Post Dental Surgery

[daftcat75]

Thanks mrsgreenjeens . It really has been a pretty horrible few days for Gracie and me.

Yup, the ER vet said I could switch her to gabapentin, which I already have on hand for her pre-vet anxiety.

And Gracie is scared of spritzers, so we’ll see how that goes.

Right now, my challenge is getting her to eat. Her last meal was 10pm yesterday, but she threw it up at 1am. I boiled some chicken, but she refuses it. And the ER vet said not to give her the A/D, as it’s too high in fat for her system right now. It’s also the food she ate and threw up at 1am, so I’m avoiding it.

I took the cone off, but it made no difference.

To help with her stress, I have Feliway Optimum plugged in, and Feliway Classic in another room. YouTube calming cat music will be next.

Oh yeah. Pure A/D is too rich. I use the pure stuff only for dipping capsules and giving Betty a starting point (a tiny smear in the corner) on her med meals. It’s tough to get her to eat something with her meds. But when the meds kick in, I no longer have to mix A/D with the rest of her food.

Other than dipping capsules/making yeast balls (or restarting her eating if this hunger strike goes on too long), I recommend always mixing A/D with something else. If her hunger strike goes on for too long, I recommend taking a pinch of the A/D and smooshing it into a corner of her food to give her a starting point. I find with Betty getting her started is the hardest part. Once she’s found that smear, she’ll eat past it for several more grams before she calls it.

 

[GraciesParent]

Tried the yeast balls with A/D (even rolled in FortiFlora) and she refused them. She also wasn’t super-keen on the A/D, in general. She ate some of it and left some of it, then hurled the stuff she did eat later.

 

[mrsgreenjeens]

does she ACT hungry, just isn't eating? Or is she just not even interested in food? If she has no interest at all, you can ask your regular Vet for an appetite enhancer. We use Mirataz, which you can rub into her ear. Works pretty well. If she is interested but not eating, then try something else. Maybe something she hasn't had before, and put her food in a new place, maybe even in a different bowl or on a plate. Just the food, nothing else just to see if she's tired of having things added to her food if that's what's happening. Then you can at least get a feel for what is happening. The cerenia the ER Vet gave her should still be working, at least until late this evening (24 hours), so she shouldn't be nauseated, but I suppose it might not be working for her.

 

[daftcat75]

Some cats lose their appetite with Cerenia. Yours might be one. If she’s not eating now, maybe just wait out the Cerenia. Or add FortiFlora to something she usually likes. She could just be spent from the ER and maybe waiting for her stress levels to come down again.

 

[GraciesParent]

She seems to be wanting to eat, then disappointed and disinterested when she smells what I offer. That said, I have managed to get a couple of teaspoons of food or a few pill pockets into her every couple of hours. So, it’s a start. I actually took a tiny amount if the A/D, mixed it with some water to make a very thin gravy, then added minced boiled chicken, and she ate it. I’ve also been giving very small amounts of the S. boulardii every couple of hours. It’s been more than 12 hours since her last frantic trip to the litter box, so I’m hoping this “quiet” day is a sign it’s starting to work. For now, she is SO SAD wearing her cone.

Once the diarrhea goes, so many of her other problems will likewise hit the road. It’s the linchpin!

 

[GraciesParent]

Update: it seems she is finally, and literally overnight, on the mend! Phew.

Zero diarrhea episodes for more than 36 hours (and counting!) now.

Her appetite has come back, so she's happily eating many small bland meals a day. Still getting small doses of S. boulardii via homemade "truffles": I put the SB into pill pockets, seal 'em up, then roll the pocket "balls" in FortiFlora powder. She loves them!

Her bum is healing up, she's learning to navigate with the cone on, and her mood and demeanour have also improved greatly -- she's much more social and chatty, and just *looks* SO much happier/less miserable.

I am now eagerly awaiting the arrival of her next poo in the hopes that it's at least semi-solid...

