Stomatitis Care & Diet Suggestions

[cytotoxic-cat]

Hello,

Sorry in advance for the long post, but I thought the details may interest anyone going through a similar stomatitis situation and provide more clarity.

I have been going through quite a few of the threads on here, trying to get my sweet Peach's (7 yr) mouth in heathy condition. She has been going to the vet once per month since the vet looked at her mouth and noted inflammation around premolars, molars, and one of her canines. The vet noted some pretty wiggly teeth due to gum deterioration around some teeth. She has always gone to annual check-ups, so I am not sure if this is something that was missed (I doubt) or a more recent development (possibly the stress of being in a multi-cat household? She has only been living with my roommates cat for 2 years). I feel so bad for her and feel like a terrible pet mom because at 7, she has never gotten a dental! I am ashamed to say last year (different vet) they suggested she could be due for a dental soon due to her age, but did not communicate any type of concern about major plaque or inflammation when I asked if it was a necessary matter. This office was still implementing social distancing measures with no owners allowed in appointments, so something may have gotten lost in translation. Obviously, I will never make this mistake again. I hope I am not being ignorant in hoping that by adding some rigorous dental and preventative care to her treatment, she can put this in remission.

Her treatment so far
11/29 - Annual appointment when stomatitis is first suggested. Inflammation and wiggly teeth where gum has deteriorated noted. FME recommended. Depo-medrol Inj. 40mg/ml PER ML (QTY=.2) administered. Blood work done to make sure anesthesia will cause no issues. Weight=8.7 lbs (the heaviest vet record she has!)- I believe the depo quantity refers to ml, so I am inclined to think this is 8 mg of depo-medrol.
- diet at this time is Purina Naturals Indoor dry cat food and Friskies shreds or meaty bits wet food .
12/18 - Check-in: vet happy with effect of steroid, but would like another appointment to see how her mouth reverts once it is worn off. Weight=8 lbs (this is down from previous appointment, but I will note her roomie cat LOVES to steal her food and I was out of town for part of this period, possibly had less diligent monitoring of who was eating what). I inquire about possible diet changes, and the vet gave me a sample of VetriScience Perio Plus Powder. They also recommended another VetriScience item they sell in office that contains coenzyme Q, but was more for cardio support and they only sold it in large quantities at high cost (no samples) so I opted out. The vet tech looked around on the web while I was waiting and found VetriScience Perio Plus Feline Bites (more of a treat variety), which actually do contain CoQ10, so I got those to supplement in diet. The powder is mixed into her food and the treats are broken into bits (they are pretty hard and large, I know it reduces some of the plaque removing ability but alas).
- diet is switched to Tiki Cat Grain-free kibble and Tiki Cat After Dark wet food gradually between these 2 appointments (the ingredients seem noticeably higher quality and I wanted to see if she could potentially have some sort of grain allergy, but I welcome feedback on this brand)
1/9 - Check-in: there is some inflammation, but vet remains pretty happy, dental cleaning scheduled with some extractions expected. Vet's current opinion is that Peach should not receive a FME due to not being symptomatic (no drooling, very vocal about eating, diligent groomer) and what appears to be a less severe case of stomatitis. Weight=8.4 lbs (up from last time)
1/31 - Just a note that around here I noticed one of her teeth that the vet said was "hanging on by a thread" fell out (poor girl)- not sure of exact date, but no sign of infection or abscess
2/5 - I ordered VetriScience CoQ10 10 mg capsules that I plan on breaking open and mixing into her food after looking at the relatively low dosage in the treats (2mg) and her hesitance to eat them whole.
2/26 - Date of scheduled dental. Vet noted to just call if there are any changes about her symptoms. Peach has a very small mouth and is good at covering her teeth with her lips when I try to look, but is generally very compliant. Currently, there is inflammation isolated around her top left canine and more limited inflammation around some premolars (the matching tooth of the one that fell out definitely needs to go!)

