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Stomatitis treatment after full tooth removal

post #1 of 8
Thread Starter 
Clio was born in April of 2007. In November of 2008 she stopped eating and lost half her body weight. We put her on an allergy diet for 4 weeks along with Medicam for the inflammation to see if it was a food reaction, but when she showed no improvement we scheduled a biopsy. The results showed severe stomatitis and so our vet removed all of her teeth, scraped the sockets clean, and reshaped her gumline so she'd be more comfortable. From the x-rays done during surgery we learned she had already reabsorbed about 25% of her tooth roots and had almost no ligaments left. It was really bad, but within 12 hours of surgery she was eating again. Within three weeks she had regained all her lost weight.

(Whatever the cause was it appears it was genetic as her twin sister started loosing weight and having mouth problems as well. Four months after Clio had her surgery, Elda had her teeth removed to her canines. That seemed to be enough for her and El's been fine ever since. Our vet explained that they probably have an autoimmune disorder that made them allergic to the ligaments that hold the teeth in place.)

For nearly two years Clio was healthy and happy with no signs of any mouth problems. Then this last November she went downhill again and was back to being actually worse then when she was first diagnosed. Severe swelling, bleeding, and drooling, so bad that she wouldn't let me get near her. She started loosing weight again as well.

This time we put her on Prednisilone. It's helping, but it's not like she's back to the normal happy cat she used to be. Even on the medication she's depressed and sleeps a lot. I can tell she's still uncomfortable, though she eats like a pig and is at a great weight. The other problem is that if it's been more than 24 hours since her last dose she starts hurting again, and then I can't catch her to medicate her, and then it's just horrible for both of us at that point. (I've got health problem too and can't move the furniture to get her or chase her down.) In over six months I haven't been able to lower her starting dose of the steroid at all. The only thing that's nice about is that I can get her a 4 month supply for $10 at the local human pharmacy.

The doc mentioned that the next step he'd take is to put her on Cyclosporine. The monthly cost for that type of drug is plain out of our reach. (We've hit a rough financial patch, and I had to stop taking all my asthma medication because we couldn't afford it, which is not healthy but it's not like I had a choice.) My vet is very open to new ideas, so I know I can talk with him about other treatment methods.

Is there any?
post #2 of 8
I'm so sorry you are going through this! My boy Stumpy had the last of his teeth removed a couple of years ago due to an auto-immune version of stomatitis and he's been on pred for about 4 years now. At 16 years old, he is actually doing very well.

When your vet ran tests, did they actually test for a disease called Lymphocytic Plasmacytic Stomatitis? This is the auto-immune version of stomatitis where a cat thinks that it's teeth are foreign invaders. Even after teeth extraction, there may be residue in their mouth which can keep their gums inflamed. What seems to happen most often is that during extractions, a small fragment of tooth is left behind, which triggers continuous inflamation. If you had gone to a feline dental specialist, they would have done a complete set of xrays afterwards to ensure everything was gone. Not all vets know to do this, nor know what to look for.

If this is what your girl has, there are options out there other than strictly steroids. It seems that sometimes you have to work thru the options to find what works. Some vets rotate antibiotics in for short periods of time. Some (outside of this country) recommend immune booster medications (most are not sold in this country), and some recommend laser surgery on the gum tissue.

After Stumpy was diagnosed, I found a great support group in Yahoo (go to Yahoo.com and look up stomatitis). The folks there shared what they tried and what was successful or not for them. What I learned is that you just need to keep trying until you find what works. Laser surgery helped only a small number of cats, and actually made most of the cats worse. It is a last ditch effort when all else fails.

For my Stumpy, I found the best thing is keeping him on steroids, giving him whatever food he likes (he loves dog food therefore he gets a little of it each day), and keep his stress level down. His mouth looks better now than it did even a year ago - it keeps improving 4 years post surgery. There is hope, it's extremely frustrating while you work through the problem.
post #3 of 8
I also have a cat with LPS stomatitis. He did have a couple of extractions due to periodontal disease, but otherwise has kept all his teeth. He is on daily treatment that does not involve any steroids- it has been nothing short of a life-saver for him. He has yearly dentals, but that's pretty much it- evidently since your kitty has no teeth, that wouldn't be the case. I am in Dallas, but they will work with your vet, if you want I can send you their information by PM- the medicine is their proprietary formula. They have treated over 6,000 cats with it since the 70's...
Anyways, just letting you know that there are choices- Bugsy does great on it :wave:
post #4 of 8
Thread Starter 
Yes, she does have confirmed LPS. (Had to pull her biopsy report to be sure.)

I know he did a bang-up job of the tooth removal. He's considered the best dental veterinarian in the tri-state area, and treating advanced cases of this is a specialty of his. (He does a few cats a week on referrals from other practices.) There was a series of about 30 dental x-rays which he brought out to show me when I picked her up. He was also talking about how much better she looked after surgery looked now that her lips weren't pulled back over her ears. I still have her teeth in the back of my computer drawer. He sent them home and I never had the heart to just toss them out.

The other issue was that if he hadn't managed to get everything she shouldn't have healed to normal for almost two years. And I do mean completely normal - her mouth was the healthiest shade of pale pink, and she would gum my arm when she was happy. (ew) To see how easily she bounced back after the teeth removal and then watch her go back downhill is the confusing part. The did retest her in November for FIV/FeLV and did a complete blood workup just to make sure the mouth problems weren't secondary to another health issue, but everything came back normal. About the only thing it could be is a relapse of the stomatitis, although how is confusing.

