allpetsdr : Hi, this is Dr M and I will try to assist you today.
allpetsdr : When did he have his dental?
allpetsdr : Did he have any extractions?
yes he had extractions
allpetsdr : Have much food is he currently eating?
allpetsdr : Is he on any medications? Like pain medication or antibiotics.
he ate 1 can on Sunday...1/2 can yesterday...and 3/4 of a can so far today
yes he is currently on clavaseptin which I am thinking is quite possibly making him nauseated
allpetsdr : Is he in any pain reliever? When did he have his dental?
we got some pain reliever yesterday...they didn't send it home with him initially
allpetsdr : The bottom line to prevent fatty liver disease is to continue eating. As long as they are getting some calories in, the chances are smaller. Over weight cats are more prone to it.
allpetsdr : What type of pain medications is it?
he is definitely not overweight
allpetsdr : Good!
allpetsdr : It seems he had a bad dental disease. With that say and the fact he just stared pain medication, he should start to improve.
allpetsdr : This is what I would do,
he has had extractions twice before...but recovered much faster last time
allpetsdr : Continue with the medications as directed. The pain medication is very important here.
allpetsdr : He is older now and every time is different, different disease and different extractions.
allpetsdr : Keep offering food, small meals more often.
what about the antibiotic - any chance he can go off it? it seems to make him so nauseated
i've read that in most cases they don't even need antibiotic after dental surgery
allpetsdr : Are you offering any dry or just can food? Can food would be better considering that he had extractions. The only thing with can food is that it spoils fast and it should be a room temperature or warmer before offering it.
allpetsdr : No, that is not true. Most times antibiotics should be given even before the procedure.
we are giving him canned food - Hills a/d right now
allpetsdr : Your doctor should make that decision. After a dental, there are a
allpetsdr : A lot of bacteria that moves around. This increases the chances for bacteria to reach important organs like kidney or heart.
allpetsdr : You should continue with the a/d. Have you tried other cat can food, like frisky's?
It feels like we are kind of caught between a rock and hard place...if we give him the antibiotic he gets nauseated and is lethargic and doesn't eat well...if we take him off it sounds like he could get an infection...he had the surgery saturday late afternoon, so at what point would you be concerned that he isn't back to normal?
allpetsdr : Some cats may take other cat's food better because of their smelt.
allpetsdr : I usually say 2-3 days post-op is normal. Now, you should start counting this from the time you started your pain medication.
allpetsdr : Pain medication is very important here. When something hurts, nerves become more sensitive and pain sensation increases.
sorry I'm confused by that last statement - start counting from the time you started your pain medication...shouldn't he improve with or without the pain medication (the vet didn't even send us home with any), also I was told that the pain medication will probably also make him sleepy so we just started to give it to him last nigh
allpetsdr : You should call tomorrow your vet about your concers regarding the antibiotic. In most cases, it is not the antibiotic though.
allpetsdr : With the pain medication. Think about this, how will you feel if your dentist works on your mouth for 1 hour, and pulls some teeth. To me, every patient that has extractions should go with pain medication. At least to give them the benefit of the doubt.
oh i totally agree, I wouldn't want to be without pain meds but shouldn't he be getting better with or without the pain meds?
allpetsdr : Most of the times, the decrease of appetite after a surgery is due to a combination of factors. The anesthesia, the pain induced during the procedure and the combination of medications to go home.
allpetsdr : Unfortunately, a cat or dog would not tell us what is. The first thing to think about is, in my opinion, pain. That is why I said "from the moment you started pain medication". There are many studies that have proven that recovery is faster when pain relief is provided vs. no pain relief provided.
allpetsdr : This is what I would do:
allpetsdr : 1) because of your reasonable concern about over medication, I will contact your vet tomorrow to see if the antibiotics should be stop. Your vet did the dental so he/she know for how she wanted your cat to be on.
okay...two last things...is there any risk to taking him off the antibiotics for a day to see if his appetite improves? Also - he hasn't had a bowel movement in at least 5 days - reason for concern? Bearing in mind he hasn't eaten much either
allpetsdr : 2) continue with the pain medication for now. I usually do 3-5 days depending on how bad they may be feeling. The medication may cause mild sedation. If the decrease of appetite is due to pain, increase food consumption may happen about 1 hour for the medication. That is probably at its peak and beginning of its action. Butorphanol in cats tend to last 6-8 hours, but we usually prescribed it to be given every 12 hours to avoid over medication.
did you mean increased food consumption may happen about 1 hour after the medication is given?
allpetsdr : Anesthesia would delay gi transit. If he has not vomit, then it is probably be still ok. As constipation occurs, there is vomiting. In a case like yours I would start him on a laxative at this time. I don't worry about defecation for the first three days, but this is now 5.
allpetsdr : It should, soon after the medication is given instead of as the medication wears off.
allpetsdr : I said gi transit, sorry, this referred to gastrointestinal transit!
allpetsdr : As per your second question, I would not stop the antibiotic without checking with your veterinarian first. When antibiotics are stopped, resistant bacterial can be selected and the antibiotic may lose its efficacy.
okay I want to let you go but just want to clarify - if the buprenex makes him sleepy - how would that make him want to eat?
allpetsdr : Because of the pain relief action. Unless he gets really sleepy from it, this should be the effect. Most cats only show mild,sedation for the first hour or so.
allpetsdr : I wil clarify again,... I was saying that unless he gets very sleepy from the medication, the pain relief action should make him feel better and improve his appetite.
okay thanks for all your help
allpetsdr : After what you said about him not going to the bathroom, I would worry that he may be mildly constipated. This can affect also his appetite as he may feels full.
allpetsdr : So, please consider the option and mention him about this fact. He may gives you some laxative then.
allpetsdr : Did I answer all your questions?
allpetsdr : I will switch now to question-answer mode. You should be able to get back to me, if you have any other question. To finish now, if you were my client, as your primary vet, I would recommend you a recheck appointment to make sure that the extraction sites are healing well, to asses constipation and to make sure there is not fever.