the consultation. The point I’m trying to drive home here is that if you wait until you need a dentist, you won’t get that appointment for two to six months. But if you’re proactive, you can make the appointment now and either the dentist says everything looks great, or she needs more work. And if she needs more work, you’ve got expert hands on the case. It’s better to have a consultation with the dentist and not need it than to need it and not be able to get it.
 
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