Hank-(still) recuperating- On the mend! Tues-update

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bettyandhank

bettyandhank

Member Since 2010
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Good morning LL!
Would have thought we'd be all done recuperating by now. I know so many of your kitties have dentals and are back to normal the next day. But that hasn't been the case with him. Wasn't sure when to worry but have been obviously. There have been moments where i thought he finally turned the corner and was on his way back to normal but it hasn't continued or been progressive. He then seems to go back down. By day 3 he was still eating next to nothing and basically only sleeping still.

His appy had seemed to come back a time or 2, but was short lived and then he would turn his nose up. I was coaxing, warming, bringing him food..trying all the tricks. I got a few licks and bites here and there but he was not eating anywhere near enough. And then he would retreat. He suddenly has all but been living in his carrier- such strange behavior...probably spent 10+ hours in it on Friday. He changed locations once yesterday sleeping on the cat tree perch for a few hours..but that was it. He's been completely quiet and still not himself. He is usually such a talker, affectionate, purry and a clown. He did come to me for pets yesterday morning seeming briefly more himself, plus same the day before...so I would think great!..he's bouncing back. But it was just moments. And by yesterday when he continued retreating, I really wasn't sure what to do. Just seemed this was too long and not normal. From what I can tell and read he should have come around by then. So I decided to go get some more bupe (charged more than they said). Our schedule is still totally screwed up from the other day. He was still basically only sleeping or in the carrier. Little to no appy. Baby food wasn't of interest anymore.
I do not think it is just the bupe, because he was on bupe prior to the procedure for 12 days and was not like this. He did sleep, but also had periods of being up and around, alert, chatty, playing etc..

I am not clear if its all pain. or some depression (almost seems it). I know his mouth is bothering him. It is filled with sutures. I think the dynamic of using it is freaky to him. He does sort of make a frustrated(?) moan-y noise. And have seen him paw at it whether it be to eat, groom, etc...
SO maybe part of this is the adjustment period some of you mentioned.
As of last night he was still pretty much staying in carrier most of the time...was there when I went to bed. He ate a tiny amount but nowhere near enough. I have not seen poop. We are done with the ABs so thank goodness for that.
Civvie spent another night in garage.

BUT when I woke up in middle of night he was right next to me on the bed...super loving and sweet. Then he woke me up a little later, wanted to cuddle, got on his side..made biscuits,his sweet self. I fell back asleep and he woke me talking (his usual) - he did eat a decent breakfast- maybe an ounce. He is being super finicky about it though - seems to only want fresh can right now. SO throwing out a lot. Normally he is a hoover and wants a 2nd brekky within 30-45 minutes. That is not happening, but I was happy with what/how he ate today. So thinking..ok finally...
But he has yet again retreated back to the carrier.

So this is where I could use some advice.

Hank has been on bupe for 12 days BID pre-procedure. I gave him 3 doses the first day post-procedure and 2 doses a day since. Originally they prescribed it for 3 days post-op. I picked up more in case we needed it. I have 3 syringes left. Of course if he is in pain I want him to have it. But I am not 100% sure if he is or what to do for today. It is day 4. hate to keep him on this longer if not necessary. He did seem more himself this morning at least briefly. He did eat some. But also then went straight back to the carrier.

I do not know at this point if it is pain...could it be we need to give him a break from being doped up?
Is he just frustrated, maybe depressed a little?
I know his mouth is sore. The vet says it may be more like when we have corn or something stuck in our teeth. I think it is more then that...but cannot be positive if it is real pain...vs sore, discomfort, or what.
I am ready for him to feel better..
I was not prepared he would still be recuperating or it would take so long.

So given where we are would you give more bupe at this point or try it without?
He is due pretty quickly if I am going to do it.
Should I give it a break?


edit to add: I just checked and while I have been typing he has left the carrier for the cat tree perch where he is sleeping.
 
Re: Could use some (still) recuperating advice for Hank

Betty --

Did the vet do post-procedure x-rays? If not, they need to be done. If there's a root that has remained, it could be causing problems like infection or unnecesary pain. It Hank's behavior continues tomorrow, I'd get him in to see the vet and let the vet check Hank's mouth.
 