I am seeking any feedback on what has worked for you (supplements, diet info, etc) and your feline friends, especially if you have a case in which the Vet chose only partial extractions. I have also attached a quote of the dental procedure (sorry if this is weird, but I guess it may be helpful for someone looking for comparison- I am in southeast USA), so if anyone is more of an expert in that and has a comment on their procedure seeming inadequate or reasonable I would love to hear it. I do not think x-ray is listed on there, but they said they do offer and recommend it, and it is definitely something I will be doing considering the nature of the disease. I am not at all against FME as I was on board when the vet suggested it at the very first appointment, but she believes that Peach may be able to keep her teeth so I would hate to jump the gun on it. It has been crazy to compare her teeth with my sibling's cats of similar (or older) ages, as they have pearly white teeth.

I think this is likely of little importance, but Peach had a littermate who passed at 2 years to FIP, this is before the (blackmarket?) treatment was more widely known to my knowledge; he was suspected to have some sort of feline herpes because he occasionally got a watery eye, but I have never seen anything like this present in Peach.

I forgot to say the vet told me that her blood work came back all normal so she will be good to go for her procedure

TLDR: have you had any success with supplements in mitigating inflammation related to stomatitis?

Ty!

O

 

[Furballsmom]

VetriScience Perio Plus Powder.

This is the only brand I've found that makes a difference, where it actually decreases the gum line color from redness to more healthy pink. This, of course, is the one Mr Captain doesn't like

However I appreciate you mentioning the treats form so I'm going to try that with him, after talking to my vet. --the other brand that has a couple of varieties is Tartar Shield that they suggested to use, and in his case anyway, this doesn't seem to do a thing that I can tell.

Every cat is different but Tiki Cat After Dark is liked in this house

 

[cytotoxic-cat]

This is the only brand I've found that makes a difference, where it actually decreases the gum line color from redness to more healthy pink. This, of course, is the one Mr Captain doesn't like

However I appreciate you mentioning the treats form so I'm going to try that with him, after talking to my vet. --the other brand that has a couple of varieties is Tartar Shield that they suggested to use, and in his case anyway, this doesn't seem to do a thing that I can tell.

Every cat is different but Tiki Cat After Dark is liked in this house

Just a little warning, they are in fact treat shaped, but I find the scent to be pretty similar to the powder and I consider them pretty hefty sized treats! Mine still crunches them even broken in quarters Here is the size compared to a greenie if that helps

 

[Furballsmom]

Here is the size compared to a greenie if that helps

That helps a lot, thank you

 

[FeebysOwner]

Hi. I know there are members on this site that have dealt with stomatitis, and many of them ended up with their cat going through FME to help the most. I sure wish they would show up now and offer their input because that is what you need to hear. Cats can do quite well without their teeth, once healed. The younger she is if this is determined to be needed the better off for her.

There are vet dentists, usually part of a specialty group, and maybe you need to get a second opinion from one. Your vet should actually know of some they could refer you to.

 

[mrsgreenjeens]

One of my cats gets Tooth Resorption (used to be called FORL), and so each time he gets a dental, more teeth need to be pulled. Now at age 15, he only has a few teeth left, and none of them have a matching tooth below or above except for the canine teeth. He doesn't even have any of those cute little front teeth on top anymore, just on the bottom. BUT, he can still eat treats and kibble just fine, along with his wet food. Not that this helps you with how to prevent stomatitis, just lets you know cats can do fine without all their teeth, or without "matching" teeth.

Oh, and not all cats need dentals. One of my other cats lived to be 16 and never needed a dental. It's genetic, I guess. All my other cats needed dentals, but not her. So you shouldn't necessarily feel guilty about Peach never having had a dental. If your Vet(s) never suggested it, then I would hope that she really didn't need one until recently.

