Cat hasn’t been the same since dental surgery.

[Hellocassini]

My cat had a canine and a few smaller teeth removed. He did not seem to recover at all bit has been eatin and drinking normally. However, he has used to have a “witching hour” where he played with his toys but he hasn‘t played once in the weeks since his surgery. He keeps his back hunched and mostly sleeps but it confused and clearly in pain. We took him back after a week and they said he’d had a bad reaction to his sutures, so they removed it but everything looked ok. He has been getting worse, never vocalizes and seems dazed and uncomfortable. Then I noticed that one of his pupils was bigger than the other. I took him back immediately and they said that there was no sign or increased blood pressure in his ryes, did an X-ray on his spine but it was fine. His neutrofils were high (they were low when he went in for surgery) and he has been prescribed prednisone but 2 days in, he seems worse if anything. I just don’t know what to do. They said there isn’t much more that can be done. It’s so hard to see him in pain. My vet is a very good vet. Please help.

 

[nurseangel]

Daisy is an older obese cat and did not recover as quickly as the vet said after her dental surgery. We did a bad thing; we found pain medication left over from our Oscar's urinary surgery and gave her the same dose. I know it was wrong, but we were desperate and of course it was a weekend. The emergency vet's office told us over the phone they didn't handle dental problems at all. I would request to your vet about pain meds. She took hers in liquid form; all my cats do. I will say it did take Daisy a while to get back to what I consider her old self.

As for the enlarged pupil, I just don't know. Did they shine a light in his eyes to see if they reacted?

Thank you for coming to TCS. I wish I could be of more help. I am hoping someone will come along who knows more about this than I do. I really hope your cat improves soon. I would recommend calling the vet again, to see if there is anything else they can try. Just as certain medications don't agree with people, I'm sure the same can be true for cats. I am so sorry that both of you are going through this.

 

[mrsgreenjeens]

Eating and drinking as normal is a good sign, but the rest doesn't sound good to me. The uneven pupils can be a sign of either injury or possibly an infection, and it really does sounds as if he is in pain. I'm wondering if during the removal of those teeth they inadvertently left some of the root behind? daftcat75 , have you got any advise on this topic? I know you went through the wringer with Krista and her mouth issues.

Hellocassini , did they say why they did an xray of his spine? That's seems kind of odd to me, but perhaps they explained it to you. Do you know if they xrayed his mouth again AFTER they removed the teeth? Do you feel confident with your Vet? If not, I'm thinking a 2nd opinion is in order, but if you do that, be sure to take your records with you

 

[daftcat75]

If they removed canines, that could change the shape of his bite. He could be biting into the opposing lip or gum where a canine was previously stopping him from doing that. I recommend finding a dentist/specialist and booking the earliest appointment you can get. Which for specialists are unfortunately very long wait times. Two to six months. So if you have multiple specialists in you area, book an appointment with each of them and ask to be placed on a cancellation waiting list to take an earlier appointment if they have a cancellation. You can cancel any appointments you don’t need after your cat has been seen.

In the shorter term, you may want to give him a bit longer to figure out his new mouth. It might help to break up his meals into smaller more frequent meals. Or possibly explore different textures with him. If he is eating kibble, maybe a pate would be an easier texture for him. Or conversely, sometimes dentally challenged felines find dry food easier than wet because they can figure out how to do one or two good crunches before swallowing what’s left.

You can ask your local vet or a non-specialist second opinion (while you are waiting for the specialist appointment) about lip entrapment and gum ulceration. That’s the technical terms for his bite changing shape due to the extraction of structural teeth like the canines. They may or may not be able to help you. That’s why I recommended a specialist. General vets don’t have the same skill and experience and generally don’t like pulling healthy teeth even if it would fix the problem.

I’m sorry. It may not be an easy or quick problem to fix. But cats are remarkably resilient. If there’s nothing wrong with the rest of his mouth, he should be able to learn to adapt. But it’s possible that he could continue to irritate the opposing lip and gum until a specialist can recommend a corrective course like removing the matched canine(s), filing down the points, or something else that’s probably going to fall out of the skill set of a general vet.

