Abnormal symptoms after teeth extraction?

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Ohwellok

Member Since 2017
Hello

My cat had three teeth extracted last Wednesday and I don't know what to think about the way his convalescence is going...

The vet gave us 7 days of buprenorphine (twice daily) and 5 days of Metacam (once a day) for pain and inflammation. He recommended I feed him Purina DM wet food, which I bought. He also gave us a prescription for Lantus for his diabetes and said I could start giving it right away if he had a reading above 13, but I preferred to wait and he’s been testing lower than that anyways so I haven’t started yet.

On his first day back, he was groggy and slept most of the time, which I expected. He ate his Purina DM and drank normally. I gave him his pain meds as planned.

On the second day, he was less groggy/lethargic, still ate and drank normally, but I noticed he had some dark colored diarrhea so I called the vet and he agreed stopping the Metacam was a good idea. I only gave Buprenorphine.

The third day is when things started going down the drain. That night, my cat threw up all the food he ate in the evening, had some light colored diarrhea in the morning, was lethargic and generally not himself all day. He drank a little but wouldn’t touch his food. Didn’t want Purina DM, his old Hill’s canned food that he used to love, I tried four different flavors of PC canned food to no avail. The only thing I managed to make him eat was some Fancy Feast Turkey and Giblets, and even then, I had to hand feed him and he ended up eating maybe one can in the day which is a third of his calorie needs. I started suspecting maybe his wounds got infected but his temperature reading was normal. I didn’t test his glucose because he was miserable and hadn’t eaten much so I didn’t think his symptoms could be due to high blood glucose… I wasn’t sure if I was overreacting so I gave him his Buprenorphine and told myself I’d bring it to the vet in the morning if things didn’t improve overnight.

Today, things were looking up in the morning. He was almost his normal self, purring, asking for affection, following me arround. He ate a tiny bit of his fancy feast on his own and had a normal stool. I thought things were back to normal so I skipped the Buprenorphine and the vet. Bad call, because he returned to his lethargic state in the afternoon and since then, will not eat anything, even if hand fed, with crushed treats, parmesan, etc sprinkled on. When I bring food to him, he just looks away. I gave him Buprenorphine, thinking maybe pain was bothering him but that didn’t seem to do much. His temperature is still normal, his blood glucose is at 10 mmol/L and I’m going nuts...

Anyone has an idea of what could be wrong or tips on getting him to eat? I’m taking him to the vet in the morning for sure, but it’s breaking my heart seeing him like this and I don’t know how to help…
 
I'm glad you're taking him back to the vet- it sounds like he really needs vet attention, asap.

Here
is a sticky on tips for getting a cat to eat.

I can think of at least three possibilities for what could be going on, but none of them can be fixed with home care, so the sooner you can get Ari to a vet, the better.

1) Metacam is known to cause kidney problems in cats at higher doses. I think vets are more conscious of the risk these days and dose conservatively, but still, it's something to be aware of.
2) Ketones/diabetic ketoacidosis. The "recipe" for ketones is: not enough insulin, not enough food intake, PLUS some underlying infection or systemic stress. Even though his BGs aren't all that high right now, he's a diabetic who isn't eating enough or getting any insulin, so he's at risk.
3) Incomplete extraction of one or more teeth during the dental. Did they take X-rays (before and after)? Is he showing any signs of his mouth bothering him (rubbing it with a paw, etc.)?

The only one of these you can rule out without a vet is the ketones-- you can test at home using urine "dipsticks" (found in human pharmacies with the diabetic supplies). If you test for ketones and find anything above "trace", it's imperative that you get him to a vet ASAP-- ketones can be treated fairly easily at early stages, but can develop into a life-threatening and difficult-to-treat situation very quickly.

Hope he's feeling better soon. :(
 
Agree with seeing the vet. If the DM food is new it could have caused the diarrhea or upset stomach. The metacam could have caused it also. Your kitty just like people probably doesn't feel to well after the extractions yet. Seeing the vet is good.
 
