7 teeth extracted today

emilyann

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My cat Buddy has been diagnosed with IBD for years and last October we had a bad scare where the doctor suspected small cell lymphoma. Whether it was that or not we don't know, his current medication regime and has (thankfully) been managing it. Back in October the vet said she suspected some minimal tooth decay. She said she would not consider oral surgery until the  IBD/SCL issue was taken care of. He wound up having his dental cleaning done today and were told at his last exam last month that they would need to extract a tooth on the bottom where the gums were swelling up over the tooth. They said that 2 crowns in the back of his mouth must have fallen out at some point, but the roots were still in his gums and needed to be removed. 

I get a call a few hours after dropping him off and they said he is doing well and they are currently working on him, but upon looking at X-rays and the inside of his mouth they determined they had to extract a total of 7 teeth and 2 roots. One of the teeth removed was one of the upper canine teeth. They were able to extract the tooth without causing damage to it (the others they had to split and then remove) so they actually gave us the tooth to view the damage. I don't recall exactly what she said it was, but she said it's a disease where the decay begins at the root of the tooth and works its way inward towards the pulp then out the enamal where the tooth is exposed. On top of the decay at the root we could see 3 very tiny holes where it eroded through. They said his nerves were exposed and he has likely been in pain for a long time, but most cats do not show that they are in pain unless it is fairly serious. We had one incident 2 weeks ago where he started clawing at his mouth and rubbing his head against the floor after eating. It was obviously pain so we had his cleaning moved up so it could be done sooner.

He's been home for 4 hours and the vet said we could offer food and water immediately, but he may not eat anything until tomorrow. If he hasn't eaten by tomorrow afternoon I need to bring him back in. So the thing is I can see that he is hungry. He goes up to the food (first we tried his regular frozen raw rabbit, it was very mushy). He sniffed it for a few minutes, looked like he was interested, but wound up walking away. Then we thought wet food would be easier so we gave him some of that. He sniffed it and rubbed his lips against it like he is hungry, but when he starts to lick it he pulls his head away and starts licking his mouth and runs under the bed. For round 3 I pureed the wet food with some water and placed it on a small stool so he didn't have to bend his head down as much (thought maybe pressure was hurting him). He has sniffed that twice and rubs his mouth against it but when he started to lick it the same thing happened and he ran under the bed. He is obviously hungry, but he must be in too much pain to eat. The vet gave him 2 doses of pain meds that last 12 to 24 hours as well as a nerve block in his jaw that works from 4 to 8 hours, but I don't think it's enough. 

I'm going to call the vet when they open first thing in the morning if this continues, but has anyone else come across this issue? Any food suggestions I could try? He takes a hyperthyroid medication twice a day in a small glob of laughing cow cheese, but I honestly don't think he will be able to get it down. He can miss one dose without any issues, but if he misses 2 there could be a problem. I'm just worried because he hasn't eaten since dinner yesterday; no food or water past midnight due for the anesthesia, so it's been a full day without food. He got a lot of IV fluids today, but no actual food.

Is there anyone else who has had an experience like this? What happened and how did you resolve it? 
 

red top rescue

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If his mouth is causing him that much pain, you might need to have a feeding tube inserted for a week or so.  Cats cannot go too long without eating or they will get hepatic lipidosis (fatty liver).  He had a LOt of dental work done and evidently that's not enough pain medication to handle his pain.  Maybe you can get your vet to raise the amount of pain medication, but a feeding tube would give him time to heal and it could be left in until he begins eating on his own again.  That can take care f his medications also.

