Stomatitis Recurrence AFTER complete extraction

Hi everyone,

This is my first post & I hope that I can benefit from your collective experience & wisdom. My beautiful ginger tabby, Bruce (age 8, neutered indoor male) was first diagnosed with stomatitis in 12/2011. (*He had the WORST breath imaginable) We took him to the vet,he got depomedrol, clindamycin, and then extraction of 17 teeth a week later. He did great for 1 month, but the bad breath returned. Took him back to the vet, stomatitis had returned. Steroids & antibiotics again, then 1 week later, complete dental extraction end of January 2012. Over the past few days, he has been running from food. Much more frightened, withdrawn than usual. No odor though (probably because he has no teeth). Took him to the vet today, and lo and behold, the stomatitis is back. We are given 2 options: laser treatment or interferon. We are told that his prognosis is not good. Our vet did not want to have him on life-long steroids. (*Of note: I am an doctor for people. I know what steroids can do) Granted, the side effects of steroids are not great, but neither is the suffering and pain that my Bruce is enduring.

I do not like my options. I am worried that the laser treatments are not going to do very much & we are subjecting my boy to car rides (that he hates), vet visits 3 times a week for treatments (also hates), with no reasonable guarantee of success.

Anyone else out there have a similar experience? Any advice?

This is not about money. I would eat toast for the rest of my life if an expensive treatment would offer benefit to my boy. But what would I be getting him into?

Thanks for taking the time to read this. I look forward to reading your responses.

Hi, this is not too uncommon.... but I am sorry your boy went through so much and is still having problems.... Exactly because of this (recurrence after extractions), I chose treatments instead - I too have a boy with stomatitis.
The treatments do not involve steroids or antibiotics.... but do involve daily medication.... Are you able to pill him?
Bugsy is doing fabulous :bigthumb:
He has also improved quite a bit since he went on a raw diet - you might see some improvement as it is quite good for inflammation related issues :nod:

The people who treat Bugsy will work with your vet, if you want to contact them for more information I will be happy to PM you their info - they are wonderful and caring people..... They will mail the medication to your vet, and work with him.
The treatment is not a "quack" treatment - it was developed by Dr. Wiggs (Robert), which is considered by many as the father of Veterinarian Dentistry in the US. He was a specialized in stomatitis, but unfortunately passed away a few years ago. You can google him for more info.

Good luck

The problem was allergies, but when faced with a decision between steroids and treatment, I chose treatment for one reason: I did not want a diabetic or sick cat. If you love your cat, you want treatment for him - and of course the best food he is able to eat without teeth.

I know the utter misery of caring for a cat with chronic stomatitis so I empathize with you. At the shelter where I volunteer, they use depo shots on their FIV+ cats who have stomatitis.  Several of these cats are in their teens and have been getting monthly shots for years without any other problems arising.  As you know, cats have fewer bad reactions to steroids than humans.  Not that I like that route, but it isn't the worst scenario.

I haven't used laser treatment on any of my cats or fosters but my vet's office, where I've been a client for 30 years, are very enthusiastic about it and told me they have seen good results in cats with a variety of chronic illnesses - even ones you wouldn't think of using laser treatment on usually, such as chronic unresponsive URI.

And, there is pain medication. It's up to you to decide on the quality of life Cage will have with various treatments. Some cats just roll with the punches, disliking the treatment but coping well. I think they are in the majority. There are others, and I've cared for a few, who seem ruled by their illness and treatment (rather like most humans.)
 

I think contacting the group Carolina recommended is a great next step. Given he hasn't responded to past treatment, and the two options given you don't have a very good outlook, I think it's worth the try given it's easy to implement and it's working for cats all around the country. :nod:

Hello   am in the same boat as you. My Cat Binder has had a total of 4 surgeries to remove all his teeth and still the stomatitis is back. The only thing that works is the depo medro {steroid} whis as you know causes diabetes. After months of searching on internet came across a article  about a vet named {Dr. Rober Wiggs DVM} who has a treatment with great results. However he died in 2009, But I think the practice is still using his treatment for stomatitis.   I cannot find the correct vet hospital that he worked at. Still am trying. If you find it they can ship meds to your vet. Please I will let you know if I find it and please let me know if you find it. Thank you and good luck with your family member.