Re: Could use some (still) recuperating advice for Hank

i asked in advance about pre/post-op xrays and they said they would/do. I don't know for certain they did but they were supposed to.

For now would you give more bupe or give it a break?

he is back in his carrier- but when I took some food to him he ate it.


he has been on bupe over 2 weeks now.
Maybe that is part of the issue vs helping?
i just don't know for sure since he can't talk. (dammit)
I don't want to NOT give him pain med if he needs it.
what to do for today?
 
Re: Could use some (still) recuperating advice for Hank

I have no answers for you. I wish for Hank to make a full and speedy recovery. It sounds like his appetite is coming back, though. :-D
 
Re: Could use some (still) recuperating advice for Hank

I am so wishing I could get some wisdom on this. It is now 4+ hours past if I should have been giving more.

I really didn't know what to do...was hoping for advice.
this is out first time with dental or on bupe.
..and 2+ weeks of it is alot. He did have a big procedure..but it's a long time.
I did see more glimpses of him being normal today...but he has since also retreated back to carrier.
Is it pain..I am not sure.
maybe he is sick of being doped up and needs a break...i just don't know.

is carrier just his new spot now and not indicative of anything ...?


why can't they talk!?
 
Re: Could use some (still) recuperating advice for Hank

Betty

I'm sorry he's not totally back to himself. Why don't you continue to try him without the bupe or start cutting it back to sid or even cut the bid doses in half? I think it will just have to be experiment and see how he does and then adjust.

If he's not more like himself in the morning, I'd probably call the vet. My cats have had some major extractions and are usually pretty much on the mend by three or four days.

Sending healing vines.
 
Re: Could use some (still) recuperating advice for Hank

I think it might be better to not give the bupe and see if it has a positive effect on Hank's behavior. Just because it didn't seem to effect him before doesn't necessarily mean it's not now.

Of course nobody wants him in pain, but with the difference in his eating and behavior, it might be helpful to see how he does without it for awhile.

Hoping you get your baby back to "normal" soon!
 
Re: Could use some (still) recuperating advice for Hank

I would definitely call the vet tomorrow so they can check on him.... do an x-ray if they didn't do it post op.

I believe there is depression with losing fangs. It was 2 years ago for mine but the part I remember most is how it definitely took her down a notch or two.
It was as if her confidence ( her mojo, her moxie) was stolen.
And she never has gained her confidence back to it's pre-fang removal days....
She'll retreat now rather than put up a fight.


I would expect Hank would be hiding in a closet or under a bed rather than the carrier.
I don't know if any one else agrees but I think I would try putting it away and see what his next choice is. If you find it upsets him too much, you could always give it back.

Now my own vet, didn't want me to give wet food after the surgery ( only dry). He was afraid that all the pushing around with her tongue would irritate her mouth/stitches but she doesn't eat dry ( she barely ever did) and I knew she wouldn't eat it after that surgery. That was why I had to make pate into little kibble size lumps spaced out on a plate. She couldn't pick them up since she wasn't used to using her tongue ( still doesn't).
I know the sutures are very tender until they are dissolved and gone.
It sounds like he's going up and down, feels a little better, than he doesn't. We did that too.

maybe note when he is willing to eat in relationship to when the pain med was given. Does his hunger pick up a bit when the medicine is wearing off?
He needs to not be in pain but it might also be making him not want to eat.
Mine was oversensitive to her pain meds and would just get so wild eyed and agitated ( paced and relocated for hours) that the vet took her off it early.
You start feeling like every bite they take is worth celebrating.

He had the surgery on Oct 2, correct? That's only 4 days.
It sounds to me like he's about where I would expect him to be given what he's been thru.
But only the vet can tell you if there is a problem.


