Cat with stomatitis

meimipop

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Hi all, my 1 y/o Tama has just been diagnosed with stomatitis, the vet suspects it is linked to a calicivirus infection as a kitten. My other cat came down with a URI when we first brought Tama home, so this would make sense.

He has been given long-acting steroids and antibiotics and the vet said to watch him for flare-ups in the next month or so. If it flares up again, we will discuss long-term management treatment options including tooth extraction.

I have been reading about stomatitis as I already suspected this was going to be the diagnosis. My question is, does anyone have any experience with having stomatitis managed with medication only? Most articles recommend extraction asap and I am concerned about delaying the extraction and prolonging his discomfort needlessly.
 

daftcat75

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I don't know what this long acting steroid is or if steroids and antibiotics will be enough. I honestly know very little about stomatitis. But Krista had tooth resorption and there were some days that I wished she had the other one, stomatitis. Because it would have been a blessing to the both of us to remove all her teeth after that first or second time and be done with it. Instead we had nearly two years of piecemeal extractions that would get her a few more good months before she had to go in for more extractions. It got to the point where her regular vets told me they no longer wanted to work in her mouth and that I should take her to a dentist. Long story shortened, that was the best decision in her care that I made and only wish I had made it much sooner.

Animal dentists are few and far between with very long lead times for consultations (two to six months is standard.) While you are waiting to see if your vet's first course of steroids and antibiotics are going to help, I recommend making that consultation appointment. If the dentist believes he can help you, the procedure appointments are much quicker to come by (two weeks to a month.)

Two caveats:

1. Dentists are few and far between. You may have to drive two hours to your dentist appointment. If you have the luxury to do practice car rides with your kitten, I recommend that. The other thing I recommend is getting a hotel room even if it's only a two hour drive. Travel first and then see your dentist the next day with a much calmer, rested kitty. Otherwise you can ask your vet for gabapentin to relax kitty for the drive if you're going to do it all in one day.

2. Not every dentist works out of a full-service animal hospital. In that case, some dentist prefer your cat to be otherwise healthy because if something goes sideways, they won't be equipped to handle that. This is why I recommend that you make your dentist appointment before you think he needs it and/or make it with a dentist who does work out of a hospital if you have that choice.

If you're in US or Canada, you can use this site to find board certified dentists. Otherwise, call around to specialty hospitals or vet schools to see if there is a dental specialist who may not be AVDC board certified. They're not required to be AVDC certified to practice animal dentistry. But it's helpful for finding them if they are. Make your consultation appointment now even if you don't think he needs it yet. Because with two to six month wait times, you'll never get an appointment in time if you wait for him to need it.

Find a Veterinary Dental Specialist | AVDC.org
 
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meimipop

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Thanks for all the tips and sorry your Krista had such a difficult time with her teeth.
Previously when my senior cats needed a few teeth extracted, their regular vet did it (it was a cat only clinic) so I am not familiar with dental specialists and will look up how it works over here in the UK. I believe my vet needs to refer me instead of booking directly myself.
 

daftcat75

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General vets can do basic extractions. But they aren't nearly as experienced or practiced with animal dentistry as much as a specialist. And with a chronic condition like stomatitis or tooth resorption, you want a specialist on the job. You can have your regular vet extract teeth. But your regular vet likely doesn't know about post-recovery risks like lip entrapment and ulceration caused by mismatched extractions. Another member here just brought her cat back from the dentist today (it was like a two or three month wait for that appointment) where they were able to preserve a canine with a root canal rather than extracting it. Despite being more costly, that will save the cat much trouble down the line as she won't have any mismatched canines to bite or scrape against the opposing lip/gum.
 

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Hi, sorry to hear about your cat. I know how stressful this diagnosis can be for pets and their owners. In my experience treating stomatitis with medication was only a short term solution. Over time the meds stopped working as well as they used to. My cat was on steroids on and off for a couple months at a time and in the end he was worse off. Steroids weakened his immune system and made him very susceptible to infections and colds. You should look into herbal remedies I am currently using a brand called hampl pet formulas that I think really helps his condition. You should also know that it’s a fifty fifty chance on whether or not his gum inflammation will go away with extractions. My cat had two separate surgery’s the first one to take all of his teeth except for his canines. He was okay for a few months after this one but developed tooth resorption in his remaining teeth which were extracted by a dental specialist. It’s been nearly three months and he still gets the occasional flare up. The hampl products are the only thing that’s helping, it’s slow going but I do notice an improvement with each week that passes.
 

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I'm so sorry. As a feral feeder and rescue mom I've seen these damn mouth sores too often. I personally don't agree with full tooth extraction. The recommendation seems to be based on a single study of a small number of cats, over a short period of time. I know two people that had it done only to lose their cats within 9 months. Not to mention that a study indicates that over 90% of cats with stomatitis have underlying immune issues, and what could be harder on an immuno-compromised cat than anesthesia and major surgery.

I have a product due today from Chewy - Oratene - which got high ratings from 51 users. Sadly the kitty I ordered it for is not long for this world, but I will keep it for the next poor soul.

My recommendation would be to keep your kitty as comfortable as possible. I've had some that could swallow small kibble dry food in water, like you would a pill and others that would eat pulverized chicken. The best luck I've had is when I've added real meat to their diet.

It's a heart breaking situation. Trust your gut. No one knows your cat the way you do.
 