Thanks for the replies, guys. It's reassuring to be able to talk this over with someone...
I'm crossing my fingers it's only the transition to new food and not something horrible like his kidneys failing...
I should have taken him to the vet sooner :(
 
Upset stomach and diarrhea could cause nausea too but glad you are taking him to the Vet :bighug:. Make sure to update us! Healing vines with you both!
 
Don't beat yourself up. He's been up and down, with some encouraging signs that he was feeling better, so of course you were thinking positive. If nothing else, I think that should point away from the really horrible possibilities...
 
Hell, I would probably have an upset stomach and diahhrea if you pulled 3 of my teeth too. Others are giving good advice. Maybe an infected tooth socket.

Little Dude had 3 teeth pulled 2 weeks ago and got thru it real well. Just got lucky. In cases of not eating, I tend to provide the richest food to get them going again. Maybe some cooked chicken that is minced will stimulate the appetite.
 
Not sure were out of the woods yet but things are a little better …

The good news is we ruled out ketoacidosis. The vet gave me some dipsticks to continue monitoring at home.

The bad news is that the pancreatitis in house test came back abnormal. The way I understand it, this isn’t 100% conclusive so they sent in a blood sample to a lab to get a more precise diagnosis. Will know more tomorrow.

They also sent in a urine sample for micro analysis to check for urinary tract infection

In the meantime, they gave him an anti-emetic injection and water subcutaneously. He’s completely terrified of the vet now and wouldn’t even let them weigh him, so his cries while they were doing the injections were horrifying… He had diarrhea in his carrier too, so that meant a bath when we got home… So basically, he had all the things he hates the most done to him today : car, vet, bath. Poor baby… But he’s back home, resting in his basket now and he’s a little more alert than this morming, so there’s that

He has prescriptions for Cerenia, Pepcid AC and Mirtazapine for the next four days or so. I still can’t get him to eat anything so far. I’ve opened so many different types of cans, nothing works… I just gave him some mirtazapine, and am hoping it’ll get him to eat something tonight. Otherwise, he might have to be hospitalized tomorrow…

Sorry, wish I could write something more positive but I'm felling gloomy and exhausted right now.

Thank you all for your replies and advice, it's really really appreciated
 
Cerenia and bupe helped my cat when he had pancratitis. Don't worry so much about the carbs right now, it's more important that he eat something. Anything.

At first the only thing I could get my cat to taste was delectables pouches. It was enough to wet his appetite though.
 
Yes-- anything he'll eat right now is the thing to give him.

Is he acting nauseated? Lip licking, going to food and turning away are classic signs. I believe the meds you are giving are anti-vomiting and appetite stimulants (the pepcid may help with nausea, if excess stomach acid is the cause), but a good anti-nausea like ondansetron is another thing to try. That said, there's only so much time you want to try to work on this at home-- a cat that isn't eating for any length of time is at risk for not just DKA, but other serious complications such as hepatic lipidosis. Hopefully the fact that he's looking more alert after his extremely rough day (poor little guy!!!) is a good sign that he might be pulling out of whatever has caused this.

Crossing fingers he'll be feeling better very soon. Hang in there!
 
The good news is it is not DKA. Pancreatitis can be managed though once he is past this hump. You can give baby food beef, ham or chicken, no onions or garlic in it. A lot of cats will eat that in the beginning. It's best not to force his favorite food as he might develop an aversion to it. Boiled chicken is also good to give. If your up to cooking for him try bone broth on his food. It has beneficial nutrients and you can continue to give even when better. Getting him to eat is probably the toughest part of it but so important. Hang in there.

http://www.ibdkitties.net/bone-broth/
 
I'm glad you're taking him back to the vet- it sounds like he really needs vet attention, asap.

Here
is a sticky on tips for getting a cat to eat.

I can think of at least three possibilities for what could be going on, but none of them can be fixed with home care, so the sooner you can get Ari to a vet, the better.

