post dental extractions issues

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Karen & Rudy

Karen & Rudy

Member Since 2014
poor Rudy went in to extract a cracked tooth on Friday and came out with 7 removed. All of his canines had to go :-( He was given buprorphine for pain and that put him very lethargic and not acting right at all. He could barely even walk with out falling over. Today, Sunday, we didn't give him the buporphine and he was way more alert and able to walk around. He didn't seem to be in a ton of pain. My problem is that he hasn't really eaten since Friday night- two days. I finally caved and shredded some boiled chicken and he ate a little bit of that, but not much.

How long can he go like this? Anyone have experience with this many extractions as to when they started feeling better and eating again? I am really worried about him :-( I am debating on if I should go to work tomorrow or if I should stay with him and possibly take him to the vet? Maybe this is all normal and I am totally overreacting. I just hate seeing him this way. He looks so frail....
 
Buporphine can cause some GI upset and slowed GI motility. I would touch base with the vet.
Meanwhile, anything you can get him to eat is good. Have you tried baby food of plain meat, chicken, or turkey, with nothing else added?
 
I haven't tried any broth, didn't even think of it. I tried mixing water into his pate. He didn't go for it at all. He would go near the food bowl and then stare at it and walk away. He put his mouth to the water bowl so that his whiskers touched, but didn't actually drink anything. Just not sure if that is normal past day 2 post op or if he should be eating or drinking by now? He finally started opening his mouth today to meow, but that is about it.
 
He might be somewhat nauseous, or his jaw may be sore from being held open during the dental. If the former, 1/4 of a plain Pepcid AC may be helpful.

Can you get an oral syringe or moderate size baster to use in assist feeding?
 
Do you think I should keep giving him the buporphine? It made him so weird that I am afraid to leave him alone. Or perhaps a lower dose than they gave me? They prefilled syringes .22ml (.3mg/ml).
After what happened while I was at the vet on Friday, I really don't want to call them- I am now in the process of looking for a new one. They were terribly disrespectful and said I am wasting my time home testing and I am going to kill my cat. There was a bunch more horrible things said on their part and I left the office with my poor kitty still half out of it and me completely sobbing. I really can't trust them at all, they were insisting that I have to come there for all testing (fructosamine and all glucose) and they literally wanted me to go home with a brand new type of insulin. The same day he had 7 extractions. I said I think it is best to let him recover fully from this and then discuss options and they rolled their eyes at me and repeated that I am going to kill my cat. I can't believe that people who get paid a lot of money treat their customers that way. I love Rudy so much and everything I do for him is because I am trying to help him, not hurt him.
 
BJM said:
Can you get an oral syringe or moderate size baster to use in assist feeding?
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I had thought about that, but I am so afraid to go near his poor little mouth right now because I don't want to cause him more pain. At what point do you think it would be necessary to do just to get something in him? By tomorrow?
 
I agree with BJ that Rudy sounds like he might be nauseated. See the symptom checker on Tanya's Site here.

I've just had similar issues with Saoirse after she was prescribed a higher and more frequent dose of bupe than she has ever had before. She is very med-sensitive in general. She stopped eating after the second dose and was really ill on Friday (and she had an abnormal poop).

I am gobsmacked at the way your vets are behaving. If that had happened to me I'd definitely be looking to move to another practice. I hope that you can find a better vet.

(((Karen)))

:bighug:
 
Miles had a dental a couple of weeks ago and the vet looked at his teeth a couple days ahead of time to have some idea of how many were going to need to come out. In retrospect, I am glad he required that (extra $13 or so was all; he thought two teeth might need to be removed, but actually only one came out). We knew what to expect and didn't have any surprises. Did you have any idea that seven were going to be removed? It sounds like your vet is trying to extract more than just teeth!! :eek:

I hope you can get Rudy to a kinder, gentler provider ASAP. He needs some nourishment and TLC. Good luck!
 
