Tuesday, April 28, 2009

Feline Stomatitis, Stomatitis in Cats

Dear Dr Gordon: I have a 3 year old Maine Coon cat that has a constant odor coming from the mouth. When I took him to the vet, she was able to look into the back of the mouth and show me my cat’s throat. I couldn’t believe what I was seeing. The back of my cat’s throat was raw and the gum tissue around the teeth was very red. The doctor convinced me to put my cat under anesthesia and biopsy the back part of the throat. All the teeth were cleaned and the biopsy revealed a disease (which I can’t remember) that the doctor says has no cure. I am worried that my cat will suffer his entire life with this sore mouth. Is there anything else that I can do? PB

Dear P.B.

Although it is possible that your cat may have some type of cancer in the back of the mouth (a disease that has no cure), I am hoping it is something else. You probably would have remembered if the doctor had said that your cat has a form of throat cancer. I suspect that the biopsy may have revealed a syndrome we see in a certain percentage of pure breed and mixed breed cats, called lymphocytic and/or plasmacytic stomatitis. Please call the doctor to get the name of the disease, for that can affect treatment and outcome.

It is essential to use immune support such as  Power Probiotic for your kitty to feel better. Probiotics can help restore the natural flora in the mouth and throughout the digestive tract.

Let’s dissect the words describing this syndrome. Stomatitis is an inflammation or infection in the mouth. Ok, so far so good. Lymphocytic and/or plasmacytic is a descriptive term illustrating the type of inflammatory cells that are migrating to this inflamed area.

What causes this infection/inflammation to occur in certain cats and not others? We are not sure.
Some viral infections are suspected of increasing the cat’s susceptibility to this disease. Your cat should be checked for the Feline Immunodeficiency Virus (FIV or Feline Aids virus) and the Feline Leukemia Virus. I suspect your doctor has already done this. If not, get it done. The virus does not cause the disease but makes cats more vulnerable to the disease. Others speculate that certain cats (ones that are genetically predisposed), are having an exuberant response to antigens or foreign invaders in the mouth. The suspected culprits are the bacteria inhabiting the tooth roots of some of these cats.

The syndrome is first recognized in fairly young cats that have halitosis (very bad breath, trouble swallowing, lack of appetite, and sometimes gagging). Examination of the teeth and back part of the throat reveals areas of extreme inflammation. It looks (and I am sure feels) like the worst sore throat you have ever had your entire life.

How is this dealt with? If the cat is FIV or FeLV positive, steps should be taken to insure your cat stays indoors and does not expose other cats to the disease. Oral antibiotics and frequent dental cleanings will help keep the mouth in good shape. Although controversial, acupuncture, interferon and lactoferrin can be used to improve the condition of the cat’s lesions. Supplements that we have seen help include Not Drops and Power Probiotic  If the cat is negative for these viruses, most veterinarians will use some type of strong immunosuppressive drug (like corticosteroids or others) to calm down the inflammation and analgesics to relieve the pain.

Although it may sound very extreme, sometimes full mouth extraction of the teeth is the only thing that will bring about relief and return the cat to a decent quality of life. I have seen several cases over the years that have completely resolve only by removing all of the teeth. Most veterinarians will only do this as a last resort, when all other therapies have failed after repeated attempts. I personally have been reluctant to recommend this procedure because it is difficult for the pet in the short term, expensive for the owner, and time consuming for the doctor. The long term success rate, however, leads me to believe that this may be the only thing that will save the cat from life-long pain and suffering.