1) Metacam is known to cause kidney problems in cats at higher doses. I think vets are more conscious of the risk these days and dose conservatively, but still, it's something to be aware of.
2) Ketones/diabetic ketoacidosis. The "recipe" for ketones is: not enough insulin, not enough food intake, PLUS some underlying infection or systemic stress. Even though his BGs aren't all that high right now, he's a diabetic who isn't eating enough or getting any insulin, so he's at risk.
3) Incomplete extraction of one or more teeth during the dental. Did they take X-rays (before and after)? Is he showing any signs of his mouth bothering him (rubbing it with a paw, etc.)?

The only one of these you can rule out without a vet is the ketones-- you can test at home using urine "dipsticks" (found in human pharmacies with the diabetic supplies). If you test for ketones and find anything above "trace", it's imperative that you get him to a vet ASAP-- ketones can be treated fairly easily at early stages, but can develop into a life-threatening and difficult-to-treat situation very quickly.

Hope he's feeling better soon. :(

Just to address point 3 : I asked the vet about x-rays and they did do them before and after and said there wasn't any complications during the procedure. His mouth looked fine when the vet examined it today and he hasn't shown signs that its bothering him too much...
 
Just to address point 3 : I asked the vet about x-rays and they did do them before and after and said there wasn't any complications during the procedure. His mouth looked fine when the vet examined it today and he hasn't shown signs that its bothering him too much...

That's great news! And, it sounds like your vet is on top of things, which is a fantastic help in situation like this.

I'm very hopeful, from what you've said, that Ari is going to make a turnaround soon. Woodyswife had some great suggestions for "alternative" foods to try. Really, anything will do right now! Just getting him started might be enough to get him back on track.
 
Yes-- anything he'll eat right now is the thing to give him.


Is he acting nauseated? Lip licking, going to food and turning away are classic signs. I believe the meds you are giving are anti-vomiting and appetite stimulants (the pepcid may help with nausea, if excess stomach acid is the cause), but a good anti-nausea like ondansetron is another thing to try. That said, there's only so much time you want to try to work on this at home-- a cat that isn't eating for any length of time is at risk for not just DKA, but other serious complications such as hepatic lipidosis. Hopefully the fact that he's looking more alert after his extremely rough day (poor little guy!!!) is a good sign that he might be pulling out of whatever has caused this.


Crossing fingers he'll be feeling better very soon. Hang in there!



Yes, that's pretty much how he acts, when the Mirtazapine kicked in, he came meowing in the kitchen and seemed really interested in his dry food bag so I offered him a bowl and he ate a couple of bites then turned away. Every wet food can he smells then loses interest without tasting it. The only thing I got him to eat with some appetite so far is his Temptations treats, but even that he's lost interest in now.

I went to the pet store and bought a selection of dry and wet foods, and no luck so far


Hell, I would probably have an upset stomach and diahhrea if you pulled 3 of my teeth too. Others are giving good advice. Maybe an infected tooth socket.


Little Dude had 3 teeth pulled 2 weeks ago and got thru it real well. Just got lucky. In cases of not eating, I tend to provide the richest food to get them going again. Maybe some cooked chicken that is minced will stimulate the appetite.


The good news is it is not DKA. Pancreatitis can be managed though once he is past this hump. You can give baby food beef, ham or chicken, no onions or garlic in it. A lot of cats will eat that in the beginning. It's best not to force his favorite food as he might develop an aversion to it. Boiled chicken is also good to give. If your up to cooking for him try bone broth on his food. It has beneficial nutrients and you can continue to give even when better. Getting him to eat is probably the toughest part of it but so important. Hang in there.


http://www.ibdkitties.net/bone-broth/


Thanks for the advice, I’ll keep baby food and cooked/boiled chicken in mind.

Cerenia and bupe helped my cat when he had pancratitis. Don't worry so much about the carbs right now, it's more important that he eat something. Anything.


At first the only thing I could get my cat to taste was delectables pouches. It was enough to wet his appetite though.


I’m glad it worked for your cat! I couldn’t find pouches at my local pet store, I’ll try elsewhere…
 
If he's not better by tomorrow, definitely ask the vet about an anti-nausea. It sounds like he's still interested in eating, which is a good sign, but nausea will make anyone turn away from food.

Small things you can do without meds: raise food and water bowls a few inches off the floor, so he doesn't have to bend down to eat.
 
