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.

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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In 1991 veterinary medicine suffered a disturbing revelation. Two commonly used feline vaccines were linked to the development of malignant tumors at the site of vaccination. The tumors, called fibrosarcomas, are associated with the vaccines for rabies (in cats only) and feline leukemia. They are aggressive and difficult to remove. They occur in approximately one out of every 3000 – 10,000 cats who receives a rabies or leukemia vaccine.

The discovery of these so-called vaccine associated fibrosarcomas lead to the creation of a special task force (called, unsurprisingly, the Vaccine Associated Fibrosarcoma Task Force). The recommendations of the task force were supposed to cause a dramatic shift in the way cats are vaccinated.

Prior to the discovery of the fibrosarcomas and the formation of the task force, most cats were vaccinated against rabies and leukemia every year. The vaccines were administered between the shoulder blades because that is the easiest place to give injections to cats.

The task force recommended that the leukemia vaccine should be administered only to cats who spend time outdoors. The rabies vaccine should be administered as required by law. If possible, both vaccines should be administered no more frequently than once every three years.

Finally, the task force advised veterinarians to change injection sites. Fibrosarcomas between the shoulders are virtually impossible to remove. Therefore, the leukemia vaccine should be administered in the left rear leg, near the ankle. The rabies vaccine should be administered similarly in the right rear leg. If a fibrosarcoma develops in either of these locations, the cat’s life can be saved by amputating the leg–a less than perfect solution to the problem, but better than the alternative.

Vaccine associated fibrosarcomas are a source of angst for me. I have worked during my career to minimize the number of rabies and leukemia vaccines I give to cats. And I always give the vaccines in the rear legs.

However, a very disturbing paper published in the February 1, 2009 Journal of the American Veterinary Medical Association (JAVMA) indicates that many veterinarians are ignoring the recommendations of the task force and needlessly endangering the lives of their feline patients. According to the paper, significant numbers of cats are developing vaccine associated fibrosarcomas between their shoulder blades. This means that significant numbers of veterinarians are still giving rabies and leukemia vaccines in that spot.

Here are the conclusions of the paper.

Conclusions and Clinical Relevance–Despite publication of the vaccination recommendations, a high proportion of tumors still developed in the [region between the shoulder blades] . . . [v]eterinarians are complying with vaccination recommendations to some extent, but need to focus on administering vaccines as [far down] as possible on a limb to allow for compete surgical margins if amputation of a limb is required. (J Am Vet Med Assoc 2009;234:376-380)

What can you do to ensure that your vet is following the task force’s recommendations? Talk to him or her. Ask whether vaccination for leukemia and rabies is appropriate for your cat. If the vaccines are appropriate, ask where they will be administered. Never accept a one-size-fits-all approach to vaccination.

Photo: A vaccine associated fibrosarcoma between the shoulder blades of a cat, courtesy of Texas A&M’s School of Veterinary Medicine.

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Idexx laboratories is a major veterinary diagnostic corporation with veterinary-specific laboratories located in North America, Europe, and Asia. The company is an innovator in veterinary diagnostics. And, I am happy to see that Idexx has signed on to the current initiative to boost the quality of health care delivered to cats.

As I have mentioned in at least one previous post, feline health care generally receives short shrift relative to the care that canine companions receive. Vets, industries linked to veterinary medicine and cat lovers are working to change the situation and give cats their due.

As part of its work to promote feline health, Idexx has launched a new website. The site, www.kittytest.com, displays the number of cats infected with FIV, FeLV and feline heartworm in each county in the USA as reported to the laboratory.

It’s a very interesting site. I recommend that you check it out.

Photo: Red, of Texas, has been diagnosed with FIV.

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Hi Dr. Barchas,

Lindsay
Gainesville, FL

FeLV, or Feline Leukemia Virus, is a disease of cats that is related genetically to the human AIDS virus (experts do not believe that FeLV poses a health risk to humans). It can spread from cat to cat by sharing food, water or litter. Cats that groom each other or fight with each other may pass the disease as well.

You were very wise to keep Palatka separated from the cat already living in the house. The risk of the disease spreading is very real if the two cats come into contact with each other. However, if you keep them separated and practice good hygiene, the risk is low.

I also commend your vet for wanting to re-test Palatka in a few weeks. The test for FeLV sometimes yields false positives (in other words, the test comes back positive even though the cat isn’t truly infected). As well, some cats are able to fight off and clear the disease.

Unfortunately, other cats are not able to fight off the disease. These cats develop fatal immune system problems and cancers.

Keep the two cats separated until the follow-up test. If the next test is negative, the risk to your original cat is low. Nonetheless, you may want to consider vaccinating her against FeLV (be sure to discuss vaccine-associated tumors with your vet before you take that step) as a safety precaution.

If the next test is positive, I see no reason to put Palatka to sleep. Finding her a new, single-cat, indoors-only home is a better option in my opinion.

Share this entry with your pawple anywhere:

• Why is my Cat’s Tongue Inflamed?
• Despite Controversy There is no Doubt That Vaccines Save Lives
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• Where do Vaccine-Associated Tumors Develop in Cats?
• JAVMA Study Reveals Many Vets Aren’t Following Feline Vaccination Guidelines