Critter Mom said:
Are you monitoring for ketones, Karen?
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I do monitor every few days, I don't always post it on my spreadsheet....lol I tested him two days ago and he was neg- yesterday he didn't go, he just went this morning and tested negative. He also drank some water!!!! first time in a few days- this is HUGE :-) I hope that means he is coming out of it and that he'll also start eating soon.
 
marniepaul & miles said:
Miles had a dental a couple of weeks ago and the vet looked at his teeth a couple days ahead of time to have some idea of how many were going to need to come out. In retrospect, I am glad he required that (extra $13 or so was all; he thought two teeth might need to be removed, but actually only one came out). We knew what to expect and didn't have any surprises. Did you have any idea that seven were going to be removed? It sounds like your vet is trying to extract more than just teeth!! :eek:

I hope you can get Rudy to a kinder, gentler provider ASAP. He needs some nourishment and TLC. Good luck!
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Thanks! I'll be looking on my lunch break today for a new vet that will work with me. Rudy went in for one extraction, then xrays showed he needed 7. it was a total surprise. my quote was $600 and it ended up being $1,000.
Because he hasn't been eating, his numbers have been very low and we haven't been able to give him insulin. My awesome vet never mentioned anything like that at all. They don't want me to home test and if I didn't and continued to give him the dose they said, I would have killed him. I guess that solidifies my search for a new vet...
 
Hi Karen,

Great news on the ketone front, and I'm delighted to hear that Rudy's drinking again. Now that he's willing to ingest fluids again, I wonder if he might take some kitty chicken soup for you? That's what I gave Saoirse after her recent dental. Do you have a processor or blender? If you do, try poaching some chicken breast then blitzing up the cooked chicken with some of the poaching broth and a little water to make a slightly thick soup. If he won't eat it too thick, you can keep adding a little more water or broth until it gets to a consistency Rudy can manage OK. Try raising his bowl, too. You really do need to get him to eat as a matter of urgency. If he won't take the thick soup, maybe you could assist feed him some of it? If he doesn't eat today then if he were mine I'd be looking to take him to see a vet. And on that subject ...

WRT the vets, you are doing a great job keeping Rudy safe. If you were able to register him with another practice quickly then the new vets might be able to advise you on buprenorphine dose if Rudy still needs pain relief (and he might). If I were in your shoes I'd definitely be looking to move Rudy to a new, kind and collaborative practice for the long term. I'm particularly concerned that they advocated a change of insulin immediately after the dental. Bearing in mind that any inflammation from sore teeth/gums may have been elevating Rudy's numbers, diligent monitoring of his numbers post-dental is really important because his current dose (pre-dental) may be too high once the inflammation and post-op pain has resolved. With all of that going on, throwing a different insulin into the mix seems to me like a strategy fraught with unnecessary risk. If I had been in your shoes, I wouldn't have changed insulin either.

Sending you good 'find a friendly, compentent vetty bean' vibes and a big hug.

(((Karen and Rudy)))
.
 
Poor Rudy! My civvie Ripley just had his two upper canine-fangs removed and he was such a zombie on the painkillers. He was only on them for 3 days and he kept trying to eat, but I can just imagine what you're going through trying to also handle diabetes issues with a kitty who doesn't want any food.

Depending on what you're finding for vets, you may want to post a separate thread with your location asking for a recommendation. I know how overwhelming it can be - I had to change vets after my Tasha's diabetes diagnosis because I was having a similar experience. Home-testing was bad, I was doing everything wrong, I should be blindly giving doses of insulin that would've killed my girl. The best decision I ever made was switching to the new vet, thankfully without it reaching the point you've reached, and I can't recommend them highly enough. I know others here would be happy to recommend vets to seek out (or avoid).

I hope Rudy continues to perk up and gain interest in food. It sounds like you're doing everything in your power to take the very best care of him. He's a fortunate little dude to have you fighting for him.
 
We had an extraction like that....
In Shadow's case, she had to re-learn how to eat. I actually took her pate and made little tiny lumps scattered across a big
plate. She had a very hard time picking them up without those fangs. It affected her psychologically to lose those teeth.