It's hard to watch , I know.
That's why I compared it to a woman getting a mastectomy. There's a physical loss as well as an emotional loss.
Sending hugs to you.... and Scritches to Hank. cat_pet_icon
 
Re: Could use some (still) recuperating advice for Hank

thanks everyone.

ok. so have been back to check on him. He was still asleep in carrier. I have not given bupe yet. Longest he will have gone without.
I brought food but he was not interested. I was on bed nearby with civvie who is starved for attention. Hank came out an jumped on bed.
Had seriously groggy eyes- he has done nothing but sleep for 4 days. He layed down and I brushed him. Seemed fairly relaxed. I can tell his mouth bothers him. He was licking around, licking lips, then kind of making the yeow-ow sound, and pawing at it. It is like he is about to groom but does not then groom. I am really on the fence as to what is pain vs just bothering him. I was glad he came out for awhile. I warmed some food and he would not eat on his own-he took a couple bites I hand fed, but that was it. He was done and jumped off bed. He went to door to go to other side of house. I have it blocked because Elvis is banned from that side due to spraying.
I made a spot for him on the fireplace hearth-where there is still a slice of sunbeam coming through. And he is there now. This was just a few minutes ago. At least he is up and around a little. This is good.

So since I am so far off schedule. Maybe I will just give one shot today. Or is it like Lantus and better to give less but BID?
Each dose is in one syringe so not likely if I did try to split I could make it exact.

Isn't this sort of a long time for him not to be back in the saddle fully?
I don't want to over-react if not unusual. But don't want to under react either.

my poor little pumpkin. i want him to feel better. it's taking forever.

BTW, how long does it take sutures to dissolve?
 
Re: Could use some (still) recuperating advice for Hank

sutures can take 2-4 weeks to dissolve.

Will he let you look in his mouth.? just to see if there might be any food stuck near a suture?
I doubt he has any but it might make you feel better to see ....


I'll be curious to see if his appy picks up with less bupe.
I would continue baby food if he'll eat it, it's less abrasive than canned food....
 
Re: Could use some (still) recuperating advice for Hank

the baby food was a hit the first time- and no interest since. I'd forgotten i bought it. I have read all the tricks here a 100 times, just have not had to personally apply them until now.

This is my first time with this vet. He is nice, young...doesn't seem particularly deep. he will say, well if you think so you don't have to convince me.
They do not like if I ask...did you do so and so. Or are you going to do so and so? I asked and noted that I wanted the to xray before/after, among other things, and was told yes they do that. BTW, wouldn't he have to be anesthesized for more xray?

Rhiannon, I did think about what you said about the possible adjustment, which is why I was trying to discern pain vs depression, etc..for at least deciding about the bupe.
But you saying this is where you think he should be helps..as that is not what I understood. I was under the impression most kitties bounce back to normal in a day or so...even if it takes awhile to get used to the sutures, eating, etc..So I had begun to wonder if this is normal or whether to worry. Just when I think he is better, (and I then feel better) then he gets all quiet and reclusive again. SO yes, I think he may have better moments but is still up and down.

I am not sure about taking carrier from him. It is strange- but hate to take it if it helps him to hole up in there.
He has never been an under the bed cat. But he does nap in the chair under the breakfast room tablecloth-his little dark nook. Hasn't gone there since he got home.
Ok this is all helpful.

I need to determine whether to do less BID or just the one today.

They would have had us do a follow up in 2 weeks from surgery regardless.
Just need to determine if or at what point I might need to do something sooner.
 
Re: Could use some (still) recuperating advice for Hank

I think other teeth extractions are all pretty quick recoveries.... just a day or two but the fangs are more involved than molars even.
The roots can be deep. You said he had a fissure. ( or am I confusing you with someone else?)
He had that filler product used .
That's why I think it's more like a week to get back to normal for fang removal.


Here's an article for regular dentals. None of us like the Metcam.... but in reading these instructions ....
why don't the vets give us something else that acts like it for an anti-inflammatory?
I hadn't read that about Bupe before... that it just helps them disassociate from the pain... but doesn't block it.

http://www.allfelinehospital.com/site/view/206548_dentalextractions.pml
 
Re: Could use some (still) recuperating advice for Hank

He had a fistula between the canine root and nasal cavity. He has the consil added to the root socket on the lower canine. Some of the other extractions were molars. And they also did some 'smoothing out' where other teeth had resorbed already. Plus he had to cut some gum tissue away that had malformed in a hole. I am still not clear on everything. But it was alot.
I think he has many sutures. I have wondered if any of those are too tight or sticking out too much or something. He looked swollen and bruised under his chin...seems less swollen now.

