Wednesday, May 5, 2010

54. Oral ulcers + Caudal stomatitis in a Burmese cat

Gingivostomatitis (inflammation of the gums and mouth) and Caudal Stomatitis (inflammation at the back of the mouth). I report an early case as the Danish owners are animal lovers. Burmese cat, Female, Spayed, 7 years. Fever.

Complaint: "The cat used his paws to scratch her commissure of lips one month ago," the gentleman said it was more to the right side of the mouth. The wife said it was both sides. In the last 2 days, the cat pawed on the right side of the mouth more than the left side and would not eat her dry food. What's the problem?

EXAMINATION
I suspect toothache due to decay and loose back teeth but when I examined the cat's mouth, the teeth were in excellent condition except for tartar on all the four 3rd premolars. I smelt the mouth. No bad breath or very faint.

ANAESTHESIA: 3.6kg. Xylazine 20 + Ketamine 100 0.1ml +0.4ml one syringe IM sufficient.

Ulcers back edges of tongue (white fibrous granules) both sides 3cm x 3mm. Why?

Owner says that this cat has no stress. The dominant of 3 Burmese cats.

Cause: Unknown. Virus or bacterial infections said to be involved.
More common in purebred cats like this Burmese.

Unusual report in this case: No bad breath (I smelt the mouth). No loose teeth at all. No serious gingivitis but tartar is present in all the premolars 3. Dental scaling done.

TREATMENT:
Tooth extraction is said to be most effective but this cat has no loose teeth at this stage.

ADVICE:
1. Baytril and predniosolone anti-inflammatory injections.
2. Oral baytril
3. Tolfedine for 3 days next week.
4. Medazole for 3 days.
5. Soft canned food for the time being as the ulcers are painful. But this cat is fixated on dry food for the past 7 years.
6. To check back of tongue weekly forever and let me know when small ulcers recur. I asked the husband to get the wife to come into the consultation room to see the ulcers on both sides of the back of the tongue while the cat is still under anaesthesia. I shone the torch-light for her to see. Red strips and white globular fibrous tissues lined the ulcerated areas of around 3 cm x 2 mm. Bilateral and equal in length. Is this an auto-immune disease?

A very interesting case. See picture of one similar case in a dog not vaccinated too as owners seldom vaccinate their dogs or cats after 5 years of age. Could these two be due to virus?

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