Vet Blog

10/24/09

Why is my Cat’s Tongue Inflamed?
Dr. Eric Barchas, DVM

alistairMy 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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01/02/09

How Can I Treat my Cat’s Refractory Gingivitis?
Dr. Eric Barchas, DVM

909633_1226704372.jpgI 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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