I would continue the bupenorphine but make the dose smaller.
You can get it down to 0.1 ml, the pain will make him not want to eat too. So it's better to have something on board to
help with the pain. And with that many extractions, he is in pain. They just hide it so well.

think outside the box of things he might be able to eat. white cheese.... a scrambled egg.... fried chicken ( take off the breading)
and break it into tiny tiny pieces
lunch meats

if he won't take any of those, then definitely start syringe feeding but i'd try to find anything he might eat himself.
 
He's eaten less than an ounce of food per day for the last 3 days and hasn't had any water in at least 2 days. I'm taking off work today to take him to the vet. He just vomited a ton of yellow bile this morning. Poor guy is trying, but it isn't enough.
 
Dumb question: Were post-dental x-rays done?
Sometimes a tiny fragment of bone or tooth is inadvertently "left in there" when there are extractions. This can fester and cause pain, inflammation, or even infection.

If you find it necessary to feed by syringe, here are some instructions, information, and a video I posted for someone else: Syringe feeding.
Using a blender to mix kitty's food (without adding water) into a "whipped" consistency allows kitty to lick small amounts of the mixture off your hand or even a plate or saucer held tilted to their mouth. I found this particularly helpful when you don't want to/can't insert an oral syringe into kitty's mouth.
 
I am not sure if they took any xrays after- not a dumb question at all! I finally spoke to the vet. I am giving him an appetitie stimulant pill and have to pick up an anti nausea medication. She is giving me some syringes to feed him with. I will check out that link because I have NO idea how to do that. I know he needs about 270 calories per day, but how much can I possibly feed him from a syringe? how much at one time and how often should I even do this? I am home with him today, but I am supposed to be at work all day tomorrow, so I'm not sure how to do this :-(
 
I know that new things can be really scary, Karen, especially when our little ones aren't doing so good. You will be able to syringe feed! Remember, once upon a time you didn't know how to home test or give Rudy insulin and you mastered those. :)

I hope that the appetite stimulant and anti-nausea meds will kick in soon and help Rudy get some much-needed grub on board.

(((Karen and Rudy)))

:bighug:
 
KarenBlasky said:
I know he needs about 270 calories per day, but how much can I possibly feed him from a syringe? how much at one time and how often should I even do this?
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Hey, you're one step ahead knowing about how many calories he should consume daily! Take that amount of food and mix it in a blender til you get a "whipped or thick smooth pudding-like" consistency. Fill your syringes. Ideally, you'll want to divide the number of syringes into meal times, but you may have to go slower in the beginning. FWIW, Alex would usually consume around three 10mL syringes in about 10 minutes = 4 times per day (food only --- no water mixed in). I would syringe 5mL water in-between each syringe filled with the food mixture.

Syringe feeding takes some getting used to... for both you and Rudy. Relax and do the best you can. If Rudy becomes irritated, stop and take a break. Be gentle. Talk, pet, and praise & encourage him. Go slowly. It's usually messy in the beginning, but that'll change.

You may not even have to consider syringe feeding once the meds are on board. Although, syringe feeding is always good to know.
You can do this! Just be patient and cut yourself (and Rudy) some slack. :D
 
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Thank you for all the support! I'm laughing hysterically at my first attempt as I am covered in food and so is Rudy...we both need a bath! I think he actually only ate about 2 ml...lol

I feel bad doing this with his mouth hurting so much, but this guy needs to eat. He hasn't had his joint meds in days and I can tell he is having a hard time walking and squatting too. I think the stimulant kicked in a little, he had wandered over to his food bowl prior to my syringe disaster and ate 1/4 ounce of minced chicken. He won't touch anything else I put out for him (gravy, baby food chicken, chicken pate). No water since 8:30 this morning either. I'll probably have to give him some in between the food as mentioned.
Thanks for the help! I would take him in to the vet if they were going to do anything different, but they said they would just give him the meds and syringe him, so I figure I'm better off doing that at home.
 
