Vet Blog
11/01/09
 Hello, Dr. Barchas!
I wrote to you about a year ago about my kitty that was born with an overbite and asked how common were there etc etc…well, since then she has gotten a bit worse unfortunately. The vet said a tumor has infected her poor deformed jaw and could slowly suffocate her to death because it’s pressing on her throat and eye. We are currently treating her with cortisone and Antirobe, which we see a small change but these medicines never seem to last long enough because abscesses keep coming back. My question is there any hope of this turning a tumor around? Does this seem like the only thing that could be done or used to treat this infection/tumor in the bone? Is there body that could help us on the cost of further treatments? She’s only 2 years old and too beautiful to let go…I would appreciate any help or advice.
Thank you!
shannon
Middletown, Ohio
Overbites are very common in cats. Usually they are harmless. Cats are lucky to be less superficial than humans–cosmetic trivialities like overbites don’t lead to social ostracism or low self esteem.
Severe overbites can be more than a cosmetic problem. In some cases the teeth of the lower jaw can grow into the tissue of the upper jaw. This can lead to painful infections or areas of chronic inflammation (irritation).
The areas of chronic inflammation can look just like tumors. True tumors are extremely rare in the mouths of two-year-old cats.
I therefore wonder whether your cat actually has a tumor. It sounds more likely that a wayward tooth is causing chronic inflammation that looks like a tumor. I suspect that dental work (specifically, extraction of teeth that are growing improperly) might remove the source of inflammation and solve the problem permanently.
I agree that it is too soon to give up on your cat. Some local SPCAs have veterinary hospitals that offer discounted services to needy individuals. If such a facility is available in your area perhaps your cat can benefit from a procedure that will allow her to live a normal life.
Photo: no sign of an overbite on Ben.
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10/24/09
 My seven-year-old rescue cat has really gross lumps on the back of his tongue. My vet tested for FIV and feline leukemia – both came back negative. He gave the cat a cortisol shot (I think – some kind of steroid) and the cat is going back after 2 weeks to see if that helped.
He also had some ulcers around his mouth. The vet also told me a couple of other things that it could be, which I will need to ask him about again, because I don’t remember. We are to watch him carefully to make sure he can still eat – no problems there and I hadn’t noticed any problems before he was diagnosed. We found the issue when he was in having a wound attended to.
Have you seen this before? Thanks in advance. Will he need periodic shots to keep this under control? I really feel bad for him.
Lynne
Houston, TX
Based upon your description several things could be going on.
Your cat may be suffering from stomatitis. Stomatitis is a painful condition in which the immune system attacks the teeth. This causes inflammation of the gums and in some cases the tongue. Cortisone shots sometimes reduce the inflammation associated with stomatitis. However, the benefit usually is temporary. Extraction of multiple teeth generally offers the best hope of a permanent cure for stomatitis.
Severe dental disease also can cause symptoms similar to stomatitis. Unlike stomatitis, dental disease does not involve an improperly functioning immune system. Professional dental work at your veterinarian’s office should eliminate oral lesions caused by dental disease.
Eosinophilic granulomas, also known as rodent ulcers, are common causes of ulcers and sores in the mouth. Rodent ulcers occur when an overactive immune system attacks the lips, gums, or tongue. Cortisone is the most commonly used treatment for rodent ulcers. I also recommend that cats with rodent ulcers receive consistent flea preventatives. Flea bites can stimulate the immune system and may exacerbate rodent ulcers.
Certain viral or bacterial infections may cause sores or masses to develop on the tongue or mouth. Calicivirus, feline leukemia virus (FeLV), and feline immunodeficiency virus (FIV) are the most common.
Unfortunately, tumors can develop on the tongue. Squamous cell carcinoma is an aggressive cancer that sometimes develops in the area.
If your cat’s condition does not improve significantly after the cortisone injection or if the lesions return when the cortisone wears off I recommend that your cat’s mouth be evaluated under anesthesia. At that time dental work can be performed if it is indicated. A biopsy of the affected area also is very likely to yield insight into the problem.
Meanwhile, watch your cat’s appetite and feed him soft food if necessary.
Photo: Alistair Growley’s tongue looks fine.
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03/28/09
 One hundred, or perhaps 150 years ago, dentists and barbers were one and the same. Cowboys in the wild west could ride into town and enjoy one-stop-shopping for a shave, haircut and premolar extraction.
