Polyps/Feline Orofacial Pain Syndrome

[Rysiek]

Absolutely correct! You did not cause any of his pain and he would be much worse without your interventions. It is good that you are going to see a vet who has an interest in neurology.

I have been very low today, thinking that all these investigations and treatments led to no improvement...Almost thinking that it was all unnecessary and my fault...
I don't know what is right and what is not anymore...

He is not "talking" to me since yesterday...I think this relates to the tiny dose of buprenorphine...namely he does not like it...He did not come to my bed yesterday and over the night either...
I want to give it for three days, hopefully we will break the pain cycle...
I am not convinced about gabapentin somehow...
The pain clinic vet wrote: "It seems more like neuralgia but you would wonder when it happens with using his mouth on toys there is some source of pain in his mouth. Expect the fact that he has had the most thorough check he could possibly have between Dental Vets and the CT. If we extrapolate from trigeminal neuralgia in humans it is short self limiting attacks of severe electric shock/stabbing type and it can be set off by tooth brushing etc. So it would seem much more like neuralgia than FOPS. I would do buprenorphine for 3 days and see what happens."

I have another task for this weekend, to complete my complaint against insurance company with the financial ombudsman. I was postponing this, as it brings bad memories, but it has to be done...

 

[fionasmom]

I think it is the right course of action to give the bupe for the three days and see what happens. If he is having even mild nerve pain that comes and goes, it would explain some of his behavior. Can you administer the medication when he is sleepy or relaxed, especially since it only has to go into the mouth and not down the throat?

I have had a couple of go arounds with my pet insurance, so I sympathize.

 

[Rysiek]

I think it is the right course of action to give the bupe for the three days and see what happens. If he is having even mild nerve pain that comes and goes, it would explain some of his behavior. Can you administer the medication when he is sleepy or relaxed, especially since it only has to go into the mouth and not down the throat?

I have had a couple of go arounds with my pet insurance, so I sympathize.

After 1.5 day of bupe he is back to his normal self...
You are so right, he may be having some mild nerve pain that comes and goes, but I don't want to over medicate him with gabapentin...this is tricky, as I need to think about quality of his life...he is much happier with no meds...
I will be having a remote consultation with the herbal vets, suggested by the pain clinic in 10 days...
As I said, I moved him to a different vet practice, I have to have an appointment with them, but I will just turn on my own. He has had enough check ups recently...
I also started some mild CBD product, namely some pastilles CBD for Cats - Cibapet. He took one today with no problem.

Did not manage to write to the ombudsman, it all brings this back to me...but I will eventually...

 

[Rysiek]

Pain assessment in cats | Feline Grimace Scale

The Feline Grimace Scale is a tool for assessment of acute pain in cats based on changes in facial expression. It can be used by veterinarians in hospitals, clinics, shelters and research laboratories. Useful for pet owners and anyone interested in feline health and animal welfare.

www.felinegrimacescale.com

https://journals.sagepub.com/doi/10.1177/1098612X221145499?icid=int.sj-abstract.citing-articles.53

 

[fionasmom]

That is a very interesting site; it seems it would be extremely useful for all cat owners to know about.

I completely agree that you are looking for a correct dose of pain medication as needed. Nerve pain can be so elusive and irregular that it is hard to find a regular routine to manage it. He may well have had a reaction to the gabapentin.

 

[Rysiek]

We have started CBD pastilles. Just trying to figure out the dose. He had been sleepy and relaxed...
It is our third day...

Does CBD Make Cats Sleepy?

CBD may help cats indirectly sleep better by relieving anxiety, pain and other issues, but likely does not directly act as a sedative.

www.cibdol.com

 

[Rysiek]

He had a small attack today, more fops-like when scratching the post, clearly stretching triggered this...

I often find myself thinking that by taking him to the vets it only made him worse...that I should have left it as s quirky behaviour rather than health condition that is untreatable...

It is sad...

 

[fionasmom]

I would follow the dosing directions from the manufacturer of the CBD product. These can vary from product to product depending on how it is formulated.

I never thought that this was quirky behavior personally.

 

[Rysiek]

I would follow the dosing directions from the manufacturer of the CBD product. These can vary from product to product depending on how it is formulated.

I never thought that this was quirky behavior personally.

I feel so powerless so blame myself, as if I have not done enough or have done "too much" by exposing him to all these investigations and meds...

I am a bit puzzled, as I read that the dental work may trigger fops, but yet he had lots of dental work from the vet who knew a lot about fops...And I was told to do his dental cleaning once a year...

It has been 8 weeks since stopping metacam... perhaps this impacts on him having more attacks?
Metacam unfortunately impacted his kidneys...

