#stomatitis

[always-a-fairycat]

Donate to Save Sassy: Urgent Dental Surgery, organized by Rachael Tresler

Hi guys! This isn't a typical thing for me, but after being turned down for care cre… Rachael Tresler needs your support for Save Sassy: Urg

My friend @last-laments has a cat, Sassy, who has been diagnosed with stomatitis, an autoimmune disease. Her body is attacking her teeth, so she will need most if not all of her teeth pulled. This surgery alone will cost around $1150. She also will need medicine.

Please spread this around and help out if you can!

[ask-a-vetblr]

Hi! I did see stomatitis mentioned on a few of your pages and on here, but I'd really like to ask for advice on how to approach it. I'm autistic and have a hard time communicating, but I gotta advocate for my baby. My vet suspects my 4M cat has stomatitis. He was tested for FeLV and FIV 2 years ago and is strictly indoors. He is otherwise healthy as far as we know. He will be going in for bloodwork, dental cleaning, X-Rays, and possible extractions. (1/?)

My understanding from the vet was just extractions of the teeth that are inflamed if it is what he thinks it is (not full mouth extractions), but that may have been a misinterpretation. Further research into it, and I think I'm going to ask about full mouth extractions if it isn't ruled out as something else. From what I'm seeing, trying to manage it long-term without them can backfire at any time. But I am guessing I won't even know for sure until he has already been put under anesthesia. (2/?)

How do I politely go about ensuring that the person doing the procedure is experienced enough? I was seeing a lot about how you need to make sure they get the root. My clinic is great, & there is a vet there that has special interests in feline medicine & dentistry. Her credentials look good & it says she primarily does surgeries there. Should I ask about it before the cleaning/XRay/extraction appointment, or should I wait to ask about full mouth extractions? I'm lost on the logistics. (3/3)

gettingvetted here.

Every cat is an individual regarding stomatitis. Some cats only need the inflamed teeth removed and they never have another issue especially if strict medical management (immunosuppressants, superb at-home dental care) is used. Some cats will eventually need all of the teeth removed (although the canine teeth are typically left behind, since for some reason they don’t tend to be as problematic).

In general it is much more difficult to remove a healthy tooth than a diseased tooth, so it is debated whether removal of all the teeth, even if some of them are still healthy, is a good idea in stomatitis patients. I don’t think it’s wrong to do that, but it’s not my approach. Why would I lengthen the anesthesia time, cause more pain, and prolong the healing of my patient for a set of problems that may never happen?

If a clinic is offering the dental procedure, their staff is experienced enough to perform it. Why would we offer something we cannot do? It is important to remove the entire root during every extraction, not just full mouth extractions or extractions in stomatitis patients, so making sure to remove the entire root would not be something unusual surrounding stomatitis cases. It sounds like your vet knows what she’s doing. If you wanted to ask *something*, you could say that you were reading about full mouth extractions and wanted to know if it was a good idea for your cat. You could also ask how many stomatitis patients does your doctor see that end up needing full mouth extractions over time?

Hope this helps.

[allcreaturessmall]

So Trooper, the special needs kitten who is deaf, cross-eyed, clumsy, and neurologically impaired, has a new issue to add to his repertoire: stomatitis. Stomatitis is an extremely painful oral disease in which ulcerations form on the gums and in some cases on the throat or tongue. It is more commonly observed in senior cats with periodontal disease, but can occur in cats of any age.

Cats with stomatitis find it painful to eat, groom, and open their mouths in general. Trooper has always had difficulty chewing, which we thought was part of an old jaw injury he suffered as a kitten, but his extremely foul breath and reluctance to groom himself suggested more was going on.

One of the most effective ways to manage stomatitis, in addition to anti-inflammatory and antibiotic treatment, is the removal of the molars are premolars, which often harbor bacteria that can worsen symptoms. So, two days ago, Trooper had all but his canines and a few incisors removed. He is already finding it much easier to eat soft food, and overall seems more comfortable.

This does make Trooper a bit more special needs, as he will need soft food and monitoring to ensure the ulcers don't reoccur. We have a foster who is willing to keep him as long as we continue to cover his food and vetting, so at this point he is an ACS "resident."

[drferox]

Another tooth question from a different person: my young kitten began having mouth pain, and it lead us on a journey of all kinds of tests and lots of steroids and antibiotics and cleanings. Turns out the immune system seemed to be attacking her teeth. It was so bad that we finally had to remove all the teeth. She's completely fine and healthy now, but why exactly would her body do this to her teeth? I know autoimmune disease exists but I never thought of it acting in that way.