 

[GraciesParent]

Not sure whether to start a new thread for this question, but will ask it here since it's part and parcel of Gracie's post-dental digestive situation covered in my previous posts: it's been about 50 hours since her last episode of diarrhea, and she hasn't yet pooped. She's peeing fine, though.

She was pretty cleared out from the diarrhea and vomiting as of 6 a.m. on Sunday, and has been eating fairly light (compared to her normal diet) over the past couple of days, so is this normal(-ish) in terms of wait time? She's been getting a lot of water mixed into her food, as well as the probiotics (S. boulardii and FortiFlora).

I'm just not sure if/when I should be concerned.

I'll be contacting the vet's office once they open, but was wondering if anyone has any anecdotal advice.

Thank you in advance, as always, for any insight!

 

[daftcat75]

She has to eat to poop. If she’s been eating only lightly, she may not have built enough of a backlog, so to speak, to require a poop yet. But certainly a call to the vet is not a bad idea. They can tell you timetables and when it’s concerning enough that she should return to the vet.

 

[GraciesParent]

The vet said most cats poop within 24 to 48 hours, but some "take longer." She asked me to watch for signs of constipation/straining in the litter box, and wondered if I want to bring Gracie in for a rectal exam. I do not -- vet-visit stress and the dental are what caused the diarrhea in the first place. That was compounded by the stress of the ER-vet visit. So I reeeeeally don't want to take her for another vet visit unless necessary.

Gracie certainly has some signs of constipation (iffy appetite, somewhat lethargic and sad today after having been perky yesterday), so I gave her some plain pumpkin earlier. She's still getting the S. boulardii + FortiFlora "truffles." And, after trying unsuccessfully to get her to eat any of the bland-food options this morning, I gave her a small serving of her usual oceanfish wet food with some water and a tiny bit of A/D mixed in, and she ate it all. Then, about an hour later, she ate about a teaspoon of boiled chicken. So, she IS hungry.

 

[daftcat75]

I hate to tempt fate because it sounds like you’re getting things back under control. But you can give a little egg yolk (raw or cooked) about 1 tsp to be on the conservative side. Egg yolk stimulates the gut contractions that move things along. And it’s also a bit of a laxative. It contains an emulsifier which will help fat move along. Anything that helps fat move along is going to get everything else moving too. So yeah. A little dab will do ya.

 

[GraciesParent]

Yeah, I’m not sure I want to give her anything laxative-y just yet. But I’ve noted your suggestion (thanks!) in case things don’t improve.

 

[GraciesParent]

One additional thing that just smacked me in the head: I changed her litter box after the ER-vet visit.

She couldn't maneuver (with the cone on) in the one she always uses, and was getting panicky and freaked out each time she bonked her cone against the side, so I swapped it out for a HUGE one (big area, low walls) to give her (and her cone) more room to move.

She's used the huge one for pees multiple times since, but I wonder if, for some reason, she doesn't want to poop in it... ?

Part of me wants to take off the cone, put the old litter box back and then see what happens.

 

[GraciesParent]

THIS JUST IN: she has pooped!

I took her back to the vet today because she seemed really lethargic. She got a full once-over, all is fine, everything is healing. Not constipated. In fact, the vet said she felt a poop in the chute, and figured it would happen soon.

About five minutes after we got home, BOOM. First big, solid poop in 80+ hours. Yay!

But then she's gone 5 more times since (over the past 20 minutes or so), each one softer/runnier than the last. And I think we might be back at diarrhea.

Edited to add: yup, we're back to non-stop diarrhea. She's gone to the box eight times over the past hour. The last couple of trips, she pooped out little to nothing. But it's liquid again. OMGGGGGGGGG. Does this mean we're back at square one?! Or is this normal -- i.e., that the first few poops will be inconsistent? Firm, then soft, then liquid, then (hopefully) firm again?

