Meme (update after 10 days on Clindamycin)

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rawia

rawia

Member Since 2017
https://www.felinediabetes.com/FDMB...t-after-tooth-extraction.234133/#post-2624904

Hi again,

Meme was on Clindamysin for 10 days now, we went to the vet for a follow up and i thought that i am going to hear some good news, but so far it seems that there is no improvement, the infection and inflammation is still there. vet thought that it is Stomtities what she has, but i just see little redness at one side and little on the back where there is no teeth.

we do not have her in middle east many medication option ms and the vet does not want to put her on Cortisone ( steroids) which is what they usually used in this condition, she said that it will make her diabetes much worse.

her second option is to put her on anti- inflammatory medication which is Metacam that they only have and I refused this option.

Is it better to go straight for tooth extraction??! At least the one that inflammed for now?

she had her surgery three months ago and the inflammed where the teeth extracted healed very will, now we have problem on other teeth.

The vet said that we can do a Biopsy to confirm if it is Stomtities and to see the underlaying causes.

she is hesitating to do another surgery now because of her age and condition which I think that it would be fine as i see many deabitic kitties went for even a full mouth extraction.


Please give me some openion.

- is it a good aidea to do a biopsy and is it a painfull processur?

- should we continue using Clindamycin ( we are doing now 10 more days) , does it take long time to clear infection ?!

- should i asked for an extraction ?


Thank you
 
Awwwww Poor kitty kitty. I dont have answers but I do send healing vines and some prayers as well.
I'm sure others will guide you.
God bless
j
 
It is not a good idea to keep him on antibiotics for longer than recommended and I think you need to know what you are dealing with to make a better decision and on that line of thought maybe it is not a bad idea to do the biopsy that the vet is recommending that given the fact that it would be in the mouth it shouldn't be that bad since is only a tiny sample of tissue taken from the affected area, and certainly a lot less painful than the surgery for removing her teeth even though if it is estomatitis that may be what is going to be needed at the end

You could give him Metacam just for a few days to help her with the pain, I probably wouldn't use it long term but if it's only 3-4 and dosed properly it should be ok and can help him while you and the vet determine what the next steps should be

Cortisone is not really recommended for diabetic cats, well actually for any cat, but if a cat's condition can't be treated any other way then you will probably need to work around it and probably adjust his insulin dose accordingly, hopefully it does not come to this and you can find another option

Regarding her age, 12 years is not that old one of my cats went through a dental having a lot of their teeth ( 13) removed and adapted just fine and she was 13 years old at that time
 
Veronica & Babu-chiri said:
It is not a good idea to keep him on antibiotics for longer than recommended and I think you need to know what you are dealing with to make a better decision and on that line of thought maybe it is not a bad idea to do the biopsy that the vet is recommending that given the fact that it would be in the mouth it shouldn't be that bad since is only a tiny sample of tissue taken from the affected area, and certainly a lot less painful than the surgery for removing her teeth even though if it is estomatitis that may be what is going to be needed at the end

You could give him Metacam just for a few days to help her with the pain, I probably wouldn't use it long term but if it's only 3-4 and dosed properly it should be ok and can help him while you and the vet determine what the next steps should be

Cortisone is not really recommended for diabetic cats, well actually for any cat, but if a cat's condition can't be treated any other way then you will probably need to work around it and probably adjust his insulin dose accordingly, hopefully it does not come to this and you can find another option

Regarding her age, 12 years is not that old one of my cats went through a dental having a lot of their teeth ( 13) removed and adapted just fine and she was 13 years old at that time
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She was 10 days on the antibiotics and the vet asked my to try another more 10 days but i stopped it for few days , she is feeling upset and she had bad nausea even with ondansetron. She isnt doing well at all so i stopped the antibiotic to see in few days, she is paeing at her face, scratching again which is hard to see. I think that i will do the biopse as you said , I need to know what we are dealing with becase she is not doing will.
 
It might help to talk to the vet about changing the ondansetron dosing. According to Plumb's Veterinary Handbook ondansetron can be dosed at 0.1-1.0mg/kg by mouth twice a day (caveat: for severe pancreatitis). Also, it is possible to give ondansetron more frequently than twice a day. Maybe ask your vet about giving Meme 1mg (1/4 of 4mg tablet) every 8 hours to see whether that might help her better? Your vet might also be able to make other suggestions about size and frequency of dose.