One last note: just remembered that the mirtazapine does have some anti-nausea properties, so maybe that will be enough to get him back eating again.

The thing about mirtazapine is that you don't want to mix it with opiods like bupe, due to the risk of serotonin syndrome, so if pancreatitis (very painful during flares) ends up being the diagnosis, I think there are better choices for dealing with nausea. For right now, though, hoping it does the trick!
 
Yes, that's pretty much how he acts, when the Mirtazapine kicked in, he came meowing in the kitchen and seemed really interested in his dry food bag so I offered him a bowl and he ate a couple of bites then turned away. Every wet food can he smells then loses interest without tasting it. The only thing I got him to eat with some appetite so far is his Temptations treats, but even that he's lost interest in now.

I went to the pet store and bought a selection of dry and wet foods, and no luck so far








Thanks for the advice, I’ll keep baby food and cooked/boiled chicken in mind.




I’m glad it worked for your cat! I couldn’t find pouches at my local pet store, I’ll try elsewhere…
Walmart usually has it and many grocery stores

It's not low carb but it might get her to eat.

Delectables Bisque Lickable Treat - Tuna & Chicken 1.4oz - Pack of 12 https://www.amazon.com/dp/B00T76GKKW/?tag=felinediabetesfdmb-20
 
We got the results back from the lab today. It is pancreatitis. :(

Ari still has zero appetite. I cut up his Temptations treats and heard him take 4-5 bites last night, but the bowl is still pretty much full today. I brought him to his water bowl in the morning and he had a long drink, so that's good at least.
I got him baby food (chicken, no onions) but he didn't want it so I gave him about 10 ml of the chicken juice with a syringe. He didn't seem to mind too much.
This afternoon, I tried the syringe trick again with some rich canned pate that I added water to. That didn't work quite as well as he spit up most of it.
He had some diarrhea just now, but didn't throw up today...

Despite all of this, he's a little more himself today. He comes to the door when he hears my keys in the lock and he used his scratch pad a few times, which is better than the previous days where he stayed in his basket all the time. Still, it's a world away from how he normally is...

The vet said I should bring him in for hospitalization so that they can put him on fluids and start him on small insulin doses and generally keep an eye on him. I'm completely torn about it, because on one hand, it'll be a horrible time for him and I'm afraid he could end up dying in a scary place surrounded by strangers. I'm ashamed to admit this but the financial aspect is also an issue... On the other hand, I don't know that I can help him get over this on my own and trying to figure this out is emotionally exhausting...

Sorry again for the depressing update
 
This is a list of foods I've tried so far, for reference :

Purina DM dry - Worked for a while
Purina DM pate - No
Purina DM morcels- Worked for a while
Hills urgent care pate- No
Hills digestive care pate- No
Hills urinary morcels (old food from before) - No
Hills age defying dry (old food from before) - No
Oven baked tradition dry - No
Friskies pate (several flavors) - No
Fancy feast pate (Turkey, salmon, chicken, beef) - Turkey and giblets worked for a while
Cat milk - No
Kraft singles (he used to love when I gave him a nibble of those) - Had a small bite
Temptations treats - Might still work
Canned white tuna- No
Canned chicken- No
Baby food (chicken)- No
Adding parmesan- No
Adding crushed treats- No
Adding water- No
 
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It's great that you were able to syringe feed something into him, and that he's feeling a bit better!

--Here's a tipsheet on assist feeding, maybe there will be something here that helps. It may have just been going a bit too fast for him that led to the vomit.
--Here's a very informative primer on pancreatitis. It's very treatable-- not curable, you are only treating symptoms, but treatable. Main lines of attack are on the pain, lack of appetite, and dehydration
--Here's the recipe for a "liver shake" that many cats find extremely palatable

If he were my cat, given the positive signs and given his strong reaction to being at the vet, I think I'd try to treat at home a bit more before hospitalization, but only if I was sure I could get a decent amount of food into him and were testing regularly for ketones.

