feline stomatitis (update from "difficult recovery from feline dental extractions")

[Larissa]

My original post is below.

I have a 14y FIV+ cat who’s been dealing with stomatitis for about six months now. He’s had all but his canines taken out at this point. He struggled recovering from both surgeries required to remove the teeth but then seemed to level out. He wasn’t eating with gusto but he was eating. He’d dropped from 18lbs to 16 but held steady there for a time.

He’s now going on food strikes and is down to 14lbs. He’s been to the vet a few times and what’s visible in his mouth doesn’t seem severe enough to warrant this kind of reaction. He has redness on the back along tooth/jawlines on both sides but the throat seems fine. No hamburger appearance, just redness. He doesn’t have a serious reaction when eating. Occasionally something will land on the back gums and he’ll wince and whine but he’s not panicky so although it clearly hurts it doesn’t seem to be searing pain. He does seem to have pain when opening wide or yawning.

I try to manage him really well. A selection of soft/soupy/blended foods always available plus soaked dry food. He goes to the clinic for 3-4 days of laser therapy whenever his pain comes above the “ok” threshold (ie - he backs off of food or begins hiding or is less social). We’ve recently begun lysine, amitriptyline, 1-TDC and daily at-home laser therapy. I have a rinse he hates with a passion, so use that sparingly. I keep buprenex on hand but try to use that sparingly as well because pain gets better but he obviously feels off physically and hides. Onsior will NOT go down.

Are we missing anything?

We recently added a puppy to the household. Had I known of his issues in advance we wouldn’t have done it but deposit was made long before he got sick. How much effect does the stress of this change make? He has his own room with closed door and dog-free zones at all other times. He doesn’t lov e her but will sleep on the same couch with her and freely enters spaces she’s in.

I’m at a loss to help my sweet boy.

---

My 13y cat (neutered male, FIV+) is having a terribly hard time recovering from dental extractions. Does this mean anything more than he’s just having trouble recovering? Will things go back to normal once all is well again?

Backstory - 4 years ago, he had two canines taken out and recovery was no big deal. Just before the New Year he had an exposed tooth root, inflamed gums from the FIV. Extracted 3 teeth and cleaned the rest. Recovery was rough - he acted fine but it was easily 4-6w before he was eating well again. Timely recheck showed nothing abnormal. Last Tues he was acting like a tooth was hurting so promptly went to the vet. Gums were inflamed all around again so Thurs we extracted the remaining back teeth. He stayed overnight for meds and monitoring, came home Friday, tried a little soft food (nope) and seemed mostly himself. Ate tiny pieces of handfed deli chicken that night and Sat but wouldn’t let anything touch his gums. He seemed to be gradually getting more sensitive despite a Fentanyl patch intended to stay on til Monday. Sunday his willingness to try food disappeared. I left the patch on but added Buprenex to try to get a handle on the pain. Monday, called vet about the problems, they prescribed more Buprenex and Oncior (which I cannot get in him, no way, no how). Yesterday he hid after morning meds. Was still in hiding at lunch, cowering in a litter box by the time I got home from work. Rushed him back to the vet, where they found nothing really amiss, just angry gums, and I asked that they keep him this week to keep an eye on him and get the pain under control. Annual and presurgery bloodwork has never shown ANY issue in 10+ years, last panel done last Tuesday.

He’s typically super resilient and nothing affects his personality. To have him so out of sorts and in so much pain has me really worried that I made the right decision and that we are properly caring for him. Would appreciate hearing experiences!

[Marshfield]

I know it seems drastic, but some cats who undergo major oral surgery need to have an esophageal feeding tube placed so that they can get their medication and nutrition while waiting for the mouth to heal

[Larissa]

Thank you Marshfield. That actually doesn’t sound drastic to me at all. I cannot even fathom how uncomfortable a full extraction must be. I trust my vet but wouldn’t mind asking - what pain meds would you have onboard a cat like this?

[Marshfield]

Usually transmucosal buprenorphine. I am guessing from your description that your cat has stomatitis. The gums in bad cases look like hamburger. They take time to heal. Hence the feeding tube

[Larissa]

Yes, stomatitis was the original diagnosis. We’ve done regular cleanings and vet presumes this is a complication of FIV (first one we’ve seen, honestly). I’m a little alarmed at how quickly this has come on in the last few months. Appreciate you chiming in! Your advice coincides with that of my vets, save for the feeding tube they’ve not yet mentioned.

