Question:
My cat (male 14yrs) has really bad gingivitis. I have had his teeth cleaned
by the vet and he has had antibiotics, but this has not helped. The vet has
stated that current thinking is that this is virus borne and so cannot be
cured.
He is currently prescribing monthly injections of a long lasting pain
killer (steriod?), but this does not seem to be having a great deal of
effect.
Yawning causes him to yelp loudly and if he tries to eat anything "chewy"
then it causes him pain. We are trying to feed him soft food only but he is
eating less and less and this is causing me deep concern.
Has anybody come across this problem before and have any helpful advice or
treatment methods?
Answer:
There are severeal different possibilities for what is going on with your
cat. Unfortunately, I know from experience that this can be a very
frustrating problem to deal with.
FIV positive cats are more prone to getting a severe stomatitis/gingivitis
that is unresponsive to antibiotics. It may respond to sterid treatment,
but you need to be careful using steroids in FIV cats (lowers their immune
system further). A blood test is the simplest way of ruling this
possibility out.
Total mouth extraction (or even removing just the molars/premolars) is often
recommended for animals that just won't heal, and I have seen some good
results with this method.
An immune condition - plasmacytic/lymphocytic gingivitis. (may also be
caused by FIV) Most common in Siamese, but I have seen it in other cats.
Generally non-responsive to antibiotics(althoyugh obviously these can
prevent sepitcaemia), can respond well to steroids (I am assuming what your
vet is giving is some kind of long actng corticosteroid like DepoMedrol?).
Mouth clearance can also be beneficial for these cats. Biopsy will
generally be diagnostic - but even after biopsy this can be a long road of
treatment.
Then theres things I am sure your vet would have ruled out, like caustic
toxins causing ulceration, oral tumours, or gingival hyperpasia due to
tartar. Kidney problems can also cause ulceration of mucous membranes.
If not already done, I would ask your vet about blood tests (probably full
panel including FIV/FeLV) and then possibly a biopsy (which will usually
require another anaesthetic).
Like I said, a diagnosis in some of these cases doesn't always mean an
instant cure. It can be a long process. I've seen some people go through
it with great results, and some people not really see total improvement
after months of treatment. Hopefully your cat is an easy one to figure
out....
The vet has already done blood tests and I know the cat doesn't have FIV or
leukemia. Antibiotics helped when first diagnosed but the problem
re-occured in about 6 weeks. Last time I went to the vet I asked for
another course, despite the fact the vet was not optimistic about their
effectiveness. He was right - they did nothing.
The vet things that taking the teeth out will do nothing for the problem and
that I'll just have a toothless cat with gingivitis!
