Stomatitis- is my vet not being proactive enough?

lsanders

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I fostering a 3-year-old cat from the shelter I volunteer at. She has been at the shelter all her life and was always one of my favorites, but until recently, I wasn't in a position to have more than one cat. I've had her for several months now, and within a couple days of adopting her, I noticed her breath was awful.

The shelter was founded by a veterinarian whose office is next door (he's now retired, and his daughter is the main vet there now) and while an animal is being fostered, we're supposed to take them there for all their medical care.

So, I brought her in and they diagnosed her with stomatitis. They gave me about 10 days worth of Prednisolone and then an anti-inflammatory. That settled it down a little, but of course, didn't cure it, so they've just been having me spray Chlorhexadine into her mouth once a day to stave off any secondary infections. They're reluctant to pull her teeth because she's so young, but from what I've read here and in other places, most cats are okay with no molars, after the initial adjustment period, of course.

She was fairly shy to begin with and has never really liked being held, but now that I have to try to catch her every day and spray some nasty-tasting stuff into her mouth, she's terrified of me and gets more stressed out. She's still friendly- she'll come and sit next to you, or sleep on me at night, but if I approach her, she runs like hell. It's gotten to the point where I rarely bother to even attempt catching her every day because it makes her so miserable.

I work in a dental office and a couple months ago, I went to a dental conference and they had a veterinary dentist, Dr. Gregg Dupont out of Seattle, giving a lecture. He's a former president of the American Verterinary Dental College. He did a whole section of his presentation on stomatitis and he said he believes it's the most painful thing a cat can go through, worse than breaking a leg. He said that pulling the teeth is the only solution, that trying to treat it with steroids and anti-inflammatories can only make things worse because it weakens their immune system and causes further problems. Well, after I heard that, I was ready to run out of the lecture and take her straight to the vet to talk seriously about pulling her teeth! But I didn't- I brought her back a couple of days later and talked to them about it. They were concerned, but still don't want to pull her teeth.

If I adopt her, I can take her somewhere else for a second opinion, but I'll have to pay for the surgery (if I went to them it would be about $250-$300; I called a veterinary dentist to see what their prices were and they wanted $1500-$2000
I'm not sure what the vet I normally see would charge.) I can find a way to get the money together- I'm willing to do just about anything for the medical needs of my cats, whether it's a second job, a loan from a bank or family member, selling an organ
but I just want some opinions on whether this vet is handling this appropriately or if I should find someone who will be more aggressive with the problem.

I've heard that many cats with stomatitis can be anti-social until they get the teeth removed and the pain is gone. I'm hoping that's the case with her.
 

white cat lover

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Having been through this with a shelter kitty & 2 of my own - pull her teeth now, IMO. I'm sure other wouldn't agree with it - but Twitch was diagnosed when she was 8 months old - the vet I went to then kept putting her on meds until she was almost 2 years old, and she nearly died because of it. We pulled her teeth. She turns 8 years old in a month & it hasn't stopped her once. She eats dry food, wet food, and does everything a normal cat would.

If you have any specific questions, I'm always a PM away.
 

catnurse22

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I agree. Pull the teeth! Steroids and anything else your vet can use for treatment, is just that, a treatment. It isn't a cure and sounds like it isn't even giving her much more comfort (only stressing her out more, which can make her stomatatis worse actually.)

At the clinic where I work we've done several full mouth extractions for stomatatis kitties. Every cat has adjusted wonderfully to it. These are cats ranging in age from 2Y-14Y, so age doesn't seem to make a difference in their adjustment. I can sort of understand your vets reasoning if this where something that could be kept at bay with steroids/etc. But that doesn't sound like the case for this kitty.
 

Ms. Freya

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I'll third this. Get them pulled.

I wrestled with this with decision with one of mine not long ago and getting the teeth out was the absolute best thing for his health. He's had a fraction of the issues since they were removed. In my experience, we had more difficulty with stomach troubles due to the meds than with the actual removal of the teeth.
 
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lsanders

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Thanks for all the info. I'm taking her back in on Saturday and am going to push for it, whether I have to pay for it or not.

Do you think it's worth going to a specialist to have the extractions done? At the lecture, Dr. Dupont said that they need to make sure they get all the root tips out (sometimes they can break off and leave a little bit) and the periodontal ligament (the ligament that helps hold your teeth in), then debride (clean) the extraction spots really well or else it's ineffective.

Is this something that a regular vet will know to do?
 

momofmany

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First of all, realize that all cases of stomatitis are not equal. I had one with a chronic version which was controlled through antibiotics. I have another one who had a chronic case caused by an auto-immune disease and his only recourse was to have all of his teeth pulled.

I really suggest to find a vet who specializes in dentistry and see if they can identify the cause behind the stomatitis. If it turns out that your best recourse is extractions, it may be that only some of them need to be removed, or the teeth removed in stages. Cat teeth are fairly fragile and break easily upon removal. Unless the vet is skilled at this procedures, it is possible to leave tooth fragments that can cause even more problems.

My Stumpy had about half of his teeth removed in each of his 2 surgeries. I'm glad I left some teeth for him in between so that he could adapt more readily to becoming completely toothless. He does great with food now. And yup, dental specialists are pricey - his surgeries ran between $1100 and $1500 each.
 

addiebee

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Why don't you PM Carolina. Her cat Bugsy has Lymphocytic-Plasmacytic Gingivitis Stomatitis --- and is getting special treatment with a vet clinic in Dallas that I know is helping him.
 

2gr8cats

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We had almost all of our boy Walli's teeth removed back in Feburaury due to severe Stomatitis, he is 3. The gums around the front teeth and canines were not inflammed at the time and the oral specialist we were consulting recommended leaving them in. Now 3 months later Walli's mouth is all inflammed again and the front teeth have to be removed. I swear he is in more pain this time around than he was back in February. I was very hesitant to take out the rest of his teeth, but I feel a little more comfortable seeing 3 people are in favor for your cat. I believe we paid $1175 for the first surgery and we're looking at another $450 or so for the upcoming one, so the prices you mentioned sound about spot on. Good luck.
 
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