 

[daftcat75]

This is beyond normal and I hate to keep sending you back to the vet. But at this point, I would recommend an ultrasound and a diarrhea PCR. The ultrasound can rule in/rule out IBD and/or lymphoma (but can't distinguish between the two unless it's a large cell lymphoma.) An endoscopy would be needed to tell the difference between IBD and small cell lymphoma. I don't recommend that for an unstable cat. Instead, I would ask for an A/B treatment plan: try A first (steroids), agree on an interval for how long to try it, and then if that doesn't work, add in B (chemotherapy.) The diarrhea PCR could rule in or rule out a gut bug such as clostridium which can also cause continuous diarrhea.

 

[GraciesParent]

That sounds super-extreme. Could it not just be the stress of the visit today, and a stress-colitis flare up?

The clinic was really loud, they poked and prodded her rear end, did a rectal exam (inserted finger et al.), shaved and washed her bum, applied ointment there, etc.

I also wiped her bum with a warm washcloth after the first few litter-box visits at home, and I know that can actually stimulate bowel movements in cats, so maybe I wound up aggravating an already tender area?

Before the dental, Gracie had PERFECT poops, like clockwork, once a day (virtually the same time every day), zero issues. So I don't think she would suddenly develop lymphoma or IBD in a few days. She also had bloodwork done at the ER vet a few days ago: all normal.

The diarrhea seems to have stopped for the time being, and Gracie's asleep. I don't mind taking in a stool sample for a PCR if needed, but will wait to see how tomorrow goes. In the meantime, it'll be back to bland food and the S. boulardii "stop the diarrhea" protocol, which worked.

 

[daftcat75]

It is possible. You could wait and see. Another week or two probably won't make a difference if it is IBD/lymphoma. But I also wouldn't get too stubborn. IBD and lymphoma don't show up in bloodwork. It's possible it's always been brewing and all the recent vet stress tipped it over. It's also possible that it's simply a gut bug. It's also possible that vet stress and a finger up the butt was just too much for her. Anything is possible. Give the stop diarrhea protocol a few days. Take a sample in for the PCR if that doesn't work. And if the PCR doesn't turn up anything, that will probably take you out two or three weeks from now. If she's still having diarrhea, I would recommend the ultrasound. I'm not a vet. But I have heard anecdotally that some cats who were pre-IBD tipped over to full expression as a result of a stressful event like dental surgery.

What foods, meds, and supplements is she taking now? Any of them have xanthan gum? That one gives both me and my last cat much grief.

Feel free to run all this past your vet. Don't take the word of an internet stranger over a qualified professional (except maybe on metro. That stuff really can do more harm than good and set her perfect poops back several months.)

 

[GraciesParent]

The vet has (just now) suggested metro or tylosin -- is the latter as bad as the former?

 

[daftcat75]

The vet has (just now) suggested metro or tylosin -- is the latter as bad as the former?

I don’t have experience with tylosin. When that happens, I usually search that something plus VCA to get a well-written easy to understand page.

Tylosin | VCA Animal Hospital

Tylosin may be better than metro because it also has some anti inflammatory action. It’s sometimes used in stubborn IBD cases. It is bitter and you’re likely going to have to put it in a capsule for her and use A/D or a pill pocket or something to get her to take those capsules. It is not something to mix in food unless you don’t want her to eat that food.

 

[daftcat75]

I also encourage you to search this site for both metronidazole and tylosin and see what others experiences have been.

 

[daftcat75]

Here's a more technical article.
TYLOSIN

But I am encouraged by this piece:

Tylosin has been used against intestinal infection caused by Cryptosporidium, a single-celled parasite, as well as those caused by the toxin-producing bacterium Clostridium perfringens.

I mean other articles have said that metro is effective against c. perf. But that has not been my experience. Metro seemed to actually set Krista further back. She had a solid poop for a day and then even more mush than we started with. The only thing that really helped was S.B. and a lot of it for a long time.

The good news is that it sounds like, if tylosin will work, it will happen quickly. And it can be given for longer than metro if it needs to be given over a longer course. But yeah, search this site for tylosin to see what others think about it.