I sent them your information Jack. You should Hear from Kelly from their clinic soon. More Vibes going your way

Carolina
I would love the info for stomatitis treatment. My cat was diagnosed in December 2009 and has had extraction prednisolone and monthly depo shots. The depo shot are losing their efficacy and I'm looking for something that will keep him comfortable. In addition he has hyperthyroidism which is treated using a transdermal cream applied twice a day. We have a vet appointment Saturday for another shot so any information you could provide me would be greatly appreciated.

Hi JPrawlings--

I'm not Carolina, but I also have a little kitty with stomatitis. Mine has had a PARTIAL (all but the four canines) extraction and is not doing well. She is scheduled to have the remaining 4 canines removed in 10 days or so. She has had three courses of Depo but I am so very concerned about the high potential for disaster in the form of diabetes, heart disease and so on.

I've been told over and over again how you MUST do a full extraction for a good result. I'm wondering if your kitty has had a full?? I am so sad about putting her thru another surgery. How sad if it doesn't bring complete relief!

Carolina was wonderful enough to provide the info on the Dallas Clinic to me. But when I contacted them with my story, they simply sent me a list of local dental vets in my area. If you have a better result, I'd love to hear about it.

I know how horrible this is. My best wishes for your kitty.....and mine! 

Hi,

As I understand it, stomatitis is still relatively poorly understood, but cats in the wild get it, so current thinking is this may be a virus (but these days, everything is now being blamed on virus's so don't be surprised if this changes over time). I have been told that vets are working on a vaccine for stomatitis. So maybe in a few years it won't be such a problem. Keep our fingers crossed.

I have two boys who have FIV and Stomatitis. Basically, I am about to tell you everything I have learned. Please use your own judgment  before following any of my advice. I don't know you or your cat. I can only share what I have learned.

We pulled all their teeth and treated with Depro and Clinicure (antibiotic) for about a year for one, a few months for the other.  We did not see much improvement. We then had laser treatments on both cats. The idea here is that the laser creates scar tissue and scar tissue does not infect. We still had problems and our vet at the time was more then willing to put one of the cats down. However, remember we have cats with compromised immune systems already, so it is entirely possible you have better success. We were told for some cats a second laser treatment some times  works. Because both cats seemed so weak and sick at that point in time we decided not put them under anesthesia at that time. My understanding is that the laser treatment is a hit or miss kind of thing. Some cats respond well, others don't.  I was also told  the length of time the cat has had the disease can make a difference. We brought one cat into the house with stomatitis, the other developed it after we had him for two  years and we started treatment on his stomatitis at the beginning of problem.

Because we moved and changed vets (because of location) we found a vet with her own stomatitis kitty. She gave me the prednisolone and antibiotics to give to both cats. At this point we gave the two cats different treatments regimes.

We gave one of the cats 10 mgs a day (a higher dose then is recommended). We were able to get the stomatitis in remission (this is what worked on the vets own cat). The next trick was to slowly reduce the amount of prednisolone over time. We were able to do this also.

The other cat we gave the standard 5 mgs a day. He still has stomatitis.

One difference between the Depro and the prednisolone that I saw was with the Depro I would see significant improvement after the shot, but then it would wear off and our cats would lose ground, lose weight etc. They were on a kind of medical roller coaster. With the prednisolone, and consistent dosing they did better. There was not this kind of up and down in their response.  Maybe it is because my cats have other health issues but there were times when one would lose so much ground I honestly did not think I would get him back. Now I am able to keep him at a consistent health weight looking, well OK.

Now yes, there is a high potential for side effects. This is something you should never do without the full cooperation of your vet. Problems  such as diabetes and I would add infections as a result of lowered immune system among other things is very real. However, you can check for these with periodic blood work and good basic monitoring. In other words watch you kitty like a hawk. Watch her eat, check her box for problems and watch for changes in behavior.  But if you cat is not eating because her mouth hurts then you need to weigh the risks against the benefits. Neither of our cats have developed diabetes but one did develop an infection. I have been worried that the prednisolone would trigger the FIV. With one cat definitely no, the other not so sure.

