Lack Of Vitality A Week After Full Dental Extraction

[pixies ma]

My cat is almost 7 years old, FIV +, weighs 13lb, and had a bad case of stomatitis. He's eating Natural Balance limited ingredients venison due to allergies to poultry and fish.

A week ago yesterday, he had all his teeth pulled out. The pre-op exam and blood test looked fine, surgery went well, and I got him home same night with Metacam 6kg once a day for 4 days, and burprenorphine 0,23ml twice a day for 2 days. He was also already on doxycycline since a week before surgery, and his last dose an hour ago (completing a 14 days treatment).

24 hours post-op, he went from ravenous and hyper to not eating much and lacking vitality. He has been that way ever since. Some days, I could only get half a can in him diluted with water. The most he ate was a full can, and it took some convincing and patience. He was interested in kibble and ate a few pieces when I forgot to hide the plate left for my other cat. But I took it away as he's not supposed to eat kibble for 10 days. I have tried everything within his diet restrictions to intice him to eat; wet kibble, more water, less water, sprinkling treats on top, etc.

On Saturday I called the vet who did the surgery (not my usual expensive vet) and told her he's not eating well. She prescribed an appetite stimulant once every two days. His Saturday dose did no difference.

Sunday night, I thought his eyes looked weird and pinched his skin. He was dehydrated. I gave him a cup of water in 3 hours mixing it with canned food and sprinkling treats on it. I let him eat kibble, and he ate about 1/8 of a cup.

Yesterday morning, he ate a bit of canned food, but not much. He used the litter box normally, grooms, and even played with a ball for a couple minutes.

But he's still not eating enough, feels limp, seems depressed, and sleeps under the covers which he never did before.

First thing yesterday morning, I called my usual vet who is across the street and they had me bring him over. I couldn't take him to the vet who did the surgery cause I didn't have a lift. No fever, no infection, mouth looks good with a few spots redder and more sensitive than others. So nothing besides being a little dehydrated. The vet thinks he might still be in pain, so I left with buprenorphine 0.8mg twice a day(I just noticed it's not the same dosage as last week) and cyproheptadine 4mg, half a pill twice a day. He got 40ml of subcutaneous fluids.

I was able to talk to the vet who did the surgery in the afternoon, and she concurs with my usual vet and said that some cats don't bounce back as well as others, perhaps cause of the fiv. Says she's not too worried.

Last night and overnight, he ate somewhat better on his own and with some encouragement (bringing food to him in bed). Still using the litter box, still hides under the covers though his sleep position is more relaxed, sometimes comes for cuddles. But mostly, he's just pitiful. I know the painkillers cause sedation, but he feels like a rag doll in my arms and his eyes are still a bit lifeless. He just looks so depressed.

This morning, eating took some encouragement, but I think he ate kibble early in the morning so maybe he wasn't hungry.

So I did everything they said, I've consulted with two vets, but I still feel something is not right.

I know full dental extraction is a big surgery, but he's not doing well and I'm worried.

Maybe I'm being overly worried, but his facial expression and lack of vitality reminds me of when my dog went into renal failure after a dental surgery.

Did any of you experience this with your cat?

 

[FeebysOwner]

Hi. I don't have personal experience with buprenorphine, but a lot of what you are describing can be side effects from it. And, your cat just completed a 14 day antibiotic treatment, which can also cause similar side effects. Maybe he needs a different type of pain med? Maybe you will see a continued reduction in his side effects as the antibiotic gets out of his system?

Do you have any reason to think he is having renal issues? Was your dog diagnosed with renal issues as a result of the dental surgery, or did the dog have them before?

Hopefully, other members on this site will come along and offer first hand experiences they have had with the cats who were on buprenorphine - which would be much more helpful than what I can provide.

 

[pixies ma]

He had been on doxycycline a week prior to the surgery and he seemed fine.
He had buprenorphine for two days after surgery, and didn't do better the 4 days after before he was put on it again so I'm confused.
I don't really have a reason to think he might have renal issues other than the look on his face that is similar to my dog.
My dog's pre-op tests looked fine and no one could tell me why he went into renal failure. He had no pre-existing condition other than being 12 years old. So I reckon he had a reaction to anesthesia or pain killers.

 

[FeebysOwner]

I understand your concern because of what happened to your dog, but the odds of the same thing happening is not very likely. So, try not to worry too much!!

