Stomatitis:FIV/CKD - FME recovery

[Squigglebit]

Hi everyone
I’m new here. I have a gorgeous tuxedo boy, Jack. Who I’ve had since he was 6weeks old. He is my world.

just over 6 years ago he was diagnosed with FIV due to ongoing mouth issues, and we had a battle with stomatitis that he nearly died from. He had completely given up and just hid under a duvet 24hours a day. I stubbornly refused to let him give up and syringe fed him multiple times a day until he underwent a PME that changed everything for the better.

Fast forward to December 2023 and I took him to the vets as he was hunched up. He ended up being diagnosed CKD stage 2 and his system crashed over the weekend - I was terrified I’d lose him. It also seemed to cause an enormous stomatitis flare up.

We managed to get his strength back up for a FME 2nd December which he pulled through (I think everyone was suprised and relived) which was performed by a dental specialist with both X-rays before and after. He was kept over night to monitor his kidneys and give him fluids and then allowed home with buprenorphine for pain.

He slowly went off his food (not that he was eating much post surgery) and was admitted to the vets Friday and kept in for bloodwork and put on IV as he was dehydrated. Blood had actually improved since pre op which is great news.

So that’s a bit of background. We’re now just shy of 14 days post op and he is definitely experiencing some pain/discomfort still. He also drools excessively and can’t seem to keep his tongue in his mouth. We are back to the vet Tuesday for another checkup but I just wanted to hear other people’s experiences.

Is the drooling and tongue normal? Is he taking longer to heal because he is FIV?

He’s started to eat a bit more, including some kibble but he’ll lick his mouth and then appear to be in pain. It doesn’t actually seem to be as he’s eating but triggered by licking his mouth/gums.

I just want my boy to be comfortable. He is a million times brighter in himself, alert, purring and interested in life. He is on 0.4ml transmucol buprenorphine twice daily.

 

[FeebysOwner]

Hi and welcome to TCS! So sorry you are going through all of this with Jack. How old is he?

I'm not speaking from direct experience, but still wanted to offer my thoughts. I hope other members with direct knowledge will soon respond.

You said he was diagnosed with FIV due to his mouth issues -which are the primary problem with stomatitis; so did he really test positive for FIV? And, if so, was his current problems what he experienced with any FIV flare ups - or, don't you really know because of the stomatitis?

Nonetheless, a vet visit is good as perhaps he has a bit of inflammation in his gums that can be treated. I don't think that is extraordinarily uncommon. And, that he drools after eating some and then licking his mouth and gums could simply mean that he wants to eat but it still hurts. It is hard to 'overdose' on buprenorphine, so maybe he needs a third dose within a 24-hour period. I don't know version he is getting via transdermal, so the efficacy/dose can vary, but many transdermals, in general, don't seem to be as effective as orals.

He could also be experiencing some CKD effects too, given what he has been through. I'd ask the vet about that too. Drooling can also be a sign of nausea, which can be common in CKD cats, even as early as Stage 2.

 

[Squigglebit]

Jack is 15.

Yes he really tested positive. It was on going mouth issues and abscesses on his body that made my vet test him all those years back.

in terms of his FIV he’s actually been a very healthy cat, just sadly stomatitis seems to be the thing that is directly related to his FIV. We’ve been very lucky for many years after the PME. But now we’ve had the FME he still seems to be suffering.

we’ve got cerenia for nausea but it’s definitely related to his mouth. He seems to be in quite a lot of discomfort tonight, it seems like he’s experiencing what you or I would call a sharp pain rather than static pain.

sorry it’s oral not transdermal and he gets 3.5ml for his dose.

 

[FeebysOwner]

I'm sorry, I guess I didn't realize how commonplace stomatitis can be with FIV. I searched this site for any other threads that were directly affiliated with both conditions and didn't really find any that fit.

I think given what you had to deal with the PME back then when he was younger, and his age now with the FME, you may be dealing with a similar situation in getting him over the hump again.

I know it sounds kind of drastic, but have you considered a feeding tube to keep up his nutrition while you see if he just needs more time to heal?

 

[mrsgreenjeens]

After two weeks, I would think his mouth should be fairly well healed up by now, so I think something is wrong. Perhaps there was a root left in there, or some other issue. You did say this procedure was done by a dental specialist and they took xrays afterwards, but I am still wondering if their could be some fragment still there . I would definitely get him back in for a follow-up exam. Plus, FME doesn't always clear up stomatitis, unfortunately, especially in cats with FIV

As to his tongue hanging out slightly, that is not uncommon when all their teeth are extracted.