Poor kitty won't eat after full mouth extraction....any tips??

FriendofFerals

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So Mr. Squeaky (100% feral up until 3 years ago) got 18 teeth pulled yesterday. Everything except 3 of his 4 canines. His teeth were bad when I rescued him, but he had allergic dermatitis, an inner ear infection a decade in the making, whipworms, severe diarrhea, and asthma. I had to get him healthy before addressing the teeth which were already Stage 2 when I rescued him after a cat fight and injury.

He progressed to Stage 3 in the second half of last year and it was a race to get him healthy enough for dental work (they estimate he is 16-18 years old and his SDMA was just under the normal limit).

He made it through yesterday like a champ, ate a little wet food this morning after his Gabapentin mixed with a little Mirtazapine I had on hand. By afternoon he was not eating, but he did drink a lot of water around 2PM and peed, so that's good. This evening, I gave him the gabapentin with another quarter pill of Mirtazapine and half a Cerenia I also had on hand (I have two other special needs cats). It's been an hour and he's back into hiding again and not seeking food like before. I have that mousse/pudding textured food along with some Fancy Feast beef pate which he never usually is allowed to eat on his hypoallergenic diet.

Question for the pro cat moms....Should I give him more Mirtazapine? Should I syringe feed (carefully)? They gave him a 72 hour buprenorphine and cerenia shot so that should still be working but id he doesn't eat tonight, that will be 48 hours since a full meal...starting to get worried. Sure, he ate a tiny bit this morning, but I'm worried about the liver issues with not eating.

Trying my best here....Never had a full mouth extraction before, only one with 10 teeth out and he was eating fine within 24 hours.

EDIT: I did speak to the vet who agreed to go ahead with the Mirtazipine and Cerenia I already had on hand but I'm wondering why 1/4 tab didn't work tonight like it did this morning....unless his pain is just off the charts. I know the first 24 hours is the worst, but when can I expect him to start rounding the corner? He's got lots of dried crusty drool and his mouth is hanging open, poor buddy. Ugggh it kills me....

Pic from last year when he still had his teeth ☹
 

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FriendofFerals

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UPDATE: I gave him another 1/4 tab of Mirtazipine out of desperation since it's been 48 hours since he ate anything substantial, and the 1/4 tab at 6:30 PM did nothing at all.

He decided to have an asthma attack and his AeroKat inhaler can't cover his nose and mouth since it's so swollen, so I had an idea....the nebulizer unit I bought when I built him his own chamber came with an adult and child-sized plastic mask. The child-sized one would fit over his nose and open mouth. So I McGuyver'ed his Aerokat and removed the canister, then taped the inhaler attachment and metering valve to the plastic mask for the nebulized and it worked! Got him out of that attack and when he could breathe again, it was back to the eating issue....

I tried the Momma bird method of chewing food (my own chicken dinner) that I know he likes and giving him pieces and that seemed to work for a bit, or at least it got him started. He wanted to go out on the patio so I put him out there with a bowl of chicken mousse/pate and another bowl with beef pate with actual pieces of smashed roast beef on top to give him the "King's Feast" and out of nowhere that medicine must have kicked in because he ate both bowls, then wanted more and polished off half of another bowl of assorted tuna juice, beef pate and whatever else from this morning. Then he drank a bunch of water. Thank goodness! We are out of the danger zone, he's realized he can eat without teeth and he just pigged out. Whew! Now it's 11PM and I gave to go to work tomorrow but I might call in with a 'mental health day' after this battle:lol:
 
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FriendofFerals

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I don't have much to offer, but can you try baby food meat (Gerber Stage 2 or Beechnut). It is not nutritionally complete, but it is so soft that he won't have to do much but lap it up. Maybe it will help him to round the corner. Any chance of getting more pain meds?
I think I got lucky tonight with the appetite stimulant working but tomorrow if he's "pain purring" and looking glassy-eyed with pain, I'll need to ask for something. Poor buddy had Stage 3 periodontal disease, stomatitis, resorption on almost every tooth, and erythema. He's a fighter, that's for sure, but I want him to feel comfortable so we'll see what tomorrow brings and if he's not going for breakfast by noon, I'll call in for some pain meds to get him through the 72 hour post-surgery mark.
 

