"To Pull His Teeth or Not"?? Chronic Stomatitis/Gingivitis

Anyone out there that has had this problem with a cat? I really need help with answers to my questions?

Littlefoot is a 5 year old male who has had chronic stomatitis/gingivitis since he was a kitten.

Over the years he has had numerous teeth cleanings, Oral hygiene rinse, and for the past year he has been on 7.5 mg Prednisolone (steroid). There always comes a point that he will quit eating and starts to loose weight. After his teeth are cleaned at about $400-500 a pop, he will start eating again. But, the stomatitis/gingivitis never goes completely away

I have gotten to the point every time I need to give him his medication (steroids) I start to cry because I am aware that this medicine will lead to complications and a horrible death for him.

Well we are at the point where he is loosing weight again and I called the vets office to make an appointment to get his teeth cleaned. Well guess what my vet is gone I am very particular who I take all my babies to. I am not confident with the "other vet" in that office. They have a temp replacement from another office taking up the slack until they find a permanent replacement for my vet. I tend to like the vets graduated from UC Davis here in Calif.

So my hubby, LF (Littlefoot) and I go see her the temp vet. I like her that is sooooooo important to us because, we don't own cats, the six fury kids owe us!

Diagnosis has not changed for LF and this is the second vet out of UC Davis who has receomended we pull his teeth.

I have no idea what all the pro's and con's to this are ;( anyone have a cat or know of a cat that had to have this done?

The look LF's blood and urine today to test. We have scheduled surgery for this coming Wednesday. I wanted to get some feed back before I do this to my baby.

LF is not the only cat in the house but he is the dominate male. We have 3 girls and 3 boys. What will this do to him mentally? Physically? Behaviorally?

hugs Menou Lover

I don't have any advice but my heart goes out to you. Lots of vibes and prayers that everything will work out whatever you decide.

Sorry I forgot to mention that we have opted for surgery for LF but not to take all his teeth out at once.

She has scheduled him for 8 teeth to be removed wednesday. The back two on top and bottom (left - right).

My husband and I are very worried about doing any of this. We don't really want to do this at all ;( but I don't think I can continue giving him a drug that will create horrible consequences for him in the long run. Especially if giving him the drug does not cure the problem.

hugs Menou Lover

Hi - I'm so sorry for your baby. A friend of mine had a Himalayan cat that had to have all his teeth pulled. This was a few years back and from what I recall it was quite expensive; like $2,000. He had the procedure done and the cat made out fine. He still ate everything he always ate, including dry food. As my friend used to say "he just gums it" I guess like anything else, they get used to it after a while. Your baby might actually feel better when it's all said and done because he will no longer be in pain. Please let us know how it goes. Good luck

I believe it's white cat lover on here who has a toothless kitty, so she may be able to help settle any worries you have.

Just like with humans, if the teeth are bad - they have to go. Otherwise there can be all sorts of health problems, as you're already dealing with.

I don't think it will upset him to lose his teeth, right now if this is causing him any pain it would probably make him feel a lot better to have that dealt with. Also, if it means less vet visits in the future, he'll surely appreciate that.
He's still a young cat, so you have his whole life to plan for.

Good luck with Littlefoot (cute name btw ), and I hope some others can chime in to offer some helpful information.

My boyfriend's parents have a nearly toothless cat with stomatitis. Her teeth were pulled over time, but I think in retrospect they wish they had done them all at once or at least more at once. The only teeth this kitty, Calli, has left are her canines (fangs). I know my boyfriend's mother watches her carefully for signs of redness around those remaining teeth, and so far they've been okay. Calli has always been the queen of the household, ruling over 6 dogs, 4 other cats, 4 birds, and 3 humans. The loss of her teeth didn't change her status, and all she has to do is look at one of the cats funny and they stop whatever they were doing. The biggest advantage is that they don't have to worry so much about Calli not eating--she's a tiny cat as it is, so it's very scary when she loses weight.

I'd say to go for it. Leaving the teeth in means Little Foot has more frequent surgery and more exposure to anesthesia as well as the steroid. When they do the surgery, make sure they give pain medicine during the procedure as well as several days worth to take home with you.

