Cat has pain when eating - vet puzzled

[Ash]

Hello Traci!

Im once more writing on behalf of a German friend who has a problem with her male cat, 5 years old. The vet is puzzled. Maybe you have an idea what to look for, where to search to get to a diagnosis.

This is what happens:

For the past two weeks the cat seems to be in pain every time he tries to eat. He screams out as soon as the food touches the very front of his mouth, he doesn't even take any food in.

She already went three times to her vet. The cat was thouroughly examined, there are no visible injuries or abcesses in the mouth, the teeth are fine, he even was x rayed but it showed nothing abnormal.

The vet prescribed a pain killer and the cat started eating again. But as soon as the pain killers were stopped he again screamed in pain when the food touches his lips and stopped eating.

They are lost. Do you have any idea what could be bothering him? My friend's idea was maybe there's a thorn in his lips?

He drinks normally.

Thank you!

Ash

[Traci]

See a new vet? My first guess is bad teeth, and I hope the vet is experienced in looking for dental problems?! The mouth should be thoroughly evaluated, all of the teeth should be checked (back molars are often overlooked), lesions or ulcers outside or inside the mouth should be looked for. The tongue should also be checked for signs of inflammation, lesions, etc.

Was kitty vomiting? Is he deyhdrated? If vomitng and dehydration are present, the cat may refuse food because he is associating it with vomiting, etc.

I'd strongly suggest getting full bloodwork done and a comprehensive oral exam, this would require anesthesia so the vet could check all the teeth and look for lesions, etc. Since this has gone on for two weeks, there is no time to waste, tell your friend to see a more qualifed vet immediately.

[Ash]

The cat had a very thourough exam, so she says. The vet found nothing wrong with his teeth. What puzzles everybody is that he seems to be in pain immediately when the food touches his lips, he isn't even taking anything in and chewing, so they don't think it's the teeth.

No, he's not dehydrated. He's drinking normally.

I don't know if he vomitted.

[Traci]

This is where a second opinion with another vet becomes necessary. Whenever pain is involved and the vet cannot determine it's source, he should refer the client to a more experienced, knowledgeable vet.

Bloodwork is essential, it may show an inflammatory condition going on, if it does, then it's probably obvious there is inflammation somewhere and the vet needs to find out where. Kitty hasn't eaten his normal amounts for two weeks, yet he isn't dehydrated? I'm not sure I can believe that. Even if he isn't dehydrated, he may soon be, or may soon develop liver problems as a result of poor nutition. The teeth should probably be further evaluated (under anesthesia) and lesions ruled out, this should include looking at teeth, gums, tongue, mouth tissues, throat, etc...at that point, fluid samples could also be taken to rule out bacterial or viral infections. Bloodwork can help detect major organ disfunction as well, that may be leading to this symptom (any major organ disfunction can cause secondary bacterial infections and/or inflammatory response, these need to be ruled out).

New vet, new oral exam (including throat), full bloodwork. I strongly advise bloodwork first before subjecting kitty to an anesthetic. Your friend's vet is obviously missing something, she needs to see a new vet ASAP.

BTW, what food is she feeding him? Was the food recently changed? If it was dry food, did she attempt canned? What were the vet's recommendation on the diet?

[Ash]

Thanks Traci!

She just wrote that he was anestethiced for the first examination and x rays. Teeth on the x ray all look okay and nothing could be found in the mouth.

I translated all you said for her.

She will get his bloodwork done and another examination. They are going to the vet again today, hopefully they find out what it is.

[Ash]

I don't know what she feeds him. I don't think they changed it ... she was also thinking of an allergic reaction ... is that what you're thinking of?

[Traci]

Maybe allergen or toxin, but if that were the case, lesions would probably show up as a result. The vet may need to further investigate for bacterial or viral infections...i.e., calicivirus, chlamydia, etc....lesions may be found elsewhere, like the throat, esophagus, etc. A cytology sample would probably be a good idea.

[Ash]

Ok, I will tell her all that.

Thank you for your help!

[KB]

What seems strange to me if it is happening the way you describe, the kitty is not even getting past the point of smelling the food. Have they check his nose, nasal cavity, etc. also have her/vet check his whiskers, he may have a stubby by his mouth that is causing him pain when touched by eating, but not effected when drinking as they skim the water when drinking and go nose first when eating.

[Ash]

Hi KB!

Yes, thats precisely what everyone was wondering about since he didnt even attempt to chew anything.

Well, but they found out what it was. He was x rayed again and it showed nothing. Then he was put under anastetic and the vet examined him again thouroughly and finally found a diseased tooth - when he opened it the pus came flooding out! The tooth was pulled and the cat is recovering now and doing well.

So Tracis first guess was right. They will of course watch him closely now and hope that this tooth was the only thing that bothered him.

Thanks again for your help!

Ash