Thursday, February 25, 2010

Stomatitis Explained

As we wind down Pet Dental Health Month 2010, we thought we would do a primer on a condition frequently found in cats known as stomatitis. Stomatitis is a general term that refers to inflammation of the oral cavity.

Feline stomatitis is a common, painful and life threatening problem in many cats. Although it does occur in cats of all breeds and ages, there are some breeds in which it develops more frequently such as Himalayans, Persians and Somalis.

Cats with stomatitis suffer from bad breath (halitosis) as well as red and inflamed gums (also known as gingivitis). In time, the inflammation of the gums spreads from areas right next to the teeth to the back of the throat (oropharynx). In some areas, the gums enlarge and block off areas of the oropharynx. This in turn can cause eating and swallowing to become difficult and painful for the cat.

Many cats with stomatitis also have tooth resorption. The inflamed gums may appear to be growing into a tooth or the tooth may appear to have a hole. Teeth so affected are very painful for the cat.

Fortunately, it can be relatively easy to diagnose and treat stomatitis. A history of oral inflammation along with a thorough oral examination are typically sufficient to establish at least a preliminary diagnosis of stomatitis. Chronic oral inflammation with widespread location of tissues involved is typical of feline stomatitis.

However, if the inflammation is not widespread and is localized to a specific area, other diseases should be considered. Allergies, foreign body irritation, periodontal disease or tooth resorption are all possibilities. Therefore, an early, correct diagnosis is very important.

Once established that a cat does indeed suffer from stomatitis, treatment depends on the individual case. Stomatitis affects cats differently depending on the stage of the disease, the severity of the progress, and the individual cat's pain tolerance. The owner's ability to provide home care such as daily teeth brushing is also a factor in treatment planning. Long term treatment is often a combination of medical, surgical and combination therapy. Medical therapy on its own does provide short-term control for feline stomatitis, but the long-term results are unsatisfactory. Surgical therapy has offered remarkable immediate pain relief with effective long-term control.

Often the cause of stomatitis is a reaction of the gingival tissue to the teeth themselves. Therefore, the surgical procedure involves meticulous dental extractions with excision of the inflamed mucogingval tissues. Dental radiology is absolutely essential in performing surgical excisions on cats suffering from stomatitis. Leaving any portion of the tooth, such as the root tips, defeats the purpose of performing the surgical treatment. Radiographs help determine if the teeth have been removed completely. It is also essential to remove the inflamed tissue because bacteria and viruses can hide within the swelling. This causes continued stimulation of the cat's immune system and propagates further inflammation. This in turn contributes to chronic oral pain reducing the quality of life.

If inflamation remains after all teeth have been extracted, long-term medications such as antibiotics and anti-inflammatories may help some. In some refractive cases, strong immune suppressants may be needed. Laser therapy of the inflamed tissue has shown some success as well.

Tuesday, February 16, 2010

Are Online Pet Pharmacy Discounts Worth It?

"Discount Veterinary Medications!" "Get Your Pet's Medication for Less!" "Common Pet Medications - No Prescription Required!"

How many times do you see such advertising in your email inbox or on website banner ads? They sound very tempting, don't they? It seems as though online pet pharmacies are cropping up everywhere. However, not all of them are helping your veterinarian provide the best care for your cat.

According to a recent article posted on the Federal Drug Administration's Consumer Health Information web page, there are some online pet pharmacies that are unscrupulous at best. According to the article, "[The] FDA has found companies that sell unapproved pet drugs and counterfeit pet products, make fraudulent claims, dispense prescription drugs without requiring a prescription, and sell expired drugs." So pet owners who think they are saving money may be putting their pet's health at risk.

That doesn't mean all online pharmacies are scams. There are reputable, legitimate pharmacies out there that can save you money.

So what are some of the warning signs? Be cautious of any pharmacy that is willing to sell prescription medication without a requiring a prescription from a license veterinarian. If they don't require a prescription, their drugs may not be FDA approved. You have no guarantee of what you are really giving your cat.
Some of these pharmacies claim to have on staff veterinarians who can do a long distance evaluation of your cat using information you provide on a form. Using this they then "prescribe" medication. While we know that many of our clients are very intuitive and aware of their cats' behaviors, a physical exam by a veterinarian along with possible additional tests such as bloodwork are required to accurately diagnose a health condition. In addition, just as with human pharmaceutical treatments, follow up progress exams and monitoring by your cat's doctor are essential. If your veterinarian has not prescribed a medication, you should not be giving it to your cat.

Although we are all more than aware of the current economy and the need to be financially savvy, there are some things that just should not be skimped on. Your cat's health care, including medication, is one of them. Remember that old adage, "you get what you pay for".

The Scottsdale Cat Clinic partners with VetStoreRx to provide a safe, reputable option as an online pharmacy. VetStoreRx offers all the convenience of an online pharmacy, including home delivery of food and other products. Check out our website for more information about VetStoreRx.

For more information on how to pick a good online pharmacy, visit these sites:
American Veterinary Medical Association Internet Pharmacy FAQ FDA Consumer Health Information Web Page

Friday, February 12, 2010

Are Anesthesia-Free Dental Cleanings Safe for Your Cat?

February is Pet Dental Health Month and a good time to talk to your veterinarian about your kitty’s dental needs. Last year here in this blog we gave a good overview of dental care for your cat.

Of course, to do a proper dental cleaning, your cat will be anesthetized during the procedure. Many people are concerned about the risks of general anesthesia. That is why we maintain strict surgical monitoring standards (read more about that here) as well as use a combination of painkillers, anti-inflammatory medicines and nerve blockers, especially in dental procedures that require extractions.

Recently we ran across an article from Veterinary News Network that discusses new anesthesia-free dental procedures. While this may seem like the perfect solution, there are concerns about how effective these procedures really can be. While the brochures for this type of procedure often show the animals sitting complacently while a technician cleans their teeth, this is not a very realistic situation. Many animals, especially cats, will not sit still for such a procedure leading to restraint that can add to the stress and actually create a fearful situation for the cat.

Another argument against these anesthesia-free procedures is the tools that are used versus the ones that can be used if the cat is properly anesthetized. For example, in addition to the ultrasonic scaler used to remove the build-up on the teeth, here at the Scottsdale Cat Clinic we use digital x-rays of the entire mouth to spot any problem areas that might not be visible to the naked eye. Such procedures are not possible without anesthesia. According to the VNN article, the tools used in these anesthesia-free procedures can actually cause more harm than good. They often cause pitting in the tooth enamel which actually increases plaque and tartar. There can also be damage to the gums, tongue, or lips if the cat moves during the cleaning.

Advances in anesthesia medications as well as combination medicine protocols such as those we use here at Scottsdale Cat Clinic greatly reduce the risks associated with general anesthesia. Remember that there is also a risk to not having proper dental care for your cat. Tartar buildup leads to gingivitis and tooth decay which can be painful. Cats rarely show signs of mouth pain and will eat normally even with severe dental disease. Dental disease can also lead to kidney, heart and joint disease when bacteria enter through the gums and spread throughout the body.

For more information about your cat’s dental health and how Scottsdale Cat Clinic can help, please feel free to contact us.