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

Dr. Laci Schaible

As discussed in part one, feline stomatitis is a very painful condition that causes severe inflammation in the mouth and gums of affected cats.

Treatment Options

There is no one treatment for stomatitis that is effective on its own. Cats with stomatitis become severely allergic to the plaque on their teeth so professional scaling and cleaning of the teeth above and below the gum line is often a starting point. To decrease the plaque load, extraction of teeth is often recommended. Antibiotics are helpful in some patients to control oral infections and meticulous home dental care is needed.

Unfortunately, maintaining perfect oral hygiene is not possible in cats even with daily brushing, as plaque will inevitably return (I’ve yet to meet a cat who tolerates daily flossing). In many cases, anti-inflammatory medications such as glucocorticosteroids may be helpful. Intermittent antibiotic therapy known as pulse therapy helps some patients. Hypoallergenic diets may even prove helpful.

Refractory cases often require premolar/molar extractions, if not all the teeth. Removing all the teeth affected by inflammation, tooth resorption, or periodontal disease currently shows the highest success rates. The removal of the periodontal ligament lining, the alveolus, is also advisable. Special care is paid to pain control and suppressing remaining inflammation after dental extractions.

Some patients that fail to improve after surgical treatment are sometimes treated with carbon dioxide laser therapy on the remaining lesions. This laser therapy may need to be repeated monthly in an attempt to remove the plaque-retentive surfaces that are thought to be part of this plaque hypersensitivity. If all attempts fail, then immune-suppressing drugs can be used as the final medical step to try to control this painful condition.

Prognosis

Studies show success in most patients after full mouth extractions (removing all the teeth). Cats are able to eat quite well and many prefer hard food even with no teeth. Most pet parents see a marked improvement in six weeks or less post-surgery.

Some severely affected cats can take up to a few months to really show what we would finally consider adequate improvement. No matter what treatments are done, a small percentage of treated cats don't really improve significantly with full mouth extractions. Sadly, some pet parents choose humane euthanasia when pain continues despite exhausting all treatment options.

Can stomatitis be prevented?

Unfortunately, we do not currently know of a way to prevent this terrible condition. Impeccable teeth brushing may help deter the onset in milder cases but the hyperimmune response to plaque cannot be prevented. Excellent dental hygiene at home may delay its onset or decrease its severity.

Remember, feline stomatitis can sometimes be confused with types of oral cancer so if you suspect your feline suffers from stomatitis, make sure to have your pet evaluated ASAP by your veterinarian. It's a general rule that the longer these cats go without treatment, the longer it will take to get their pain under control. 

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