Anyone have a cat with acute stomatis post-FME?

I adopted a 5 yo female tortie from the Reno Humane Society with extensive dental issues, which were later diagnosed by my vet as acute stomatitis.

After a steroid injection and much research on the subject, we decide to have Stella's teeth removed (FME). This was done by a highly accaimed veterinary dental specialist in Reno. All remaining teeth and retained roots were extracted, and confirmed with dental x-rays. Six weeks post surgery Stella's stitches have healed but her stomatitis has returned with a a vengeance, especially in the posterior fossa area of her mouth.

My vet gave her a second steroid injection, and has started her on daily cyclosporine by mouth. The hope is that the cyclsporine will eventually address the inflammation, negating the need for regular steroid injections.

So my questions:

1. Does anyone have experience with continue stomatitis post-FME?

2. And can diet play a role in creating an inflammatory response, such as with a protein allergy? The reason I ask this is because my vet wants her on Hill's Z/D from a hydrolized protein source in case a food/protein allergy my be adversely affecting the acute stomatits. Whereas, I would like to see her on a single source protein or LID diet.

Thanks!

Shameless bump!

Why would the vet recommend pulling all of her teeth for acute stomatitis?!

Acute means sudden.

My Spencer who is 3 years developed acute stomatitis and the first thing my vet suggested was allergies.   She gave him a 2 week antibiotic for the infection, and something for pain.  I tried switching him (and my other 2) to Hills d/d duck flavoured dry and wet food.  None of them would eat it.  I took what I had left back to the vet and got the d/d venison.  They all ate it, so now that is all they eat.

I took him back every 2 weeks for 6 weeks.  After the first 2 weeks there was some improvement; the mouth and gums weren't as red. She gave him another 2 week antibiotic. I went back again in 2 more weeks.  Vast improvement at that time, but still room for more.  She gave him yet another 2 week antibiotic.  I took him back 3 months later and his mouth was completely healed. 

He doesn't get treats or people food, only the Hills d/d venison.   And he hasn't had a problem with his mouth since.

I fear you probably  had your kitties teeth all pulled for nothing

Your kitty likely has allergies, especially since the problem has returned. I would get your girl on a hypo-allergenic diet asap.  The food mine are on is a single protein, and corn free.  The starch is green peas.  I can't believe they love it!  LOL

Going by your post it sounds like this was not a sudden onset with your girl, and you went through the usual treatment route (cleanings, antibiotics, and steroids) prior to the FME? In my simple little mind, I think of stomatitis as an allergic and/or auto-immune response. The big, tough question is; what is their little body responding to?

My Simon had a stomatitis recurrence less than 2-months post extractions (he had all lowers behind fangs, and all uppers except fangs, removed in June 2013).  The following Aug. we were back at the vet with another flare-up. In reading hundreds of others' experience, I am finding that to be not uncommon.

Thankfully, I haven't had to take Simon back since last Aug. and the reason for that may well be an answer to your second question regarding diet; I removed all fish from his diet. That seems to be working right now, but who knows about long-term?

What's it going to hurt for you to try a different diet, and why not start with the Hills d/d venison, as Natalia_ca mentioned. You know of one kitty that's already worked for. Just keep a close eye to make sure whatever new ingredient you introduce does not worsen the condition.

Please keep us posted of your experience as it seems there are so many of us desperately seeking help with this.

OK maybe "acute" wasn't the best choice of words.

"I fear you probably had your kitties teeth all pulled for nothing". And this is clearly an insensitive statement made with little knowledge of my cat's extensive medical history.

In reviewing the medical records from the humane society, and speaking with the vet that did most of her work, I learned that Stella was surrendered with a mouthful of "bad teeth." Some teeth were missing and extensive gingivitis was evident. The HS removed teeth and retained roots on two occassions WITHOUT THE USE OF DENTAL X-RAYS! My dental vet said many of her teeth were in the process of being resorbed, so in Stella's case, the situation was beyond merely a change in diet.

The FME was not a decision arrived at lightly. I was struck by a quote I had read by a Dr Hale, a stomatits expert from Canada, something to the effect that cats can enjoy a long and healthy life without but do not deserve to live in pain.

Managing the inflammation is where I am at the moment. Obviously, I'd like to do so without the use of steroids. We'll see what results the cyclosporine yields. I wish it was as easy as a dietary choice but I'm not sure it's as simple as that. She was eating canned Evo duck strictly following her surgery. I'll continue with the z/d, as recommended by my vet, and explore the d/d novel protein more.

Stomatitis is so very frustrating because there are evidently so many possible causes. I had read so much about all of the different treatments I just ended up confused. When Simon had to have another steroid injection post-extraction my hope was to have some plan of action in case it recurred. The diet change was something I could do immediately while I held my breath for a couple of months to see if the inflammation returned. Whether the diet change really helped or not, I can't say for sure, but the stomatitis hasn't reared it's ugly head in a while, so I'll keep plugging along with what we're doing until we have another recurrence.

Stella is one lucky little girl to have you in her camp trying to hard to help her.

So, my question is, can oral inflammation be controlled solely by experimenting with various protein sources (venison, duck, etc), or does the food/protein source need to be hydrolized (Hills z/d) to minimize the chance of any POTENTIAL allergen to cause an inflammatory response?

And found the quote from Dr Frasier Hale:

"The good news is that domestic cats do NOT need teeth. Pet cats do not need to hunt and kill their own food or chew raw meat from a carcass. But they do need and deserve a mouth free of pain and inflammation and for cats with FCGS, the only way to achieve and maintain that is with whole mouth extraction - sooner than later. "

I am dealing with the same thing.  My cat Bella had FME in mid Nov. 2013.  While the stinky breath went away and the soars on the corners of her lips went away, her gums remained red.  Not as red as they were but still very red.  We tried Cylosporine in January, but it gave her the runs.  That was 2ml twice a day.  We were told to stop it since the runs were not going away and could do more harm.  My cat eats and plays so in not in terrible danger but she also has continually infected nail beds in her paws. (we think it is related)  The other night she had a bad stoma flare up in her gums as she yelped and growled at her food the first time in months.  She was back at the vet today, ,received and antibiodic shot for her paws and was told to try the cyclosporine again but at an even lower does.  .5ml twice a day for 3 days, than to increase to 1ml and stay on it for 3 weeks and see  how it goes.... and she improves and does not get the runs they might increase the dose very slow.

Dental vet says it is her best chance for less red swollen gums.

I was curious how your cat is doing on the Cyclosporin? Did it help, any side effects?  I see you started her on it in March.

I feel for you.  FME is no fun.  My cat is only 2.5 years old and was only 2 when she had them out.  She is a light weight.  She weighed only 6.9 lbs when she had her teeth out and after surgery lost more weight and was 6.1 lbs.  Now at least, I am happy to today she is 7.4 lbs!  The best weight she has ever had in her life.  She's a fluffy mini Maine Coon mix, a rescue cat and love her dearly!

Please let me know how it is going with your cat and treatments.  I have not yet tried changing the foods.  We tried a few different brands in the beginning when we got her, but nothing seemed to make a difference. I did not try any of the Hills brands.

What is the most recommended food to give, if it is a food allergy (although I doubt it)

Currenty she eats Royal Canine Specail for skin and coat and Royal Canine Intense Hairball.  They are both dry food.

She has Purina Pro Plan in various flavors for wet, mostly pate classics such as Chicken, Salmon, Turkey and Ocean White Fish.