Maybe he is noticing the sutures more cause the pain meds wearing off.
 
Re: Could use some (still) recuperating advice for Hank

Okay. I remembered right then.
Shadow had molars removed too, and all 4 fangs.... and her recovery wasn't fast.
And it was almost as if she new immediately that her bite was impotent. I remember her trying to bite me to be left alone and she just knew.....

As you described it, It was a lot.
So there is a lot to recover from.... the mouth recovers quickly but not as quickly as we imagine.
The sutures are rough, lots of raw surfaces, and food can feel really abrasive in a tender mouth.

Sending appy vines to Hank. Hope you can find something he'll eat.
 
Re: Could use some (still) recuperating advice for Hank

Do you recall how long you continued giving bupe after?

That article was interesting, that it makes your cat disassociate from the pain vs blocking the pain.

I wonder if giving 1/2 dose will even do anything...am i just wasting it at that point? We have effectively skipped a dose at this point.
But if I give him more now, whether just the one or 1/2 dose now and 1/2 in 12 hours..it puts us back on a much better clock.

What would you do?

He snuck upstairs where I am on the computer without my realizing...and into the guest room right by here and was on the bed snoozing. He purred when I went to check on him...yay!
 
Re: Could use some (still) recuperating advice for Hank

Bupe is an odd drug in that the amount you give effects duration not the intensity of the effect. So, giving a smaller dose means that you might need to give it every 8 hours but it will still be effective.

As far as bupe causing "dissociation from pain," maybe that's technically true. However, I would ask anyone who's had surgery and had Oxycontin or Vicodin prescribed. They do just fine at alleviating the pain. Bupe is a safe but very powerful synthetic opiate. It is more powerful than morphine and it is routinely used to manage pain in veterinary medicine.
 
Re: Could use some (still) recuperating advice for Hank

Have you bern able to look at his tongue? The last extraction my GA Teddi had! they bruised her tongue so badly from moving it around that she couldn't eat. I took her back due to the anorexia and the vet noticed her tongue was swollen. Also, Because the cats mouth is so small and they have to work in such a small space, sometimes the jaw becomes really sore. He might not be able to eat just due to the soreness.

I wonder if it's just a combination of things that is causing him to feel poorly. And yes, they have to anesthetize him to do more X-rays. That's why they need to do post surgical X-rays while he's still under to be sure they got all the roots and any bone chips from extracting the teeth. If they didn't, that could also be part of the problem....a leftover part of the root or a bone chip.
 
Re: Could use some (still) recuperating advice for Hank

Let's hope not.
All this is making me hurt. I think i will bupe him now.....


......hmmm 1/2 or full?
i will run out soon on full

I think that he is up here sleeping on the bed is a good sign...and the purring. I consider it progress.

I hate to wake him to give meds. I want him to wake on his own. That's when he wants to go hide
guess I will give a little while longer and bite the bullet if he doesn't get up on his own.

and get myself some dinner in the meantime.
 
Re: Could use some (still) recuperating advice for Hank

It does sound like Hank is making progress, and he has been through a pretty significant procedure. One thing that happened with my civvie who had the emergency dental earlier this year (had two molars removed)...he got a piece of food caught in a suture, and that caused him pretty major discomfort and distress. With all the sutures Hank has, maybe something like this has happened as well.

Continuing to send prayers for you guys....
 
Re: Could use some (still) recuperating advice for Hank

hmmm...I guess i can check. Did you have to open wide to see it. That will be an awful undertaking. Leaving him alone is what he mainly wants right now.
How do you get it out?
I did discover some liqui-poo in(and outside) box....in 2 different boxes. We gave last AB dose Friday night, but apparently there is still residual affect.
I also could not get his probiotic down him yesterday. he was not eating enough for the fortiflora. I wrapped a pearls in cheese and he licked at it but did not get it down. I left him be. So here we are.

