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Sheldon: Does your cat need full mouth extractions?

Steve Sheldon
Pet Talk

“A full mouth what, Doc? Why would you pull all of my cat’s teeth out?” asked Megan. 

“Because I want your cat to be out of pain from this condition called stomatitis,” I replied.

While extreme and dreaded, the full mouth extraction is a curative procedure that almost always cures a painful and frustrating and common disease of cats called stomatitis.

Stomatitis, or feline gingivostomatitis, is as bad as the name sounds. It is a painful condition of the teeth, gums and oral cavities that results in a mouth full of rotting teeth. It is peculiar to cats. Cats, who we all know are as tough as steel, have suffered through this disease for years and veterinarians have struggled to cure it or even control it.

Something goes awry in a cat’s immune system and immune cells, mostly plasma cells, react to the plaque on the teeth and attack enamel of the teeth at the gumline. It is like your cat is allergic to their own teeth. The attack continues to eventually include the roots and crowns of the teeth. The gums become red and infected; a rotting smell ensues due to the infection and necrosis (dying tissue).

We don’t know what causes the immune system to go astray. A small percentage of cats have viral diseases like feline leukemia, feline aids, calici and herpes viruses but, unfortunately, there is no cure or even good way to control those conditions. Most cats have no explained reason.

For years, veterinarians have attempted to control the disease with frequent cleanings, antibiotics, steroids and immune-suppressing drugs. All with limited success and patients who continue to be in pain. 

Veterinary dental specialists (yes, those exist) have been telling us for years to pull all affected teeth and possibly even the ones in proximity because, sooner or later, they will all be affected by this disease. So better to bite the bullet so to speak and pull all the questionable teeth. Oral radiographs can help identify which teeth need to be pulled.

Many veterinarians are understandably reluctant to do this and I myself have been guilty of attempting other remedies before full mouth extractions. But time and time and time again, after we do the procedure and control pain and infections, we hear this: “Doc, my cat is a new cat; I really can’t believe it.”

It’s like this, I tell them. If you are young and healthy and have a chronic sinus infection or persistent bronchitis, you are still going to work, still going to the gym, still watching football on the weekends and still functioning. But you are tired and feel like crud all the time. That is how your cat with stomatitis feels: functional but crummy.

So, if your cat has this painful condition, here is my recommendation: Look for a cause like those mentioned above. You need to know if it one of those viruses even if there is no cure. Certain medications must be avoided with those viruses and others can help the condition a little. But nothing is going to make your cate feel like a cat again like a full mouth extraction surgery.  And yes, your cat will still be able to eat just fine.  

Stephen Sheldon, DVM, practices at Gypsum Animal Hospital.  He can be reached at drsteve@gypsumah.com, http://www.gypsumah.com or 970-524-3647.


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