Another consideration is that the cat on the high dose prednisolone did not have the same level of disease as our cat on the lower dose. In other words, his mouth was not as red or inflamed, yet he was the one who had simply stopped eating. In other words, it seems, like people different animals have different responses to pain. Our low dose kitty for whatever reason was not as affected by the pain of the disease as our high dose kitty. Our high dose kitty is the one who were able to start treatment right at the beginning of the disease. So, any of these things could be a factor as to why we were able to get one cat into remission.

One other thing I have done for both the boys is periodic shots of B-12 and periodically give them fluids. The steroids make them 'go', a lot, and it seems they are prone to becoming dehydrated over time.  The B-12 does seem to significantly boost their immune system and stimulate their appetites. If you want to be conservative you might want to investigate what can be done to help improve your kitty's immune system. I have not done a lot of work in this areas, but you might consider putting them on a hypo-allergenic diet. I did put my cats on the Royal Cannin hypo allergenic diet. I have heard both positive and negative things about the Royal Cannin, but  we could not get our cats to eat the Science Diet version.  In other words treat the problem as if it were a food allergy. Talk to your vet for more specific information.  I would recommend doing some good research before starting a raw food diet. My (limited) understanding is that a raw food diet is an excellent way to go for some animals and not for others. In other words it is not a one-size fits all kind of treatment option.

My vet is willing to give me the B-12 shots and the fluids etc. to take home. Bringing your cat into the vets regularly for these simply treatments can be very expensive. If you don't have experience sticking needles into your cat, ask you vet if they would be willing to train you. It can be nerve racking at first but other than the emotional stress to the human it really is not that hard. I have one cat who I would much rather give an injection to than pill. Oh, if pilling is problem, I have been successful grinding  the prednisolone up and mixing it into their food - baby food works great.

One other thought, prednisolone is different from prednisone. As, I understand it cats have to be given prednisolone. Dogs and people can take prednisone. I believe that prednisone breaks down into prednisolone in the body. Cats are unable to break down prednisone. (Forgive the obnoxious coloring but it took me a while to get the two drugs straight and I have even had a pharmacist give me prednisone by mistake not realizing they could not be substituted).  I have had problems getting the prednisolone. At one point I had to go to a compounding lab which was more expensive and for whatever weird biochemical reason, did not seem to be as effective. So before starting prednisolone treatment you might want to check your supply line. It was a big issue for us last year.

One last word, there are thoughts that there is some connection between Stomatitis and intestinal lymphoma. Neither of my cats have developed lymphoma, but my vets cat has. I don't know if the connection has to do with chronic inflammation (chronic inflammation is connected to lymphoma) or the medication or some other connection like cats with compromised immune systems. I don't think this is even confirmed with solid valid research, however it is being 'discussed' and something to watch for.

Good luck

Hi,

As I understand it, stomatitis is still relatively poorly understood, but cats in the wild get it, so current thinking is this may be a virus (but these days, everything is now being blamed on virus's so don't be surprised if this changes over time). I have been told that vets are working on a vaccine for stomatitis. So maybe in a few years it won't be such a problem. Keep our fingers crossed.

I have two boys who have FIV and Stomatitis. Basically, I am about to tell you everything I have learned. Please use your own judgment  before following any of my advice. I don't know you or your cat. I can only share what I have learned.

We pulled all their teeth and treated with Depro and Clinicure (antibiotic) for about a year for one, a few months for the other.  We did not see much improvement. We then had laser treatments on both cats. The idea here is that the laser creates scar tissue and scar tissue does not infect. We still had problems and our vet at the time was more then willing to put one of the cats down. However, remember we have cats with compromised immune systems already, so it is entirely possible you have better success. We were told for some cats a second laser treatment some times  works. Because both cats seemed so weak and sick at that point in time we decided not put them under anesthesia at that time. My understanding is that the laser treatment is a hit or miss kind of thing. Some cats respond well, others don't.  I was also told  the length of time the cat has had the disease can make a difference. We brought one cat into the house with stomatitis, the other developed it after we had him for two  years and we started treatment on his stomatitis at the beginning of problem.

Because we moved and changed vets (because of location) we found a vet with her own stomatitis kitty. She gave me the prednisolone and antibiotics to give to both cats. At this point we gave the two cats different treatments regimes.

