My cat has gingivostomatitis. Should I consider tooth extraction?

I am sorry to hear that Sweety has a painful mouth. Unfortunately, gingivitis/stomatitis in cats can be very severe and quite debilitating. It can be made even worse in cats that have other immune issues, such as allergies or FeLV/FIV infections. Antibiotics and immune-suppressive medications can be used in mild cases. Thorough dental cleaning will help many of these cases more than just medical treatment. However, many cats will need all or most of their teeth pulled to ease the pain. The pain and inflammation is caused by an immune reaction to the tartar. Since we can't completely prevent tartar build up on the teeth, often removing the teeth is our only option. Obviously this is quite a bit more expensive than a simple teeth cleaning. I recommend discussing your options with the veterinarian that has treated Sweety as far as medications or financing for the dental cleaning. Here is some more information that you may find helpful: https://www.petcoach.co/article/7-smart-solutions-for-pet-care-financing/ http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=170

It depends how bad the gums are at the moment, i usually recommend at least one week of antibiotic treatment prior to the procedure and continue the antibiotic treatment another 2 weeks after the procedure. if you are talking about total extraction (often it can be done without extracting the canines), it's important to provide adequate pain relief for after the surgery as some cats may stop eating if the recovery involves a lot of pain. wet food feeding is usually a must after the surgery for as long as needed.

I'm very sorry to hear about Taiga, this is a horrible condition. With the combination of gingivitis extending into the pharynx, it sounds like your vet has diagnosed what we would know as gingivostomatitis in the UK. Which basically means the mouth as well as the gums gets horribly inflamed, ulcerated and sore. It is a tricky condition to treat but very much needs to be tackled head on as it is so painful. It would be a great idea to get your vet to run bloods first as a general health check for possible complicating factors thsy could effect treatment options, also an FIV FELV panel would be useful. Regarding treatment the key is to reduce the bacteria in the mouth and try and suppress the immune system. Various drugs combined with oral rinsing can help to achieve this, however results can be unsatisfactory and any benefit is temporary. You could certainly try and see how well Taiga responds. The other option for severe gingivostomatitis is full extraction of the teeth as you mention. Although it sounds extreme once the teeth are fully removed the mouth heals and there is no more inflammation as the source is gone. I would strongly recommend approaching a vet with extensive experience in feline dentistry as it is imperative that all teeth are removed fully. This may end up being the best option, but in the mean time bloods and meds will help. I hope you find a comfortable solution for Taiga.

From this picture the level of plaque does not justify the gingivitis, as there is not much plaque on Mimi's teeth. So it could be that the nature of gingivitis is viral, or it could be just immuno-mediated. Further testing is required to understand if the cause is a virus. If these test are not available, then symptomatical treatment is advisable. Flagyl is an antibiotics that we commonly use for gastro-intestinal bacteria so perhaps I would consider a different antibiotic with a broader spectrum.

Poor Zelda! Stomatitis is such a frustrating and terrible disease. I assume the surgery was full mouth extractions to help control the stomatitis? This is definitely a good option but totally understandable that it is too expensive. If you haven't already, you may want to talk to your vet about steroid injections. I personally have had good luck with depo-medrol injections and an antibiotic injection called convenia for cats with stomatitis. It isn't a permanent fix but it may help to keep the inflammation under control so she is more comfortable. The depo-medrol isn't ideal for the liver and kidneys but if it is the only thing that keeps her comfortable then it may be worth the risk. I would talk to your vet but the steroid injection could potentially be given every 4-6 weeks depending on her response. The antibiotics injection usually lasts for about 2 weeks. Dependent on her response, she could receive that injection every 2-6 weeks or as needed. If y'all have already tried this then euthanasia may be the best option if you feel like she is suffering. You have to do what is best for sweet Zelda. I know it is a difficult decision. I hope this helps! Hugs!

I find that only 2 treatments definitively help stomatitis. The first is to remove the teeth that are in the portion of the mouth that is affected. Current theories are that stomatitis is an immune-mediated reaction to the teeth themselves that may be precipitated by feline viral diseases (typically chlamydophila and calici) and that is why steroid drugs also help to calm the inflammation and improve the condition of the gums. Antibiotics are very limited in their efficacy, because they don't address the true problem.

That looks like pretty painful gingivitis. There also may be some lesions on the neck of the canine tooth (FORL). Your vet will inspect the whole mouth and may suggest a tooth cleaning under anesthesia where the teeth are also cleaned underneath the gingiva. Unfortunately the teeth can look very clean, but underneath the gingiva bacteria congregate and cause tooth decay, inflammation, and, in serious cases, heart and kidney disease, This is not an emergency, but should be addressed soon.