 

[silent meowlook]

Hi,
What you are describing is not normal at all. How old is your cat? How long ago was the dentistry? What teethe were removed? Why did they remove them?
There is lots more that can be done. I think you need to get your cat into a specialist.
Did they do dental radiographs before and after the removal of the teethe? The roots can easily get left behind without radiographs and they can get infected. What pain medication did they send your cat home with?

 

[CatladyJan]

I too question the X-ray of the spine and not the mouth

 

[silent meowlook]

They probably took radiographs of the spine because of the complaint that the cat was hunched up. The dental radiographs would be telling though.

 

[CatladyJan]

I’m following this thread because I have a cat with stomatitis and he will need a cleaning and maybe extractions. Here is an article I found: Cat Tooth Removal - Tooth Extraction in Felines

 

[daftcat75]

Oh yes. Root fragments. I forgot about those nightmares. While you still should consult with a specialist because of the possibility of lip entrapment or gum ulcerations from missing canines, you can and should ask the vet who did the work about whether mouth xrays were taken after the work. It is possible that root fragments were left behind. Some extractions go more smoothly than others. And sometimes those fragments can be beyond the skill level of a non-specialist. But in at least a couple of instances, Krista needed follow up roots work after a round of extractions. Sometimes it is something a general vet can fix. Certainly pursue both courses: a specialist and follow-up with the one who did the work (or a second opinion.)

 

[Hellocassini]

Thank you everyone for the responses! Odin is 16 years old and a pretty small (6.5 lbs) but very active cat. His dental surgery was nearly one month ago (July 19). He had his bottom right canine removed, as well as four of his tiny teeth that had experienced some breakage. I requested his medical file from the procedure and there are x-rays before and after the extractions.

Regarding the spine X-ray: He seemed to be having trouble sitting and is constantly hunched, so the vet wanted an X-ray to see if he had suffered any damage to his spine but it looked fine. He didn't charge me for it so I know he's not adding on extras. I do know that he took a very good look in his mouth and said that things were healing well.

I'll certainly ask him about the tooth fragments. I've been taking him to a vet at a different branch from the one who did his surgery (same practice, though, so they have the same records). They have a dental specialist at another branch.

They did not send him home with any pain meds, only an anti-inflammatories. When he was not immediately improving, they gave us a second round of them. We had some gabapentin left over from an unrelated issue earlier this year and we got the OK to administer that to him initially. It has long been used up now.

He is eating and drinking and seems pretty excited about his food. He's also hiding under the bed a little (for the first time in his life) and is mostly sleeping. I don't get the feeling that he is having a hard time getting used to the missing canine, I believe that he is in pain. He has also stopped bathing. I'm going to contact the vet tomorrow again. Is there any particular specialist I should request? The vet mentioned getting a CAT scan or an MRI from a specialist if the prednisolone didn't help.

 

[Hellocassini]

And I don't know if it's relevant in any way but they also found a bit of tapeworm when he went in to get his dental work done (despite having had a fecal sample analyzed the week prior and coming back clean). We gave him a deworming medication that squeezed onto his neck. He is also on Bravecto.

 

[silent meowlook]

I can only say what I would do if he were my cat. I would take him to an internal medicine specialist and have an abdominal ultrasound. I would have a urinalysis done and whatever blood work they recommend. I know you had blood work done before but things change. I am worried about his kidneys. The hunching can be abdominal pain.
Bottom line is: anesthesia can be hard on the kidneys especially with a long procedure if the blood pressure drops. Anti inflammatory medications can cause kidney failure in cats ( I wish vets wouldn’t use them). This combined could have damaged the kidneys.
Where I work when we have extractions we keep the anesthetic as low as we can by doing nerve blocks and running fentanyl cri for pain as well as iv fluids. The cats stay in the hospital post op for 2 to 3 days on fentanyl cri and fluids and go home on buprenorphine. That said some places can’t do that and only have access to limited medications.
I am not a vet and am not saying your vet did anything wrong. Allot of vets don’t keep the cats in the hospital and allot use medicam anti inflammatory, I assume without incident.
I am only stating from my personal experience I have seen anti inflammatory do more harm than good in cats.

