Vibes for Merlin---dental

I could use some vibes for my aby, going to the dentist on Monday.

Merlin has been dealing with gingivitis ever since I got him at 5 months of age. Initially it was fairly mild and the vet thought I should be able to keep it under control with regular brushing with an enzymatic toothpaste.

Unfortunately, it has gotten progressively worse. Apparently it's not just a regular type of gingivitis. The diagnosis the vet has on Merlin's record is "hyperplastic plasmacytic gingivitis". Basically, in addition to the inflammation there is excessive growth of the gums.

Over the past year Merlin has had:
1. Depo-medrol shot which reduced the inflammation but had no effect on the hyperplasia.
2. Full dental (under anesthesia) including trimming the excess gum tissue.
3. Course of antibiotics which had no visible effect.
4. Another shot of depo-medrol which helped some, but less effective than the first time.
5. A third shot of depo-medrol (about 6 months later) with moderate improvement of the inflammation on the right and very little effect on the left side of his mouth.

My vet says there isn't much else he can do except to pull Merlin's teeth, which he is reluctant to do since the teeth are actually in good condition. He's referred me to a dental specialist and I have an appointment for Merlin Monday morning.

Merlin needs all the good TCS vibes he can get for a permanent solution and the least amount of trauma. So far he's still eating anything and everything, but I know he's in pain when I try to brush his teeth, even with just using my finger to apply the toothpaste.

Thanks, everybody. I'm hoping for a non-surgical intervention, but I don't really think that's going to happen. They've asked me to have him fasting just in case they need to do something under anesthesia. At the very least they'll be taking X-rays and possibly doing a full dental cleaning.

The fasting part is going to be fun. I have two options. Either take all the food away Sunday evening and have a bunch of hungry unhappy kitties jumping on me all night, or keep Merlin in my room without food and have unhappy kitties banging on the door all night wanting to come in to sleep with me. I'm still trying to decide which option will be the least traumatic for all of us.

It's been a bit of a roller coaster, sometimes worse, sometimes better. It's only in the last month or so that it's gotten really horrible.

The woman who called me from the dentist office said I should take up his food at 7:00 PM. I'm not quite sure why it has to be so early. His appointment is at 9:45 tomorrow morning. When I had my girls spayed they only had to be fasting after 10:00 PM for an 8:00 AM surgery.

I normally do a measured free feed, putting out half in the morning and half in the evening. They get their wet meal some time between 8:00 and 9:00 PM and I'll put out the evening dry food while they're eating that. I'm thinking if I feed them around 8:00 and don't put out the dry food for the night, that should be plenty of time.

So I fed the kitties their wet meal about 8:00 last night and took up their dry food while they were chowing down. That worked pretty well until 5:00 AM when Shareena tried to dig me out from under the covers, literally, to feed her. I finally got up about 6:30, put Merlin in the carrier, and put out dry food for the others. They all made a beeline for the food, ate a few nibbles, and walked away.

I left the food out for 15 minutes then put it away again and let Merlin out. I didn't think it was fair to leave him in the carrier for an extra two hours. Poor baby has been following me all over the house begging for food. He made me feel terribly guilty for eating my own breakfast.

We leave in about half an hour, and I have a feeling this is going to be an all-day ordeal. If we get home early enough I'll post again before I go to work tonight, but it may be tomorrow morning before I can get back.

Thanks for all the good

We're home. For those who get bored quickly, here's the short version. Merlin had all of his teeth extracted and he's recovering nicely. The girls have been sniffing at him but no hissing or swatting.

Now for the novel-length version.

When the dentist first took a look in Merlin's mouth he kept saying, "Oh my. Oh. Oh my." Then he showed me a series of pictures and X-rays of various forms of periodontal disease, not all of which applied to Merlin. When he got to the pictures of hyperplastic plasmacytic gingivitis he said, "This is what your kitty has, only his is worse."

The type of gingivitis Merlin has is probably an autoimmune response--he's allergic to the plaque on his teeth. Since it's genetic it's never going to go away and even brushing his teeth daily and having them cleaned frequently will not help. This is basically what I had been reading in my internet research the last few days. I was just hoping it wasn't really what he had.

The dentist was very thorough, went through the procedure with me step by step and named every single drug that he would be using. He mentioned metacam as a possibility and when I questioned that he said it can be given only once because continued use can cause liver and kidney failure. He did end up giving Merlin the metacam, so if he ever need pain meds in the future I have to be sure to tell the vet that he's had his once-in-a-lifetime dose.

Scheduling was a bit of a problem because they normally keep the kitties for 3-4 days ofter surgery, partly to make sure they're eating again. My problem was that I wouldn't be able to pick him up until next Monday because I have family coming in Wednesday night and my niece and I are running in a long-distance relay Friday and Saturday. The dentist didn't want to wait until next week because he felt Merlin would be in too much pain. He was amazed that Merlin was still eating anything.

Because I have experience with tube feedings (in human babies, not cats) he finally agreed to let me bring Merlin home today just a couple of hours after the surgery. He said that it's about 50/50 whether the kitties will start eating immediately after the surgery, so they always put in a feeding tube.

I got to pick Merlin up at 3:30 and they showed me his X-rays and lab work. The lab work was all good except the hematocrit was a little low. The doctor said it might have been because they had given him a little IV fluid before they drew the blood, or might be because his gums have been bleeding, or a combination. Anyway, I need to get it rechecked in a few weeks, but my own vet can do that.

The X-rays looked horrible. He had actually already lost most of the incisors in the front, which I hadn't noticed because I was concentrated on the back teeth. One of the molars just fell out when they started working on it. Almost all of the back teeth had resorptive areas, especially the lower teeth. That surprised me because I had thought from the look of the gums that the upper teeth were the worst. Several of the teeth had been eaten away so the root was completely exposed. My poor baby must have been in horrible pain and he wasn't letting me know.

The fangs were actually in good shape, but the dentist said that wouldn't last with the autoimmune problems. He said they might be okay for quite a while, or I could be back within six months to have them removed, so he went ahead and took those out too. He'd told me ahead of time that that was what he would do, so it wasn't a surprise.

So now I have my baby home with a feeding tube going directly into the esophagus. He has a soft wrap around his neck to keep him from pulling the tube out. Now all I have to do is stop Shareena from trying to groom it out. I may not even have to use it if Merlin eats enough on his own, then my vet can take it out in two or three days. I put out some wet food and Merlin dove into like he'd been starved for days. I told him it was only abut 20 hours, but he didn't believe me. He didn't eat as much as usual at one sitting, but he keeps going back every little while for more.

I have a large dog crate that I'll put him in for the night. It's big enough for a bed, food and water, and a litter pan. That way it will keep the other cats away from him and I'll be able to monitor how much he eats.

I have clavamox (antibiotic) to give him for the next two weeks, and buprenex (pain med) for about a week. The one time I had to give him medication before he was really good about it. I hope it's the same this time.

Now all I have to do is find out if being toothless will disqualify him for showing.

The doctor had given me his home number to call in case there were any problems---so far none. He just now called me from his home to check on Merlin.

The vet gave him one dose of metacam and said he could never have it again. He sent buprenex home with me to give Merlin for the next 5-6 days.

Merlin is doing well this morning. He ate a little of his dry food during the night, but didn't look like he drank any water. He did have two normal sized pee clumps in the litter pan, so I know he's not dehydrated. This morning I took about a tablespoon of the a/d food the vet gave me, mixed it with some warm water, and put it in his bowl. He gobbled that down in 3 minutes flat. I don't think I'm going to have to use the feeding tube at all.