Mate, if I could tell you exactly why autoimmune disease develops, I’d probably have a Nobel prize and a million dollars.

Best we can tell in cats, is that it’s one of the quirks of the species that some cats, and it may be up to 50% of cats if they live long enough, have an immune system that overreacts to antigenic stimulus (infection, calculus etc) on the teeth and at the gum line. You can get very exaggerated immune responses (eg plasmacytic-lymphocytic gingivitis) and even Feline Odontoclastic Resorptive Lesions (FORLs), where cells are stimulated to dissolve the tooth, or the ligament holding the tooth in place.

Sometimes removing the antigenic stimulus (regular teeth cleaning, low allergen diets) and cortisone or immunosuppresants help, but a lot of the time we end up removing most or all of the teeth. Then there’s nothing for the immune system to bother with, and the cats live happily ever after.

We do know that FIV and FeLV can make this worse, and both of those viruses will do weird things to the immune system, but some cats are just very, very unlucky.

[snakewrangler47]

Oral ulcers in 🐈 cat. #VETYCOS #jammu #cat🐾 #catlife #cat #persian #stomatitis #unvaccinated #calci #animalpharm (at Veterinary Surgeon Jammu)

[ask-a-vetblr]

Are some cats just predisposed to gingivitis? My old cat has had recurring gingivitis ever since maybe 5? Now 19 this summer. Due to her age making anesthesia more risky my vet recommended just pulling every tooth that was even slightly inflamed when it last flared up. Is that a common course of action for cats? Now she just has 3 teeth and still insists on only eating her dry kibble, she's my spunky ol' lady.

gettingvetted here.

Yep, I would say cats as a whole are prone to gingivitis, but some cats (possibly yours) are especially prone to stomatitis. Removal of all the teeth is a fairly common course of action and yep, even animals with no teeth will insist on eating kibble! That is one of many reasons why I am comfortable recommending the procedure. Many pet owners fear that their pet won’t be able to eat anymore with no teeth, and I love being able to give examples like this.

[ask-a-vetblr]

One of my mom's friends had a cat who, while young, had to have all her teeth removed because everything was horrible and smelled like death. Later on I heard through the grapevine that the poor baby's body was actually attacking her teeth, like she was allergic to them or something. What's up with that? Is there a reason that would cause a cat's body to attack her teeth and just turn them into rotting chunks of grossness?

gettingvetted here.

It sounds like that cat had stomatitis, which is a blanket term for extensive, chronic and painful inflammation in the mouth. Up to 4% of cats have this disease.  Researchers haven't yet discovered the cause of stomatitis in cats. They know that affected cats have altered immune function, but it's not clear why. Viruses, bacteria and periodontal disease are all thought to contribute to the disease, but scientists don't know what makes affected cats' immune systems go haywire in response to plaque and bacteria. Some studies suggest a link between stomatitis and calicivirus, a virus that causes upper respiratory disease in cats. Viruses that affect the immune system, like feline leukemia virus (FLV) and feline immunodeficiency virus (FIV), may also play a role. All that scientists know for sure is that affected cats develop a disproportionate reaction to plaque and bacteria that leads to excessive inflammation in the mouth.

[drferox]

Came for the Brachycephalic Airway posts, stayed for everything really. You run a fantastic blog. I was wondering if you could provide some reliable information about Stomatitis in cats. One of our cats was diagnosed at 6 months old during neutering, our vet seemed clueless about the condition, but it seemed to clear up with dietary changes and tooth brushing. He's 4 now and it's back even worse. Our vet doesn't seem to know why, should I seek a specialist?

Stomatitis is a non-specific term meaning inflammation of the mouth, and there are lots of things that can cause it to various extents. In cats this includes but is not limited to:

trauma (chewing pointy or caustic things)

Renal failure (uremia)

Immune mediated disease

Respiratory viruses

Immune system suppressing viruses

infection in the mouth (tooth root abscesses, gingivitis)

severe peridontitis

osteomyelitis

certain toxins

So there’s a bit of a list for why your cat might have stomatitis. Renal failure requires blood tests to detect, but then to figure it out you’re left working down the list with one test after another. You can’t be certain why a cat has stomatitis until you’ve ruled everything out, which may ultimately include biopsy of the gums.

It might be that a lower antigen load in the mouth has reduced symptoms, but I can only speculate. Some cats end up being treated with long term steroids, and some end up having all their teeth extracted to fix teh problem.

You’re certainly entitled to seek the advice of a specialist, but if it was me I’d rule out some of the cheaper to test things in general practice before I went to a specialist.