Tik cat's mum

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What you have said sounds very similar to my kitten's story. My boy got tested because of repeated vet visits for his runny eyes and the vet noticed his gums he was about 7 months at the time. She recommended the Glasgow test and a calsivirus diagnosis was given. I was told to presume my 4 year old had it to, he got flu when the kitten arrived. For my boy we are at the moment just giving antimflamatrys when needed he's 1 now and has had them twice I also brush his teeth every morning and give dental treats at night. My vet hasn't mentioned extraction but I'm fully expecting it to happen. But until then it's daily brushing and cat multivitamins with antimflamatrys when he shows discomfort for my boy. Since we put the brushing in place his gums do seem to of improved.
 
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meimipop

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Since I posted this, my cat has had all his cheek teeth extracted in two operations after several attempts to control the inflammation with traditional treatments. His mouth tissue was inflamed beyond just the gums and he had also developed tooth resorption in two of his teeth.

He is feeling so much better now with no visible inflammation left. He's also back to playing normally and no longer sleeping under the bed all day. He still has some issues with food, which the vet thinks is due to the trauma and associating food with the pain he's had most of his life, but we're hoping it will get better in time.

It seems like opinions around full mouth extractions are mixed, but it has worked very well for Tama. However I do think there is an underlying immune disease that triggers this and extractions are just treating the symptoms. I wish there was more research done on this condition.
 

Tik cat's mum

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Glad to hear that your boy is feeling better and his surgery went well. My vet said that it's common with cat's that have been diagnosed with calsivirus. There should be more research done on this your right. When I got the call with my boy's test results the vet just said he's tested positive for calciviras. Then went on to tell me there's no cure for calsivirus and my other cat would have it too. I had to call back the day after to talk to the vet that did the test. It was her that told me about the cleaning and vitamins. My other cat's gums are good and he hasn't had any problems since he first got flu. It seems some vets don't know alot about the connection even the first vet when my boy was tiny didn't say look out for inflamed gums.
 

Sylvia Jones

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My sister faced the same situation as you with a cat from a rescue He was 1 when they got him Their vet tried medication for a bit but then recommended extraction Her regular vet also had specialty training After the teeth removal he is doing great Can only eat wet food of course but is so much happier They are so glad they had it done No more pain Sounds like it has worked for you too I’m so happy for your kitty
 

tnrmakessense

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Can I ask if everyone that has personal experience with extraction report back in a year or 18 months ? I'd love to be proven wrong. The ONLY thing that is important to me is advancing the well being of cats, especially those that have been left to fend for themselves.
 

nanniecat

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Hi all, my 1 y/o Tama has just been diagnosed with stomatitis, the vet suspects it is linked to a calicivirus infection as a kitten. My other cat came down with a URI when we first brought Tama home, so this would make sense.

He has been given long-acting steroids and antibiotics and the vet said to watch him for flare-ups in the next month or so. If it flares up again, we will discuss long-term management treatment options including tooth extraction.

I have been reading about stomatitis as I already suspected this was going to be the diagnosis. My question is, does anyone have any experience with having stomatitis managed with medication only? Most articles recommend extraction asap and I am concerned about delaying the extraction and prolonging his discomfort needlessly.
extraction should be thelast option i would think. prednilisone is prob the first option. but the sooner the bette. dont be afraid of pred. my cat has been on it for 5 yrs. daily. i give it to her in a chewy form from bcp pharmacy.
 

silent meowlook

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Hi. Where I work we do many full mouth extractions due to stomatitis. We get referrals from other hospitals. I have never seen it well controlled with steroids and antibiotics. It is a very painful disease and they don't know what causes it. It can advance to the back of the throat as well. Best to have an experienced dentist with dental radiography and the ability to keep the cat comfortable before during and after the procedure. We do full anesthesia, nerve blocks, and run fentanyl for pain during and after the procedure. We keep them for at least 3 days after on a fentanyl IV drip with IV fluids and IV antibiotics. They usually are eating by the first night. We wean them off of the fentanyl and send them home with buprenorphine. We recheck them in a week if all is going well.
 

tnrmakessense

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Hi. Where I work we do many full mouth extractions due to stomatitis. We get referrals from other hospitals. I have never seen it well controlled with steroids and antibiotics. It is a very painful disease and they don't know what causes it. It can advance to the back of the throat as well. Best to have an experienced dentist with dental radiography and the ability to keep the cat comfortable before during and after the procedure. We do full anesthesia, nerve blocks, and run fentanyl for pain during and after the procedure. We keep them for at least 3 days after on a fentanyl IV drip with IV fluids and IV antibiotics. They usually are eating by the first night. We wean them off of the fentanyl and send them home with buprenorphine. We recheck them in a week if all is going well.
Does your clinic follow up in 6 months or a year ? It would be really valuable to pet owners to know that the long term prognosis was good. If not do you know of any clinic that does track that information?
 

silent meowlook

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Yes we do. They do great provided the extractions are done right.

It isn’t inexpensive, and they are under anesthesia for a while.
 

tnrmakessense

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Do you know or get a sense of what the survival rate is beyond 2 years and how long they are pain free after the surgery ?
 

silent meowlook

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We see many cats up into old age. Of course sometimes there are other issues besides the stomatitis, such as FIV. But even then they still do well once the teethe are removed.

I can’t stress it enough though, you must have someone who has the equipment, knowledge, and experience doing them.
 

tnrmakessense

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I've looked at a number of studies and published articles on FCGV. Several studies point to FIV in cats that do not respond to tooth extraction, another implicates FCV (calicivirus).

My cats have all been rescues. It has been the former ferals that have suffered with FCGV. I have also noticed FCV symptoms in outdoor colonies and my ferals brought indoors.

It seems as though testing for FIV and FCV would be prudent before extraction is performed on a formerly outdoor cat.

There also seems to be some success with laser and stem cell therapy in cases where extraction did not work. As a pet owner, I would insist that these therapies be tried before extraction on cats which show signs of FCV or FIV.

Just my opinion.
 
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