Mogs
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Critter Mom said:
It might help to talk to the vet about changing the ondansetron dosing. According to Plumb's Veterinary Handbook ondansetron can be dosed at 0.1-1.0mg/kg by mouth twice a day (caveat: for severe pancreatitis). Also, it is possible to give ondansetron more frequently than twice a day. Maybe ask your vet about giving Meme 1mg (1/4 of 4mg tablet) every 8 hours to see whether that might help her better? Your vet might also be able to make other suggestions about size and frequency of dose.


Mogs
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I will give it to her every 8 hours to see if it is going to clear her nausea. To be honest i used to give it to her once with her antibiotics thought it will be enough.

I called the vet and set an appointment for the Biopsy next week, she told me that it might take two weeks for the result to come back.

what we should do in this time, I guess that i have no option but to give her the oral metacam for the pain ( the vet cut the dose for me to the half minimmum), they do not have any other kind.
 
Be sure to talk to your vet about the ondansetron dosing, Rawia. Meme's a small kitty so be sure to check the dosing is OK.

rawia said:
I guess that i have no option but to give her the oral metacam for the pain ( the vet cut the dose for me to the half minimmum), they do not have any other kind.
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Out of curiosity, is buprenorphine not available where you are? (Note: Buprenorphine is an opioid analgaesic, not an anti-inflammatory drug.)

Poor little Meme. I hope she gets better soon. (((Meme)))


Mogs
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Critter Mom said:
Be sure to talk to your vet about the ondansetron dosing, Rawia. Meme's a small kitty so be sure to check the dosing is OK.


Out of curiosity, is buprenorphine not available where you are? (Note: Buprenorphine is an opioid analgaesic, not an anti-inflammatory drug.)

Poor little Meme. I hope she gets better soon. (((Meme)))


Mogs
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I already emailed the vet about the dosing.

yes, i remember that the vet told me that he used opioid injection when i told him not to use Metacam last time, I am not sure about the liquid, they used to have it years ago but now they told me that they have only Metacam as liquid.

i live in middle east, and our vet is from UK so they ususlly deals with lab in UK for important or some specific tests.

as her mouth inflammed that why the vet think that Metacam will be better.

I will descuss my options again with her.

thank you for helping, hope she is doing fine after few days, I also noticed that she did not poop for couple of days, I am giving her probiotics te help her with upset stomach.
 
rawia said:
as her mouth inflammed that why the vet think that Metacam will be better.
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I agree, hence my note that bupe doesn't treat inflammation. I was just wondering whether it is available in your neck of the woods.

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rawia said:
I also noticed that she did not poop for couple of days,
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Constipation can affect the appetite, and it can make a cat feel queasy. The constipation needs to be addressed and sorted before the anti-nausea meds will work properly. I suggest the following:

* Get your vet to examine Meme ASAP to make sure there's no obstruction in the gut (vital for safety before any anti-constipation treatments are commenced).

* If necessary vet might administer an enema to 'free things up'.

* A couple of days of treatment with metoclopramide (Reglan) can help improve gut motility. [ETA: It doesn't really do anything for nausea in cats because they have very few of the receptors it works on.]

* Take measures to prevent further constipation, such as adding a little fibre to food (e.g. pure pumpkin, psyllium husk) or using a stool softener - see felineconstipation.org).

(Note: constipation is a potential side effect of ondansetron so it makes sense to take prevention measures when giving this medication.)

Hopefully that might make Meme more comfortable and help the anti-nausea meds to work better.

(((Meme)))


Mogs
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Last edited:
Critter Mom said:
PS: For future reference, it is possible to use buprenorphine and Metacam in combination to treat pain and inflammation.


Mogs
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Yes I thought this will be a good idea u til the Biopsy result comes.

i gave her some husk powder for her constipation and if it did not work i will mention it to the vet tomorrow before admitti g her for the Biopsy.

she is really feeling much pain, her BG drop twice to 30 and 40 today and yesterday, she is not asking for food if i did not offer it to het. I reduced her dose to the half ( she was on 0.5 and i cut it to 0.1).

i really feel upset and useless as i watching her feeling that much pain, she keep chewing on her teeth all the day, seems that the untibiotic did nothing at all or make it worse.

and I have to waith 7 to 14 more days waiting for the result, the vet did not want to make any more extraction and insist to go for the Biopsy first.

we can not use steroids and any anti inflammatory medication so i think that our options are few and will end up with extractions any way.
 
