Mouth Issue/not eating much

Hello Dear Cat Lovers,

I'm having a problem with my baby not eating.  Some background info -   he is a persian, 14 years old.  He started back in mid October not feeling well, keeping to himself, and not eating.  We went to the vet and it was determined that he had a very loose canine on his bottom right side that was bothering him.  I left him there that evening and they removed the tooth.  He is also missing several teeth on his other side, due to age I guess, but this has never stopped him from eating.  I figured it was pretty normal that he wouldn't eat much the first week, but as time went on found it strange that his old eating habits had not returned.  I volunteer at a cat shelter and we have many cats with no teeth at all that eat just fine. 

I took him back to the vet and she examined his mouth really good and said everything looked great.  She did mention though that she wasn't 100% certain that she got all of the root out when she removed the tooth.  She said generally that doesn't cause any issues and home we went, but I made a mental note of it.  Well, here it is 3 months later and he still is hardly eating.  He is at 4.6 lbs. and has been for several months now.  I have had him to 2 other vets to have his mouth examined and they both said they didn't see anything wrong.  I just can't help thinking that it has something to do with his mouth.  Since having the tooth removed he does this very strange thing with his mouth where he is constantly doing this "licking" and more so over to that same side.  He doesn't paw at the mouth at all.  But this constant licking and what it looks like to me is him favoring that one side, kind of like if you had food stuck in your mouth on one side and you were trying to get it out.  I can't help feel in my gut that the reason he isn't eating is that it has something to do with his mouth.  I could be wrong... I don't know.  I've had 3 different vets look at his mouth and say all looks fine.

A few side notes -  he is still drinking a good bit of water, and will drink milk.  He has never eaten wet food at all. I've tried everything - tuna, baby food, everything.  His entire life he has only eaten his dry kibble.  When he does attempt to eat it looks like he is having trouble holding it in his mouth.  He will get it in his mouth then drop it, then try again.  I've even bought the cross shaped kibble so he can hold it better and he still has trouble. 

Can a missing lower canine tooth cause him this much trouble, or be that difficult to adjust to?  Is it possible she didn't remove all of the root and that is causing him discomfort? 

Thank you for any input/suggestions.

Terri (and Simba)

I have had him to 2 other vets to have his mouth examined and they both said they didn't see anything wrong.

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Did they say whether remaining root might cause discomfort?  Did they give you any suggestions for what to do about him not eating?

I was told that leaving a little bit of the root behind shouldn't cause any issues.  But now I'm starting to wonder.  I can't figure out what else it could be and all the vets I've been to don't see anything on the surface.

As far as the not eating, I have been syringe feeding him 2x a day for the past 3 months.  On days that I feel he ate enough on his own (which aren't many), I don't feed him.  I don't have to force it, he takes it right down with no problem and knows the routine now.  It's a high calorie wet food that I dilute with water, called Critical Care AD.  I'm really afraid to stop doing this because he only weights 4.6 lbs.  When I first took him for this issue back in October he was down to 3 lbs., so at least he has gained some, although I wish it was more.

I've never gone through this exactly (though I do have one with mouth issues and extractions) but I'd be frustrated that 3 vets couldn't help you figure out why he's not eating and what to do about it.  Hopefully others here will have some ideas about what to do next. 

Has your vet checked for other problems? has he done blood work? Sometimes this licking is a sign you cat is feeling nauseous. I would be looking at other issues beside the missing teeth.
 

He's never been a very big eater at all, and the vets just chalk it up to old age.  The most he's ever weighed even in his healthier/younger days was 5.5.  I'm thankful he is drinking a good bit of water, and his bathroom habits are good.  He is holding at 4.6 with the weight, so I'll just continue to nurse him along.  I imagine they could investigate the mouth further, but that would require putting him under and I think they are afraid to do that considering his age and weight.  When he was under for the tooth extraction I was a nervous wreck he wouldn't wake up since he was only 3 lbs. then. 

As a side note....  if I give him an appetite stimulant he eats like a horse for several hours. But once it wears off he's right back to not eating much.  I may need to keep him on the stimulants, but I hate to do that and they also make him very high strung (for like 6 hours).  I can't give it to him in the evening because he will keep me up all night!  If anybody out there knows if there are any long term side affects to appetite stimulants please chime in. 

Yes, he's had a complete blood panel and everything came back normal.  When I had him there a few weeks ago the vet said he looked good and wasn't dehydrated.  I have seen him do the licking before when he's been nauseous and this thing he's doing now is different.  It's like he has something stuck in that one side of his mouth that he's trying to get out.  But the bizarre thing is he's not pawing at the mouth.  Hmm.... 

Pepcid AC works wonders for him when he's nauseous and it works almost immediately.  I may try that this weekend and see if it makes a difference.

So since you have been feeding him the critical care A/D, do you think he might eat that on his own?  Have you tried that?  (even though it's canned).  When given the appetite stimulant and you say he gets ravenous, what does he eat then?  What is the appetite stimulant?  Mirtazapine?  If not, maybe you could try that one since it doesn't usually cause anxiety.

I've tried leaving a plate of the Critical Care AD down for him and he wants no parts of it.  I've heated it, I've mixed it with milk, I've tried everything.   When I give him the appetite stimulant he eats only his dry kibble and some treats, still will not eat any wet.  I have given him both the Mirtazapine and Cyproheptadine and they both affect him the same way.  I'm wondering if I should try cutting the dose back.  The vet recommended 1/2 tablet which is what I always give him.  Maybe I'll try 1/4 tablet. 

How often did the Vet have you give the Mirtazapine?  Twice a week?  That's usually the dosage for cats.  And, just like people, sometimes medications can have the adverse effect, I'm guessing.  Too bad.  Did you ask if there was anything else he could try?  But, yes, I would cut it down to 1/4 to see how it reacts.  Can't hurt.  It will either work or it won't. 

And as to him not liking anything canned, my dear departed Sven was like that until I found just the right thing.  They can be funny that way.  It totally depends not only on flavor, but also on texture.  And what was really strange was, when I converted them to raw, Sven, the oldest, was the first one to say "hey, I LIKE this", after having eaten kibble for 15 years! 

It is possible that a tooth chip was left in the mouth and is causing irritation and swelling. Can you look in the mouth for redness or swelling? If he prefers kibble, this could cause him pain when he eats. Have you tried a smaller kibble? One of my cats lost most of her teeth and swallows the kibble whole. With the wet food, have you tried the different shapes of food - chunks, shreds, etc? Also, offer something else other than what you syringe-feed him. 

The dose for Mirtazapine is usually 1/8th of a 15 mg pill every 48-72 hours. Hopefully, the 1/2 tablet you are using is [color= rgb(24, 24, 24)]Cyproheptadine and not Mirtazapine.[/color]

I've started to think maybe he is naueseous.  Maybe he's just not used to that canine tooth being gone yet and that's why the licking looks funny/different to me.  So last night I decided to skip the appetite stimulant and give him some Pepcid AC instead.  Well, within about 15 he came out from under the bed and ate like a horse most of the evening.  As one of the other posters here said maybe I am focusing too much on the tooth/mouth.  The vet had prescribed the appetite stimulant daily.  I think for now if I notice he's doing the licking and not eating I am going to stick with the Pepcid AC since it worked so well for him last night. 

Yay that he is eating, but wonder why he is nauseous?  Perhaps just because he doesn't have enough on his tummy?  Hopefully that's the reason, and if he eats enough, that will cease