Stomatitis (Removed)

What to Expect When Your Family Veterinarian Diagnoses Feline Stomatitis
Oral health is a very important factor in a pet’s quality of life and, the more we learn, the more it becomes obvious that oral health can affect overall health. You are making a wonderful commitment to your pet’s oral care and we want you to know what to expect when you come to visit with us! Please be aware that each patient is different and the mouth is a difficult place to predict, however we will do our best to derive as close of a treatment plan as possible during our initial visit.

What is stomatitis?
Technically, the word stomatitis simply means inflammation (“-itis”) of the cavity (“stoma-”). In this case we are referring to the oral cavity (mouth), and in the case of cats, we are referring to a specific disease condition that leads to severe oral inflammation and pain. Stomatitis is a very complicated condition; however, what we do know about stomatitis is that it appears to be a hypersensitivity to plaque. For an unknown reason, the immune system over-reacts to the components of plaque or calculus (tartar) and creates significant inflammation, ulceration, and pain wherever plaque is found (and in some cases, throughout the whole mouth). Imagine having canker sores throughout your whole mouth everyday of your life!

How can stomatitis be treated?
Unfortunately, since stomatitis does not have a specific known cause, it is very difficult to treat. Many patients have been treated with antibiotics and/or steroids in an effort to control infection and pain, however since we have not done anything to address the plaque, the disease condition worsens again as the medications are stopped.

Furthermore, traditional medical therapies become increasingly less effective with repeated use and ultimately are not enough to control this  disease. Effective plaque control (i.e. brushing and professional cleanings) may be helpful in some cases; however, it is difficult enough to keep   plaque from accumulating on our teeth let alone our cat’s teeth. Since even minute amounts of plaque can result in significant inflammation, and we cannot get rid of the plaque entirely, we are left with one intimidating solution – get rid of the teeth. Chances are this treatment     understandably feels extreme to your ears. Please know that many of these cats feel better the night of surgery just from the alleviation of some  of the oral inflammation with the teeth and plaque gone! The term “full mouth extractions” can have slightly different meanings depending on  your cat’s specific condition. Based on the condition of the teeth and where the inflammation is, in most cases, we extract all of the premolars  and molars (the cheek teeth) and leave the incisors and canines. However, in some cases, the term is very literal and we end up extracting all the teeth. Just think, would you rather be toothless or have a mouth literally full of canker sores caused (in part) by your teeth?

It is important to know there are reports of alternative therapies on the Internet that claim to have great success with stomatitis. Unfortunately, many of these cases are single reports and after clinical trials, have not panned out to be effective.

How will my cat eat without their teeth?
Chances are your cat is not using their teeth, rather choosing just to swallow their food instead of crunching kibble against their painful gums. Amazingly, many of these cats go home and eat the very same night of surgery. In fact, after the healing period where softened food is recommended, many cats return to eating dry food. With most or all of the inflammation alleviated from the extractions, most cats go on to do great! I wish I could insert a video of all the clients who have been amazed at their cat’s recovery and change in overall quality of life. Like you, these clients were very concerned about the prospect of extracting all or most of their beloved cat’s teeth, but following treatment, they were very grateful they invested in the care!

What is the prognosis associated with stomatitis?
The frustration with this disease is that we can never say there is a cure, rather we are managing the condition. However, with full mouth extractions, two thirds of cats experience a “clinical cure” meaning no additional care is necessary (beyond routine dental care for any remaining teeth). The remaining 33 percent of cats may need additional support. Anything from oral gels, further extractions, and finally, if the
extractions have not been effective, now that we have at least reduced the plaque load, antibiotics and/or immunosuppressive drugs can be used to help manage this condition long term. Many of these cats continue to do well with these supportive measures. Still, it must be said, this condition can be very frustrating, especially in the population of cats that are hard to manage. It is important to be prepared as it can take a significant emotional, financial, and time commitment trying to achieve a decent quality of life for some of these patients.

Learn more about this disease by contacting our Dentistry service at your nearest BluePearl veterinary hospital. Here are our hospital locations.

© BluePearl Veterinary Partners 2012