KarenBlasky said:
I'm laughing hysterically at my first attempt as I am covered in food and so is Rudy...we both need a bath! I think he actually only ate about 2 ml...lol
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Ha! Yep. Sounds about right. You just described my fist few attempts at syringe feeding! :D
Things will get better. He might lick a little off the top of your hand if he doesn't like the syringe in his mouth.

You'll have to see how things go, but I don't think I'd rest easy until post-dental x-rays have been done in the case of 7 extractions. I've seen quite a few kitties have problems after dentals when the vet hasn't taken x-rays. Mine takes both pre and post dental x-rays. He wants to make sure he knows what he's getting into as well as make sure he's gotten everything out when done.

Good luck and keep laughing/smiling!
 
KarenBlasky said:
I think the stimulant kicked in a little, he had wandered over to his food bowl prior to my syringe disaster and ate 1/4 ounce of minced chicken. He won't touch anything else I put out for him (gravy, baby food chicken, chicken pate). No water since 8:30 this morning either. I'll probably have to give him some in between the food as mentioned.
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Are you poaching the chicken in water, Karen? If yes, then save the poaching water and give him a couple of tablespoons with the minced chicken. The water's flavoured with the chicken. It might tempt him to drink a little. I was really worried about whether I could keep Saoirse hydrated while nursing her through her pancreatitis flare last year. She drank the broth readily. You can also use the broth to flavour water.

Glad you managed to have a little giggle over the food bath. :)

:bighug:
 
I didn't keep the water the first time. I will next time for sure! He isn't eating still on his own and he hasn't had any water since this morning. He isn't interested in food at all :-( I'm getting ready to blend up some puree stuff and force it down. Really wish he would do this the easy way. We gave him an anti nausea pill.

OK- before I could hit send he starting throwing up bile again :-( ugh...now I'm not sure if I should go ahead and give him the food or not. Can the vet offer anything that I'm not already doing? I feel that they are out of ideas. It's the same mean vet that he had his teeth out with since I haven't had time to find a new one yet.
 
Which anti-nausea and appetite stimulant meds were prescribed for Rudy?

If he threw up bile that might be because his tum is empty and he has too much stomach acid. Was it foamy liquid?
 
It wasn't foamy, just bright yellow like this morning :-(
He's on periactin 2 mg for appetite and Zofran 2mg for nausea
 
Your vets stiffed you for Zofran???!!! In the UK the branded drug is over ten times the price of the generic. Assuming that the manufacturer's pricing policies are similar in your neck of the woods, I'd suggest asking about generic ondansetron if you need a repeat Rx. It's a human drug so I'd imagine you'd be able to get the Rx filled at a regular pharmacy if your vets can't supply the generic themselves. (That's what our vets do for us.)

Ondansetron works well for Saoirse, as did cyproheptadine. What weight is Rudy? Keep an eye on him after giving him the cypro. It's an antihistamine and it can make kitties a bit groggy (and maybe a little deflated mood-wise) if the dose is too big. If the vomiting continues to be a problem it might be worth asking the vets about Cerenia for nausea. From what I've read here it seems to help some cats a bit more with nausea when vomiting is also an issue. It might also be worth asking about something for excess stomach acid (e.g. famotidine).
 
Critter Mom said:
Your vets stiffed you for Zofran???!!! In the UK the branded drug is over ten times the price of the generic. Assuming that the manufacturer's pricing policies are similar in your neck of the woods, I'd suggest asking about generic ondansetron if you need a repeat Rx. It's a human drug so I'd imagine you'd be able to get the Rx filled at a regular pharmacy if your vets can't supply the generic themselves. (That's what our vets do for us.)