Yes, I follow dosing directions, even contacted them and they suggest to start slowly...
He seems to be calmer...
I think it takes a couple of weeks for a full impact...
(sometimes, I think I would benefit from taking it, and also I would know better about the impact...)

In one week I will have a remote herbal vets, consultation, but I am beginning to doubt that there is a cure...

 

[Rysiek]

The questions today is:
- is this a progressive condition, so it will get only worse with time? As this year it has been worse than last year
- or is this going to improve with time and stop?
- or will it fluctuate and have set back (hopefully not more severe) and remissions
- is the strong neurological medication really helpful, or it only masks the symptoms?
- is the resent relapse related to stoping metacam around 8 weeks ago?

I will ask all these questions at my next vet consult, at the herbal vets...they also trained veterinarians...

 

[fionasmom]

Those are good questions to ask as there have been so may angles to all of what has transpired. I still do not think that you caused any of this by deciding to go forward with treatment. He has been on various medications, including some high powered ones, and that all may be a residual effect.

 

[Rysiek]

Answer from the pain clinic: "It isn't thought to be progressive. Some animals achieve remission and sometimes they can have an isolated bout and then be weaned off treatment. Some cats may just need treatment during flare ups and there are a percentage of cats that can need longer term treatment. So if you get into remission from symptoms it is always right to try and wean off medication. If it flares up every time then it might be that a longer course or treatment is needed or a change of treatment."

 

[Rysiek]

Fifth day on CBD pastilles (1 pastille=1.3mg). He has been playful at home today, like a little kitten, also playing with his mouth! Such a pleasure to watch it!
He has been happy and active...
I think I will increase a dose slightly, I will give him another one in evening...
His appetite increased as well, the aspect I need to monitor a bit...

 

[fionasmom]

That is wonderful news! He looks so sporty outside in his little plaid vest and seems like a happy and curious cat.

 

[Rysiek]

We had our first herbal vet consultation. He will be getting some powder based mixture of herbs + chinese herb formula. Both targeting inflammation and neuropathic pain. Of course will take a few weeks to see any impact.
This will be tricky, as he is so "clever" with avoiding any food or treats when he senses there is something else there. We had this scenario on numerous occasions now, when he eats his food + meds, and then refuses it completely, even if it is his favourite one!
He has figured out that I was crushing CBD pastilles to his morning food...Now, I have started some drops, apparently with a fishy taste, but they may be a bit bitter as he was acting strangely (running through the house) after eating his food with the drops...
Unsure what else I can do...we went through the pill pockets, lick-a-licks, pates, cheese and his ordinary food...of course, through more invasive method via sirringe, which traumatizes him...
But he is definitely better on CBD...
I am on fops Facebook group and people share that their cats happily lick the food with meds...hmmm ...not Rysiek...he knows and he "thinks" he is clever when refusing his food...

 

[fionasmom]

Will he eat his favorite food without medication or has he decided that it is now "contaminated" and is refusing it altogether? I had some TCM for one of my GSDs and it was not exactly appealing. Did the naturopath give you any way to administer them?

 

[Rysiek]

Will he eat his favorite food without medication or has he decided that it is now "contaminated" and is refusing it altogether? I had some TCM for one of my GSDs and it was not exactly appealing. Did the naturopath give you any way to administer them?

At the moment he still eats the treat (without CBD), but in the past (different meds) refused his treat all together! Just a full stop...
Yesterday, I crushed the pastille to his night food, as he usually eats well over night, he ate nothing of it! So, I crushed a pastille to his morning meal, hoping he would be hungry, he did not touch it and left the kitchen...
I managed to mix two drops with a lick-a-lick. This was successful! This CBD formula apparently contains a fish oil (for me it tastes of fish) CBD Oil 2% For Cats

The herbal vet said to mix it with something that has a potent smell...
I will write to her again ...

 

[fionasmom]

When I have had to find something with a potent smell, it usually meant a fish based food like sardines. BFF or the Weruva products have worked in the past.

 

[Rysiek]

He has been on a tiniest dose, 1 drop twice a day of 2% CBD for pets CBD Oil 2% For Cats
He has been really lethargic...so I will cut it down.
Also, has started scratching his ears and they twitch. Unsure if this could be a type of an allergic response?

 

[Rysiek]

We stopped CBD. He has been much better today. Also his appetite is better, so perhaps he was nauseous?
It appeared yesterday a bit like overstimulation, he was as if anxious and on edge. But also lethargic, if it makes sense.
Perhaps it is something to do with a cumulative effect, or maybe the CBD brand he is taking? CBD Oil 2% For Cats
There are so many products, unsure how to make a choice...
A mystery...