 

[cytotoxic-cat]

One of my cats gets Tooth Resorption (used to be called FORL), and so each time he gets a dental, more teeth need to be pulled. Now at age 15, he only has a few teeth left, and none of them have a matching tooth below or above except for the canine teeth. He doesn't even have any of those cute little front teeth on top anymore, just on the bottom. BUT, he can still eat treats and kibble just fine, along with his wet food. Not that this helps you with how to prevent stomatitis, just lets you know cats can do fine without all their teeth, or without "matching" teeth.

Thanks for your responses. This has me wondering what the key distinguishers are between a cat with periodontal disease and/or tooth resorption and a cat with stomatitis. The inflammation is currently pretty localized and has never affected her throat, palatte, tongue, cheeks (I know this could still be the case even with stomatitis, right?). The vet suspected stomatitis at the initial visit, but never gave a 100% on this. In a young cat, is the standard treatment for Tooth Resorption a FME? Either way, I am prepared and reassured many of the outcomes of cats that have gotten FME for stomatitis if this is what soon happens.

I live in a College town with a very highly rated veterinary program according to USnews, so maybe I could look into dentistry they offer and, of course, ask my veterinarian if they have recommendations. If anyone stumbles into this thread who did a FME, did you use your primary veterinarian or a specialized dentist?

 

[silent meowlook]

Hi. I would strongly recommend you get a referral to a dental specialist of a feline only hospital that frequently does FME.

When I worked at the cat hospital we did allot of full mouth extractions. Stomatitis is serious in cats and the only treatment to date is FME. But do see a dental specialist for this as cats jaws are fragile and can be broken with a FME. You want a dentist that sees and does 10 FME a week, not one a year. Plus they have years more schooling and since they only focus on dentistry, it is what they like to do and they are good at it.

Once it is done, it is done and your cat will feel better and you won’t have to think about it again. Sure there might be things to alleviate some symptoms, but those are temporary fixes snd with depo medrol, also have associated risks.

 

[Alldara]

Hi! Magnus has stomatitis. What works for us is daily brushing. I started using just a q-tip to get him used to it. Now I use an infant toothbrush for the softness and at a second point in the day I use Vetradent teeth wipes.

Usually every other day I'll use the toothbrush just with water to brush his mouth and then the next day I'll use my (cleaned) finger to rub some enzymatic toothpaste across all his gums.

I saw a study of subcutaneous omega supplements that actually had positive results for it but I believe that the study needs replication before it becomes a true treatment. Anyways my vet and I decided Magnus would get either fish oil or coconut oil supplimented daily (1/8 tsp).

Magnus is is on Iams urinary dry food and Purina urinary wet (chicken) for the main part. He also gets Iams Perfect Portions, Fancy Feast chicken, Wureva lamb or chicken, and Beyond Duck.
I don't know if the diet is part of it but he always had gingivitis while on the grain free diet. It never cleared up even with steroids. He hasn't had stomatitis or gingivitis for a year under this plan. So we found what works for him.

He does have a now known allergy to beef and beef byproducts. He was on prescription Purina Pro Plan EN for a time.

Food allergies in cats are usually to a protein. Food Allergies in Cats | VCA Animal Hospital | VCA Animal Hospitals

Gingivitis and Stomatitis in Cats | VCA Animal Hospital | VCA Animal Hospitals

An Update on Feline Chronic Gingivostomatitis

 

[cytotoxic-cat]

Thanks. I do believe that the fish oil omega 3 content is probably helping your cat!- I am a graduate student and my project is actually a formulation for sickle cell disease (it contains high omega 3 and is thought to decrease the inflammatory response in patients). I am going to see if fish oil could be something to try with my vet.

I appreciate your feedback silent meowlook and will definitely be looking into a specialist going forward. I am inclined to at least allow the dental to be done at the current vet because there has been some wait periods and I would like to resolve some discomfort (that she hasn't indicated, but I know is there). Any idea if there would be a lot more risk with each time a cat is put under anesthesia or if they tolerate it once they will likely tolerate it later in the year? I am not trying to be 'smart' at all when I bring this up, but from "An Update on Feline Chronic Gingivostomatitis" that Alldara posted, it brings up that there was no significant differences between FME and PME (obviously a review, but it links to source of that info). Maybe the studies were not long term enough to have resurgence of the Stomatitis from remission in the remaining teeth- I have not had time to read the source in depth.