We gave one of the cats 10 mgs a day (a higher dose then is recommended). We were able to get the stomatitis in remission (this is what worked on the vets own cat). The next trick was to slowly reduce the amount of prednisolone over time. We were able to do this also.

The other cat we gave the standard 5 mgs a day. He still has stomatitis.

One difference between the Depro and the prednisolone that I saw was with the Depro I would see significant improvement after the shot, but then it would wear off and our cats would lose ground, lose weight etc. They were on a kind of medical roller coaster. With the prednisolone, and consistent dosing they did better. There was not this kind of up and down in their response.  Maybe it is because my cats have other health issues but there were times when one would lose so much ground I honestly did not think I would get him back. Now I am able to keep him at a consistent health weight looking, well OK.

Now yes, there is a high potential for side effects. This is something you should never do without the full cooperation of your vet. Problems  such as diabetes and I would add infections as a result of lowered immune system among other things is very real. However, you can check for these with periodic blood work and good basic monitoring. In other words watch you kitty like a hawk. Watch her eat, check her box for problems and watch for changes in behavior.  But if you cat is not eating because her mouth hurts then you need to weigh the risks against the benefits. Neither of our cats have developed diabetes but one did develop an infection. I have been worried that the prednisolone would trigger the FIV. With one cat definitely no, the other not so sure.

Another consideration is that the cat on the high dose prednisolone did not have the same level of disease as our cat on the lower dose. In other words, his mouth was not as red or inflamed, yet he was the one who had simply stopped eating. In other words, it seems, like people different animals have different responses to pain. Our low dose kitty for whatever reason was not as affected by the pain of the disease as our high dose kitty. Our high dose kitty is the one who were able to start treatment right at the beginning of the disease. So, any of these things could be a factor as to why we were able to get one cat into remission.

One other thing I have done for both the boys is periodic shots of B-12 and periodically give them fluids. The steroids make them 'go', a lot, and it seems they are prone to becoming dehydrated over time.  The B-12 does seem to significantly boost their immune system and stimulate their appetites. If you want to be conservative you might want to investigate what can be done to help improve your kitty's immune system. I have not done a lot of work in this areas, but you might consider putting them on a hypo-allergenic diet. I did put my cats on the Royal Cannin hypo allergenic diet. I have heard both positive and negative things about the Royal Cannin, but  we could not get our cats to eat the Science Diet version.  In other words treat the problem as if it were a food allergy. Talk to your vet for more specific information.  I would recommend doing some good research before starting a raw food diet. My (limited) understanding is that a raw food diet is an excellent way to go for some animals and not for others. In other words it is not a one-size fits all kind of treatment option.

My vet is willing to give me the B-12 shots and the fluids etc. to take home. Bringing your cat into the vets regularly for these simply treatments can be very expensive. If you don't have experience sticking needles into your cat, ask you vet if they would be willing to train you. It can be nerve racking at first but other than the emotional stress to the human it really is not that hard. I have one cat who I would much rather give an injection to than pill. Oh, if pilling is problem, I have been successful grinding  the prednisolone up and mixing it into their food - baby food works great.

One other thought, prednisolone is different from prednisone. As, I understand it cats have to be given prednisolone. Dogs and people can take prednisone. I believe that prednisone breaks down into prednisolone in the body. Cats are unable to break down prednisone. (Forgive the obnoxious coloring but it took me a while to get the two drugs straight and I have even had a pharmacist give me prednisone by mistake not realizing they could not be substituted).  I have had problems getting the prednisolone. At one point I had to go to a compounding lab which was more expensive and for whatever weird biochemical reason, did not seem to be as effective. So before starting prednisolone treatment you might want to check your supply line. It was a big issue for us last year.

One last word, there are thoughts that there is some connection between Stomatitis and intestinal lymphoma. Neither of my cats have developed lymphoma, but my vets cat has. I don't know if the connection has to do with chronic inflammation (chronic inflammation is connected to lymphoma) or the medication or some other connection like cats with compromised immune systems. I don't think this is even confirmed with solid valid research, however it is being 'discussed' and something to watch for.

Good luck

Mommyto6 said:

Carolina was wonderful enough to provide the info on the Dallas Clinic to me. But when I contacted them with my story, they simply sent me a list of local dental vets in my area. If you have a better result, I'd love to hear about it.
I know how horrible this is. My best wishes for your kitty.....and mine! :catguy:

Click to expand...

