Orofacial pain in burmese

RE: Orofacial pain in burmese

Peter Southerden — Tue, 17 May 2016 18:33:29 GMT

We see lots of these cats. Initially we stabilise them - often on gabapentin + meloxicam + oral buprenorphine + amantidine. Ketamine infusion is a very good idea initially and is commonly used in OFPS in people.

We work them up thoroughly to look for trigger factors - oral/dental disease, otitis media etc but need to be really convinced that any pathology is significant before surgery as the surgery will often destabilise them. We also want their pain to be well controlled and the cat stable before surgery.

It's also worth looking at environmental factors - stress/anxiety etc and minimising this.

Famvir is interesting and not something I have used. Herpes does affect the Trigeminal nerve and therefore a viral neuritis is possible (cant believe Ive never considered it!).

RE: Orofacial pain in burmese

Richard Carter — Thu, 12 May 2016 13:21:28 GMT

Have a highly pedigree burmese which had the oro-facial pain syndrome as a kitten and then I recently changed food with cat now a 10 year old and sudden, very severe attack with mutilation, screaming, throwing himself around clawing at mouth etc. GA (triple so had some ketamine) and some premolars removed but apart from the traumatic damage to the lips and gums, wouldn't have said it was teeth, more a neuritis humans get with tooth-ache. None of the painkillers (oral and injected vetergesic/ methadone/ preds) seemed to do very much and after 2 days (and back on old food) stopped. Trigger unknown - allergic? but then why the poor response to dex/preds?

RE: Orofacial pain in burmese

Roland Bulkyn-Rackowe — Thu, 12 May 2016 09:40:03 GMT

I've had a couple of burmese with crazy self mutilation, one oral, one the tail. Both had surgical procedures to address the potential trigger (FORL, abdominal wall rupture), both continued to self mutilate post operatively. I hospitalised them on ketamine infusions (very low dose) + NSAID + opiate and elizabethan collars for 2-4 days. The details were hazy as these were probably both over 10 years ago. Both resolved so I was very lucky.

I've used something similar for "fitting" guinea pigs where their mange is unbearably itchy.

RE: Orofacial pain in burmese

Anthony Todd — Wed, 11 May 2016 08:39:24 GMT

Never seen it ever so asked Dr Google which may save time.

http://www.fitzpatrickreferrals.co.uk/neurology/feline-orofacial-pain-syndrome-fops/

It's not something even a steroid obsessive dinovet could have missed so interesting, to me, that it has suddenly[?] appeared.

Sounds a bit like the "fly-catcher" syndrome in KC Spaniels???? but much more traumatic???

Is it inherited?

PS I seem to remember Tegretol was suggested for "flycatchers", so may be worth a try; less sedating, as I recall.

RE: Orofacial pain in burmese

Aine Seavers — Wed, 11 May 2016 01:12:50 GMT

phenobarb crushed in food is fine.Start with 5mg/kg bid of phenobarb-cat will be sedated then reduce the dose- this is what Richard Malik advises

anything that causes pain in the mouth can trigger it – commonly teething, then they get over it – then later another trigger happens – Herpes is possible trigger, but not likely to explain BREED predisposition

However, there is a sub set of these that will respond to Famvir-even tho the gene chip works suggests the genetic link, certainly some USA specialists find Famvir works.

Famvir very safe but expensive and now the pharmacokenetics known as a rate dependant prodrug with dose sautration-no point using the higher doses-30-40mg/kg bid -may have to end up on some pulse therapy effect.

also-much as I am not a lover of the blatent blanket use of Apoquel- give pain and pruritis very close and hard to d/d esp in the cat-I did wonder about apoquel in these cases-but hold off using it for the moment as that last thought very left field and I need to chat with some feline spec mates about that before even I would think of using it.

RE: Orofacial pain in burmese

Laurence Webb — Tue, 10 May 2016 21:18:19 GMT

If Amitryptilline helped but tableting was a problem could you powder it then suspend it in OraPlus or Xanthan gum and syringe it it?

RE: Orofacial pain in burmese

Jenny Boyd — Tue, 10 May 2016 20:53:12 GMT

If phenobarb hasn't worked and you are pretty convinced it's feline oro facial pain syndrome I would try and contact Claire Rusbridge at Fitzpatrick referrals for advice. If you google her name and feline oro facial pain syndrome she has written an info sheet on the condition with various protocols for management- I think it sounds like you have tried them all but you can double check and if so give her a call?

RE: Orofacial pain in burmese

Thomas Johnson — Tue, 10 May 2016 18:35:28 GMT

[quote user="dachsie_4"]

forgot to mention epiphen, did not work and cat was too drowsy to safely go out, Had guessed that I have reached a dead end and need some magic.....

[/quote]

Would there be any benefit to trying levetiracetam (Keppra)?

RE: Orofacial pain in burmese

dachsie_4 — Tue, 10 May 2016 17:59:56 GMT

forgot to mention epiphen, did not work and cat was too drowsy to safely go out, Had guessed that I have reached a dead end and need some magic.....

MOnika

RE: Orofacial pain in burmese

Thomas Johnson — Tue, 10 May 2016 15:31:35 GMT

[quote user="Kate Richardson"]

I used phenobarbitone successfully in one cat. I have a feeling it may be available in a liquid form as well which may help if the cat is difficult to tablet.

[/quote]

It is, Epiphen Oral Solution:

http://www.noahcompendium.co.uk/Vetoquinol_UK_Ltd/Epiphen_Solution_4_ACU-_w_v_Oral_Drops/-31889.html

RE: Orofacial pain in burmese

Martin Atkinson — Tue, 10 May 2016 14:29:14 GMT

[quote user="Kate Richardson"]I used phenobarbitone successfully in one cat. [/quote]I misread that as pentobarbitone but it could be a prophetic mistake!

RE: Orofacial pain in burmese

Kate Richardson — Tue, 10 May 2016 13:09:35 GMT

I used phenobarbitone successfully in one cat. I have a feeling it may be available in a liquid form as well which may help if the cat is difficult to tablet.