I just found him sitting quietly in the dark on the stairwell. I tried to give (1/2) the dose of Bupe but just as I thought, more than half came out...maybe 2/3-3/4. So there is this random amount left that will probably do no good later. This would have been at about 20 hours from the last dose.
I also think I was shorted on one of the other syringes. Looked closer to .15 than .25. Another looked a little short, but not as bad as that one.
I have been robbed on this stuff as it is already.


I will let the bupe soak in (i never know how long that takes) and then hopefull try to get some food down him. I thought his appy was better per this morning but he hasn't wanted anything in hours. I also am hoping to get the pearls down him.
Wonder how long after the AB the tummy upset continues?
 
Re: Could use some (still) recuperating advice for Hank

If you were to see something lodged, I'd probably enlist the vet's help to get it .
Unless you have a rinsing syringe....
irrigation-syringe.jpg

They give you this when you have wisdom teeth removed.
You could do it with a larger syringe ( like a feeding one) but I doubt Hank would cooperate.

I have to just watch my own cat yawn.... and look fast ;-) .... she won't let me look in her mouth....
 
Re: Could use some advice for Hank- (still) recuperating

LOL...I'm with you, Betty! When Petey had the food caught in the suture, the vet did get it out. I couldn't even get his mouth open to see what was going on...I could just tell something was upsetting him.

I hope Hank is feeling better tonight!
 
Re: Could use some advice for Hank- (still) recuperating

Sending well wishes for Hank. I hope he feels better soon!
Mr.Cat had dental surgery three weeks ago and had 5 molars removed. He recovered pretty quickly, though he was a cautious and slow eater for about a week, partly due to the sutures hanging down and the overall post-op discomfort. He went off bupe after about 4 days because I could tell it was making him feel weird and he didn't seem to have much pain. I think in Mr.Cat's case, the surgery recovery was less painful than the bad teeth/inflamed gums!
Also, Mr.Cat still had loose stools about 3-4 days after he finished his antibiotics. I gave him probiotics but they didn't really help. The stools firmed up on their own within a week, so Hank will probably be the same.
Best wishes to you both!
:-D
 
Re: Could use some advice for Hank- (still) recuperating

Betty,

Hope Hank is feeling better. My Arthur had 9 teeth pulled at once in emergency surgery, he stopped eating. I felt bad as I never realized his teeth were so bad. I was sent home with two weeks of Clavamox and Bup. I also had to syringe feed him AD for awhile after the surgery as he would not eat on his own. I kept taking him back to the vet wondering why he would not eat, she kept checking him and could find nothing else wrong. It took about a month and a half for him to get back to normal. He only has one canine left and some small teeth, he had the rest pulled some years ago, so he is almost toothless.
I think I even got more Bup for Arthur past the two weeks and gave it to him until he started eating a bit as I thought he was in pain. So it may take a little bit for Hank to start feeling better.
Will be watching for updates and hopes that he is getting better.

Terri
 
Re: Hank- (still) recuperating- but on the mend!

