Treatment For Stomatitis

Treatment for StomatitisFinding out that your cat has stomatitis can be scary. I know, I’ve been there. You will probably wonder what options there are for treatment for stomatitis. There are many ways you and your vet can attempt to treat stomatitis, but I have to be honest and tell you that there is no sure-fire cure for this painful disease.

The problem with treating feline stomatitis is that there is no way to know the exact cause of the disease. It is often believed to be caused by a reaction to plaque, but it isn’t always.

Vets will usually start with the easiest treatment options, with the hope that one or a combination of several may be enough to resolve the stomatitis. They will eventually work their way up to the more advanced treatment options if the easier ones do not help.

Treatment Options For Stomatitis

Before I get into the various methods of treatment, I want to say something about tooth removal. Having teeth removed is always to be a last-ditch effort at controlling stomatitis. If your vet says that your cat’s teeth need to be removed without trying anything else first, then you need to find another vet and get a second, or even third, opinion. Try any or all of the following treatments before going to the extreme of removing teeth.

The treatment options listed below are not in any particular order, with the exception of tooth removal, which is listed last because it should be the last thing you do.

Antibiotics

This is likely to be the very first thing your vet tries. If your cat is lucky, a round of antibiotics will clear up the stomatitis.

This was the first treatment option we tried with Lily. At first it seemed to help, but the inflammation returned after we stopped giving her antibiotics.

Diet Modification

The inflammation seen with stomatitis may be the result of food allergies, so your vet may recommend that you change your cat’s diet by eliminating foods made with grain or grain-fed meats.

I did not try this option. We have five cats, two of which have food sensitivities and do well on the Iams dry food that they all eat. Changing the food for one of our five cats but not the other four would have been a nightmare for me, which is why I skipped this method.

Supplements

There are over-the-counter supplements that you can give your cat that may either resolve or minimize the symptoms of stomatitis. You can talk to your vet about what supplements might be helpful to your cat.

I currently give Lily two suppliments, and they help her tremendously. She takes L-Lysine in the morning and at night, and PlaqueOff just at night (PlaqueOff should not be used in cats that have Hyperthyroidism). Other people have had success with AquaDent, but this needs to go into a source of drinking water and Lily wouldn’t drink the water that had AquaDent added to it. Obviously, it won’t work if your cat won’t take it.

Steroid Cream

There are different types of steroid creams, but this helps by controlling and minimizing the inflammation in the mouth and throat. Using steroids long term may lead to diabetes, which has the potential of becoming a death sentence to your cat. The reason for this possibility, according to my vet, is that a cat cannot be given steroids and the medicine needed for diabetes. If your vet recommends steroids in any form, be sure to discuss the potential harm that the steroids may cause.

I give Lily a steroid cream called Prednisolone. I apply it to the inside of her ear every morning and night. I am aware that giving Prednisolone to Lily may lead to diabetes, but the alternative is having her live in severe pain. I had to choose between giving Lily a possibly shortened life where she spends most of her days in as little pain as possible by giving her the steroid, or not giving her the steroid and knowing that she is in horrible pain. It was a very easy choice for me to make.

Update: I was able to wean Lily off the Prednisolone steroids in early 2015. The PlaqueOff and Lysine that she takes daily have kept her stomatitis under control.

Pain Medicine

Despite all that you may do for your cat, there may be days when your cat is in so much pain that she needs pain medicine. These days will be easy to see because your cat will start to drool.

Whenever Lily starts to drool I give her a small dose of a pain medicine called Buprinex. Buprinex is like morphine for cats. These days I don’t have to give this to Lily very often because everything else she takes does a fairly good job of controlling her stomatitis, but every now and then I need to. Buprinex makes her tired, so be aware that acting tired or spacey after taking Buprinex is normal.

Tooth Removal

And now we come to the last thing that should be attempted when it comes to controlling stomatitis – removing teeth. When all other treatment options fail, your vet may recommend having most or all of your cat’s teeth removed. The reason behind this option has to do with the most common cause of stomatitis, which is a cat’s inability to tolerate plaque. The thinking here is that if the teeth are removed, there will be a huge decrease in plaque, thus (hopefully) curing the stomatitis.

