Experience with facial nerve damage, canines piercing the lip or extractions/general anaesthetics wi

mirandal

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I should just call this a short novel on Tom :/
My 14-year-old cat Tom has had a horrible 15 months and the latest problem seems to be his facial nerves (injury from a dog attack) as well as his canine causing him a lot of pain by stabbing into his lip. I’m trying to avoid an extraction because he also has kidney disease. Hoping someone might have had some similar experience because I’m really not sure what to do.
I think I should put this in context – and there is a LOT of context so this is a long post – hoping you can make it through to the end! 11 years ago he had his upper canines removed. His lower canines have always caught on his upper lip (I’ve heard this referred to as a ‘Billy Idol sneer’ :) ) and he developed callouses but has never seemed bothered by it.
Now, in the last three weeks, one canine has started stabbing a small hole in his top lip – sometimes it bothers him more than others, sometimes it bleeds. Right now it seems really sore.
The vet says possibly it’s just due to movement of his teeth, and I may be best to have his remaining canines removed.
But there are a few complicating factors.
My husband’s dog attacked him about six months ago. It was awful – his eardrum was ruptured, and he had facial nerve damage which for a while paralysed his right ear and eyelid. That seemed to resolve – but in the last three weeks he has developed something like a tic in his right ear, and sometimes his whiskers, chin and eyebrows quiver – again, just on his right side. The vet thinks it is possible this is another effect of the attack – but she can’t say if this is a sign of his nerves healing or getting worse. She also says this could be causing the problem with his lip, if the right side of his face still has nerve damage and is ‘drooping’ – but again she doesn’t know. She said the quivering could even be a reaction to the pain in his lip L
But I’m hesitant to go ahead with the tooth removal because he has also recently been diagnosed with early stage kidney disease (he only has one, and his remaining one is quite enlarged). That was discovered after a UTI and a couple of crisis visits to the vet where he ended up on a drip. So obviously good nutrition and lots of water in his food is incredibly important – which is harder when his lip is sometimes too sore to eat, but also makes me scared to put him under a general anaesthetic and through the pain and stress of having his teeth out.
To complicate things even more, he had a cancer scare last year – he had lung inflammation which was initially diagnosed as cancer but is now treated with anti-inflammatories. He had an awful recovery from a general anesthetic during that time,
AND he has spent so much time at the vet that he absolutely hates it and has to be sedated even for a blood test. Plus I’m in massive debt because his bills have totalled about $15,000 – not a deciding factor because I would send myself bankrupt for him but something I have to keep in mind.
So, has anyone had experience with facial nerve damage and/or canines causing similar problems? Is there anything I can try rather than going down the route of extractions straight away? I have read that vitamin B12 can help with nerve repair so I was considering giving it a try – but I also don’t want him to be in pain anymore.
Any advice or insight would be REALLY appreciated
 

hellomisskitty

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While I do not have expirence with facial nerve damage in a cat, I do have expirence with facial nerve damage in humans...myself to be specific. I had surgery to remove a type of benign brain tumor which grows off the hearing nerve. Because the hearing nerve is close to the facial nerve as these tumors grow they adhere to the facial nerve. Often, as in my case, surgery to remove the tumor will cause damage to the facial nerve. The left side of my face was paralyzed for about 6 weeks after surgery as my facial nerve healed. Thankfully, my face is 95% back to normal. Based on what my surgeons stated any damage which was not resolved after three months was permanent. Now, I do not know if the same timeframe applies to felines but my guess is that, sadly, things have healed as much as they are going to. With that said, I don't think nerve damage can get worse. It just reaches a point where it has healed as much as it's going to. I took B-12 supplements to aid in healing but that was something I did immedialty post surgery.

In humans, there is a thing called a "hemifacial spasm" and I'm wondering if the quivering you describe is something similar. I do have spams on my surgery side sometimes when I'm really tired. If that is what it is, I can tell you they are not causing your sweet boy pain.

I don't know enough about feline anatomy to be able to give an opinion on if the tooth is causing the issue or not. In humans, the facial nerve is a motor nerve whereas the trigeminal nerve is the nerve which gives sensation to the face and mouth.

I'm so sorry this happened to your sweet little boy. Really sorry. He is blessed to have you to advocate for, take care of and love him [emoji]10084[/emoji]️
 
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mirandal

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Thank you so much for your reply. And I'm really glad your recovery went so well! That makes me feel much better that the tics and spasms probably aren't painful - I had been worrying about that. It certainly startles him but so good to know it's not hurting him
He has had a tough time - he is such a sweet little guy, it's really unfair that he has had to go through so much :(
 

hellomisskitty

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Thank you so much for your reply. And I'm really glad your recovery went so well! That makes me feel much better that the tics and spasms probably aren't painful - I had been worrying about that. It certainly startles him but so good to know it's not hurting him
He has had a tough time - he is such a sweet little guy, it's really unfair that he has had to go through so much :(
When my left side spasms, I can feel it and it is startling but it is not painful. I hope that is all that is going on.
Is there a way to give him B-12 supplements that do not involve injection or IV? I would think that extra support for his nerves could only be beneficial.

My heart goes out to your boy. I will have him in my [emoji]128591[/emoji][emoji]127995[/emoji]
 
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mirandal

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In Australia it's really hard to find methylcobalamin B12, which apparently is better. I've managed to find some online (finding it without flavouring or sweeteners was also tricky) so waiting for it to come from the US. It's supposed to be dissolved under the tongue which Tom obviously won't agree to :)
But I'll try putting it in his food. It's a long shot and probably not as good as injection but I'll give it a try. Google also told me that some studies showed swallowing was just as effective as dissolving them - so fingers crossed it helps him. Pity I didn't do it earlier!
Thank you for your good thoughts for him :)
 

hellomisskitty

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Yes, you want methyl cobalamin B-12. For humans, I've seen both sub-lingual as well as a tablet you would ingest. As you've already read, sublingual is optimal but I don't see why putting it is his food won't work. Another thought may be to see if your vet has needless syringes which you could then use to administer the B-12 between his gum line and cheek. There's a pain med called Buprenex which is administered this way because it works best when absorbed sublingually. This would allow you to easily give the B12 to Tom in a way which would provide for optimal absorption. You could disolve the tablet and then load it into the syringe.
I think the B12 would be a good way to support the health of his facial nerve. And don't feel bad you did not do this sooner. You were in an emergent situation where you were fighting for Tom's survival. He is lucky to have you fighting for him[emoji]10084[/emoji]️
 
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mirandal

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That's genius! He actually has Buprenex left over from the attack (and the vet has been getting me to give it to him when his lip is extra sore as well) so we definitely have syringes left over from that. Great suggestion, thanks!
 

hellomisskitty

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Boy, Tom and I are very similar...have some facial pain too and it's primarily in my lip area! I'm glad he has some medication for the pain. One thought to ask your vet about is giving Tom a medication called gabapentin, which is used in humans for nerve pain. I take it for my post surgical facial pain. It's given to felines as well as humans though I don't know if for the same reasons. Tom would have better coverage of the pain (meaning fewer gaps of big flares of pain) plus gabapentin is not a narcotic [emoji]128522[/emoji] It's worth a try to see if your vet thinks it would be beneficial to sweet Tom [emoji]10084[/emoji]️
 
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