Cow Mau’s updates

Cow Mau’s mouth pain came back about half a day after the first laser therapy.

Since then, I have been syringe-feeding him diluted or liquid food. But even blended diluted food hurts his mouth with every mouthful.

This is the Japanese liquid food that is suitable for CKD and heart patients. The powder is very fine, so it blends into a liquid without much residue. When I fed Cow Mau this afternoon, he seemed to be able to tolerate it much better than any other food. The pawing is still there, just less when eating this food compared to the rest of the foods.

I’ve brought forward the 2nd laser appointment to be much earlier.

Here’s a journaled article about laser treatment for gingivostomatitis in cats: https://www.asalaser.com/sites/default/files/ricerca/documenti/nir_laser_therapy_feline_stomatitis.pdf

In heavily-jargoned articles, I usually read the abstract and the conclusion, unless there are specific details I wish to know!

Here’s what it says in the conclusion:

In the management of FCGS, laser therapy has shown the
following clinical advantages:
• Easy application: in the protocols used in this study, the timing
of application is reduced to a few seconds and the number of
sessions is limited; these factors favor cooperation of patients and
full acceptance by owners.
• No known side effects.
• Virtually instantaneous analgesic effect.
• It can be used as exclusive or complementary treatment of the
disease. Moreover, it can be used to control pain when scheduling
surgery (extraction of all the premolars and molars, etc.).
• Full compatibility with other therapeutic treatments in progress.
The limit of this study is the small number of patients and a follow
up limited to a few months. Therefore, at this preliminary stage of
research, it is not possible to predict if FCGS can be completely
controlled or healed by laser therapy.
However, from a clinical point of view, the most part of subjects
undergoing laser therapy, even if with different response times,
showed an improvement of the symptoms and, in particular, a better
food intake, less pain during the yawn and increased licking of the
mantle.
The present results support the need to extend the study, involving
a higher number of patients, and to explore further laser irradiation
modes in order to develop more effective therapeutic protocols.

For Cow Mau, there was definitely an instantaneous analgesic (pain relief) effect, but the mouth pain came back after half a day. So I guess more therapies would be needed for the gradual healing. Laser therapy uses light frequency to heal.

Cow Mau likes to sit in the sun in the mornings when it isn’t too hot yet. Sunshine is healing.

There were two thunderstorms last night so I brought him in with us.

Right now, I’ve been advised that we can increase his transdermal Gabapentin to 0.25ml twice a day and transdermal Tramadol to 0.2ml three times a day.

There are two NSAID anti-inflammatory products, namely, Meloxicam and Onsior (Robenacoxib). Between the two, the vet says Onsior is safer. We have not started on these yet.

Then, there’s also the Fentanyl patch which we could consider.

One thing at a time, we will try the increased Gabapentin and Tramadol first.

Strangely, the oral Tramadol didn’t work as well as the transdermal. I did wonder if it is because Cow Mau’s absorption isn’t as good anymore. In general, the oral drug is supposed to work better than the transdermal one and the vet also told me that oral Tramadol works better.

Maybe this explains it:

Transdermal drug delivery leads direct access to the systemic circulation through the skin which bypass drug from the hepatic first pass metabolism leading to increase bioavailability. Because Tramadol hydrochloride has low bioavailability, it was selected as a model drug.


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