Dental Vet stress--Update: Perforated ear drum.

Bandit's been in remission for a bout 9 months--with the exception of an incident where he ate about a third of a pizza, his BG has never gone above 140. Yesterday he had two teeth pulled...the vet said that they came out difficult so he is probably experiencing more pain than he did last time when they were so far gone they came out easy. I didn't test him last night because I knew he would be high because of stress--but I just tested him today and he's at 279! I tested him before his dental yesterday and he was 120.

Can stress from a dental alone cause him to come out of remission? If this is temporary, how long does it typically take to clear? How long should I wait to start insulin again if it doesn't come down?

 

Re: Dental Vet stress--how long does it take to clear?

it could be some stress but it could also be pain. is he on any pain medicine? if not, i'd try to get some right away from the vet.

i would only expect higher numbers for maybe a couple days, if that. usually after a dental BG's will actually get better if there were bad teeth or infections that were taken care of. since he was already in remission i would expect those numbers again fairly soon i would think.

 

Re: Dental Vet stress--how long does it take to clear?

He's on buperenex--the liquid. I gave him a dose when we got home at 5 last night and another at 1 this afternoon. The instructions for the bupe say to give once a day.

It's already been almost 24 hours...so if he's still this high at this time tomorrow I should start him on insulin again in the PM?

 

Re: Dental Vet stress--how long does it take to clear?

i don't know that i'd start him on insulin right away moreso than call the vet and perhaps have them re-check his mouth, if he stays high, in case there's a complication. i'd probably get a re-check and if all seems fine, then perhaps consider a little help from the needle.

good on the bupe. glad to hear he's getting pain meds. wonder if the numbers could be influenced by the bupe too? like if he's feeling particularly drunk from that if maybe it causes some stress? hopefully more people chime in on this one

 

Re: Dental Vet stress--how long does it take to clear?

What dose of bupe are you giving and what is the strength of it?
if he is in pain, why wait 24hrs? I would think every 8-12 hrs is more like it... that's what I get on my bupe dose instructions.
I don't notice any increase BG on bupe with Shadoe

 

Re: Dental Vet stress--how long does it take to clear?

Each dose is .15ml. The box for the type of drug says: Buprenorphine HCL Injectable .3mg/ml. The Directions said give Once daily until gone, but I just got off the phone with the vet and she told me I can give it sooner than that--either 1am tonight or 7am tomorrow, depending on how I think he's doing. The problem is, I have no idea how much pain he's in. He just wants to lie in the same spot on the floor, except when it's meal time and he runs to the kitchen. I gave him the bupe early at lunch today because he acted like it hurt him to eat his food, even though he ate it all.

Last night he acted like he was drunk and today he's acting a little drunk but not as bad as yesterday. He had metacam last time so we didn't have the drunk side effect--he acted normal and pain-free within 12 hours of the dental. My vet stopped prescribing metacam for cats late last year.

He also had diarrhea this morning and my vet said she thought that could be stress related, too. I'm starting him on fortiflora tonight and if he has another loose stool she told me to come in and we'll switch his antibiotic from clindamycin to flagyl.

 

Re: Dental Vet stress--how long does it take to clear?

My cat, Kitty, had an extensive dental cleaning and 3 extractions 2 weeks ago.

She came home on Clindamycin. She had severe diarrhea two days after coming home followed by violent vomiting. We had to take her off of the Clindamycin after an ER trip.

 

Re: Dental Vet stress--how long does it take to clear?

How's he laid out on the floor - all stretched out or in a ball?
Also, I am glad you can give the bupe sooner, and let's hope the flagyl makes a diff; it worked well for my two.
Poor guy.. sounds like he sure has an appetite, but it hurts to eat, so hope the bupe can numb some of it.
Just wondering if any splinters left from the extracted teeth.... if they were difficult to remove, what's to say that there are not some splinters left behind.... did they do Xrays after the extraction to be sure all was done cleanly?

 

Re: Dental Vet stress--how long does it take to clear?

When my civie had his teeth out he got bupe twice a day, 20 minutes b4 a meal to give it time to absorb. I found that he preferred cool food the texture of appesauce - I just mashed it with a fork and added cold water. I don't recall the dose.

 

Re: Dental Vet stress--how long does it take to clear?

He alternates from laying stretched out to sitting with his legs underneath him. Both of these are normal ways for him to lay...he just doesn't do it all day long. He got up a few minutes ago, scratched at his scratching post, and stared intently at a moth on the other side of our glass door with his tail twitching.

Just tested again and he's at 284. :-( Thought maybe he'd gone down if he was acting a little less miserable.

I don't know if an xray was done--the vet didn't mention it. One wasn't on my bill so I'm assuming not. If there are splinters what to I watch out for to take him back in, and when should I do it?

 

Re: Dental Vet stress--how long does it take to clear?

Can you call the vet and ask about the possibility of splinters? I am not sure, but maybe someone else here has some ideas.
Also mention his having issue eating still - maybe you can take him in tomorrow and have them take a look-see.... maybe the vet will see what the problem is.

