Pet Talk column: Feline dental pain
August 21, 2013
Oral pain in cats is very common and it makes them moody. Now there's a nice oxymoron for you.
Unfortunately, chronic dental pain is often neglected in cats because pain doesn't manifest in felines like it does in dogs and people. We let you know when we are in pain; cats don't, they just become even more reclusive than they already are. I cannot tell you how many people have told me "Wow, Mr. Jingle Pants is a new cat since we took care of his dental issues." FYI, Mr. Jingle Pants is my favorite cat name of all-time and is owned by my nurse, Melanie.
There are two conditions that cause most of the dental pain in cats: Resorptive Lesions (RLs) and stomatitis. Both may be a result of an underlying immune system problem.
RLs are the closest thing to a cavity a pet gets. We think the immune cells in the gum recognize the enamel in the tooth as a foreign substance and start to attack it; the other theory is that disease in the gums exposes the root and makes it susceptible to erosion. In either case, the tooth becomes very painful. Even under anesthesia cats will flinch when it is probed — it is that sensitive.
The American Veterinary Dental College recommends full mouth x-rays in cats with this disease. That's great but it adds to the cost of an already expensive outing. Since there is no prevention except good oral hygiene and no treatment besides extracting the teeth, I find x-rays in these cases to be frivolous. Uh-oh, I'm out on the limb again. I'm an old-timer and pragmatist; I don't need an x-ray to tell me a tooth with an RL in it needs to come out. But knowledge is good, so if you can afford dental radiographs, by all means get them done.
Extraction is the treatment du jour. We've tried filling them: it failed. We tried trimming the gums and drilling the defect: it failed. The teeth need to come out, period. Your cat will thank you.
The second most common condition is called stomatitis, which means inflammation of the oral cavity. This is a really painful condition and your cat will let you know about this one. They have terrible breath, drool often, have difficulty eating and are just plain miserable. The mouth is so raw and sore it makes people cringe when I show it to them.
There are a few diseases that can cause stomatitis but mostly it is the gums overreacting again. Treatment is very aggressive and includes either one or all of the following: high doses of immune suppressing steroids, antibiotics and most often extracting most or all the teeth. Yes, it is a drastic treatment to extract most or all of your cat's teeth; the procedure is aptly named full mouth extractions. Once again, before and after pictures are quite convincing and a few can be seen here: http://www.avdc.org/dentaldisease.html.
Having your kitty's painful dental problems taken care of will make a world of difference to both you and your cat. Your cat will be pain free and will be a much happier, livelier companion.
Stephen Sheldon, DVM, practices at Gypsum Animal Hospital. August is Dental Month at Gypsum Animal Hospital; you can get a free dental examination. Call 970-524-3647 for an appointment.
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