http://www.iwillhelpyourcat.com/blog/2015/3/8/feeding-cats-that-wont-eat-at-all-pina-the-e-tube

http://consciouscat.net/2015/06/08/feeding-tubes-save-lives/
 
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emilyann

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@Red Top Rescue  He has been able to get a tablespoon of wet food down, but that's not nearly enough. I contacted my vet today and she prescribed some liquid Buprenex. She said I need to get the liquid into his cheek pouch because the mucus membranes in that area provide the best absorption. If he swallows it then it's fine, but it will not be nearly as effective. I just got home a few minutes ago so I haven't done it yet, I'm trying to figure out the best way to go about it because the last thing I want to do is grab his head and try and get something into his very very sore mouth. I don't want to make things worse. I'm looking at videos to try and figure out the best way to hold him and grip that area to cause the least pain, but none of the videos have cats that just had major oral surgery so I'm not sure that these will help me. 
 

denice

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Your kitty probably had what is called Feline Resorption Disease or FORL.  It is thought to be autoimmune in nature but no one really knows what causes it, my vet told me that it has been found in kitties buried in the ancient tombs in Egypt so it has been with kitties at least since domestication if not before.

Both of my kitties have had extraction and been given the Buprenex.  I don't think there is a easy way to give it especially since we are trying to avoid causing more pain for our kitties.  Unfortunately this particularly medicine works best when it is absorbed through the tissue in the mouth rather than swallowed.  My vet gave me a few syringes each with a single dose in it.  I would put the opening of the syringe in the side of his mouth from the front so the medicine would go right into the pouch of his cheek.
 
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emilyann

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Yes thank you that it is what he has, I couldn't recall the name of it. Once you have squirted it into the cheek pouch do you just let him go or do you have to wait a minute or so to make sure he doesn't somehow shake it out of his mouth? I have to do this myself and learned how to put him in a kitty burrito to make it easier, now I'm just not sure what to do after. 
 

greycat2

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I had one cat who had 7 teeth removed as well almost 2 years ago and he had pain afterwards for a few days. His vet also gave him Buprenex and a mild pain killer for a few days to be applied to his gums. There isn't really an easy way to administer it but once he starts feeling better, it should be easier for you both.

He didn't eat well the first day after the surgery, although he did nibble on some Pate canned food and some Gerbers meat only baby food (shouldn't be on it long term though). Hopefully your sweet kitty will start eating soon after he gets the pain numbed.

How is he today?
 

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From what you describe, it does sound like Buddy was in quite a bit of pain. He should be much happier once he heals up from the dental surgery. 


Sebastian had 6 teeth extracted about two years ago, and one was an upper canine. Here's my thread about something to be aware of when an upper canine tooth is removed (with lower canines still intact):  http://www.thecatsite.com/t/264206/extracted-upper-canine-tooth-constant-sore-on-lip

Boo also had 3 teeth extracted around the same time, two of them being both his lower canines.

Both cats received a Fentanyl pain patch on their skin, which lasts for three days. Because of the extractions, our vet didn't want any "messing around" in their mouths with liquids and pillings. Sebastian had to get another Fentanyl patch after the first three days because he was having a difficult time. I haven't seen this option mentioned yet. Maybe vets don't use Fentanyl as much anymore
, but it's something you could ask about if you have trouble with the Buprenex.
 

red top rescue

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Buprenex is very good.  It's really n ot that hard t administer because usually the amount is tiny, like 0.1 or 0.2 cc, and our vet gives it out already in syringes with the proper dose for the weight of the cat.  Just getting it into his cheek pouch will be enough, between the cheek and the gum.  It will be absorbed quickly there.  I hope it is working and he's feeling better.  The fentanyl patch that @GoHolistic mentioned is another way to go with pain control as long as they don't rip it off.
 
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emilyann

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I wrapped him up in a towel burrito and got it into his cheek pouch the first time myself, then the second and third time I had help which was nice. He's eating his normal food again. On Monday he got a little too confident and went for my other cats dry food which has those freeze dried chicken bits in it....that didn't go over so well, he spit it right back out, drooled a lot and ran under the bed. Lesson learned.

I am having a behavior issue with my other cat since Buddy came home from the vet though, but I will post that in the Cat Behaviors forum.
 
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