Shadoe had one extraction on her dental and was woozy but eating and moving around fine within hours of coming home. I had no issues with high numbers; hers were scary low.

He has no fever, right?

 

Re: Dental Vet stress--how long does it take to clear?

He's been eating fine, and I only noticed a problem at lunch today, where he was eating more slowly and left a few of the chunkier pieces of his food in the bowl. But it had been about 20 hours since his last dose of bupe. I gave it to him right after. I think I'm going to give his next dose 12 hours after the last one.

Fed him some baby food with water as a treat and he licked the bowl clean. i think I'm going to give him just EVO instead of Merricks (which has small chunks) until he heals. He ate his EVO venison with water without problem this morning.

Problem is, I work an hour away from my vet and i can't just up and take him in without having to miss an entire day of work. I stayed home today to keep an eye on him and my boss is not going to let me go two days. :-( I need to make sure there's a problem before I bring him, because I may not get the opportunity to bring him in again if something else is wrong. I spoke to my vet twice today and explained the situation and she wants to to wait a couple of days to see how he improves with the pain, diarrhea, and high BG, and call her Friday morning. She told me that she wants to see him on Monday if things aren't getting better. Is the splinters thing urgent where that wouldn't be an acceptable game plan?

 

Re: Dental Vet stress--how long does it take to clear?

He's not acting like he has a fever...no trembling. He does feel warm but it's warm today and I don't have air conditioning.

I'm afraid to take his temperature with all the stress he's been though. Is fever a sign of splinters? Is it a complication from extractions?

 

Re: Dental Vet stress--how long does it take to clear?

It sounds like he may be OK; I mentioned the splinters as it could be possible. They would be maybe in the gums still but make it painful to eat. If you give him the mush food with no lumps and it is going down fine, maybe he just needs rest and healing, yes?
Maybe some extra TLC from you will help him heal too.
I hope he keeps feeling better with time.

 

Bandit was at 200 at around 12:15am, and then 279 again this morning a few minutes after I gave him his pain medicine. He had two more loose stools last night, so I ran over to the vet and picked up the Flagyl, and he had that this morning instead of the Clindamycin.

So, I spoke to the vet again this morning and she told me that he had a small perforation in his eardrum when they cleaned his ears, and that is what is responsible for the head tilt and lack of balance, and that it will heal within the next couple weeks. I don't know if I should be angry or not...why didn't they mention this before when I brought him home? And is this sort of thing not a big deal or should I be up in arms? I have no idea.

 

deleted as response no longer appropriate to the situation

 

I just called my old vet and asked whether this sort of thing happened a lot or if they screwed up his ear cleaning, and she said without being there it's impossible to know. If there was was a problem with his ears like infection, or hard ball of wax, then it wouldn't be unusual. I know he didn't have an ear infection going in, but I suppose he could have had wax. I think I'm going to question my vet a bit more about it when I check in with her on monday, and see if I can find out why it happened. She brought it up so matter of factly that I didn't think to question until I got off the phone.

 

OK if his issues are actually due to the ear problem, maybe your vet could explain how it was not bothering him before the vet visit, AND if they noticed this problem before or even after cleaning, why was it not mentioned when you picked him up?

Seriously, did they hope that the harm they caused would not end in any noticeable issues and maybe they could just give some a/b and blame it on the dental?

I would definitely make the vet explain the problem, provide details of the healing and what precautions are needed, and most importantly get the reason for not mentioning the problem until issues surfaced.
Ask when the rupture was noticed - was it after the cleaning? Did the cleaning cause it? Is there an infection that contributed to the rupture in some way? Are the a/b to treat the rupture? How long does a rupture take to heal? What extra care do you need to take?

Ear cleaning is something that can be done most times at home, once the cat has been given a good cleaning.
I have to clean Ollie's left ear every few days because of the crazy wax he gets in that one ear; the right ear gets a few swipes once a week.

I would not let this issue slide. If they caused the rupture with the cleaning, I would expect the meds needed for any healing should be free and come with a huge apology.

I sure hope you see some improvement soon and the BG numbers drop.

 

The vet did make it clear that the perforation was caused as a result of the cleaning--but I didn't think to ask if there were any contributing factors, like ear wax. I am peeved that she's just told me when I mentioned the head tilting today--like they weren't going to tell me unless that symptom presented itself.

 

And did any of the debris get pushed into the middle ear? That could really wreak havoc with the poor little guy's balance!

 

Ugh. This is making me really upset. I'm calling her back today.

 

Yes, call back with Gayle's list of questions.

to be honest, I never thought about wax in a cat's ears before!

 

Do some searches online for info on these tears.
I would want the vet to cover all costs for repair if needed, plus all meds:

Expected Duration
Most perforated eardrums heal in a few weeks. Some take up to two months. Exposure to water or further trauma can slow the healing. Larger tears, or tears that do not heal on their own, may require surgery.