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I think I got lucky tonight with the appetite stimulant working but tomorrow if he's "pain purring" and looking glassy-eyed with pain, I'll need to ask for something. Poor buddy had Stage 3 periodontal disease, stomatitis, resorption on almost every tooth, and erythema. He's a fighter, that's for sure, but I want him to feel comfortable so we'll see what tomorrow brings and if he's not going for breakfast by noon, I'll call in for some pain meds to get him through the 72 hour post-surgery mark.
I always keep a blender on hand to make a soup of food if necessary. They they can lap it up rather than bite at all.

Good luck tomorrow!
 

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Hi. He needs much stronger medication for pain to be prescribed by your vet. There is nothing you have around that will help with that. I cannot imagine having that many teethe removed with only Gabapentin.
The injection they gave for pain that is supposed to last 2 to 3 days, doesn't. It is called Simbadol. All it is, is a higher dose of Buprenrphine given SQ because the absorption rate is slower. But in my experience it doesn't last over 24 hours, if that. There is another Buprenorphine type of medication that is topical that also is supposed to last 3 days It doesn't. Lucky to get 24 hours out of it.

When I worked at the Cat hospital we did allot of full mouth extractions. Those cats were kept in the hospital on a Fentanyl constant rate infusion for three days. It is usually pain that makes these cats not eat afterwards.

I would ask your vet in the morning for another prescription of something stronger or at least an oral buprenorphine to give at home. Side note the Buprenorphine given for injection can also be given orally as it s absorbed through the mucous membranes.
 
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FriendofFerals

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Hi. He needs much stronger medication for pain to be prescribed by your vet. There is nothing you have around that will help with that. I cannot imagine having that many teethe removed with only Gabapentin.
The injection they gave for pain that is supposed to last 2 to 3 days, doesn't. It is called Simbadol. All it is, is a higher dose of Buprenrphine given SQ because the absorption rate is slower. But in my experience it doesn't last over 24 hours, if that. There is another Buprenorphine type of medication that is topical that also is supposed to last 3 days It doesn't. Lucky to get 24 hours out of it.

When I worked at the Cat hospital we did allot of full mouth extractions. Those cats were kept in the hospital on a Fentanyl constant rate infusion for three days. It is usually pain that makes these cats not eat afterwards.

I would ask your vet in the morning for another prescription of something stronger or at least an oral buprenorphine to give at home. Side note the Buprenorphine given for injection can also be given orally as it s absorbed through the mucous membranes.
I think you're right and that pain medication wore off super quick. The good news is that since I gave him the 1/2 mirtazipine and 1/2 cerenia, he's been eating like a fat kid at a pie eating contest. I know he's still in pain because of the drool, pupil dilation etc, but the "pain purring" stopped today and I can't believe it but 72 hours after surgery he's actually acting almost normal except for being groggy from the gabapentin. I wish they'd sent me home with a pain med to give him at the 36 hour mark just to get him through. Clearly, what they gave him didn't last. But for now, he has made an astounding recovery in just 3 days...especially for his age. Happy ending to this story but for others, I would definitely recommend getting something for pain to administer after 24 hours post-surgery when the pain seems to really peak. Pic is from today.. Still some drool and signs of pain but he just ate a big bowl of wet food and licked it clean, medicine and all.

IMG_9142.JPG
 
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FriendofFerals

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Oh, what a cute little face. So glad he is feeling better!
Hard to believe this cute guy was a feral. I thought he was an abandoned pet or a "community cat" but after 7 years not being able to get near him and feeding him (with no eye contact) under my car, I guess he was the real deal. Only bad luck for him (injury) and good luck for me (he was really hungry) allowed me to trap him. And I never let him go, and now, when I open the door to the screened in patio, most of the time he doesn't want to go, or he only wants to go if I go sit with him. He's a very special cat and I love him so much!
 
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