Hi Mommyto6 - This sounds like a misunderstanding.
Yes - you DO need a local vet or dentist to do the treatment on the kitty, which is why probably they gave you the list. They won't simply ship you the meds. The kitty needs to be followed closely by a vet, unless you are in the Dallas area and treated in the Clinic.....
Your vet could work with them, if he/she is willing to.... Or the kitty's dentist. But yes, it has to go through a vet - but they will treat the kitty remotely for sure.

jprawlings said:

Carolina
I would love the info for stomatitis treatment. My cat was diagnosed in December 2009 and has had extraction prednisolone and monthly depo shots. The depo shot are losing their efficacy and I'm looking for something that will keep him comfortable. In addition he has hyperthyroidism which is treated using a transdermal cream applied twice a day. We have a vet appointment Saturday for another shot so any information you could provide me would be greatly appreciated.

Click to expand...

Jprawlings, I will post the info here as I am often out of town -
972-3858400
Veterinarians Dental
Contact Kelly or Jim

Good Luck

hi carolina. i am very interested in the treatment for feline stomatits. i have a cat diagnosed with stomatitis. he isn't even 2 years old. had teeth cleaned and has been on clindamycin. stomatitis came right back. i really don't want to put him on steriods or pull of his teeth. could you send me information on dallas vet clinic? i would really appreciate it. could you just email me with that information. thank you so much. frannie100

frannie100 said:

 
hi carolina. i am very interested in the treatment for feline stomatits. i have a cat diagnosed with stomatitis. he isn't even 2 years old. had teeth cleaned and has been on clindamycin. stomatitis came right back. i really don't want to put him on steriods or pull of his teeth. could you send me information on dallas vet clinic? i would really appreciate it. could you just email me with that information. thank you so much. frannie100

Click to expand...

It's best to send @Carolina a private message if you can.  However, I have flagged her, so hopefully she will see your comment here and respond

for your boy.  Just remember, in case you DO need to have all his teeth pulled, many cats have that done and it doesn't effect their eating too much.  Some even continue to eat raw food !  But along the same lines, my understanding is that  pulling them is no guarantee that it will completely "cure" the stomatitis either.  I have heard wonders though about the above mentioned clinic..

catmomoffour said:

Hi everyone,

This is my first post & I hope that I can benefit from your collective experience & wisdom. My beautiful ginger tabby, Bruce (age 8, neutered indoor male) was first diagnosed with stomatitis in 12/2011. (*He had the WORST breath imaginable) We took him to the vet,he got depomedrol, clindamycin, and then extraction of 17 teeth a week later. He did great for 1 month, but the bad breath returned. Took him back to the vet, stomatitis had returned. Steroids & antibiotics again, then 1 week later, complete dental extraction end of January 2012. Over the past few days, he has been running from food. Much more frightened, withdrawn than usual. No odor though (probably because he has no teeth). Took him to the vet today, and lo and behold, the stomatitis is back. We are given 2 options: laser treatment or interferon. We are told that his prognosis is not good. Our vet did not want to have him on life-long steroids. (*Of note: I am an doctor for people. I know what steroids can do) Granted, the side effects of steroids are not great, but neither is the suffering and pain that my Bruce is enduring.

I do not like my options. I am worried that the laser treatments are not going to do very much & we are subjecting my boy to car rides (that he hates), vet visits 3 times a week for treatments (also hates), with no reasonable guarantee of success.

Anyone else out there have a similar experience? Any advice?

This is not about money. I would eat toast for the rest of my life if an expensive treatment would offer benefit to my boy. But what would I be getting him into?

Thanks for taking the time to read this. I look forward to reading your responses.

Click to expand...

I happened upon this website while researching stomatitis. It was recommended by my vet that my cat Suki have a full mouth extraction due to Stomatitis and I just got bad news today after her post-op check up three weeks after the full mouth extraction (except for her front canines). Her gums are inflamed again and pictures were taken to send over to the vet that did the extraction surgery. I am at a loss here and don't know what the next course of action will be. Suki is 7 years old and I don't know what people are doing to control the stomatitis symptoms. Do you know anything new?