Thanks for checking on us-

Update: Yes I think Hank is finally doing better. I did end up giving (less than full dose) bupe Sunday eve. That was a difficult day in that I just wasn't sure if where we were was normal or where we should be at that point. Did I continue bupe or give a break under circumstances, etc.. but that was last time.
Monday late morning we got a call from vet office checking on him to see if he was better or if we want to bring him in for a look. I was on the fence at that point, he seemed more alert when we woke up, had eaten some breakfast, not normal but a little better. He had come to his regular spot to eat as opposed to me taking it to him. He was napping and I really hadn't had a chance to observe him. She needed to put us in a slot if we were coming. She said it wouldn't hurt, that she would relay to vet what we had said and if we didn't hear back to bring him. So I jumped in shower and it was time before you knew it. Of course he now is out of hiding and napping in one of his regular spots for first time in days. I had to wake him form there to get him in carrier (the one time he has not been in the carrier) And wouldn't you know he seems more alert and normal-ish than he has in days! Given a few more hours I probably wouldn't have taken him. But we went in..vet checked his mouth, sutures apparently intact. I explained that he had basically slept for 4 1/2 days and hardly eaten as long...was just still and quiet this whole time- not himself. And I wasn't sure if it was normal still this many days past procedure. I'd begun to wonder. There had been glimpses of him feeling better, it just was not progressive. But the truth is he was sitting there looking pretty good at this point. Of course! LOL!
SO i think the vet probably continues to think I am crazy and was just appeasing me. He wonders if I feel better :razz: Hank let him get a good look in his mouth. I was amazed he was so patient. Vet commented this was most he'd been able to handle his mouth including initial exam. He showed me his sutures. There are SO many! I asked about post xrays and possibility of fragments (as possible reason if hank is having trouble) ... he said something to deflect (unlikely?), I can't recall exactly. I also tried to clarify some other details of procedure regarding number of teeth involved, which ones, etc. there was some discrepancy with the report chart they gave me and what he had relayed verbally. He said he would need to check his report and notes and i could email questions on that. I think I may ask him to also take a good look at the post xrays again while he is in the file. I don't want him to be defensive or seem to micro-manage...but it does seem important. i was trying to clarify number of teeth missing and he says to think in terms of which are left.

I also mention Hank still not eating enough...not certain if due to soreness, appy or both...and his GI issues recurring/continuing even though we stopped the AB on Friday. He doesn't have much to say on either. He says' well how much do you want Hank to weigh?'..implying he could stand to lose a few lbs. Yes he could, but It is really not the point. But he doesn't seemed alarmed at Hank still not eating normally.
This was 4PM and Hank had eaten maybe only 1oz of food so far. I am.. so will continue watching.
Overall he seemed to think Hank is progressing fine with his mouth healing ..which is good news. By then I was also seeing him be more himself so felt better too.

So I get Hank home and this all seemed to wipe him out. He did not want food, went to nap instead. But last night he was more up and around, and ate pretty good before bed. I had to bring it to the carrier.
BTW. I have decided him being in the carrier doesn't bother me now..it may have been indicative initially- he had never done that before and was strange him spending 20+ hours in it. it was like the physical manifestation of a meatloaf- he was meatloafing in the meatloaf. But I think it may have just become a spot for him to hole up...and if he likes it, fine.

Today he was right next to me when I woke up. So was Elvis...it was chilly this morning. He came to kitchen and while I was making coffee and getting their breakfast, he was already in his box- and more soft (pudding?) poo first thing this AM even before breakfast. Poor thing. I am thinking it is as much this as his sore mouth making him not want to eat much. His tummy has been upset for 2+ weeks....must be miserable.
The probiotics weren't doing much plus had trouble getting any down him for a couple days after the procedure. He got a pearl yesterday because I got the vet to give it when we were there. Sprinkled a little Fortiflora on his food as enticer but he ate only a few bites, so cannot rely on dosing that way until he is eating more. Ends up getting tossed. But it wasn't helping much anyway. Haven't been able to get him to eat the yogurt I bought. Today he licked maybe 1/2 pea amount. I hope jess is right and we are soon to be over these tummy issues. We are 4 days past last AB dose.

He seemed to eat better this morning, ..and also came back later bumping Elvis from his bowl (poor thing)..so that is a good (and normal sign). And day is young so lets see how much he ultimately consumes today. If I can see him progressively eating more, I can not worry....but how much longer?
Up until now I don't think he has eaten even 1/2 his normal intake. Several days probably not 1/3rd. And I sure hope his poo firms up soon.

Overall except those 2 issues, and i am sure a still sore mouth, I think he seems much better. He is sleeping now on the guest bed nearby, was up and around this morning, got some sun and seemed generally more alert and himself. So I am not worried anymore...except concern about his tummy. But all in all things are all around much better. My Boo-Boo is i think thankfully finally on the mend.

thanks for all the support and concern.

I miss this place. Do we have to be sick to rent a condo?
 
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