Maybe asking for a round of antibiotics while keeping her on the steroids would be a good first step. We have a multitude of other cats, so the steroid treatment has always worried me about secondary infections. I'll look into the yahoo group as well - thank you for that!

Carolina - I'm going to PM you now. Thank you for letting me know about that clinic!
post #5 of 8
Is he on any pain medication? If not that can help him tremendously. I have a cat that takes Buprenorphine as needed (he used to take it daily) and it really helps. It's super expensive if you get it from the vet but I get it from a compounding pharmacy which is a lot cheaper. I get the injectable kind which is more expensive at about $98 for a 3-months supply but if you get the oral kind it's only about $40 for a three months supply. It's from Roadrunner's pharmacy in Arizona. The shipping is free which is nice.

If you have trouble giving your kitty the steroids you may want to try a depo injection which he would get about ever 6 weeks. At my vet it's about $15 per shot so it's very affordable. Since the vet tech can give the shot I don't have to pay an office fee, just the $15.

Unfortunately my cat was not a candidate for the medication Carolina is talking about but now another one of my cats is starting to have the same issue so I'm hoping to convince my dogs' vet to help me get him on that. My regular cat vet wouldn't help me since she doesn't know what's in the medication. I'm really hoping that I can find a vet to help and it will work so that he can keep his teeth. My other cat that I thought had stomatitis probably doesn't have it but instead has periodontal disease and will have to have his teeth pulled anyway. He's doing much better now though than he was a few months ago so the meds must be working some.

I'm just curious. How much did you pay to have your cat's teeth removed? I've been quoted between $2500 and $4000 and I'm just having some major problems coming up with the money.
post #6 of 8
Thread Starter 
I haven't even really thought of long-term pain medication for her. That is really something I should talk to him about. We did buprenorphine with her last time she was really bad but it didn't work as well as the metacam.

The shots are another good point. I know he wanted to stay away from them as long as possible due to the risk of side effects and the problems of getting her there on a regular basis. (He used to be 2 minutes from me, but I've since moved and it's more like 40 minutes.) Clio is a great cat, but she's definitely a shy little thing! I wish she was more outgoing like some of our other kitties because it would make treatment so much easier.

Clio's complete surgery was $1400, and we spend around $600 more on everything leading up to the surgery and the bloodwork. That was for all the x-rays, and the surgery, the biopsy, and an overnight stay because she wasn't responding well to the pain meds and they wanted to make sure she was comfortable. He not only removed the teeth but also scraped the sockets clean and reshaped her gumline (the bone) so she could close her mouth comfortably. I think he said the surgery took a few hours, but it went easy as pie since he didn't have to yank her teeth out - they more or less just fell out at that point. If they had given him more trouble then the cost would have gone up because it would have taken longer. (He actually told me that he hated that particular surgery since it can sometimes be so difficult to remove all those teeth!)

Elda had half her teeth pulled at another veterinary clinic because we couldn't afford to have the surgery done again at my vet. (She stopped eating about a month after Clio got better, of course.) We were luckily able to qualify for a medical grant through a local charity that covered the entire cost. It was just under $400 for everything for her. However, while that clinic told me that the surgery they performed would stop all of her problems, it was NOWHERE near what my vet would have done. For Elda they just pulled her teeth and flushed the sockets with saline. No cleaning the sockets, no stitching her up, no reshaping, no nothing. The vet didn't even do it - the tech did! It took Elda months to bounce back, and thankfully it did work for her and she's been mostly fine. I would still love to take her to my vet and have the surgery double-checked, but that has to wait as well. I had severe reservations about taking her there, but it had come down to either having it done there for free, or just putting her sleep. She's my psychotic Beanie Baby, and we had just spent all that money on her sister, so what was I supposed to do? (I had so many medical problems that by that point that our cards were maxed out on my bills, and then with Clio's expenses I went and begged my family for the money and I couldn't go and ask them again for El's. I didn't even have anything I could have pawned to cover it. Not a place a pet owner wants to be.)

Are there any local charities around that can help? I didn't even know the one that helped us existed until I called the local shelter and asked if they knew of anything. And before you choose a vet, make sure to ask for references of people who have had their cat's teeth removed due to stomatitis. That'll give you a clue to how well he or she does the surgery. Another place to go is local shelters as the people on staff and the volunteers there are usually very knowledgeable about feline health matters and will know which vets do a better job. Don't go cheap unless you absolutely have to. I do think El is much better off alive and somewhat butchered then completely dead, but I wish so much there had been another option for her.
post #7 of 8

My cat was a stray someone left behind at this apt complex I lived at almost three years ago.  I took him in and then realized something was seriously wrong with him.  He got diagnosed with stomatitis.  We have been doing depo injections for two years now and yearly dentals.  The last two depo shots have worn off in a weeks time.  I am so frustrated because he is so uncomfortable and just a few days ago he was purring and feeling so great.  I am looking for alternate treatment ideas that will help other than depo that I can buy myself to avoid the expense of the vet.  If anybody can help with ideas please reply.  thanks so much.  I am glad I found this forum.

lizzy

post #8 of 8

I was horrified to find out that my Mugzee was probably in severe pain. I am picking her up from the vet this afternoon after cleaning and 5 extractions. My question is, can she still eat dry food? I feed my cats a good quality (and expensive) dry formula with a bit of wet food every day. 

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