Find what needs to be done and then tell your vet that all treatments and costs for this repair will be absorbed by the vet. I don't think much of a vet that could let a known problem go unmentioned. I wonder if the vet is knowledgeable enough to even know what needs to be done.

 

I've been searching. Apparently, Bandit had Horner's Syndrome when he got home, what I thought was him recovering from the anesthesia where one eye was bigger than the other and his third eyelid was showing, was actually from the eardrum thing. He can't walk in a straight line, and I thought it was from the Bupe but now I know it's not. I'm freaking out. My vet better call me back soon...

 

If you have all your info in front of you, don't wait for the call back; try calling yourself.

Me; my vet office don't like to see me show up. I would go to the vet office, take a seat and state I would wait to talk to the vet. Their office is just a couple blocks away. I have already started with a new vet to see if they are better.

If you call now, ask for a time to expect a callback to discuss this damage that was caused by the vet office.
If it's 2-230pm, be sure to call back at 231pm to ask what's going on....tell them your poor cat can't walk because of their damaging his ear drum.

Once you have a plan for recovery, and treatment info, then it's less stressful.
While you are waiting for the call, keep jotting down all the questions you have, then ask each one on the phone and write down the answer you get.

 

I already called them, and my vet had stepped out and is supposed to call me back when she's free today. I have a list of questions sitting right near my phone. I also called my emergency vet and explained the situation and I'm waiting for the vet there to call me and share their thoughts on the matter with me.

 

Just heard back from my emergency vet, who basically repeated what my old vet said, which was it's uncommon for it to happen, but it can happen during cleaning without any negligence on the part of the vet. She did tell me what everyone is saying here, that I should call and question my vet on why I wasn't told about it until today since that was not good practice.

 

I still agree that they should have told you earlier, but I am glad that your old vet provided some comfort that your current vet didn't necessarily do anything wrong when cleaning the ear. Jumping to conclusions of malpractice is always stressful for everyone... :lol:

 

Finally heard back from the vet. When I asked why I wasn't told about this, she told me I was told by the vet tech who checked me out. Which is not true. When I said no, I wasn't even told his ears were cleaned, she apologized and said I should have been told about it. She also said they weren't positive his eardrum was punctured--she said he wasn't letting anyone touch him and was biting after he woke from the anesthesia. I'm still angry, but I don't know how angry I should be, and who I should be angry with. Grrrr. All I can do now is watch him and hope he recovers. It can take anywhere between 2 weeks to months and I have to watch him all this time to make sure he doesn't stop moving or eating. My poor guy.

 

Did your vet tell you how it is treated or what precautions to take? If your vet is not even sure, then how about if the vet checks? Info I can find talks about treatment and then ways to check if the eardrum has been damaged.

Symptoms of Inner Ear Infections in Cats
The inner ear infection may cause the penetration of the ear drum and the cat will be in a lot of pain. The cat will be pawing or scratching his ears. One or both ears may be affected.
There will also be an ear discharge which can be of various consistency or color (depending on the cause of infection), but will have a foul odor.

The interior of the ears will be red and irritated. The cat will be tilting his head toward the affected ear.
If the ear drums are perforated, the cat's hearing may be affected, so your cat may not be responsive to different noises or when you call him.
If the infection is severe, you may also notice neurological symptoms such as ataxia and confusion. You may also notice that the cat's pupils are unevenly dilated (Horner's syndrome).

Inner Ear Infection Diagnosis

The diagnosis can be performed by a vet with an otoscope that is essential, helping to establish if the ear drum is intact. If the ear drum is perforated, an x-ray is also necessary, as the vet needs to see if other areas are affected.

The vet may also analyze the discharge to establish if there is an infection present.
The cat may not allow the vet to check his ears, due to the pain, so the vet may need to use anesthetics to be able to perform the consultation.

Treatment of Feline Inner Ear Infection
If the ear drum is intact, the ear should be cleaned and then a few ear drops will be administrated on a daily basis until the infection clears (may take up to 4 weeks). The ear drops may contain antibiotics or steroids, which will remove the infection and will relive the pain.

If the ear drum is perforated, the vet may hospitalize the cat, as special treatment will be needed. The vet will establish the best course of treatment depending on the complications and the symptoms displayed by the cat.

If left untreated, the inner ear infection may cause the closing of the ear canal, which can only be fixed through surgery.

Maybe you can tell your vet that you would like to have his ear checked to find out for sure the condition.
Hopefully he'll get better soon.

 

The ear isn't infected at all, and he's already taking antibiotics for the dental. The vet told me that it should heal on its own, and I need to bring him in right away if he stops moving or eating. So there's really nothing I can do but wait and hope it heals sooner than later. The emergency vet said the same thing.

 

sometimes things happen despite best efforts and intentions. Perhaps this is one of those times? The lack of communication and associated distrust on your end is understandable, but if you like this vet and this clinic, hopefully they will do better next time and you can have faith in their ability to treat your pet (s).