Hi Dr. Marie,
What would cause recurrent tongue and gum ulcers in cats? Chuger is 11 and was originally taken to the vet for vomiting,weight loss, and blood in saliva.She had a teeth cleaning,was put on clindamycin and then doxycycline for 3 weeks.The vet said she had more than normal bleeding during cleaning and was slightly anemic.Her kidneys tested ok.She gained weight and her mouth cleared.Now less than 3 weeks later I'm noticing spot under tongue and some blood again.Thanks so much for your time.
Dr. Marie replied:
Thank you for your question. I'm sorry to hear that your cat is not doing well. The symptoms that you have described has me a little bit concerned.
If this was a young cat, then I would be thinking about things like calicivirus or juvenile stomatitis. However, at 11 years old these are much less likely.
Another possible reason for recurrent mouth ulcers in a cat is uremic stomatitis which is the result of advanced kidney disease. But, if this were the case then you would be seeing elevated kidney enzymes.
Stomatitis is still a possibility. However, I can't recall ever seeing stomatitis appear at 11 years of age.
Another concern would be for some type of a tumor to be affecting the mouth. These can often be difficult to find at first. Any time that I get recurring bleeding in the mouth of an older cat this is my biggest concern. Hopefully this is not what is happening because mouth cancers in cats tend to be very aggressive.
Another possibility is that there is some infection following the dental procedures. However, this wouldn't explain why there were symptoms even before the procedure was done.
And another option which is probably very unlikely could be that she has a problem with clotting her blood. This is not common in cats unless she had gotten into something like rat poison. I think this is unlikely.
If this were my case, I would likely be suggesting another anesthetic so that I could have a look around the mouth to see if there is evidence of cancer. If I couldn't see cancer then I would be taking a biopsy of affected areas so that hopefully we could get a diagnosis. This is probably the best option.
Another option would be to treat with more antibiotics and possibly some steroids as this would be the treatment for stomatitis. But, ideally it would be best to have a diagnosis first.
I think that the best option would be to speak with your vet and have them take another look at your girl.
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Thank you Dr. Marie.I have returned to the vet.Unfortunately expense is a problem.He said the gum is “angry” around a lower back tooth.He mentioned cancer could be a possibility or removing those teeth could help.Knowing I have limited finances he suggested trying clindamycin as needed.If it were cancer would she have gotten better on the doxycycline? What can I do to make her as comfortable as I can ?Thanks again.
Dr. Marie replied:
Cases like this sure are tough. I think that the clindamycin is a good idea.
It's hard to say whether a cancer would see improvement with doxycycline. Doxycycline could help with secondary infection that sometimes goes with cancer, and in some cases can have antiinflammatory effects. But, whether or not it helped wouldn't really tell us either way if this is cancer.
If this *is* cancer, then mouth cancers in cats tend to progress very quickly. As such, I think that it is a reasonable plan to try antibiotics and see what happens. If things get worse (which hopefully they won't) then we may have some hard decisions to make.
Thank you so much for your time and your compassion.
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Dr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.
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