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tongue ulcer

Last April my cat had 8 teeth extracted.  He seemed not to be recovering.  I took him back to the vet who could not find a problem   He recommended I bring him to a dental specialist.  The dental specialist handled my cat so well and was able to do an oral examination so easily with no sedation.  My cat has always been sedated for examinations.  

The specialist noted an ulcer on his tongue which he said is caused by something similar to an autoimmune disorder and he gave prednisone.  He advised this would be a one-time solution because this medication can cause diabetis in cats.  The ulcer returned in Sept.  I took him back to the specialist and he prescribed another medicine which is used in humans to prevent organ rejection in transplants.  This did not work so we stopped it after 10 days.  Now for the passed two months my cat is having flare ups but sometimes he starts eating well for a few days.  I believe the only resource will be to give him another steriod injection.  In the meantime, he does not look and act well at all and has lost weight.  Probably because he just eats small bits.   He does drink a lot of water.  It also seems that he has arthritis just recently.  His front legs look slightly bowed, and on many occasions he falls to the floor when he tries to jump.  His coat is also looking poor.

These are my questions:  He has taken a pain killer a few times.  This has helped him eat well.  He takes this pain killler easily.  Is it not good for his kidneys to take this pain killer regularly?  Could the flare ups be caused by stress?  I will not take him to the wonderful dental specialist again because it is an hours drive during which the entire time my cat goes beserk and tries to get out and moans and screams.  I think it could kill him.  Do you believe that this ulcer had anything to do with the teeth extractions?  Any other comments would be greatly appreciated.  I love this cat so much, and I feel like I am stuck with no solution.    Pam    
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931217 tn?1283484935
Dear crocosmia,

Its sounds like the dental specialist is treating your cat for stomatitis.  Stomatitis may be secondary to dental disease, to allergic disease or may be a primary immune defiiciency. It can be  a frustrating problem to control, and I say control because cure is uncommon, while control of symptoms is quite possible,

Control is achieved by eliminating all dental disease and having regular dental prophylaxis, determining through an elimination diet ( I use the hydrolized protein diet by Hills z/d for this) whether there is any component of dietary allergy to the stomatitis and then serial trials with corticosteroids, cyclosporine, antibiotics. Some cats are controlled on one or combinations of several approaches. If corticosteroids are required to control the stomatitis, you may notice increased thirst, urination and appetite.

To your questions:

Is it not good for his kidneys to take this pain killer regularly?  I do not know what pain killer it is, but the dose matters in many cases. In some cats, long term meloxicam at a low dose works out. In others, kidney or liver adverse consequences may result. There are other pain relievers used in cats such as buprenorphone or butorphanol which have different side effects but are options as well.

Could the flare ups be caused by stress? Stress is hard to define in a cat. Physical? Emotional? Immunologic? They may be, but you wont be able to determine how to address stress directly.

Do you believe that this ulcer had anything to do with the teeth extractions?
It may be if root fragments were left behind after the extractions. Have dental xrays taken to determine this.

Talk to your doctor and tell him/her your concerns. Perhaps with a further explanation of his/her thinking your mind will be eased.

Good luck with your cat and do let us know how things are going from time to time.


Arnold L. Goldman DVM, MS
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