Ondansetron works well for Saoirse, as did cyproheptadine. What weight is Rudy? Keep an eye on him after giving him the cypro. It's an antihistamine and it can make kitties a bit groggy (and maybe a little deflated mood-wise) if the dose is too big. If the vomiting continues to be a problem it might be worth asking the vets about Cerenia for nausea. From what I've read here it seems to help some cats a bit more with nausea when vomiting is also an issue. It might also be worth asking about something for excess stomach acid (e.g. famotidine).
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It was about $20.....I seriously need to find another vet in my spare time ;-)

I may end up asking for something else for the nausea- he just threw up again this morning. I hate seeing him this way! I have to go to work shortly and I'm going to be stressed the whole time thinking about him. I'm going to try and give him some food in a syringe before I go to hold him until I get back. Fingers crossed he eats on his own today!
 
Hey, just a question: Is he using the litterbox normally? Anesthesia can paralyze the bowel for a bit, and the opiate pain killer, and not eating on top of it can lead to some pretty significant constipation. If constipation is an issue, anti-emetics won't help until the constipation is resolved. If you aren't sure, a vet can do an x-ray to see if there is a large amount of stool he hasn't passed.
 
I had him at the vet yesterday for three hours. They said he was very sensitive to touch his lower abdomen area, but he has had normal stools until last night whey they turned runny. I have no idea what is going on. I regret having his teeth done because before then he seemed ok. now he is a mess, still won't eat on his own, lethargic, and now the runny stools. they gave him sub q fluids last night and i have to do it daily to try and help him. his bloodwork came back ok yesterday so they have no idea what is going on. I am just begging him to eat and he won't :-(
 
Runny stools can sometimes be an impaction where the loose stool is able to pass around the impaction. They'd be able to see impacted stool on an xray.
 
KarenBlasky said:
I had him at the vet yesterday for three hours. They said he was very sensitive to touch his lower abdomen area, but he has had normal stools until last night whey they turned runny. I have no idea what is going on. I regret having his teeth done because before then he seemed ok. now he is a mess, still won't eat on his own, lethargic, and now the runny stools. they gave him sub q fluids last night and i have to do it daily to try and help him. his bloodwork came back ok yesterday so they have no idea what is going on. I am just begging him to eat and he won't :-(
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Sorry Rudy's not feeling well, Karen. I know how much you love him and I understand your cause for concern. I'm praying this is just a temporary setback and that Rudy will soon get back to feeling much, much better. Sending hugs and prayers your way. :bighug:
 
Meya14 said:
Runny stools can sometimes be an impaction where the loose stool is able to pass around the impaction. They'd be able to see impacted stool on an xray.
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The only reason I'm not sure about that is because it was normal up until yesterday afternoon. could that have just been all of the stuff coming out before it was impacted? would anything at home help? miralax? or would an xray be the only thing to figure it out?
i'm trying to limit our office visits right now as i have been there 3 times in the last week and a half and my budget was blown days ago :-( but i will suck it up if that is what he needs.
 
I've never had to deal with impaction/constipation personally, so I don't know treatments, but I know there are a lot of people here that have and maybe could chime in. I would be careful with laxatives without knowing for sure because loose stools over time can impact electrolytes, so if it doesn't work quickly, I'd go back to the vet.
 
What colour were the runny stools, Karen, and were they smelly?

BTW, Saoirse went several days without any bowel motions after her dental (and she was on bupe). I got one of our vets to examine her to check for obstruction. Thankfully, there was no blockage and he prescribed liquid paraffin for her. I only gave her two tiny doses but it got things moving again (slightly loose stools at first).
 
There's a good article about fibre sources and constipation prevention on the felineconstipation.org site.
 
Sorry! It's been a crazy few days- I did take Rudy back in on Wednesday because of everything going on. They gave him a B12 shot and subQ fluids. They ran his blood and he actually wasn't too dehyraded and his kidney values weren't any worse than before his surgery. All good news. Poor guy really needed those fluids though-starting the next day he began eating food from his bowl again and I haven't had to hand feed him!!! I am soooooo happy!!!!!! I was able to start his joint meds again now that he is eating- he has been in a lot of pain :-( We are going to start insulin back up on Monday. All heading in the right direction.

Thank you all so much for your support and thoughts- I wouldn't have forgiven myself if that stupid dental surgery brought him down. It was because of all of you that it didn't, and I am forever grateful :-)
 
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