Meow Mouths

Cats are special in many ways, including many of their disease processes. While cats do get the traditional plaque and tartar buildup that dogs get, they often have less of it and more of inflammatory type disease in the oral cavity. They get things like: “neck lesions or FORLS (feline odontoclastic resorptive lesions)” and “plasmacytic/lymphocytic stomatitis.”  Any cat with oral disease should have a current Feline Leukemia/Feline Immunodeficiency Virus (AIDS) test run (even if they were tested as a kitten) as these viruses can cause oral disease.

With these conditions, they can be clinically normal but the more severe the process is, the more they do tend to show some signs. They often have bad breath (more than a typical kitty bad breath!), drooling and difficulty eating and thus, weight loss. 

When we examine your cats mouth, what we often find that while the teeth are generally clean (the usual exception is the upper pre- molars and molars - they tend to be the ones that have the most plaque/tartar), there is inflammation or redness along the tooth/gum margin. In some cases, they have severe inflammation in the corners of the back of the mouth and the hard palate as well. THESE cats are the ones that are typically in for drooling and not eating. 

One way to determine if there is an issue (especially in cats with no signs but suspicion on oral exam) with a tooth is for us to run a Q-tip along the tooth/gum margin and see how the cat responds. If they “chatter” when you get to a tooth, it may indicate a problem with that tooth that is not always obvious to the naked eye. Let me add that cats under anesthesia will often chatter too when these teeth are touched! The best way to know for sure is dental radiography, which not every veterinarian has in their office. It can also be assessed by dental probing under general anesthesia. 

Dental x-rays will show if there is resorption of the tooth or fusing of the tooth to the jaw bone.

These teeth need to be extracted as they ARE painful and will continue to be a problem. Amazingly, they are often VERY hard to extract. They don’t just come out with some prying and pulling. They often need to be drilled out. The ones that are fused to the bone should be burred down so that the cat has a smooth surface to chew on. 

The cats that have severe stomatitis (inflammation of the mouth) can respond to oral antibiotics and/or injections of a long acting steroid. However, in most cases, this is temporary and ....believe it or not...the cats need ALL or almost all of the teeth extracted. Sounds extreme, I know -  but they do EXTREMELY well. Think of it as if their body  reacting to their own teeth as a foreign invader. These cats - and I have seen this with many cases - do so well post extraction. They eat fantastically. And yes, even dry food! They have no pain. Some have major personality changes because they are NO LONGER in pain! 

A biopsy should be taken while these cases are having any procedures done just to make sure it is just inflammation and not neoplasia (cancer). That will be on tomorrow’s docket.