 

[Hellocassini]

The first vet visit that I had after he wasn't recovering well included a full second set of bloodwork. This is how I know that his neutrophils are high following the surgery but were on the low side before. They said that his kidneys and liver looked great for his age, actually! But you're right, that's the first thing that the vet thought of, also. He wanted to have the bloodwork back before he prescribed anything (before we decided on prednisolone) so that we weren't going to tax his kidneys.

 

[mrsgreenjeens]

Bravecto can actually cause neurologic issues. I wonder, now that you've mentioned he is on that plus you gave him another de-wormer at the same time, if that was too much for his system? What was the de-wormer you used? How long has he been on Bravecto?

 

[Hellocassini]

So, I've wondered this myself, too. We gave him the Bravecto not long before his dental appointment, so we were pretty confused that he had a tapeworm, as we've given it to him on time. Every time he's taken it, he gets very drowsy for a day or two and a little derpy but the vet said it wasn't bad. They wanted me to give him the dewormer right when he got home from the dentist and I asked if I could wait a few days so that he had time to recover because it felt like a lot. I waited maybe three days before I gave it to him but he had been on the gabapentin and so it was hard to tell exactly when he started to go downhill.

 

[Hellocassini]

I just looked it up, and they gave him Profender for the dewormer.

 

[CindyH66]

AW, Poor baby ! Kudos for you for being on top of his recovery ! Older kitties dont bounce back like the younger ones. The recovery can be more difficult . I have had 2 senior kitties undergo dental extractions. One had a heart murmur. the other went into it fine. The first came thru it fine. The second had life long problems after the surgery ! Bella went in for a few extractions. they called me at work and told me at first they would take ALL HER TEETH they were so bad. a while later they said they did NOT do that ; they only took 8 of them. ( little ones) that with a deep cleaning , the others were not as bad as they thought. ok, cool. sent her home with pain med, which I gave her for several days. She was under anesthesia a LONG time . went back for post op visit.. mouth healing up good.. a few days later I noticed ..she isn't POOPING ?! squatting all over but nothing comes out ! took her back.. they gave her an enema..no luck. back again for a procedure called " DE obstipation" basically , they had to dis impact her (which required MORE anesthesia ! The bowel had been slowed to a "halt" from being under it so long during surgery , the impaction formed and it was a secondary complication to the operation. It didn't show for a few days after surgery. They got her cleaned out and going again .. but sadly , they told me " once that happens, they are never right again..it tends to happen again" ..UGH ! poor kitty spent the next 6 years battling constipation , and I had to give her 3 meds a day and prescription food (high fiber ) to keep her " going" . the whole bowel thing became a bigger issue than the teeth were , which started it all. we settled in to a routine that worked for us, and it became our " new normal" she was well worth every bit of work I did for her ( she just died this year from a blood clot) ... but I have to say.. I never thought all this bowel stuff would result form dental work ! Kitties are hard to guess at whats wrong. You know something is not right ..and it can be something that has NOTHING to do with teeth . pain ? yes... but , pee pee? poo ? you kind of have to really be a sleuth to find out.... good luck and hope he feels better soon !! ..

 

[mrsgreenjeens]

I just looked it up, and they gave him Profender for the dewormer.

I can't see any adverse effect using Provender and Bravecto together, but there are exceptions to any rule.

So did you re-contact his Vet yesterday? What did they say?

 

[Hellocassini]

Thanks for remembering me, mrsgreenjeens ! I did talk to my vet. He believes that Odin had a stroke while under anesthesia, or perhaps a blood clot. He referred us to get an MRI but I don’t think that the cat can stand being put under anesthesia again. It’s always very hard on him and he’s so small and fragile right now.

 

[mrsgreenjeens]

Thanks for remembering me, mrsgreenjeens ! I did talk to my vet. He believes that Odin had a stroke while under anesthesia, or perhaps a blood clot. He referred us to get an MRI but I don’t think that the cat can stand being put under anesthesia again. It’s always very hard on him and he’s so small and fragile right now.

Oh gosh. Do they think with time he'll recover somewhat? I know other cats have had strokes and come out of it fairly well.