Advice Needed - Finn not Recovering Well from Dental

I finally scheduled Finn's dental and he went one week ago today and ended up having three extractions. They sent me home with buprenex for pain (five doses; Wednesday evening through Friday evening) and clindamycin (oral 0.8 ml 2x / day Thursday through Monday). At first he was eating but not as much as usual but these past few days he hardly eats (today he wouldn't eat at all so I skipped his am shot). He also has not been acting himself, laying in bed all day and looking generally unhappy. His blood glucose has also been high (400+ post-dental when he was 180-250 pre-dental)

I brought him to the vet yesterday and they said his mouth looks good, vitals are fine, but he had a fever. They gave him fluids, cerenia and Pepcid thinking nausea may be causing his loss of appetite and agreed not to rush to another antibiotic just yet since they cannot really see any sign of infection. When we got home from the vet he seemed better initially. He didn't go straight to bed but went and sat by the open door to bird watch, he looked alert and his old self, and ate quite a bit (compared to what he had been eating since his dental). But this morning he is back to bed and not eating.

I go back to the vet tonight to recheck his fever and don't know what to do from here. I imagine they are going to want to do another antibiotic round and will try to convince me to do convenia again but I worry about adverse reactions with that long acting a drug. The clindamycin was a bit hard to administer mainly because it was such a large volume. I worry that he is getting dehydrated (he has also had two urinary blockages - the last in 2014) and that not eating could impact his liver. I feel so terrible not knowing what to do for him. I had so hoped the dental would make things better not worse.

Any advise on what to look for / ask the vet when we go back tonight. Our appointment is at 4:30 EST. I was going to ask them to give him more fluids again because that did seem to make him feel better yesterday but other than that not sure what to do to help him.

 

Sounds like a post dental infection because fever usually = infection. Unfortunately an upset like this that leads to loss of appetite and dehydration can set the scene for ketone development. I hope your vet can make a treatment plan that helps.

 

If still a fever I would dry another antibiotic. Clindamycin is good for infections regarding the mouth (anaerobic bacteria) but your vet said he say no sign of an oral infection.

 

Be sure to have vet test for ketones.

 

What about liquid Cleocin AB?. All my kitties do well with it, they have no side affects from it. Dosed once a day.

Years ago I read a paper about ABs in general. Author stated diabetic cats should have longer than normal course. I asked my vet at the time about it. He agreed saying "that's why I give Smokey 3 weeks of ABs if he needs them".

When Olive had her dental no extractions, in July specialist scripted 14 days of AB.

 

Thanks all, we just got home. All tests and blood work are still looking good, they still don’t see any sign of infection and think his low grade fever might be stress/pain/inflammation induced. They did notice one of the suture sites a bit inflamed and think that might be the culprit to his not eating. More fluids and some pain meds, for now no antibiotics. Fingers crossed we get over this bump in the road soon! I feel so bad for him

 

I am worried about this happening next week when Mogee gets his dental.

You had responded to a post of mine where I asked about dentals etc..

Last week when Mogee got that tooth pulled they put him on Zydaclin aka Clindamycin. Within a day, he was not himself. He had diarrhea and just laid around for a day and a half before I called the vet and they told me to stop the antibiotic as he could be having a reaction to it. I know it messed with his stomach and he felt warm to me while on it as well.

I know ECID but just wanted to let you know my experience with the Clindamycin

 

Just throwing a thought out there...
You mentioned three extractions. Do you know if they took post dental x-rays? Sometimes a tiny fragment of tooth (broken off or missed) is left "in there" and causes inflammation, pain, and often infection. We've seen this happen more times than you'd think... to the point where I always ask for post-dental films any time there are extractions.

 

I asked that today as someone mentioned it in the Facebook group. They did donoist extraction X-rays sobthryre sure they got everything. It just looks like one of the extraction sites has had a suture issue causing inflammation

 

Thank you. At first I wondered if antibiotics were throwing his gut off. I tried adding some pumpkin to his food and at one point tried fortiflora since it supposedly is enticing but he still wouldn’t eat much. He just ate a bit now (his favorite dry Dr Elsey’s he gets at shot time but it’s better than nothing so I’ll take it for now especially since they just gave him fluids). Hopefully we get past this and back to routine soon

 

Oh I HATE clindamycin - believe it or not, they give it to humans, too - I had it! For the same thing! It made my right ankle swell, and it WASN'T sprained, strained, etc. but the nurse and doctor didn't care - they SWORE it was an injury, not a side affect (even though it was listed as such). The hell with that! If it's a pill, how much is your baby getting a day..?

Eating, drinking, sleeping, litter box - anything different, anything at all..? Beyond what you've said? Get your OWN thermometer - and lube, much better than the vet.

Listen, if you need your baby to eat - you CAN. Blend, blend, blend - with water until smooth. Won't lick on their own? Use your finger, hell I won't lie, Fena once wouldn't eat she felt so horrible so I smeared my own mouth and she ate THAT way - keep your baby eating/drinking.

That med is HARSH, keep your baby close to you. Seriously can you tell me the dose, per day..?

 

Hmmm, clindamycin is known to be the "go to" ab for oral infections. We've seen many of our cats, including mine, do very well on it. Alex did so well on it that she was able to take it when we decided to use pulse therapy for a recurring problem with gingivitis.

 

No antibiotics at this point, they ended Monday morning and my vet agrees this mild fever doesn’t look like infection and thinks stress / inflammation is the culprit so hasn’t pushed for more antibiotics. They did give him some pain meds today and fluids to hydrate. He did eat some of his Dr Elsey’s dry food a little while ago (he usually only gets this as a treat at shot time and LOVES it) so that tells me he’s not in pain or the dry food would hurt...maybe I’ll try offering him some alternative wet options. They did offer him his usual wellness wet post-op maybe he has a bad vet association...I’m at a loss as to why he won’t eat; he is usually a food hound

 

When Alex had oral problems I would use a blender to blend her food into a mousse like consistency. Just blend the food. Don't add any water when blending. Blend it well... probably longer than you think. Hold the plate up to Finn's mouth. The mousse like consistency will allow him to easily lick/lap it up and swallow. The mixture is also good for syringe feeding if you have to go that route.

Might be worth trying....

 

He ate his dry food this morning and I’ve given him some options of wet and he did eat a little! Enough to get his shot at least. His bg was 334 this morning which is still higher than ore-dental but lower than yesterday which was around 440. Hioefukkybthis is the start of a trend in the right direction!

 

Pre-Dinner blood glucose is 185!!!!!!! I could cry I’m so happy. I hope this means we’re on the mend

 

Wonderful! That's awesome!

 

That's great! Happy for you!