Not Stomatitis

Took my six-year-old cat to the vet. Vet looks at cat and immediately says, "All those teeth will have to come out." (Five years back, almost all of the cat's teeth were pulled because of stomatitis. They left the front four--two fangs at top, two on bottom--intact at that time because they were not affected by the stomatitis but told me that they'd probably fall out.)

To be sure I was remembering correctly, I looked up stomatitis online. Symptoms: very bad breath, bloody drool, loss of appetite, lack of grooming, swollen gums. The standard narrative is that stomatitis is excruciatingly painful.

Okay. The cat's breath is fine. There is NO blood. He's eating fine. He grooms himself (and the other cats) with no discernible difference from past performance. His gums are swollen and reddish at the two top fangs (not the bottom ones). When I touch his gums however, he does not react in any way.

I am strongly resistant to have his remaining teeth removed. He enjoys grooming his claws very much, and those remaining teeth are how he does it. I am also told that once those teeth come out, he may have trouble keeping his tongue in his mouth. If it's stomatitis and if the cat was in pain (which I do not accept at this time) then yes, I would have the teeth removed, but I don't think it's stomatitis.

Has anyone encountered this? A situation that looks like stomatitis but isn't? I don't think it's a food allergy, as I haven't changed his food in years. It certainly isn't eosinophilic granuloma. Squamous cell carcinoma tends to appear sublingually, and the vet looked right at the cat's mouth; I have a lot of trouble thinking that a vet couldn't spot mouth cancer. Uremic gingivitis doesn't seem likely either; the cat is not drinking excessive water, and he isn't losing weight.

Any ideas?

Hi. I wish I could be of help, but I do know that sometimes due to genetics a cat's teeth are just 'bad'. There are other members on this site that have had cats that ALL of their teeth have been pulled and they do just fine with eating and grooming after everything is healed. Although it is possible, I haven't read anything in their posts that say their cat's tongue hangs out due to no teeth.

I also am not sure that it is possible for a cat to have swollen, red gums and not be experiencing some level of pain. Think of your own mouth, if you had the same thing going on you most certainly would be experiencing pain. Cats are pretty good at hiding a fair amount of pain.

Until some of the members who have experience with gum/teeth issues find time to log on, read, and respond to your post - here is a TCS article about cats managing without any teeth.

Can Cats Manage Without Their Teeth?

Thanks for the info on managing without teeth. Although I suspect the cat can manage without teeth, removal is a final step. I cannot undo it later on. (I could get dental implants for him, but in addition to the expense, if it is stomatitis, the inflammation would come back, no?) And yes, I've had gum pain in the past. Which is why I am suspicious about the diagnosis. I poke and prod the cat's gums and he just lets me. No flinching, no getting up and running off. No hissing. No howling.

The only way I know that stomatitis can actually be confirmed (or ruled out) is to have a biopsy of the affected tissue analyzed - essentially determining if there is an over-reaction in the cat's immune system. Did the vet by any chance to do that when they pulled all those teeth before?

Also, FIV and/or FeLV can cause symptoms related to stomatitis. His teeth/gum issues might be connected to his auto-immune system, regardless of the actual cause. In that case, I would think the vet would want to try to give your cat anti-inflammatory therapy, which would be some sort of an immunosuppressive med and/or antibiotic. Maybe ask your vet about that?

Or, even consider seeing if you can find a vet that specializes in the dental care/issues?

It doesn't look good, tbh. They'll probably have to come out eventually. Ask your vet if a cleaning will do for now (sometimes it's the plaque the cat is reacting to). But if the cat isn't currently in pain I wouldn't want to do extractions yet either. My dental vet says that taking out the top canines is a real process because the roots go way up into the sinus cavity, so that's something that's better avoided when possible.

I don't know if this will help, but just in case - a list of board certified vet/vet specialists as determined by the AVMA.

Home

No, the vet did not mention a biopsy at the time of the earlier extraction. But even I could tell the teeth weren't coming back from their damage. It was like meth mouth. The smell? I'd call it gangrenous. Really, I was horrified when I saw it.

I'll hope it's gingivitis. I keep swabbing with the enzyme goo to help break that stuff down, but I'm really hesitant to let them put the cat under to clean the teeth because I know how vets (just like doctors) love to do the whole "Oh, we had no choice at this point, it really was for the best ..." shtick.

I'll mention these various issues that have been raised when I bring the cat back in for a follow-up (with the other vet).

Wondering if you had the follow up appoinment?

Curious since my two guys (almost 8 & 9 yo) both have stomatitis type symptoms. Only the youngest had had a dental cleaning (think its been 3 1/2 years), no extractions. The oldest probability needs a cleans (redness along gum line upper back teeth), but vet thought he was okay for now.

Hope your kitty is doing well.

Yes, had the follow-up appointment. It's still stomatitis. However, what the second vet (the one I usually go to) explained, which the first one didn't, was that early stage stomatitis doesn't have the symptoms usually associated with later-stage stomatitis. So the cat has swollen gums but no pain, no bleeding, etc.
The condition can remain like that indefinitely. Or it can advance. There's no way to know. Possibly, the teeth in question will get loose because of the swollen gums and then fall out on their own. Of course, the vets who did the extractions previously of all the cat's other teeth mentioned that the fangs would probably fall out within a year (that was five years ago).
I can't tell other people what to do with their cats, but I'm very glad I didn't follow the initial advice five years ago to simply pull every single tooth because they're all gonna fall out anyway probably. If I have to have them removed, I will. But I'm glad I didn't just listen to the first vet's these-four-remaining-teeth-have-to-come-out diagnosis.