Few people today deny that the separation of human dentistry and cosmetology is a good thing. I wouldn’t dream of going to my barber for dental work. I’d be even less likely to trust my dentist to cut my hair.
Sadly, the animal equivalent of the barber-dentist is alive and well to this day. I am referring to the unlicensed anesthesia-free tooth cleaner.
Yesterday I saw an appalling case. A beautiful sweet orange tabby came to see me. His owner was worried. She had just paid $85 to have the cat’s teeth “cleaned” by an unlicensed anesthesia-free tooth cleaner. The tooth cleaner had warned the client about a cyst on the cat’s lip.
Opening the cat’s mouth was like looking upon a murder scene. True, there wasn’t very much dental calculus (tartar) in the mouth. But the cat had florid periodontal disease. The gums were inflamed and bleeding. Several teeth were loose. Many other teeth had enamel defects called FORLs (short for feline odontoclastic resorptive lesions). FORLs are incredibly painful. The cat’s breath reeked of infection. The poor cat had over a dozen teeth that were compromised beyond hope. Many extractions will be necessary to make him comfortable.
The tooth cleaner had mentioned none of this to the owner. The owner was stunned to learn that anything was wrong with her cat’s mouth, other than the cyst.
And what about that cyst? There was no cyst. Cats normally have a small thickening on their lower lips near the spot where the upper canine tooth rests. The cat in question, an orange tabby, had moderate lentigo simplex (this is how veterinarians say freckles) on his lips and gums. Orange tabbies are redheads. Redheads develop freckles. Orange tabbies therefore develop freckles on their lips. This cat had a freckle overlying the normal thickening on his lower lip which had been misidentified as a cyst. His lips were normal.
The unlicensed tooth cleaner had misidentified a normal, freckled thickening as a cyst. She failed to notice one of the most extreme cases of periodontal disease I have seen in weeks. In other words, the tooth cleaner got everything exactly wrong.
In California, it is illegal for any person to apply any form of dental instrument (other than a toothbrush) to a pet’s teeth unless they are under the direct supervision of a licensed veterinarian. This means that a licensed veterinarian must be on the premises at the time that the instrument is applied to the teeth.
Does this provision of the law exist to safeguard the income of veterinarians? Is it a barrier to entry, designed as a protectionist measure for vets? Please! That is a ridiculous and laughable thought. The state of California couldn’t care less about veterinary income or job security.
Does the provision of the law exist to protect cats from butchery at the hands of incompetent buffoons like the tooth cleaner mentioned in this post? Now we’re getting closer to the answer, but we’re still not there. The state of California cares more about cats than about vets. But it doesn’t really care very much about cats either.
Here is the real reason why the law exists: to protect people like my client from being defrauded out of $85 by people like the tooth cleaner. The state of California cares tremendously about consumer protection. My client paid $85 and received less than nothing in return. That is fraud, and fraud is a big deal in the eyes of the state.
In some instances, anesthesia-free tooth cleaning can benefit pets. The procedure must be performed by a competent practitioner. It must be performed before gingivitis and periodontal disease have set in. It should be performed in conjunction with daily home tooth brushing.
However, if you take your pet to an unlicensed tooth cleaner, how can you know whether he or she is competent? The purpose of licensing is to set standards of competence. I readily confess that some unlicensed tooth cleaners know what they are doing. But how can you tell them from the fraudsters?
After all, as the tooth cleaner mentioned in this post proves, some unlicensed tooth cleaners are totally incompetent. Their services are complete rip offs.
I recommend that you avoid anesthesia-free dental work for your pet. It’s just too risky.
(Going back to the barber-dentist analogy, some people may be tempted to cry hypocrisy since many folks take their pets to the vet to be groomed. Vets that offer grooming services generally employ professional groomers. The vet does not do the grooming. If my barber were to set up a chair in my dentist’s waiting room, I’d be fine with having my hair cut there.)
Photo: Sylvester’s teeth don’t look like they need any work.
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03/03/09
 A recent comment caught my eye.
We have a 5 year old Cane Corso. Can the brand/ type of dog food make a difference on his teeth? They started bleeding lately and he will only eat his food if we put water in it and leave it to get mushy. Please let us know if there is anything we should be doing differently.