I am simply suggesting it is the combination of the two drugs, as opposed to just one of them. I realize you had a 4 day gap where only one drug was taken, but that was also early on in the recovery process when he might have still been feeling more pain that attributed to his behaviors. Maybe the bupe dosage that he is now on needs to be tapered down a bit?

And, as I am sure you already know, try to avoid kibble without enough water added to make it soft, at this point. Once his mouth is fully healed, he can resume dry kibble - many cats with no teeth eat dry food with no problems!

I hope you see more progress each day with him. And if you don't, you need to contact the vet again. ​

 

[Noirele]

I'm a bit worried about metacam, to be honest, because sometimes has bad adverse reactions. Also, my vet told me to stop treatment if I notice any change in appetite. How about litter box habits? Is he urinating less or more than usual?

 

[daftcat75]

Ask the Dr about the prescription side effects. Talk to her about what you're observing and if any of the prescriptions could be causing this. Cyproheptadine, for example, is an antihistamine with an off-label use as an appetite stimulant. I don't have experience with cypro myself, but I do know antihistamines frequently cause drowsiness. Bupenorphine is a narcotic and causes sedation. Just reading that, I would be a little concerned about mixing the two. Ask the Dr about that interaction. Also ask the Dr if it would be safe to take a couple of med-free days to see how your kitty is really doing without all the medications and their side effects. Obviously talk to the Dr about this. It may not be advisable in your case. I know nothing about FIV or its medication requirements.

 

[pixies ma]

Oh my....I didn't know I had replies!
The vet who did the surgery suggested not giving him the morphine last night, and he did seem more alert. All in all, he ate well yesterday, with me bringing him food to bed a couple times.
This morning, I gave his cyproheptadine around 9, but he still hadn't eaten when I left home around noon. I gave him a dose of morphine just before leaving. When I came back for dinner, he still hadn't eaten. I woke him up and put him next to the food but he kept sniffing and circling and only ate very little.
Called the vet. She thinks he might need an antibiotic boost, some fluids,etc but understands it's hard for me to find lifts especially since we had another storm today. So she suggested trying another brand of food. So I got him Hills Dd venison at the vet across the street. He ate over 1/4 if a cup eagerly, and as much kibble soup an hour later. He used the litter box and went back to bed. Hopefully he keeps eating that...
He's always used the box normally. I saw him drink twice this morning, but not excessively.
Tonight I'll give him his cyproheptadine, but skip the morphine, which is actually dosed at 0.05 ml. The 0.8 on the bag was the total not the dose.
The vet thinks it's totally fine for him to eat kibble. Thats what he wants to eat most, and it's been 10 days now.

 

[pixies ma]

He had Metacam for four days, his last dose was Friday.

 

[Jbaileyjrsi]

Diesel is nearly 8, poor fella had 9 teeth pulled beginning of this month, around or on the 12th. I feel terrible, he had been pawing at his mouth for months and I never thought anything of it. He was eating dry food one night and lunged back from bowl while pawing his mouth. I got up and saw blood on the floor near his bowl. I took him to vet the next day on a Friday after calling work, dental was recommended and I took next available slot(2 business days later) for a full dental. Dropped him off in AM, picked him up in PM after work and found out my buddy had 9 teeth pulled.

He was in a surprisingly good mood first few nights after surgery but then he started getting tired and is now sleeping all day except for feeding. I’ve got him in my bedroom right now so his sister leaves him alone. He’s got master bedroom and master bath to roam free all day without being bothered by his sis. He’s eating great and is using litter box fine but he’s tired. I’ve also noticed that he’s not drinking as much as he used to.

Vet surprisingly did not give any pain medication or antibiotics to take home. They gave him an antibiotic shot and a steroid shot on the day I took him in for exam(2 days pre-surgery). Perhaps he is just exhausted, tired of the pain and anxious to be 100% healed, as is Pop.

I had no idea that I had to watch out for teeth problems as I fed both of them, what I thought to be good, Blue Buffalo Freedom Grain-Free dry food. They both loved it, but, when Diesel had his episode - dry food was gone. I’m buying the Fancy Feast Tuna Florentine/Primevera right now but Petco is discontinuing soon for health reasons. A friend at work turned me onto the Nutro brand wet food - they seem to like it, although, it’s not fancy feast. But there’s no fancy price so that’s good.