FIV, Stomatitis, and Teeth Removal

[Alex_and_Bodie_s_Mom]

I have a four-year old cat who has been battling stomatitis (mouth sores) for about 18 months. He is FIV-positive, and we monitor him carefully. I have learned to be aware of his eating habits and his ‘tells’ for when the mouth sores are flaring.

He was on daily antibiotics for a while, which didn’t do much good; we did Convenia for a while after that, then moved to steroid shots (Depo) in order to manage the situation. Since March, the Depo shots have been every 4 weeks, almost like clockwork. As long as the Depo is working and he’s not in (a lot) of pain, he’s a very happy, energetic kitty who loves life.

Today, the sores flared again after only two weeks since his last shot. The vet suggested that since the stomatitis is getting progressively worse, I should consider having all of his teeth removed.

He had two molars removed last winter, which helped for a bit. I am not against this IF it will help. I’ve read up on the surgery and the vet and I talked about the vet which would do it (a veterinary dentist), and the aftercare (he’d have to stay at my vet for a while with a feeding tube). I’m just wondering if it’s worth it. I am willing to do it if the cost isn’t prohibitive, but has anyone had this done? What were the results?

[vxf111]

I had an indoor cat with stomatitis (not FIV positive, however) who I managed on atopica for many years. I should have had her teeth all pulled the moment she was diagnosed, but I was gunshy about it for mostly personification reasons (I couldn’t imagine a person with no teeth). She ultimately succumbed to kidney disease very young, but it was getting to the point where the teeth were going to have to come out when she died. She was always a very sickly kitten/cat. Something was going to get her young, for sure.

Her full sister (also indoor cat, non FIV) didn’t have stomatitis but did have the most rotten, awful teeth (why do cats even come from the factory with teeth? They don’t need them and they’re just a liability. #faultydesign). I learned my lesson and pulled them all. She did not have to have a feeding tube or any unusual care. She did say at the vet for a couple days post surgery. She woke up from the surgery, ate dry food the second she was awake, and never looked back. Pulling those teeth 100% increased the quality of her life and bought my lots of extra years. This one was always tough/a fighter. I lost her just this year to kidney disease and she was 18.

Currently recovering in my bedroom is the barn cat. She had a mass on her face (benign, thank goodness, it was a cat version of a pore of winer with a cyst in the middle). While they had her under to remove that, they did a dental. There were 2 rotten teeth and 4 ones with pockets. I removed them all. Better to get them out now rather than let them go bad. She was a little swollen when she woke up but within days was 100% back to normal. She’s not a tough cat, she’s a destroyer of worlds. She’s going to be FINE. Even as an outside cat.

If I had another cat with any inkling of major tooth problems, I’d just take all the teeth out. It’s worth it. If you leave them, they’ll only be more trouble in the end.

[Zu_Zu]

just … Jingles & AO ~

[Alex_and_Bodie_s_Mom]

@vxf111 - thanks so much for that! The veterinary dentist is the one who puts in the feeding tube, and since his gums are so awful right now (the second the vet opened his mouth on Saturday, I could see they were the worst they’d ever been) we probably need that time for them to heal, too. Glad to hear that yours did well with it!

@Zu Zu - thank you!

[Larissa]

i HIGHLY recommend the full extraction - all teeth, all at once. i learned at my poor FIV-positive guy’s expense that it’s really the best and only way to treat this condition for good. i have owned him for 10 years and never experienced a flare until he was about 14.

i hemmed and hawed about how difficult it would be for him at that age and my local vet offered that it could perhaps be done pulling only affected teeth then all but the canines and fronts. we spent a year and a half doing three surgeries, laser treatments, antibiotics, stomach meds, pain meds, shots, three surgeries and syringe only feedings. i saw multiple vets but didn’t make it to the right specialist until after that year and a half. after another surgery to remove the remaining teeth and clean up any remaining fragments and roots from the first few surgeries, plus an immune suppressant for a few months, he is doing fantastically at almost 16. his recovery was tough but likely due to how advanced his was and the previous surgery pains.

my non-FIV female cat displayed some weirdness about grooming around the same time he was doing check ups with the specialist so i took her in for evaluation - stomatitis at 12 and a full mouth extraction for her as well. there were almost zero days of hardship with her after surgery.

neither has ANY problem eating or grooming or any changes in personality from before onset. they can eat pate, gravy and shredded wet food and dry food either dry-from-the-bag or soaked. my male was a big cat from day 1 (around 18 lbs), dropped to 11 lbs at his worst and has more than bounced back - 21 lbs now about a year out from surgery. (he’s far too fat but i can’t figure out where he’s getting to food outside his diet?! work in progress).

your dentist sounds like a good one if they’re already prepping for a full extraction and feeding tube. having a vet do it all up front and handling the first few days of recovery ought to set you on the right path pretty promptly. if i’m not mistaken, my dental specialist practice said the recovery rate for FIV cats is pretty good - only 10-15% have problems that extraction and immune suppressants don’t take care of for good. happy to answer questions on any part of the process or recovery! i had a thread or two about some of the struggles during the worst of it.

[DMK]

Yes, I have friends who have done the full mouth extraction and the cats are so much happier for it.

I have one (a Maine Coon) with stomatitis as well, however he has been managed quite well in daily application of EFAC and regular cleanings. But with what we know about the disease now it does appear there are two types or at least two levels, and Zifu appears to have the milder version. It’s been about 4 years managing this way and he’s very comfortable still eating crunchy teeth cleaning treats in addition to his regular food.

So I guess I would say full extraction isn’t something you have to immediately go to if your cat has stomatitis, but when they have the aggressive version, it’s the best choice.

[Alex_and_Bodie_s_Mom]

@Larissa - thanks so much! That’s precisely what I needed to hear. It will have to be quite soon, as three days after his antibiotic, he is still too sore to eat dry (he ran to the bowl this morning before I could get his broth/bits in his bowl and - big mistake). So I’m thinking the recovery from the sores is going to be a road for him as well.

@DMK - that’s really interesting - I didn’t know there were two types. I imagine Minion has the more aggressive type. My vet wants to do it this month if we can get him in with the specialist, and after this morning, I agree.

[Larissa]

poor baby. it is SO hard to watch them in this condition. eating was a chore for my guy but his sores also extended to the rear of his mouth and throat. every time he’d yawn or stretch his jaws he’d end up screaming and bolting away

i would definitely have the conversation with the surgeon’s office about how to dose him with pain meds and such afterwards. my local vet wanted me to pill him (:eek: a full mouth of stitches!) whereas the specialist worked with me to get him injections until he could tolerate the liquid i could put on his gums. i forget the names of each but would be happy to go look up any information that would help when you set the appointment. i think you’re going the right direction and will have a whole new kitty very soon! best of luck!

[rubygirl1968]

My neice adopted a cat two years ago with stomatitis. She had all her teeth pulled and hasn’t had any other issues since then. I wish you and your guy good luck with the surgery! Hopefully he’ll feel much better afterward.

[Alex_and_Bodie_s_Mom]

@Larissa - thanks so much for that! I will definitely ask about the pain meds (giving him ANYTHING is impossible; his sores are front and back, and he really doesn’t even want me touching his head right now). Waiting for the vet to call me with the information from the specialist now.

@rubygirl1968 - thank you! I hope he will be better.