Heather
The most common cause of bleeding in the mouth is dental disease. Since dogs don’t brush their teeth, they are prone to infections of the teeth, gums, and bones in the mouth that can become severe.
Pets with advanced dental disease may prefer soft food to dry food. They may also experience bleeding from the gums.
This sort of dental disease is very painful. It also poses a serious health risk.
Dogs that eat dry food generally develop dental disease more slowly than those that eat soft food. However, all dogs are at risk for dental disease. If your dog is unable to eat hard food, then you should continue to feed him soft food until a vet can evaluate him.
Speaking of vets, I recommend that you take your dog to one as soon as possible. In addition to dental disease, problems such as fractured (chipped) teeth, tumors in the mouth, exposure to rat poison, and foreign objects lodged in the oral cavity can cause the symptoms you describe.
Whatever is causing your dog’s symptoms needs to be addressed. The problem is likely to get worse over time. Your dog almost certainly is in pain. He needs to see a vet.
Photo: Jack shows off his teeth. They look good.
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02/14/09
 I have a very old female cat. Most of her teeth
is gone – she has one fang in front that’s left.
I am worried about her food intake. Sometimes I
do give her mashed canned tuna. Is this ok? What
else can I feed her?
Rica
Philippines
Cats and dogs can thrive without teeth, as long as their gums are healthy. If your cat’s teeth were extracted by a veterinarian the odds are high that her gums are in good shape. If the teeth fell out naturally due to decay, then there is a significant chance that her gums are inflamed or infected. I recommend that you have a professional assess your cat’s oral health and perform corrective procedures if necessary.
Cats with healthy gums and no teeth generally have no problems eating. Many such cats prefer soft food, but I know several toothless cats who happily gum down crunchies. In other words, most cats without teeth don’t have special dietary needs.
If you are worried that your cat is not eating enough, you should monitor her weight. Cats that don’t get enough food lose weight over time.
Tuna generally is safe as a treat for cats. However, tuna is not nutritionally complete. Tuna should not be the only ingredient in your cat’s diet.
Photo: Curtis‘ teeth look healthy.
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02/02/09
 My year old Shih Tzu male, drooled a last night
and this morning. What would cause that? He ate
today and drank water. He drooled a lot all over
the bed. Please help. Thank you
Naomi
Park City, KS
There are many causes of drooling. You can read all about them here:
http://drbarchas.com/drooling
I am worried about my 14 year old cat, I just
discovered she had peed in her bed and has still
been sleeping in it after the urine had dried. I
had always thought that cats and dogs do not sleep
where they releive themselves.
Deb
Cincinnati, OH
There are several reasons why a pet may urinate in an unusual or inappropriate location. Please check here for more info:
http://drbarchas.com/feline_housesoiling
My beagle is three years and he has breath that smells
like he is rotting from the inside out. This has
only been in the past year. His diet has not been
changed what could be causing this and how do I
correct it?
Annette
Lafayette, Indiana
Dental disease is the most common cause of halitosis (bad breath) in pets. But there are other causes. Read here for more information:
http://drbarchas.com/halitosis
Unfortunately, I can’t answer all of the questions I receive through Catster and Dogster. If you submit a question that doesn’t get published, you may still be able to find an answer at my website, drbarchas.com. It’s completely free!
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01/25/09
 Is there something safe that I can buy OTC that I
can give to my dog for bad breath? It is only the
occasional bad breath, not constant.
Jenny
Versailles, KY
The other day I was walking on the streets of Washington, D.C. when I saw a billboard promoting scientific knowledge among children. The billboard featured the a young person stating that she knew her Golden Retriever’s bark was transmitted as vibrations through the air. She then, however, made a confession: “But I still don’t know what causes his stinky breath.”
It appears that the organization promoting scientific knowledge among children is itself somewhat lacking in scientific knowledge. The cause of bad breath in dogs and cats is very simple. Bad breath is caused by bacteria growing on the teeth and releasing malodorous waste products.
The bacteria that cause bad breath will, if allowed to grow unchecked, cause dental disease, dental abscesses, gum loss, and tooth loss. They can spread to the heart, kidneys, and blood. They may contribute to cancer, arthritis, and premature death.
Fortunately, the best way to prevent bad breath also prevents the other negative consequences of dental disease. And, the products involved are affordable and available without a prescription: a toothbrush and veterinary toothpaste.
