9 year old cat has stomatitis. She is NOT FIV positive. She has had all her teeth pulled as a last resort. She received a depomedrol shot every three weeks for pain. Have had her on Atopica for 5 weeks in addition to the depo. She needs a shot today because the Atopica is doing nothing, and the depo has worn off.
When she's on the depo, she eats like there's no tomorrow...great appetite. But when the 3 weeks are up, her mouth is so sore that she won't let me put anything in it, like any kind of drops or any kind of pain meds. She HURTS.
We also tried a laser treatment on her gums, but it did not help.
Is there anything else I can try? I don't want to put her down. We love her very much and seeing her in pain is heartbreaking. I am taking her in to my vet tomorrow, but just thought you might have some suggestions that might help.
Dr. Marie replied:
Stomatitis can be extremely difficult. Not all stomatitis cats are FIV positive. I have seen quite a few that were healthy other than their stomatitis.
It sounds like you are doing all of the right things. In the vast majority of cases, full mouth extractions solve the problem and there is no pain after this. But I have heard of some cases where pain persists.
The first thing I would suggest, if this were my case would be to have dental radiographs done to see if perhaps there are any tooth roots under the gums. This can sometimes happen after extractions and could be contributing to pain.
Otherwise, treatment can be difficult. You can ask your vet if perhaps adding buprenorphine could help with the pain. Gabapentin is another drug that can sometimes help for chronic pain. You can ask your vet if those options would be likely to work for your girl.
I hope things improve soon. You are doing all of the right things.
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Thanks for that suggestion of the x-rays for tooth roots. I will suggest that to my vet.
With her, she is doing great one day, then the next day she is in so much pain she can't eat. I have no advance warning. So I get her to the vet as quickly as possible for the depo, but it takes it a good 2 days before she can eat again. The depo has been lasting approximately 21 days between shots.
I have Buprenex on hand for her, but unfortunately once the pain starts, she refuses to allow me to give it to her because she hurts. Holding her by the nap of the neck and forcing it in her mouth only makes her hurt more.
After my visit yesterday, my vet says we are going to suspend the use of the Atopica because it's not helping. We got another depo shot, and we added prednisone once daily to see if we can get her past the 21 day mark for the depo. I understand the risks involved there concerning the possibility of diabetes developing, but at this point I am up against a wall.
Dr. Marie replied:
This sounds like a very difficult case. The only other thing I could suggest is to ask your vet whether a referral to a veterinary dentist could possibly help.
I really wish I could offer more.
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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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