According to my vet, 80% of cats respond well to having their teeth removed, meaning their stomatitis goes away. That also means that 20% of cats continue to suffer from stomatitis after having their teeth taken out. It can take up to six months after teeth are removed to know if the surgery was a success. The reason it takes so long is because it takes months for the mouth to heal from stomatitis.

IMPORTANT!!! If you DO decide to have your cat’s teeth removed, it is critical that your vet performs an x-ray after the teeth have been extracted to make sure there are no tooth fragments left behind. Cats teeth are very brittle and break easily. Any fragments left in the gums can easily lead to infection, causing a whole different set of problems and pain for your cat.

Ask your vet before you agree to this surgery if he takes x-rays when he is done. If he says he doesn’t and tries to convince you that this is not needed, run as fast as you can from this vet and see a new one!

Lily fell into the 20% of cats who do not improve after having teeth removed. To clarify, there was improvement, but she still very much has painful inflammation in her mouth and throat, as you can see from the pictures on this site.

How I Treat Lily’s Stomatitis

Lily was first given antibiotics, but that helped only temporarily. I did not know about supplements until after her teeth were pulled, so I didn’t try that next. Lily’s stomatitis was very bad and our vet recommended that her teeth be pulled. I consulted with another vet, and he agreed. So, we had her teeth pulled.

During her first surgery Lily had all but her canines removed. The canines were left to prevent Lily’s tongue from flopping out of her mouth. Apparently some cats are unable to keep their tongues in their mouths after their canines are removed.

About six months after her surgery it was obvious that the four canines also needed to go. The redness in her mouth was much more severe around her canines than in the rest of her mouth. The canines were removed, and the gums improved some where the teeth had been.

However, as I said above, Lily still has stomatitis. After getting all her teeth removed I learned about the supplement L-Lysine. In cats, Lysine acts as a booster to their immune systems, which often helps them fight off stomatitis. It did help Lily, though not enough to prevent her from having pain. My vet said that there are no problems with long-term use of Lysine. It is like people taking Vitamin C daily.

When my vet saw that Lily still had a bad case of stomatitis despite having her teeth pulled and taking Lysine, she decided to start her on the steroid cream Prednisolone. That, along with the Lysine gave Lily quite a bit of relief, but she still had a lot of painful days. These days were marked by drool that was often tinged with blood.

My vet then suggested that I try AquaDent, but Lily wouldn’t drink the water that contained this supplement. In desperation, I went to Amazon.com and searched for anything that mentioned stomatitis and cats. That is how I found PlaqueOff and decided that I was willing to spend the $30 or so dollars that it cost. If it didn’t work, I wouldn’t be out much. If it did, then Lily would be happier and more comfortable. Fortunately for Lily, it worked very well and gave her back her quality of life.

These days Lily has very few bad days, but they do still crop up. Whenever she starts to drool I give her a small does of the pain medicine Buprenex.

To sum it up, here is what we have done to treat Lily’s stomatitis:

  • Antibiotics
  • Teeth pulled
  • Lysine
  • Prednisolone
  • PlaqueOff
  • Buprenex

04/28/2015 Update: It has now been over two years since we started treating Lily for stomatitis. Today (04/28/2015) you would never know there is anything wrong with Lily. Her stomatitis is completely under control and she doesn’t show any signs of pain. She no longer needs the Buprenex (pain medicine) or Prednisolone (steroid cream). She takes Lysine and PlaqueOff daily, and I now give both of these supplements to all five of our cats.


Comments

Treatment For Stomatitis — 601 Comments

  1. MaryB,

    I’m so sorry for not seeing this sooner. I regret that I don’t remember how long it was before Lily showed improvement with Lysine (it’s been several years since I first started giving it to her) but I do remember that she started to get worse within just one week when I ran out at one point.

    Thank you, also, for your kind words about my surgery. I’m much better now.

    Rochelle

    [Reply]

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