Brushing your pet’s teeth is, by far, the best way to prevent bad breath and dental disease. Several other products (doggie breath mints and certain chew toys, for instance) may temporarily cover up bad breath. But only tooth brushing reliably prevents dental disease.
I recommend that you brush your dog’s teeth. It will help his breath. It will also help his health.
Photo: Leo’s teeth are looking good.
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01/12/09
 My kitten of 10 months will not eat dry cat food.
What can I do to get him to eat it?
Dolores
Kingstown
An old adage holds that one can lead a horse to water but one can’t make it drink. Cats are not horses. One can neither lead them to water (or food) nor make them drink (or eat).
Some cats develop strong food preferences. These cats may resist diet changes. In my experience, the best way to transition cats from one food to another is to do it very gradually. Dolores, try mixing a small amount of dry food in with the wet. If your cat eats the mixture, you can increase the proportion of dry food a bit each day. After several days, you may have switched him to dry food without him realizing it.
Or, you may not have. Some cats don’t fall for the trick. If your cat is in this group, you may want to try other brands of dry food. Or, you could continue to feed wet food and dedicate a few minutes of each day to brushing his teeth to combat dental disease (wet food promotes dental problems more rapidly than dry food).
I should point out that in the case of the health benefits and risks of dry food v. wet food, the jury is still out. Wet food has been linked to dental disease and hyperthyroidism (so have home made diets). Dry food may be linked to obesity.
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01/02/09
 I have an eight-year-old blue silver Maine Coon,
Sterling, who for the past several years has had
problems with recurring gingivitis of the upper
left side of his mouth. Our vet has tried several
rounds of antibiotics, and several rounds of
monthly cortisone shots. The gingivitis clears up
for a few weeks or a couple of months, and then
comes back. Now he’s talking about possibly
having to remove all of the teeth from the upper
jaw. Do you know of anything else that we can try
before making such a drastic decision?
Carol
Albany, IN
Severe, recurrent, refractory gingivitis in cats can progress to a syndrome called stomatitis. In feline stomatitis the mouth becomes severely inflamed (irritated). Feline AIDS and feline leukemia virus may trigger stomatitis, but most cases occur for unknown reasons.
Cats with stomatitis have immune systems that reject their own teeth. For this reason, extracting multiple teeth may cause the inflammation to go away. In my experience, this sort of procedure is effective about 85% of the time.
Some mild cases of stomatitis can be managed with medicines that modulate the immune system. Prednisone and cyclosporine are the most commonly used. Prednisone, in particular, may cause unpleasant side effects.
Although extracting multiple teeth sounds extreme, remember that if the gums around the teeth are severely inflamed the teeth are painful and aren’t being used. In my patients, one complication of multiple tooth extraction procedures is weight gain. After the painful teeth are removed, some cats begin to over eat!
You can read much more about stomatitis here:
http://drbarchas.com/stomatitis
And you can read about milder gingivitis and dental disease here:
http://drbarchas.com/dental_disease
About the photo: Sylvester is showing off his dental arcades. There is no sign of stomatitis!
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12/14/08
 My kitten’s new teeth are coming in over his baby teeth. Will his
baby teeth come out on their own? They do not seem
to be loosening up any. What do I do?
Carol
Ocala FL
Dogs and cats, like humans, have two sets of teeth during their lifetimes. The first set of teeth are called deciduous teeth or baby teeth. They erupt within a few weeks of birth.
Deciduous teeth generally fall out between four and six months of age as adult teeth underneath them erupt. In some cases, however, the adult teeth develop adjacent to the baby teeth rather than underneath them. In these instances, both adult and deciduous teeth may be present in the mouth. These so-called retained deciduous teeth are most common in Persians, Pugs, Boston Terriers, Shih Tzus and other breeds with short noses.
If your kitten’s adult teeth are still erupting, there is a good chance that the baby teeth will become loose and fall out spontaneously. However, I’d recommend that you have a vet check him out. Retained deciduous teeth can lead to malocclusion (improper location of the teeth in the mouth) or to premature dental decay if food becomes stuck between an adult tooth and a baby tooth. In some cases, retained deciduous teeth must be extracted by veterinarians.
Photo note: I’m confident Dega’s teeth erupted normally.
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Hello, Dr. Barchas!
You have questions. 