FORLS, any advice?

[Muggs]

Hello,

I’m new to this site and looking for a bit of advice! My cat was diagnosed with FORLS and so far, it has been a nightmare! She went through one surgery and 7 teeth were removed. She was not healing well due to inflammation and infection. Since her surgery she has been flicking her head a lot like she is in pain or discomfort. She went through a revision surgery where the specialist filed down more of the bone as well as some teeth however the head flicking continues.

I had asked the specialist if there could be residual nerve/root pain and she got very defensive and would not answer my question. I spoke with my regular vet who thinks maybe there’s some lingering root being reabsorbed as this can be a lifelong condition. Gabapentin seems to decrease the flicking so that is my go to for now with the hopes I can wean her off in the future maybe.

my question to all you cat lovers, has anyone had experience with FORLS and head flicking?

 

[daftcat75]

Get her to a dentist.
What is a Veterinary Dentist? | AVDC.org

This will continue to be an issue and general vets only can do so much for it. They don't have the specialist training that dentists do. I like my general practice doctor. But when my teeth are bothering me, I go to a dentist. A couple warnings with dentists. They are few and far between and thus have very long wait times for initial consultation. If they decide a procedure, hopefully a full mouth extraction, is appropriate, those appointments get scheduled quickly. It's only the initial consultation that takes forever. Two to six months wait is standard. So get her on the calendar now. You can always cancel the appointment if you change your mind or her circumstances change. My other warning about dentists is that some work out of vet hospitals and some don't. If you can get one who works out of a vet hospital, that will be better than the alternative. The distinction is that if there are any complications during the procedure, or if your cat's condition declines between now and then you have to put a feeding tube in her to get her from today to her appointment (something that I almost had to do with Krista), those who work out of a hospital will have more support and resources to handle complications or special accommodations (like the feeding tube.) Those who don't work out of a hospital will only want an otherwise healthy cat (besides the dental issues, of course) because they won't be equipped for anything else.

At that appointment, I would advocate for a full mouth extraction as FORLs will continue to be an issue for her until there are not teeth or roots to resorb. The other reason why you should opt for a full mouth extraction rather than piecemeal extractions (besides how expensive and stressful it is to keep doing these every few months) is that the more teeth that are removed, especially if she's had one or more canines (fangs) removed, the greater the chances for her remaining teeth to cause issues with the soft tissues in her mouth like lip entrapment, scraping, or biting into the opposing gum. Also, as mentioned earlier, general vets have only so much experience with dentistry. I had four or five vets who did extractions in Krista's mouth. When the dentist reviewed the X-rays with me, I was appalled and saddened at some of the shoddy work done. One vet drilled out the teeth and left the roots. Since FORLs starts at the roots, that was either a source of pain or a future target for future pain. Your girl will just be so much happier when all her teeth are gone.

In the meantime, if she's not eating a pate style wet food, that's going to make it easier for her to eat and hopefully avoid areas in her mouth that hurt. Even better if she tolerates a mousse-like food like Tiki Cat Velvet Mousse or Weruva Slide-n-Serve. My Krista couldn't eat these because the xanthan gum that makes these foods smooth ran right through her. Mousse in, mousse out. *facepalm. When push came to shove in Krista's mouth, the only food she would eat was homemade raw. It was highly appealing. I also used a meat grinder to make sure it was a slurpable consistency for her.

Finally, any specialist who isn't going to give you the customer service you paid for isn't worth the big bucks she's charging you. The dentist who did Krista's RME (remaining mouth extraction as her mouth was far from full when he got to her) gave me his personal cell number and told me to text him any concerns with her recovery at any reasonable hour.

 

[Muggs]

In the meantime, if she's not eating a pate style wet food, that's going to make it easier for her to eat and hopefully avoid areas in her mouth that hurt. Even better if she tolerates a mousse-like food like Tiki Cat Velvet Mousse or Weruva Slide-n-Serve. My Krista couldn't eat these because the xanthan gum that makes these foods smooth ran right through her. Mousse in, mousse out. *facepalm. When push came to shove in Krista's mouth, the only food she would eat was homemade raw. It was highly appealing. I also used a meat grinder to make sure it was a slurpable consistency for her.

Finally, any specialist who isn't going to give you the customer service you paid for isn't worth the big bucks she's charging you. The dentist who did Krista's RME (remaining mouth extraction as her mouth was far from full when he got to her) gave me his personal cell number and told me to text him any concerns with her recovery at any reasonable hour.
[/QUOTE]

You are awesome for responding! She is eating really great and is also on a raw diet!!!! Hers is mushed really well so eating is easier for her. All my kitties get raw and love it!

Ironically, it is a dental specialist she is seeing right now and she’s the one not giving me enough info! The Dentist is making it seem like it’s an inconvenience to be seeing her which is sad. She is getting a recheck tomorrow, hopefully her last one! I will push to try and get answers tomorrow about her head twitch.

You are correct, dentists are few and far in between and she is the only one in my city
I will take your advice and if this flares up again, which I’m sure it will, I will insist on a full extraction.
my regular vet has been super supportive, I’m really disappointed in this Dentist.

I hope that Krista is doing well

 

[daftcat75]

You are awesome for responding! She is eating really great and is also on a raw diet!!!! Hers is mushed really well so eating is easier for her. All my kitties get raw and love it!

Ironically, it is a dental specialist she is seeing right now and she’s the one not giving me enough info! The Dentist is making it seem like it’s an inconvenience to be seeing her which is sad. She is getting a recheck tomorrow, hopefully her last one! I will push to try and get answers tomorrow about her head twitch.

You are correct, dentists are few and far in between and she is the only one in my city
I will take your advice and if this flares up again, which I’m sure it will, I will insist on a full extraction.
my regular vet has been super supportive, I’m really disappointed in this Dentist.

I hope that Krista is doing well

I had to travel for Krista's dentist. It was only a couple of hours and Krista was a wonderful road trip companion. She only spoke up when she needed a break. I'd pull over, fetch a litterbox from the trunk, put it at her feet in the passenger compartment, and let her out of her carrier. She got to use the box if she needed to. Otherwise I let her roam the cabin to stretch her legs. When she wanted to spend more time in my lap than roaming about, I stuffed her back in the carrier, the litterbox back in the trunk, and we resumed the driving. We had early morning appointments. I decided to book us a hotel room for both visits. Smart move because our consultation appointment turned into a procedure appointment thanks to an afternoon cancellation.

If FORLs was all Krista had, she might still be with me. Sadly, she also had IBD which progressed to lymphoma. I didn't take my own advice and seek out a specialist for her lymphoma. I believe my vets meant well but were overworked and ultimately out of their element with GI lymphoma. She passed away back in August. She was 16 and she was so tough. So when she finally succumbed, I knew it was not for a lack of trying on hers or my part.

Here's her remembrance thread and specifically, my recounting of our dentist road trip. With pictures!
Remembering Krista

And the anniversary of her "shortest dentist visit ever!" (the follow-up) just passed. Here's my recounting of that trip with pictures and a memory video.
Remembering Krista

 

[Muggs]

Oh no, I’m so sorry you lost you fur baby
I looked at the pictures and she was a beautiful cat! She was lucky to have you and it shows how much you cared for her

 

[daftcat75]

Oh no, I’m so sorry you lost you fur baby
I looked at the pictures and she was a beautiful cat! She was lucky to have you and it shows how much you cared for her

My first cat was pts at 8. Oral cancer. Krista lived to 16. If the pattern holds, my next cat should live over 30 years!