Is a long wait if she's in pain, you may end up needing to consider giving her some antinflamotory or some med to help with the pain an inflammation on the mean time even if it is metacam or steroids this could raise his blood sugar levels so you may need to raise the insulin dose but pain can also raise and alter blood sugar levels plus cause eating problems
 
Veronica & Babu-chiri said:
Is a long wait if she's in pain, you may end up needing to consider giving her some antinflamotory or some med to help with the pain an inflammation on the mean time even if it is metacam or steroids this could raise his blood sugar levels so you may need to raise the insulin dose but pain can also raise and alter blood sugar levels plus cause eating problems
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I was thinking of this too, if i have to use steroids then i will but not leaving her with this much pain.

I just want to ask, does steroids like prednisone cause kidney problems??! or it is safe ?
 
Hi

So I admitted Meme yesterday for the Biopsy and the Vet just called me, she said that her lower right teeth is really sore and start to build pucket so she needs to extract some more teeth, the left side is also sore and might need extraction too but she does not want to do it all at one time, she said it is better to wait for her to heal then will do it gradually. I do not know, I saw many cats do full mouth extraction at one time but it is her call, also she wants to keep her for few days on fluids and injectable painkillers.

what do you think?!
Is it ok to do the extraction as she said or maybe i had to asked for full extraction, i just thouht she knows better.

she wants to wait for the Biopsy.

it was a short time between now and her first extraction, just 3 months and all get worse again, how that come?

her teeth was very very healthy.

I am afraid that it is stomatitis, I have other cat at home that has same condition but they told me that it is not contagious, the vet told me that if he had calicivirus she might took it from him, he never showed any symptoms before, he is 3 years now.

other vet told me that it is rare for old vaccinated cat to get the virus.

I am really confused and scared if this is true then i caused her this :(

Her vet said that the Biopsy will give us better look if the underlying cause is calicivirus.
 
Hi I just stopped in on this post, so I don’t know all your history. But if she is in that much pain and it is affecting her ability to eat, I would just take the teeth out.

I have two three year old cats who had half/most of their teeth removed because of a condition called cerebellar hypoplasia. They bump their faces and teeth and that cracked a bunch of them in the shelter. They seem perfectly happy.

Have you tried to mix food with water to make it so she can just lick the food instead of chewing? This is helping my cat right now a lot.
 
Back again,

i received another call from the vet, she said that she did not do the extraction because when she took a deep look , the teeth was very healthy and attached well to the bone and she does not want to force removing them, she think that the problem is only an infection but she wants to wait for the result if they can identify any specific bacteria type.

she will give her a low dose short acting cortison injection ( last for 7 days)which she think that it is the best option for now till the result come back.

I will be sent with two types of antibiotics and tramadol for pain, i read somewhere about tramadol but never use it before, is it a good pain killer? They do not have bup and gabapentin does not fit her before so just want to know if we are on good road or not.

unfortunately we do not have dental specialist here but they are a good staff and she did alot of full mouth extraction before, her doubt was that the teeth look very healthy when she took a close look up.

I do not know if the medication will give her some comfort to eat.

so, what should i expect from the cortisone injection?
How high can her BG goes?
 
As far as tramadol for a cat goes, I honestly don’t know. But for a human, it’s not too bad. It helps with moderate pain. In the United States it is a controlled substance, not as strong as most narcotics/opioids but not bad. I hope it is helpful for her. Good to hear she may be keeping her teeth! I hope you find the infection soon.
 
https://vcahospitals.com/know-your-pet/tramadol

Here’s a little basic information on tramadol use in cats. I see only a couple of potential concerns, mostly not to use it with ondansetron, a medication for nausea, which I don’t know if you even have available there. Overall it looks like it should be effective for mild to moderate pain but not severe pain, and must be used with caution in cases where liver or kidney problems are already present.
 
