I was thinking of my teeth and mouth and I have a sensitive nerve, which is sometimes aggravated, when I chew something too hard myself. Is not seen on x-ray, but when described to my dentist, he said this can happen, like a sinus area near the tooth.
My Candy who passed from nasal carcinoma that had metastasized to her bones in her skull, had some issues with her teeth before we discovered the cancer. She would also not eat crunchy things sometimes, and her breath became bad. She did have a tooth pulled and teeth cleaned. Once we put all the symptoms together, including her nosebleeds, there was not a lot to be done for her, as her x-rays indicated. Her cancer was so extensive, surgery was not an option. We kept her as comfortable as possible. I miss my girl.
I would ask about the gabapentin vs galliprant and feed your dog softer food items if that works out ok for him. You and your vet know his history better than I would, but just though to mention in case.
Wish you the best with him.
