Advice/opinions on cat with Stomatitis

[oceanslily]

I have been doing as much reading as I can over the last few weeks/months on Stomatitis and I keep hitting a dead end in regards to my question. It seems as if every article ends on the note "most cats see relief with the removal of their teeth."

We are in the midst of dealing with this ailment and have gone through many of the recommended procedures -- began with cleanings, rinses, gels, antibiotics, steroids, etc. etc. Finally decided to have his back teeth removed, after which he seemed 100x better -- temporarily. He quickly went back down hill (drooling, not grooming, not eating, pawing at his mouth, "screaming") so we opted to have the others removed. The vet pulled all put three canines. He didn't want to risk removing them because his teeth are very healthy and firmly implanted. He feared breaking his jaw.

After his last surgery, he very temporarily seemed better after recovering from his surgery. After about three weeks, his health seems to have taken another dive. It's been over four weeks since his surgery and he's getting worse and worse.

Now, we are in a conundrum -- what do we do next? He's a decade old and has been part of our lives since a few days after his birth (his litter was abandoned and he was the only survivor).

In some ways, I feel like we should try to remove his final three teeth. Then, I think about the risks to him and can't really stomach the idea of him suffering through a broken jaw on top of all of this. Then, I wonder, what if it doesn't do anything? We've put him through another surgery, not to mention the financial aspect. If it didn't work, I don't think I could go through all of the other treatment options as they are risky, expensive, and don't seem like they are overly effective.

We love our kitty, but are realistic. We feel we've given him ten great years. At the same time, we don't want to rush to "that" decision if we feel that we can improve his quality of life without causing him more suffering and us to go broke.

I guess I'm just looking for thoughts, anecdotes, or opinions.

[Dr Lee]

Originally Posted by oceanslily

We feel we've given him ten great years. At the same time, we don't want to rush to "that" decision if we feel that we can improve his quality of life without causing him more suffering and us to go broke.

I guess I'm just looking for thoughts, anecdotes, or opinions.

Stomatitis is indeed a difficult, painful and frustrating disease! Luckily our goal for most cats is to make it to 20, so at 10, he will be happy to know that he is still a young man. Or at least middle aged.

There have been many things tried. However for cases that are refractive to conservative treatments, surgical extraction of all teeth behind the canines is usually recommended. Most all of these guys do very, very well. I have had a couple cases that additionally had laser treatments, but that is not the majority of the cases.

Here is a Client Handout on Stomatitis from our VIN network (written by Dr. Jan Bellows):

"Feline Stomatitis

Cats can also be affected by inflammation of the entire mouth called stomatitis or lymphocytic plasmacytic syndrome (LPS). An immune related cause is suspected due to the large amount of plasma cells encountered on microscopic examination of the inflamed tissues. Many cats affected by (LPS) will be unable to eat, develop weight loss, and excess salivation. Oral examination often reveals a cobble stone-like redness in the throat area and severe inflammation where the tooth and gums meet. The premolar and molar areas are usually affected more than the canines and incisors. Intraoral x-rays often reveal moderate to severe periodontal disease. In addition to generalized inflammation, all stages of feline oral resorptive lesions may be present.

In the past, therapy options for feline stomatitis included thorough teeth cleaning and polishing, fluoride, corticosteroids, gold therapy, antibiotics, lasers and strict daily brushing . In most cases cats were only temporarily helped with these therapies.

Newer treatment options include general cleaning, polishing, application of fluoride, and extraction of those teeth affected by FORLs or severe periodontal disease. In addition, a home care program is begun. The client is instructed how to brush their cat's teeth daily followed by irrigation with .2% chlorhexidine. If the initial treatment does not succeed within 2 months, then all remaining teeth are removed behind the canines. Although somewhat radical, in most cases this will provide long term success.

Dr. Jan Bellows is a board-certified veterinary dentist. His office, Hometown Animal Hospital and Dental Clinic, is located at 17100 Royal Palm Boulevard in Weston, Florida.

Date Published: 6/17/2002 5:49:00 PM
Date Reviewed/Revised: 4/5/2007"

[oceanslily]

Thank you very much for responding to my post. Like I mentioned, he's had all but three teeth removed already (his canines), which has only brought very temporary relief. I'm guessing that was mostly due to the pain killers and prednisone. We are now in the situation where we have to decide whether the risk of removing the final three canines is worth it. Our vet is concerned that his jaw could be broken, as the teeth are very healthy and well implanted.

[sugarcatmom]

I feel for you and your kitty, stomatitis is a horrible condition.

If you haven't seen this thread on the subject, it might have more info for you to: http://www.pets.ca/forum/showthread.php?t=58407

What does your cat eat?