I have had three Siamese with this problem ... the first, I went along much as you are now, doing the regular cleanings and extractions when they became necessary. After the third trip for extractions, I chose to go with the full-mouth extraction. My cat's condition wasn't going to change, we knew it was only a matter of time/money until we pulled all of her teeth anyway, so we chose to do it before she got any older and less tolerant of the anesthesia.

The change in her was remarkable. She did not, of course, choose to eat her dry food for several days after the procedure, but after her recover, she ate it with no issues whatsoever.

If your cat's condition is to the point where you know the outcome will be the same, no matter what you do, it might be better to consider cutting to the chase and getting the full-mouth extraction done now rather than putting her through multiple procedures down the road.

Thanks everyone for the well wishes!

After Littlefoots trip to the vet this am, he has patrolled the hallway talking up a storm. I am not sure what he is telling the other 5 cats in the house. lol

We are not wealthy people but when it comes to our cats we have never let that stop us. If they needed some medical attention we always find the money even if we had to borrow it.

Having pets is like having babies, they can't tell you it hurts or where it hurts. They just have to trust us to take care of them.

So, is it the consenses of most people reading this post is to have all his teeth done at once?

hugs menou lover

My Stumpy just had the rest of his teeth extracted 2 months ago due to stomatitis. The term stomatitis is a generic one, and depending on the underlying cause, treatment options vary. Stumpy's specific stomatis is called Lymphocytic Plasmocytic Stomatitis, which is an auto immune disease where his body thinks his teeth are foreign invadors. The only way to diagnose this disease is through a biopsy of his gums.

He first showed symptoms of this about 1-1/2 years ago. Like you, we treated with pred until his appetite was no longer helped by the pred and we had the left side of his mouth extracted. We started there as that is where the gums were the most inflamed. He was then back on anti-biotics monthly and pred for life. After about 6 months, it flared up again and we had the rest of his teeth extracted 2 months ago. He is still on pred and will always be on pred.

Immediately after surgery, you could tell that the underlying stomatitis pain was gone, but for about 4 weeks afterwards, he still had some pain from the surgery. But the good news was that the surgery pain was not as bad and he immediately started to eat again. While the vet told me that he would only be able to eat wet food the rest of his life, he has started eating some dry. Most of his diet is wet food right now. His hardest adjustment was figuring out how to eat again. It is obvious that cats depend very strongly on their front canines to pull food into their mouths. More often than not, I help Stumpy eat his food by picking it up in a small spoon and holding it up to his mouth to scoop. Without this help a meal takes him 20 minutes. With this help he gets through it in about 5 minutes.

My opinion for you, having gone through this myself:
Understand the underlying cause for the stomatitis before you extract his teeth. If it is not his teeth causing the problem, you will be back to square one and you will have put him through a major ordeal for nothing. Complete extraction is a major ordeal.

If you choose to get his teeth extracted, first focus on the areas where the stomatitis is the worst. Leave in his canines if you can - they will help him to be able to eat.

Prednisone is easier on cats than it is on humans and dogs. Personally, I would rather give Stumpy a higher quality of life than a longer miserable life.

There is also a yahoo group that is geared toward feline stomatitis. It is here, but you have to sign up to become a member. That group has helped me through some of the decisions I've had to make in the last few months:

http://pets.groups.yahoo.com/group/F...guid=317889602

The first thing that I learned from this group is that the majority of vets are not necessarily good at dentals. In the case of LPS cats, if the vet leaves even a sliver of bone fragment during the extraction, that the disease will come back. Find yourself a vet whose specialty is dentals if you go through this. They will also tell you to use extractions as a last resort. By that I mean you choose extraction or euthanasia.

If you want to talk about this offline, please PM me.

Originally Posted by Menou Lover

So, is it the consenses of most people reading this post is to have all his teeth done at once?

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Absolutely NO!!!

And I just want to add: I've had 2 other cats with stomatitis that was not LPS. I was able to manage their disease without radical surgery. But yes, it involved Pred and regular change out of antibiotics.

