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Thursday, August 25, 2011
Case of the Week: Koli Poki
Koli Poki is an eight-year-old Burmese that was brought into the clinic to have her teeth checked. Her owners were concerned because she did not seem to be eating well. When I examined her, I found that she had moderate tartar build-up over most of the teeth and the gum above her upper left carnassial tooth was very inflamed. The carnassial tooth is the fourth premolar (cats typically do not have the first premolar present) and has one large and two small roots.
I prescribed an antibiotic to start right away and scheduled her for a dental procedure. I knew I would need to extract this tooth but would also probe and radiograph (x-ray) all of her teeth to see if there were any other problems.
Once Koli Poki was anesthetized for her dental procedure, I was able to thoroughly examine her mouth and discovered many problems with her teeth. She was already missing seven teeth, including her upper right carnassial tooth. Two of her premolars had resorptive lesions - erosions of the enamel of the teeth - which are usually progressive and painful. She had gingival recession at multiple spots including the upper left carnassial and there was gingivitis around most of the teeth. I also did radiographs of all her teeth and found a large amount of bone loss around the roots of her incisors, premolars and molars.
I extracted all of the teeth that were mobile, had resorptive lesions, or a large amount of gingival recession and periodontal bone loss. In all, I extracted fourteen of Koli Poki's teeth. I closed the gum tissue with sutures that dissolve, usually within one to three weeks. I then treated all the extraction sites with the Companion Therapy Laser. Unlike our surgical laser that we use to cut tissues, the therapy laser works to reduce inflammation and pain and helps to speed healing. We also gave her an injection of an anti-inflammatory medication, which also helps with pain, and prescribed oral pain medication for a few days.
The following day, Koli Poki's owner reported that she was doing well. She was eating and acting normally. At her progress exam a week later, her owners were very happy with her recovery. They said she was more active and affectionate than she had been for a while. Her gums were healing very well although they were still a little inflamed. She was eating well and did not seem to have any pain.
Most of our patients develop some dental disease over their lifetime. Even though Koli Poki did show some symptoms of a problem, it was subtle and many cats do not show any signs of pain. Although Koli Poki's owners did notice a problem, they had no idea how severe her dental disease was. They are very happy that we were able to relieve her pain.
A thorough dental exam and radiographs under anesthesia are the best way to investigate any possible problems. At every physical exam, we look for any indication of dental disease and can recommend if your cat needs a dental cleaning and a more thorough exam under anesthesia. Tooth lesions can be very painful but the symptoms a cat will show can be very subtle. Many of our clients, like Koli Poki's owners, are not able to see how much the painful teeth are affecting their cat until they see how much better their cat feels after the problems are resolved.
Dr. Judy Karnia