Why a Full Mouth Extraction is the Best Option for Some Cats Suffering from Feline Stomatitis, Part One

Dr. Laci Schaible

"You want to remove all my cat's teeth? Won't it be painful? How will she eat? Can't we take the worst teeth this time and take more later if she doesn't improve?"

These are all typical cat parent responses when a veterinarian makes the recommendation to move forward with full mouth extraction because of a painful condition known as feline stomatitis, and I fully understand their concerns. Suggesting that we remove a full set of teeth is rather drastic; still, for this condition, radical treatment remains the best option for many patients.

Defining Stomatitis

Feline stomatitis, aka feline lymphoplasmacytic stomatitis, is the cause of a lot of heartache for the veterinarian, the client, and the cat himself. Stomatitis is severe inflammation of the mucous lining of the mouth. Mild inflammation in cats’ mouths is present in the overwhelming majority of adult cats, but this is not what I am referring to. Stomatitis goes far beyond gingivitis or even periodontitis. Stomatitis is a painful problem leading to weight loss, lack of eating, drooling, “hidden cat syndrome,” aggression, and a generally miserable feline. Stomatitis hurts, and in a big way.

What causes stomatitis?

The cause is not completely understood, but the disease is believed to be multi-factorial. Viral causes have been seen, as well as chronic immune stimulation and autoimmune components. In some affected cats, the plaque that forms daily on their teeth causes an allergic reaction and the cat essentially becomes allergic to his own teeth.

Diagnosing Stomatitis

A complete oral examination is a necessary step for the diagnosis of this feline dental condition. While many cats have to be under general anesthesia for a complete oral examination due to the painful nature of the disease, your veterinarian may have a strong suspicion even in a patient who is guarding his mouth.

The cat’s breath will likely smell very strongly due to infected gums. In most cases, the gums are bright cherry red and may be bleeding. There may be missing teeth already. Many patients will appear unthrifty, with poorly groomed coats and progressive weight loss, all traceable to oral pain and discomfort.

A blood workup including viral assays is necessary to rule out FIV, FeLV, and other possible causes. Examination of cells at the cellular level, either by fine needle aspirate cytology or biopsy, is needed to definitively diagnose the condition as it can resemble a type of oral cancer (squamous cell carcinoma) or another condition known as eosinophilic granuloma complex.

Typically, cats with stomatitis show a widespread and dramatic inflammation of the oral tissue, often spreading into the oropharynx and along the mucosa of the hard palate. This is somewhat unique, but with treatment protocols for these diseases varying vastly, a confirmed diagnosis is wise.

Although any cat (or dog for that matter) can develop stomatitis, mature cats and certain purebreds such as Siamese, Persian, and Abyssinians are more likely to develop this condition than others. Cats that suffer from kidney disease or diabetes mellitus are also more prone to feline stomatitis.

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