Feline Trigeminal Nerve Damaged When Aggressively Intubated

Bette Sees Dentist Who Rules Jaw Issues are Likely Trigeminal Nerve Damage  

From Aggressive Jaw Opening When Intubated

I know it looks scary that her tongue is hanging out. But the photo from last Wednesday when I took her to the ER and her tongue was really hanging out and her mouth was really wide open and she was breathing hard is scarier. 

But we saw her dentist today and he observed and checked her and he said that she is actually doing much better than what I described that she was doing a week ago and then last Saturday and last Wednesday at the ER. She’s no longer holding her mouth all the way open, she’s no longer sticking her tongue all the way out, not moving it. She’s able to close her jaw even if it is somewhat still open. She can move her tongue which he said is a good sign even if it still hangs out a wee little bit. He believes that someone once, or more than once got aggressive, not in a mean way, but in a “they aren’t paying attention” way when they opened up her mouth, opened her jaw wide for intubation. That damaged or inflamed her trigeminal nerve. It’s a nerve that connects throughout the face, the jaw, the eyes as in the outside of the eyes not the optic nerves. That is why he suspects her right eye is not responding, that’s why she was drooling, had open mouth, her tongue sticking out while she was swallowing hard a few days ago. He believes that she’s on the mend. He said to give it another 7 to 10 days. If after 10 days it hasn’t completely improved then maybe something else needs to be done but right now he thinks she’s on the mend. She may not be perfectly healed, because once the damage is done, depending on how severe it is, it may not heal all the way. He said he doesn’t think there’s a reason to get an urgent MRI either. And don’t intubate her for the next two weeks. Just let her rest. So we will not go ahead with the last two radiation treatments. We do have to see them and go over whatever. But we’re going to skip the last two treatments so that she’s not intubated and I called her neurologist, and I said we will no longer need an urgent MRI but we would like to get one sooner than the one that we have five weeks from now if possible. So we are back to at least she’s no longer drooling. That is a major improvement over this this past week and she’s able to not drool and spit out her food or medications. Now we just need to eventually get her to eat on her own, and hopefully that will happen when she’s more comfortable, licking or chewing and swallowing more solid food. So better news, good news, etc.

He also gave her a shot of the antibiotic Convenia. He suspects that there’s an infection and given that she supposedly had a UTI and then her radiologist said she didn’t he suspects, she probably did, and Zenequin can be too strong. It gets the job done but it’s too strong and so he said Convenia is nice and slow and quiet will work its way through a system and fight off anything.

Bette at home, head on counter.

Bette May 9 before ER-mouth hung open, tongue out, fast breathing.

 

Elizabeth Still Has Difficulty Chewing After Dental Surgery

In March Elizabeth (does not have HCM) had dental surgery to remove what was left of a resorption tooth root that for two years has not disappeared. The vet had also sewed up the pockets of gum around her canines-bucal bone-to keep out material that could lead to infection and deterioration of the bone and teeth. 

BUT she continued to chew with pain as observed by chewing on the side of her mouth, tilting her head, nashing her teeth, etc. So, we went back last week to the dentist who removed what was left of the surprisingly unresorbed sutures and saw she had gum irritation along the surgery site. He gave her a shot of Cerenia-an antibiotic-and said to give her another in two weeks. By the next day, she was chewing normally again.

If your cat is chewing funny, they will need xrays, a dental cleaning, and possibly surgery. All cats should see a cardiologist for an ultrasound of the heart to determine if the cat can undergo anesthesia safely before ANY type of surgery even if they have had one in the last year because anesthesia can cause major life threatening complications. And heart disease can suddenly appear from one year to the next. 

And if you think there is still irritation of the teeth post-op, trust your gut and take the cat back to the dentist for a recheck. You are likely correct about what you are seeing.  As with everything with your pets, if you think something is wrong, likely it is so take the cat to a vet. 

HCM cats CANNOT have surgery because they cannot have anesthesia because it lowers the heart rate and that can lead to stress and CHF and increased complications. If an HCM cat needs surgery that cannot be avoided, careful discussion and a plan around managing the HCM condition and possible complications must be made, with a plan to save the life as needed, and close recovery monitoring post-op at a hospital for a day or so, and further close and careful monitoring at home.