[CindyCRNA]

I agree with the feeding tube. Cats get hepatic lipidosis (sp?) pretty quick and a feeding tube for a week to allow healing would not be a bad thing.

[glitterless]

My dog had stomatitis and endured several surgeries until he finally had a full mouth extraction. The surgeries did get progressively worse for him; especially when the canines were extracted. I remember times when I sat on the floor trying to coax him to eat anything and wondering whether I’d made the right choice. He did eventually recover and did well without any teeth, but it was a hard road for him. Not much advice to offer, but I hope your kitty improves and gets back to his old self soon.

[kimkatsooo]

It was bad enough for our girl that we will not do it again She was in so much pain and just did not understand what was happening. She never really over came it. She got very finicky about eating and lost a lot of weight despite trying all of the tricks I have used before. She lasted another 6 months but they were not good months.

[Larissa]

Thank you guys so much for sharing. It really is quite upsetting as the owner. I don’t know that I was prepared for such complications even though the last surgery was difficult as well. The take home instructions of “should be eating by tonight, soft food only for 10-14 days” seems laughable. We’re 11 days out and he still is in severe pain, expected to stay at the vet again this week. I am so sorry to hear your pets had to suffer too, and longer in your case kimkatsooo

[CanadianTrotter]

So sorry he’s still in pain, hopefully the stay at the vets will help him along.

[Larissa]

(update to the original post)

I have a 14y FIV+ cat who’s been dealing with stomatitis for about six months now. He’s had all but his canines taken out at this point. He struggled recovering from both surgeries required to remove the teeth but then seemed to level out. He wasn’t eating with gusto but he was eating. He’d dropped from 18lbs to 16 but held steady there for a time.

He’s now going on food strikes and is down to 14lbs. He’s been to the vet a few times and what’s visible in his mouth doesn’t seem severe enough to warrant this kind of reaction. He has redness on the back along tooth/jawlines on both sides but the throat seems fine. No hamburger appearance, just redness. He doesn’t have a serious reaction when eating. Occasionally something will land on the back gums and he’ll wince and whine but he’s not panicky so although it clearly hurts it doesn’t seem to be searing pain. He does seem to have pain when opening wide or yawning.

I try to manage him really well. A selection of soft/soupy/blended foods always available plus soaked dry food. He goes to the clinic for 3-4 days of laser therapy whenever his pain comes above the “ok” threshold (ie - he backs off of food or begins hiding or is less social). We’ve recently begun lysine, amitriptyline, 1-TDC and daily at-home laser therapy. I have a rinse he hates with a passion, so use that sparingly. I keep buprenex on hand but try to use that sparingly as well because pain gets better but he obviously feels off physically and hides. Onsior will NOT go down.

Are we missing anything?

We recently added a puppy to the household. Had I known of his issues in advance we wouldn’t have done it but deposit was made long before he got sick. How much effect does the stress of this change make? He has his own room with closed door and dog-free zones at all other times. He doesn’t lov e her but will sleep on the same couch with her and freely enters spaces she’s in.

I’m at a loss to help my sweet boy.

[Zu_Zu]

no advice … just a boatload of Jingles & AO ~ he’s is very lucky to have you helping him ~

[shiloh]

Poor boy. I had cat that Per my vet had the worst case of stomatitis she had ever seen. All teeth removed and still it would not heal. She put him on cortisone (prednisolone?) shots every month. This went on for nearly a year and he finally healed up. It was a struggle and I have to keep in mind that this sort of thing will probably be his cross all the rest of his life.

[Larissa]

Thank you shiloh and Zu Zu! Shiloh, how was your cat during his treatment? Did he really struggle with eating? My guy is eating well using blended wet food and a syringe but he’s not terribly interested in the same food from a bowl. Or different food from the same or different bowls. I can’t figure out what’s preventing him from eating. I’ve varied the consistency from pure liquid to puree and none of it is appealing. He randomly licked clean a full bowl of straight-from-a-can pate, hasn’t had interest in any food bowls since. His baseline pain seems much better now. He eats from the syringe without any complaint, grooms himself clean, is back to talking a bit. The only time I see him wince is when he yawns. So why no food?? This is an INSANELY frustrating condition!