cats tooth extraction and resulting infection

Question
Cat = 11 year old n-male in excellent health. Grade I teeth were cleaned two weeks ago. Canine tooth with lesion was extracted, no antibiotic prescribed. One week check-up showed mild infection,CET topical was prescribed. Week 2 check, infection worse, food in socket was not fully irrigated and removed.

Clindamycin was prescribed.  Minimum effective therapeudic dose says 5 mg/kg/day but vets prescrip is at 3.5 mg/kg/day (cat is 14.5 lbs). Is this a problem?

What is your opinion on my vets course of therapy after tooth extraction? I'm not happy with it. I understand issues with antibiotics, but I think it should have been prescribed after oral surgery.  We should be done with this by now.

Thanks, Keith

Answer
Hi Keith

I generally put all patients on antibiotics after teeth have been extracted.  My one colleague is more lax and often does not use antibiotics when one or two teeth are pulled.  If the animal has severe dental disease, I will put them on antibiotics BEFORE and after a dental procedure.  Doses for antibiotics vary....Clindamycin and Clavamox are the 2 best antibiotics for oral infections.  If a pet is in between dosing weights with pills, I would rather underdose a bit than overdose for fear of inappetance and vomting and diarrhea.  

Unfortunately when canine teeth are extracted it is easier for get food impacted in there but it is not always easy to close the hole with a suture.  And with or without antibiotics the socket could have got food in it and secondarily infected just from foreign matter and irritation.  I would recommend that you flush the socket with saline at home once or twice a day as it is not quite as thick as the CET and are more likely to be able to dislodge food particles.  Sometimes I will pack the socket with Gelfoam--maybe you could ask your vet about putting some of that in there after irrigation.

You can also give CoQ10 to assist with healing...10 mg daily as well as Ester C...100 mg twice a day.

I would encourage you to talk to your vet and tell him/her that you are unhappy.

Best wishes,
Dr. Fry