If he does have to go in for hospitalization due to not eating, I'd ask about putting in a feeding tube that you could use at home. It's something they might not generally do right at first, but with a cat who has such a strong reaction to the vet, it will likely be faster and cheaper than trying to get him to eat while he's in the hospital.

Hope he's feeling better soon-- there are definitely some encouraging signs!
 
I have heard quite a few good things about that Liver shake. Hopefully it will work for Ari! :bighug:. Could also try the FortiFlora stuff from the Vet. Majority of kitty's will eat just about anything with that sprinkled on it. It's like a flavour enhancer, kind of how people might use salt and what not.
Sending healing vines for Ari!
vibes.gif
:cat:
 
I managed to make him swallow some urgent care soft food just now and he didn't seem to hate it, yay! That stuff is great for syringe feeding, very fluffy.

I think so far today, between the urgent care can and the baby food, he ate about 70 calories. Not super impressive, but it' s better than nothing. I'll try giving him some more before bed.
I know his normal caloric intake for his weight should be around 300, but I'm wondering, what the minimum amount of calories he should eat in a day to be considered a decent amount?

I agree the liver shake sounds great! If 3-6 10cc portions a day are enough to meet nutritional needs, that's definitely manageable

I'm reading the pancreatitis primer now, it's very interesting. He had his last dose of buprenorphine tonight, so if I decide to keep him at home, I'll see with the vet if he can give me more for the pancreatitis pain.
 
I have heard quite a few good things about that Liver shake. Hopefully it will work for Ari! :bighug:. Could also try the FortiFlora stuff from the Vet. Majority of kitty's will eat just about anything with that sprinkled on it. It's like a flavour enhancer, kind of how people might use salt and what not.
Sending healing vines for Ari!
vibes.gif
:cat:
I'll keep this in mind, thanks! I think I did see Fortiflora in my vet's store
 
What is his weight? Just curious how you figured out 300 for his caloric in take as well? :bookworm: Some formulas I researched, 300 calories per day is for like a 22 lb kitty.
 
Haven't tried this myself only because I didn't have one near me KFC (Kentucky Fried Chicken) or if you have a market that sells fresh roasted chicken. Pull skin off, people say kitties like it. Be careful make sure no onions or garlic. Try the baby food beef or ham. Hugs and prayers for Ari. :bighug::bighug::bighug:
 
Royal Canin RS is a really good recovery diet. It smells like pure chicken liver which I think makes up most of it and is very creamy and stinky! It was the only thing my previous kitty would eat after coming home from the hospital. It can also be watered down to syringe for syringe feeding from what I've read.
 
Haven't tried this myself only because I didn't have one near me KFC (Kentucky Fried Chicken) or if you have a market that sells fresh roasted chicken. Pull skin off, people say kitties like it. Be careful make sure no onions or garlic. Try the baby food beef or ham. Hugs and prayers for Ari. :bighug::bighug::bighug:

There is a KFC close by, I'll give it a try

The beef baby food was a success! The smell didn't seem enticing so I had to syringe feed at first, but he liked the taste and lapped up about a quarter of the jar! He wasn't into it when I tried again at lunch so I’m syringe feeding again, but it was amazing to see him eat by himself this morning and I hope it'll happen again tomorrow. Thanks for suggesting this!
 
Interesting... Wish they listed how they came to these numbers. Highest I calculate for a 12lb kitty is 233 calories per day. :smuggrin:

I like that number better than mine :)

If I manage to have him finish his 100ml baby food bottle, which should be possible since were more than halfway through, he'll have eaten 185 calories today! Not too bad!
 
Royal Canin RS is a really good recovery diet. It smells like pure chicken liver which I think makes up most of it and is very creamy and stinky! It was the only thing my previous kitty would eat after coming home from the hospital. It can also be watered down to syringe for syringe feeding from what I've read.

I'll add this to the list of things to try, thanks!
 
Small update: I had a talk with the vet today. I told him I wanted to avoid hospitalization at all cost and he gave me some instructions and supplies for things I can do at home. He gave me some antibiotics, more buprenorphine and he showed me how to give subcutaneous fluids. We did this in the evening and it went well. No agonizing cries or aggressiveness. He whined a little and gave me a mean look but stayed put and took it like a champ.