Editing:
Stumpy is the alpha male in my large household (see my siggie). The vet claimed that he would not eat after surgery for days, would never touch dry food again, and needed to be confined post surgery for a week. We took him home the day after the extractions and he immediately reclaimed his alpha status in the house. When he got home, he would go to the food bowl to eat because, as alpha cat, he always ate first. When he realized it hurt him to eat dry food, he would sit next to the bowl looking dejected. He reclaimed status when we fed him, and only him, his wet food (btw that is 3-4 times a day) and he ate better when the other cats were trying to hoard in on him (I don't let them touch his bowl when his face is in it). We had to do this to reestablish the pecking order at feeding times.

Stumpy beat all the predictions from the vet. My theory is that, as alpha cat, he could not show the other cats that he was not in charge. Any pain he felt he hid well and went about his business as usual ruling the household. Your TF will most likely do the same. If he comes home and cannot handle the pain of what he went through, you will probably have marking wars.

And btw - ask your vet if LF would need to remain on pred the rest of his life. If you are concerned about that causing him a shorter lifespan, you will want to know what you are getting into before the surgery.

Momofmany, wow thanks for the input.

Ya know, I don't think they ever did the biopsy on him... I can't remember

They just told us he was allergic to his teeth. So my husband and I just talked and thank you so much for the input.

We have decided to let the vet do the cleaning on Wednesday and a biopsy of his gums. If it is in fact true he is allergic to his teeth, we will deal with it then.

The vet does not want to take them all out at once since he is alpha male with 5 other cats in the house.

Again the decision was left up to us.

About the steroids, she believes he won't need them any more.

hugs menou lover

I went through this with one of my cats and if I had to do it all over again I would have all of the teeth behind the canines removed at one time instead of the way it was done - remove a few and hope that takes care of it. Nope, never again.

Originally Posted by Menou Lover

Ya know, I don't think they ever did the biopsy on him... I can't remember

They just told us he was allergic to his teeth. So my husband and I just talked and thank you so much for the input.

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I talked to cat specialists on the topic and did a lot of reading on LPS. It cannot be diagnosed through bloodwork and absolutely must have a biopsy. If they told you that he is "allergic to his teeth" and did not do a biopsy, then they are only guessing his diagnosis. When a vet uses the phrase "allergic to his teeth", they are typically referring to LPS. I'm unaware of any other auto-immune disease that does this.

I think you are making the right choice by having a biopsy done to confirm what he has. LPS is one of the most challenging and frustrating diseases that I've ever been confronted with (and I've lived with cats a long time). Having his teeth extracted, even if all bone fragments are removed, doesn't always cause a full remission. For some cats, it works wonders. For others, they relapse. Thus my question to you about the pred - my vet understood that even with the extractions, Stumpy's problem will be lifelong and chronic (Stumpy is 12).

Check out the Yahoo group that I gave you earlier. There are a number of very good holistic ideas that people are using successfully on their babies. The trick with the disease is finding the combination of treatments that work for an individual cat. Sometimes it comes down to pain management.

Please tell us how it goes on Wednesday? I will be thinking about LF all day!

Originally Posted by strange_wings

I believe it's white cat lover on here who has a toothless kitty, so she may be able to help settle any worries you have.

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My Twitch is indeed toothless & has been for nearly 3 years now. We struggled for 2 years trying to contain her dental issues before we finally pulled them all at once. Best decision I ever made! If you've got any questions, feel free to PM me!

I have some questions. Kingston was diagnosed with Stomatitus. I was told it was auto immune and also a part of the reason why he gets loose stools. All related to the auto immune. I was also told by my vet that the skin biopsy can cause the gums to inflame worse and she did not recommend doing it. I talked with Kingson's breeder who also talked with another breeder and they agreed that the skin biopsy will cause more irritation. Right now Kingston had the predisolone injection which is good for 2 months I was told. He does not act like his gums are hurting him. But they are very red and swollen to the point they cover his teeth (not as severe on predisolone but still quite noticable). At this time I do not plan on teeth extraction. Do I go ahead with the skin biopsy or just treat this as stomatitus? Did you have the vet do the skin biopsy or a dental specialist? Do any of the cats with the auto immune stomatitus have stool issues? Let me add that Kingston is only 11 months.

