Update
Hi everyone,
Pancake seems to be doing well after GA. I've been feeding him LL and CC on top of his pellets and hay to make sure he is ok. Just letting him eat whatever he wants and not forcefeeding him. I do have metacam on hand as well just in case.
Today at the vet he got his head xrays done, and the tear duct flush was not performed because they could not find the duct opening. None of his teeth had spurs. His x-ray did show that the roots of his teeth in his upper jaw are longer than usual; its considered mild but there. It would explain his tearing eye and not eating as much as before. However, the vet doesn't know if he was born like this or it eventually got this way.
Treatment right now is to monitor him and see if it worsens. I'm looking for "rougher" hay to add to the timothy hay to possibly wear his teeth down a little more. Is there anything out there?
Also, a last resort that the vet suggested that they can do is to pull the teeth out (top and corresponding bottom). That sounds extreme....has anyone done that?