He also wants me to give insulin : 1 unit if he's over 12mmol/L before food. I think this sounds reasonnable, right? He's rarely that high, so I doubt we'll be able to do it, though...

I have until Sunday to help him get well… I’ll be away for five days next week for work and I can’t ask my cat sitter to do any of this so he’ll have to be hospitalized if he still needs meds/injections/hand feeding…For now, though, he's with me and I'm doing all I can.
 
There is a KFC close by, I'll give it a try

The beef baby food was a success! The smell didn't seem enticing so I had to syringe feed at first, but he liked the taste and lapped up about a quarter of the jar! He wasn't into it when I tried again at lunch so I’m syringe feeding again, but it was amazing to see him eat by himself this morning and I hope it'll happen again tomorrow. Thanks for suggesting this!

That's a good start. After you syringe some in try feeding from your hand or spoon to see if he will continue to eat it.
 
Small update: I had a talk with the vet today. I told him I wanted to avoid hospitalization at all cost and he gave me some instructions and supplies for things I can do at home. He gave me some antibiotics, more buprenorphine and he showed me how to give subcutaneous fluids. We did this in the evening and it went well. No agonizing cries or aggressiveness. He whined a little and gave me a mean look but stayed put and took it like a champ.

He also wants me to give insulin : 1 unit if he's over 12mmol/L before food. I think this sounds reasonnable, right? He's rarely that high, so I doubt we'll be able to do it, though...

I have until Sunday to help him get well… I’ll be away for five days next week for work and I can’t ask my cat sitter to do any of this so he’ll have to be hospitalized if he still needs meds/injections/hand feeding…For now, though, he's with me and I'm doing all I can.

I don't know, it's early in this illness and he isn't eating well. Not sure starting insulin now then stopping for 5 days is good. See if one of the vet techs can come to your house to continue treatment. It would be cheaper than hospitalization and he will get the care he needs.
 
I don't know, it's early in this illness and he isn't eating well. Not sure starting insulin now then stopping for 5 days is good. See if one of the vet techs can come to your house to continue treatment. It would be cheaper than hospitalization and he will get the care he needs.

Oh, what could be the consequences of starting and then stopping for a week? Would it be a case of his symptoms returning or would it potentially worsen the situation? I'm really hoping I'll receive my alphatrack meter today so I can get an accurate BG number.
 
I'm not sure if it's yesterday's fluids or babyfood or both, but he's doing great this morning! He was sleeping next to me and purring when I woke up and he's been walking about all morning, which hasn't happened to this extent since his surgery! He ate a few bites of dry food, drank a little, and he's not completely limp when I hold him. Things are looking up!
 
Depends on so many factors. Yes, symptoms will come back. Talk to your vet and let them know this, see what they say. Depending on how high the glucose is, a possibility and only a possibility is to change diet now to no dry food and give low carb wet and start insulin when you get back.

Insulin needs to be consistent, some more than others. It's not like taking a allergy med when you have sneezing, running eye and then stop when they clear up.
 
I'm not sure if it's yesterday's fluids or babyfood or both, but he's doing great this morning! He was sleeping next to me and purring when I woke up and he's been walking about all morning, which hasn't happened to this extent since his surgery! He ate a few bites of dry food, drank a little, and he's not completely limp when I hold him. Things are looking up!

Sounds good. He is probably starting to feel better after the extractions.
 
One last note: just remembered that the mirtazapine does have some anti-nausea properties, so maybe that will be enough to get him back eating again.

The thing about mirtazapine is that you don't want to mix it with opiods like bupe, due to the risk of serotonin syndrome, so if pancreatitis (very painful during flares) ends up being the diagnosis, I think there are better choices for dealing with nausea. For right now, though, hoping it does the trick!

Oh wow, I completely skipped over this! Thanks for pointing out this incompatibility, I'll definitely bring it up. Can ondansetron be mixed with bupe?
 
Depends on so many factors. Yes, symptoms will come back. Talk to your vet and let them know this, see what they say. Depending on how high the glucose is, a possibility and only a possibility is to change diet now to no dry food and give low carb wet and start insulin when you get back.