I don't know about the Stomatitus but I do know about the gingivitis. Clint came to us at a very yound age and he never really learned to eat right. He eats well just not right. His teeth were always terrible and his gums even worse. We went the cleaning route for a while and most of the time there would be at least one tooth that needed to be pulled then antibiotics after that. Finally one of the vets said that we needed to just get rid of the remaining teeth exept for the canines.


After Clint recovered from the teeth being removed he was like a new cat. He started playing again and his whole general attitude and mood improved. His gums must have just kept him in pain.

Honestly I just don't know any more about what the vet says.

We have decided to go with the teeth cleaning and get a biopsy of his gums.

His teeth are BEAUTIFUL honestly they are just absolutely perfect (accept for the large amounts of tartar and that is mostly on the molars) and his cainines are huge.

I really am beginning to wonder if maybe there is more we can do for him. I have never brushed his teeth but he does use mouth rinse (he fights me tooth and nail when that comes out).

After reading a bit in here, I went to the store last night and bought 6 tiny tooth brushes.

I told my husband with 6 cats I am going to need some help. Most of our kittys are from rescue and have been abused or neglected we call them our shy babies. As a joke one of the white twins, we call him "50 first dates", if you have seen the movie you will understand what that means. In the morning he acts like he has never seen us before, then by the end of the day you can look at him without him running away in terror, it starts all over again the next morning. It is very hard to get there trust and maintain it.

Do you think a differant food might help? Their diet consists of:

1. fancy feast canned for breakfast (appx 5:30 am)
2. fancy feast gourmet gold for a snack (appx 1/2 cup at 5pm when my husband gets home at night.)
3. during the day there is always a big bowl of dry food which is a mixture of iams adult hairball and a prescription diet W/D available for them to eat.

I stay away from anything that has any ash content because it can be really bad on urinary track infections.

I think they eat better than us sometimes.

Well you all are the only people I know who loves animals/cats as much as my husband and I do. So I come here when I am at wits end what to do

I guess in the end as Littlefoots guardians it is up to us to take it all in and make the best decision we can for his care.

I feel like a newb when it comes to raising them lol.

hugs Menou Lover

Fancy Feast is not a very good quality food and may be contributing to your problem. Our vet told us she had more cats that were eating Fancy Feast come in with health issues. Sharky is our nutrition expert around here and she can perhaps guide you to a better quality food.

Originally Posted by Yosemite

Fancy Feast is not a very good quality food and may be contributing to your problem. Our vet told us she had more cats that were eating Fancy Feast come in with health issues. Sharky is our nutrition expert around here and she can perhaps guide you to a better quality food.

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I agree. I've heard FF nicknamed "Kitty Crack". We've switched our dry food over to Wellness. We're still working on which wet foods that Stumpy will eat without teeth, but are circling through the better brands. Find yourself a good pet food specialty store that carries brands like Innova, Wellness, Felidae, California Natural, etc and try those. I thought they would cost more, but since I've switched them over, they eat less and only costs me slightly more each month. You might want to find threads in Health and Nutrician that Sharky has responded to. She is clearly our resident expert and has guided me through changing my foods.

I think the most important thing to understand with any stomatitis cat is the underlying cause for the problem. IMHO, pulling teeth in many cases is simply treating the symptoms and not the cause. And while it might eliminate all pain, it is such a drastic measure for them. I couldn't imagine myself having my teeth pulled then not given dentures. Cats teeth, particularly their canines, are almost like hands to them.

If LF really has LPS, then you know for certain that it is the auto immune disease that attacks specifically the teeth. Your plan sounds like a very good one to me.

We have 18 cats that range in age from 3 yrs old to 14 yrs old with the majority in the 8 to 14 year range. Three of our cats were diagnosed with stomatitis. Two have had all but their canines removed with no complications and they have enjoyed good health since (4 years and 3 years ago). Our Cassie (5 yrs old) had 4 teeth removed 4 months ago during a dental (they found a mass also; it was removed and biopsied and found to be benign, thank God) and then had all the rest of her teeth removed last month because of severe stomatitis. She is fully recovered from the surgery and is so happy and pain free now! She has no problem eating dry food or wet. For her that was the best solution to her problem.

I will be thinking of you and your baby on Wednesday and sending good wishes and healing vibes.