 

[Furballsmom]

Any idea if there would be a lot more risk with each time a cat is put under anesthesia or if they tolerate it once they will likely tolerate it later in the year?

I don't believe the risk increases unless the overall health of the cat declines (ie, heart, sinuses,et al), and there is the age factor, but as I understand it there is a lighter version of anesthesia that can be used for older cats if necessary.

 

[mrsgreenjeens]

Just to answer your question about tooth resorption and FME, with tooth resorption, they only remove the teeth that are being resorped. This is totally different from stomatitis. And FME doesn't always resolve itself with FME, if it's really bad, which doesn't sound like the case with your Peach.

 

[fionasmom]

Find a Veterinary Dental Specialist – AVDC.org
American Veterinary Dental College directory in case you need to look for other doctors

 

[cytotoxic-cat]

Find a Veterinary Dental Specialist – AVDC.org
American Veterinary Dental College directory in case you need to look for other doctors

Thanks guys! I reached out to the only one in the state. I did figure they were few and far between, but I guess I never realized just how rare!

 

[cytotoxic-cat]

Hmm anyone have thoughts on this: I have been reading several reviews from people saying they were referred to our University's Community Animal Clinic for full mouth extractions due to stomatitis, but do not actually see any listing for them in the AVDC. I do not mind sharing it is the University of Georgia if anyone has experiences with their program.

 

[fionasmom]

I only see one dentist listed for GA. The only thing that I can suggest about any of these organizations is that a doctor might have to join them, and if not there is no listing. That would not mean that anyone who is not a member would be incompetent, just not a member.


Brett W Beckman
Atlanta Veterinary Dentistry & Oral Surgery
145 Cliftwood Drive
Atlanta, GA 30328
877-771-1107

 

[posiepurrs]

Feline chronic lymphocytic plasmacytic gingivostomatitis

This link has a book available BUT if you scroll down there is a lot of good information without buying it. I used some of the dietary info when my cat, Boo was diagnosed. We never did full mouth extraction. In another article I read while researching it ( which I can’t find right now) pointed to possible allergies to certain foods like poultry. I took all poultry out of his diet. I also removed kibble. I used coq10, and slippery elm and raw honey as she talks about. He gained weight and was eating fine. He lived another 7 years until I lost him to chronic kidney disease.
One article I read also talked about success in using Zyrtec - this I haven’t tried, Here is the link to that article:
Why I Love Zyrtec for Cats

Keep in mind, my experience with stomatitis was close to 10 years ago so treatments may have changed ( other than full mouth extraction). I believe UCDavis is doing research on lasers to treat it. A friend of mine, a vet tech is doing cold laser treatments on one of her pets for stomatitis with the vets blessing.

 

[cytotoxic-cat]

Both of those articles I found helpful. I am not sure of the exact type, but I did see a post by my vet's office about doing laser therapy on a stomatitis cat, so that is something I will keep in mind to ask about

 

[cytotoxic-cat]

A bit discouraged.... unfortunately the only AVDC certified specialist is simply out of the price range right now (~$7k, could be more) . I guess this is a good lesson for me about the costs of being a pet owner. I have what I thought would be sufficient savings, but this would exhaust ALL of them and if it were to exceed the high end of the quote or Peach be in the small percent that require lifelong medication, I really just would not be able to care for her.

I still want her to get the best care possible.. so now to ask around about finding someone who is still very experienced, but may not be registered. Here's to hoping.

 

[fionasmom]

As I said, the registration may not be any more than joining the organization and paying dues. If you have nextdoor.com you might post in your area for suggestions about vets.