Insulin needs to be consistent, some more than others. It's not like taking a allergy med when you have sneezing, running eye and then stop when they clear up.

Ok, makes sense. I can try asking at the vet. I know they have a home visit service.
 
Oh wow, I completely skipped over this! Thanks for pointing out this incompatibility, I'll definitely bring it up. Can ondansetron be mixed with bupe?

Pretty sure those two can be combined, I think lots of folks around here do just that.

I should say, I am not 100% certain of all of this-- I think the situation is that a lot of these things can act in this way, but some have a stronger effect than others, and I'm sure there's a dosage effect as well. Mirtz is just the one for which I've heard the most negative anecdotes, so I'd be inclined to be careful with it.
 
Sorry I have not gone through every post so this may be redundant. I don't know how your cat is doing now regarding food intake and bowel problems. Your first post was Sunday where you mentioned you were given a seven day supply of buprenorphine (four days ago?) which I assume is being given orally. It's one more thing in the cats GI tract that can upset things but you don't want him in pain either. Noah has ongoing dental problems (can't have surgery, long story) and absolutely hated his buprenorphine, so much it almost brought me to tears to force it in him. Our vet had some transdermal made up at a compounding pharmacy and now he just gets his ear tickled twice a day. It made all the difference in the world. I'm in Canada as well and I was told the injectable buprenorphine was a bureaucratic nightmare so option 3 was the transdermal paste. I can give more details if you want, just tag me or PM me. I'll also be watching this thread for a bit.
If anyone else is in the same leaky boat don't take no for an answer, there is always another way of doing things.
 
Sorry I have not gone through every post so this may be redundant. I don't know how your cat is doing now regarding food intake and bowel problems. Your first post was Sunday where you mentioned you were given a seven day supply of buprenorphine (four days ago?) which I assume is being given orally. It's one more thing in the cats GI tract that can upset things but you don't want him in pain either. Noah has ongoing dental problems (can't have surgery, long story) and absolutely hated his buprenorphine, so much it almost brought me to tears to force it in him. Our vet had some transdermal made up at a compounding pharmacy and now he just gets his ear tickled twice a day. It made all the difference in the world. I'm in Canada as well and I was told the injectable buprenorphine was a bureaucratic nightmare so option 3 was the transdermal paste. I can give more details if you want, just tag me or PM me. I'll also be watching this thread for a bit.
If anyone else is in the same leaky boat don't take no for an answer, there is always another way of doing things.

An ear paste does sound a lot easier to manage, thanks for the info! I don't have trouble giving it orally, but if it contributes to the nausea/diarrhea, it's really not ideal. I was given the bupe last wednesday, after his surgery, so I ran out of it yesterday, but got more from the vet for the pancreatitis pain. I think I have another 7 day supply now.

I havent given him any today because he's doing so well and because he needs to take his mirtazapine tonight. If he starts needing pain relief again (crossing my fingers he doesn't!), I'll see with the vet about alternatives.
 
In case you are not aware..

Metacam has a black box warning for cats.

https://www.fda.gov/AnimalVeterinary/SafetyHealth/ProductSafetyInformation/ucm472976.htm

WARNING

Repeated use of meloxicam in cats has been associated with acute renal failure and death. Do not administer additional injectable or oral meloxicam to cats. See Contraindications, Warnings, and Precautions for detailed information.

Thanks for sharing this info. I'm glad I looked up his medications before giving them to him and saw this warning, because he did have dark diarrhea so I stopped Metacam after the first dose. He had similar diarrhea previously from the switch to Purina DM, so it likely was just a continuation of that, but I didn't want to take a chance...
 
A positive update : Ari has been doing great today! He continued eating by himself throughout the day and even ate some canned food without any coaxing from me. He's been active and happy, although still weak and wobbly.
I used a dipstick and got good results : no ketones / low sugar. And we got the results back from the urine culture and there was no growth! I really hope the worst is behind us and he'll keep improving like this in the next days. Thanks again for helping us out, he's definitely better today thanks to all of you! :)
 
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