AliceMeowliss&Cassandra said:
https://vcahospitals.com/know-your-pet/tramadol

Here’s a little basic information on tramadol use in cats. I see only a couple of potential concerns, mostly not to use it with ondansetron, a medication for nausea, which I don’t know if you even have available there. Overall it looks like it should be effective for mild to moderate pain but not severe pain, and must be used with caution in cases where liver or kidney problems are already present.
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Her kidney’s value back to normal , it was little bit elevated since the infection present but today labs was in normal range, I guess that i do not have many option because they do not have bup.
 
rawia said:
Her kidney’s value back to normal , it was little bit elevated since the infection present but today labs was in normal range, I guess that i do not have many option because they do not have bup.
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If you have some kidney concerns, I would just make sure to add some extra fluids in with the food, this is always good for health anyway. Make sure she eats and gets lots of water, and if you are concerned still you can maybe give a lower dose. I try to give the lowest dose possible of any medication.

It’s probably going to be just fine, and I think I would still give this to my cat if I needed to, but with Alice’s kidney disease I would do a very low dose and monitor her. Meme does not have kidney disease right?
 
rawia said:
Her kidney’s value back to normal , it was little bit elevated since the infection present but today labs was in normal range, I guess that i do not have many option because they do not have bup.
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With cats with kidney problems you have to be careful with basically any meds or substances that you give them since everything ends up in the kidneys but with cat with healthy kidneys as long as the vet is monitoring her and the doses are ok for what I've heard tramadol is ok to use just make sure it does not have paracetamol in the formula, and is good to hear her kidney values are back to normal they were probably a bit of because of the infection and dehydration so you don't have to worry about that
 
I have gabapentin and tramadol, when she was on Clindamycin gabapentin make her vomitting so i stopped it. Now with the new antibiotic, can i give it another try if it is better than tramadol, it is capsule and vet said to give her 1/8.

which one is better?
 
AliceMeowliss&Cassandra said:
If you have some kidney concerns, I would just make sure to add some extra fluids in with the food, this is always good for health anyway. Make sure she eats and gets lots of water, and if you are concerned still you can maybe give a lower dose. I try to give the lowest dose possible of any medication.

It’s probably going to be just fine, and I think I would still give this to my cat if I needed to, but with Alice’s kidney disease I would do a very low dose and monitor her. Meme does not have kidney disease right?
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Her kidney was fine as I did the SDMA test 3 months before her surgery and everything was in normal range, but with the infection the numbers elevated a little above normal and now when she did the biopsy the labe work came back withen normal range.
 
rawia said:
I have gabapentin and tramadol, when she was on Clindamycin gabapentin make her vomitting so i stopped it. Now with the new antibiotic, can i give it another try if it is better than tramadol, it is capsule and vet said to give her 1/8.

which one is better?
Click to expand...

I don’t think one is better than the other, maybe depends more on the type of pain you are treating. If it were me, I think I would try the tramadol first. I see gabapentin as being more for neuropathic pain and sedation/anxiety.


rawia said:
Her kidney was fine as I did the SDMA test 3 months before her surgery and everything was in normal range, but with the infection the numbers elevated a little above normal and now when she did the biopsy the labe work came back withen normal range.
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If you have her kidneys showing as fine or just mildly vaguely elevated, I wouldn’t worry. If kidney values are ever slightly elevated it’s just a good idea to try and get in more fluids and keep doing your best with the necessary treatments for diabetes and any infections. :)
 
Critter Mom said:
@jayla-n-Drevon -

Do you know whether there's any issue with the above?


Mogs
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Hi Mogs--I am not getting my notices errr! I do not have personal experience (except when Rico got steroid induced FD because of it) with this but I do know pred will weaken the immune system as it literally sort of shuts it off to relieve some ailments. However I am not sure it would be my first choice as it has many possible side effects especially for diabetic who already have a immune system that needs to be maintained.:bighug:
 
jayla-n-Drevon said:
Hi Mogs--I am not getting my notices errr! I do not have personal experience (except when Rico got steroid induced FD because of it) with this but I do know pred will weaken the immune system as it literally sort of shuts it off to relieve some ailments. However I am not sure it would be my first choice as it has many possible side effects especially for diabetic who already have a immune system that needs to be maintained.:bighug:
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From what i read on webs, I think that steroids is not an options even if she was non-diabetic. It is a temporary treatment, so i will wait for the Biopsy and if non of the antibiotics work and if she was in too much pain, I will ask the vet to do an extraction.

so far she is doing good, I gave her the teamadol yesterday and she acted different, sleeping with her eyes open, she scared me, she sleeps most of the time and her a tivity is less, i did not like her reaction at all.
 
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