post dental surgery problems may be due to meds? Help

Need some advice.  My Rosie came to me as a foster after being rescued from up a tree. She saw a vet before I took her in and was vaccinated, treated for worms and severe malnutrition. We have been unable to find her a home and after six months I realized she was here to stay. She had not seen a vet for about 1 1/2 years due to my own illness and she was acting more perturbed and twitchy than usual so I took her to the vet. She had massive dental disease and went into for dental surgery for 7 extractions. Rosie is an eater -- her appetite was always unstoppable likely due to her earlier life.  I took her home on Thursday nite and vet game me clindamycin hydrochloride  1ML 2X day and painkiller which starts with B… liquid 2 x day. She was eating like a champ though clearly not feeling well.  This morning I gave her meds and she was clearly not feeling right - looked more lethargic though she was sitting in the kitchen -- she scooted under the bed and no amount of tempting with food would work - tuna, fancy featst, baby food, wellness chicken - you get the picture. I called the vet in a panic and he said stop the meds.

My question is this - can it be the medication that is making her feel too sick to eat now?  Vet said it would be ok for her to be off pain pads till Monday. Of course I am freaked as i do not want her to be in pain but as she is a cat whose eating has been unstoppable, I am of course concerned.

Any advice or thoughts would be appreciated.  This is a vet I used many years ago - could not get her to her regular vet as I cannot drive any distances anymore and we were in the middle of a snow storm and needed to get her medical care.  I am beside myself.

ANy help would be appreciated.

Thank you.

Erica  

Hi Erica !

Plumb's Veterinary Drug Handbook, 7th edition, indicates that clindamycin is known to produce gastrointestinal upset as a side effect. Now, many antibiotics are prone to the same, and usually the recommendation is to not give them on an empty stomach - so, some food first, then the med.

There's another, more serious caution with clindamycin. If one is using tablets or capsules, it's critical to immediately follow up with a liquid "chaser" - water/tuna juice, etc. Dry pilling should always be avoided in cats, anyway....but, with clindamycin, it has been known to cause esophageal injury, most noteworthy in cats.

You have to be super careful with syringing any liquid into a cat's mouth - they are notorious for choking on the liquid - and, if they aspirate it, they are prone to an often fatal form of pneumonia. SO - a tiny medicine syringe, a few drops at a time into the side pocket of the mouth, allow her to swallow, then repeat. (A little more than a teaspoonful is recommended in Plumb's.)

The lethargy may well be from the pain med. It sounds like she was given Buprenex (buprenorphine). Now, this drug needs to be absorbed through the oral mucous membranes....so, it's dropped into a side pocket/corner of the mouth, not swallowed.

I don't see any gastro issues noted for that drug, nor have I ever experienced any with using it.

I have no idea why the Vet would suggesting stopping the pain meds - she MUST be in a lot of mouth pain. I certainly would not be stopping that med.

One more note about Buprenex. I found that it needs to be dosed more frequently....in my experience, its effect lasted about 6 hours (Plumb's dosing confirms that)

For a fuller read on pilling, including the problems with dry pilling, this is excellent: http://www.catinfo.org/?link=pillingcats

Hope that helps !

It could very well be the medication.  Clindamycin is a drug I can't take due to the stomach upset it causes me.  Call the vet and ask for a different medication.

The vet never mentioned that I should not give her the anti-biotic on an empty stomach. I gave her pain meds and then the antibiotic before breakfast. It was right after that she refused t eat.  

I am concerned about stopping the pain meds -- I specifically asked the vet and he said we needed to stop both to see if the meds are the problem.  I am to call him on Monday morning.  My heart is breaking.  She is moving around a bit for the first time in 12 hours.  The vet told me not to force food on her -- I offered her some food about an hour ago and she was not interested so I will try again in two hours or so.  I simply do not know what to do. I do not want to defy the vet and give her pain meds -- the dosage was 2X day of 1 ML in a pre-measured syringe.

Erica

Yes the name of the pain meds you mention is what she was on .

Erica

Most Veterinarians have some sort of after-hours service available....and, almost all of these start out with a phone call.....have you tried calling the Vet's office? You may be able to have an on-call Vet call you back, or you may be directed to another clinic (which you could simply phone).

You weren't told about the possibility of stomach upset with the antibiotic......the Vet didn't say the drug might be causing the food aversion....yet, the most popular veterinary drug handbook shows - right 'at the top of the page - in coloured, bold print:

Prescriber Highlights

•  Adverse Effects: gastroenteritis, esophageal injuries possible if "dry pilled"....

Click to expand...

If you were given tablets or capsules, were you told not to dry-pill ?

At the very least, I'd urge you to phone the Vet's office and see what kind of (even) phone help you can get.

If you need some reference point yourself to read about both drugs, there's a popular reliable Veterinary site that may reassure you, especially about the Buprinex:

• Clindamycin:  http://www.marvistavet.com/html/clindamycin_hydrochloride.html

• Buprinex: http://www.marvistavet.com/html/buprenorphine.html     Note that there's NO mention of any gastro side effects there

Hopefully, even if you can't get through to this Vet tonight, you might feel confident enough to take care of any pain.

Thank you all for your help. I have started reading about this anti-biotic and while i can see why it is prescribed, it is dreadful. Rosie is a bit better this morning. She at about a teaspoon of food and she is walking around a bit. Her stools were a mess -- She has been drinking water.  Vet told me to call him on Monday morning.  I am watching her very carefully and will continue to offer her small amount of food throughout the day and see if i can get her to eat a bit more,  Some of the side effects of this antibiotic are lethal… i am freaked.  I dumped the litter right after she used pooped as i have two other cats who have been battling gastric issues and i read about c. difficile which freaked me out.

I called my regular vet and all they can offer is to bring her in - no phone advise which is understandable since they did not treat her. I am going to try and sit tight and watch carefully - if she looks any worse, i will take her to 24 hour vet which is a distance away.  I do not want to stress her out anymore than she is and as long as she looks a bit better and at even a little, that is much better than yesterday.

Vet told me to stop all meds including pain -- i do not know what to do. She is still not comfortable, understandably, but I do not want to give her meds and make things worse than they are. My heart is breaking.

Thank you for the information on this drug which I suspect is at the root of the problem. What I do not see is how long it takes to leave the system or what to do to counter the effects.  Rosie had very bad dental issues and I do understand why this drug is given, but there must be a less toxic alternative. 10% of all patients taking this med develop that life threatening bacterial overgrowth.

Erica

It could be the medication it could be the extractions.  My cat Mini Dee just had to have 2 teeth pulled and it took her about 3-4 days after getting home to get her appetite back and to start acting normally.  She was on both the same medications.  I was VERY worried about her for the first few days as she barely ate, I finally ground down some canned into almost watery liquid and she licked up food like that.  Her mouth was just so tender with the extractions it hurt her to eat.  I think that is what is going on with your kitty.  Extractions are quite painful.  If we pull more than one or two teeth we give the cat or dog a morphine drip to help control the pain.  She just finished her 10 days of the clindamycin and is back to normal.  I have worked in the field for about 20+ years and have only seen maybe a handful of reactions to the clindamycin.  While it can happen it isn't super common.  You said you have stool problems going on with your other cats, maybe that is a combo of things going on with this kitty that are making everything worse.