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Pre-Surgical Information
Spaying or neutering your pet is a big step! There is a lot to consider
when we are planning your pet’s surgery. Here is some information to help
you make wise decisions.
Click here . . .
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Special LibraryOur Special Library
is a collection of informative articles on a variety of health topics.
Click here . . .
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Discharge InstructionsClick here for
information on how to care for your pet at home.
Click here . . .
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Stomatitis
Stomatitis is often seen in conjunction
with Resorptive Lesions, but not always.
Stomatitis can be very challenging to treat.
Stomatitis is defined as inflammation of the mouth.
While occasionally seen in various forms in dogs, it is
much more common in cats. Cats with stomatitis often
have severe oral pain, have difficulty eating, and may
drool excessively. They have a greatly decreased quality
of life.
 There are two patterns of inflammation seen.
The most common is where there is severe inflammation
of the gums next to the teeth. When you open their
mouths, you will see redness along the gum lines. These
cats also often have fairly severe periodontal disease,
and they may have various stages of
Resorptive Lesions present as well. This type of stomatitis can be seen in
the image to the right.
 In addition to inflammation next to the teeth,
some cats will also have severe inflammation in the back
of the mouth, sometimes extending down their throat.
This pattern of inflammation is also called Faucitis,
and it is more severe than the kind of stomatitis that
just affects the gums. You can see the red sores in the
back of this cat’s mouth in the image to the right.
We do not know what causes stomatitis in cats. An immune
system problem is suspected to be the cause. The cats
may be reacting to plaque and bacteria on the teeth, or
some feel that they may be reacting to the enamel of the
teeth themselves. There are some associations between stomatitis and various feline infectious diseases, but
there is not much science behind those associations. But
let me re-emphasize that we do not know what causes
stomatitis in cats. This means that there is no
universally accepted way of treating stomatitis.
Because we do not know what causes stomatitis, we are a
little handicapped when it comes to treating it. Some
veterinary dentists view stomatitis as a medical
condition and recommend starting slow, with dental
cleanings and medication, then progressing to limited
extractions, then progressing step-wise to more
extractions if needed. Others view stomatitis as a
surgical disease, going straight for extractions, then
medical treatment if needed. I personally tend to do the
slow, staged treatments in cats with mild stomatitis,
and opt for immediate extractions in cats with severe
stomatitis and any degree of faucitis.
Extractions in a cat with stomatitis can be very
difficult and time-consuming. It is vital that every
last bit of tooth be removed. If even a small root
fragment is left, the stomatitis will persist. The teeth
to be extracted are often unhealthy and diseased
themselves, and they can break easily. There are a few
tooth roots that can be left safely, but X-rays are
important to evaluate which ones can indeed be left and
which can't. It is also vital that as much diseased gum
tissue as possible be removed, and that the extraction
sites be sutured closed. Pain control is another very
important concern. Because of the delicate and
time-consuming nature of extractions in a cat with
stomatitis, it is relatively expensive procedure. It can
cost from $400 to $800, and in certain cases even more,
for this kind of procedure and the associated
medications.
In the past,
steroids and antibiotics have been advocated as a good treatment
for stomatitis. While I feel that this treatment has
some use, it works best in the mild cases and the cases
that have already had extractions. Lasers have been
proposed as a treatment for stomatitis, and while I find
them useful to a degree, I am not yet convinced that the
benefit gained is worth the expense and the risk of the
multiple anesthetic episodes required. I do on occasion
use it as a one-time treatment when patients are under
anesthesia for extractions, however.
It is important to state for the record that some cats,
especially those with severe stomatitis and faucitis, may never reach the point that
they are fully cured, even if every tooth is extracted.
Some of them will require treatments from time to time
throughout their life. Some will flare up every few
months. However, it is also important to note that even
those cats that do not clear up entirely are much much
more comfortable and happy after extractions than they
were before, even if they may have a flare-up from time
to time.
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