The Maus in our Haus

As many of you know, our beloved Maus (also known as Sasha) underwent surgery last Friday for complete tooth extraction.  So, we now have a toothless cat. Even writing that, I feel a bit of a churning in my stomach at having put her through such drastic surgery, but her story speaks for itself.

About a year ago in June, right around the time Michael and I bought our home, Sasha began refusing to eat her dry food.  I assumed she was being a picky eater, and while I would give her canned food every other day or so, I didn’t take her to the vet.  She also appeared outwardly healthy in all other aspects – her weight was good, her coat was shiny, and although she was shedding a bit more than usual it didn’t seem to be cause for concern.  Within months, though, she rapidly deteriorated.

Whereas before she had been able to eat wet food easily, she began refusing any kind with “chunks” in it – only the pâté-style food would do.  Soon after, around the time of our wedding in December of 2009, she developed the strange habit of eating, and then running away from her food very quickly – almost as if something was chasing her.  I put that down to living with our other cat, Sophie.  Sophie is a rambunctious little one, and Sasha is more of a quiet, reserved lap cat.  It seemed that Sophie kept trying to eat Sasha’s food, and Sasha would run away.  Again, I didn’t take her to the vet.

By March of this year we realized that something much more than picky eating or fear of other companion animals was going on – Sasha’s coat was dull, her skin dry, and when she ate she would occasionally howl in pain.  It was the sort of noise you hear when stray cats are fighting, or when a cat’s paw or tail is shut in a door or recliner footrest.  It was a sound of pain, pure and simple.  After the first time we heard her make that noise, I scheduled Maus for a veterinary checkup as soon as they could see her – three days later.

I still have feelings of guilt when thinking of that appointment, because we discovered that Maus had gone from 11lbs to 8lbs 9oz since our last visit – a span of only four months.  After we described the problem, our veterinarian examined Maus’ mouth and determined that she had rather advanced gingivitis and needed to be brought in to have her teeth cleaned thoroughly.  We (the vet, Michael, and I) reasoned that inflamed gums were causing Maus pain, which was causing her to avoid food.  At that appointment, Maus was given subcutaneous fluids and an injection of steroids to try and ease her pain while we waited for a time slot to open up for feline dental work.

That was a Friday, and on the following Monday we took her in for a tooth cleaning.  In the afternoon, we got a call informing us that her teeth had been cleaned and that they’d had to remove five infected teeth while she was under anesthesia.  I was surprised, but figured that with her infected teeth removed and her gums nicely cleaned, Sasha would no longer be a cat in pain.  She was put on steroids and antibiotics, and we all assumed that the problem had run its course.  Obviously, we were very wrong.

About a month later, once her steroids and pain medicine had run out, she began exhibiting the exact same symptoms – only worse.  She was now afraid to go near her food dish, and would only eat if I put her on my lap and stroked her the entire time, creating a cave of sorts with my arms and chest and legs.  Even then, after only a few bites she would yelp and run away to hide.  I immediately called the vet, who speculated that one of the “sockets” from where her teeth were extracted had perhaps become infected.

When we took her in again, it was discovered that her gums were entirely inflamed – a bright, livid red and quite obviously painful to the touch.  I was the only person who could touch her jaw without being swatted, so I had to open her mouth for the vet to examine her.  She had also dropped from 8lbs 9oz to 7lbs 0oz – a loss of 20% of her body weight in just over a month.  The vet vaguely mentioned that very rarely, there were cats who became “allergic to their own teeth”.  She said that these cats sometimes were able to recover with medical rather than surgical intervention, and that while 80% of cats who had a total tooth extraction recovered completely, the surgery was too drastic to jump to immediately.

She also brought up the possibility of Feline Leukemia, and we spent an unmentionable amount of money on a FLV test.  To our relief, it came back negative.  It was decided that we should try an injection of a long-acting steroid, which would stay in her system for about three weeks.  The thought was that this steroid would help Maus fight off the infection she was battling, and that combined with stronger antibiotics it would solve our problem.

Precisely three weeks after that appointment, the crying began again.  Even with the steroids, she’d only been able to eat a pureed, soupy mixture of wet food and warm water.  And now, she couldn’t even eat that.  Another vet visit, another round of steroids and antibiotics, and another two weeks passed. By this time, Michael and I (along with our normal vet and the specialist we’d seen during an emergency visit) were convinced it was FLPS – Feline Lymphocytic Plasmacytic Stomatitis.

If you’ve never heard of FLPS (I know I hadn’t…), here’s a quick run-down:

“Feline Lymphocytic Plasmacytic Stomatitis (FLPS) is a severe inflammation of the entire oral cavity is cats. The gingival (gums) and entire oral cavity is swollen, red and very painful. Cats may cry out suddenly when eating or opening their mouth even to yawn. We had one patient that was so painful, he hissed at himself when he opened his mouth. Often the teeth do not look diseased. They may be pearly white, but the tissues surrounding them are seriously inflamed.

We believe that FLPS is a disease of the immune system wherein the cat is intolerant to the plaque bacteria on the teeth. Normal animals are able to handle the 750,000 bacteria present in each milliliter of saliva without signs or symptoms of disease. Cats that are affected by FLPS have a much exaggerated inflammatory response to the plaque bacteria. This severe inflammation causes the gingiva to be cherry-red in appearance and to bleed easily. Cats may approach their food bowl, but not eat because they are so painful. As a result affected cats may lose weight, become dehydrated and show other systemic signs of disease.

Cat owners may see very red gums that bleed easily, causing the cat to avoid eating, even when he is obviously hungry, or to eat only soft food. The physical signs of inflammation are clearly visible inside a cat’s mouth. What may be more noticeable to an owner, however, are behavioral changes; irritability, aggression, depression, excessive hiding, and poor grooming. Affected cats also may drool and have bad breath. A cat may cry when opening its mouth or eating.”

Additionally:

Surgical tooth extraction is often necessary to alleviate the pain FLPS cats experience. The rationale for this treatment is that the teeth harbor the plaque bacteria. By removing the teeth we are removing the plaque bacteria. However, even this treatment only addresses the symptoms — not the cause. We may suggest extracting the cheek teeth (premolars and molars) first, to see how effective this is in controlling the inflammation. A cat’s appearance changes very little with this procedure, because the front teeth (canines and incisors) remain in place. Eventually all teeth may need extraction. As veterinary dentists, we do not like suggesting this option, but sometimes the welfare of the patient necessitates it. Again, it is very important that all tooth substance is removed, since any fragments left behind can be a cause for treatment failure. Dental X-rays will confirm that this has been accomplished. Typically, once a cat has recovered from the surgery, he is able to eat remarkably well.

This treatment sounds drastic, but the results are often amazing. Most of the cats treated by extraction are eating hard, dry food within a week or two of surgery and sometimes even by the next day! These cats may have stopped chewing their food because of the pain. Treating the inflammation and thereby alleviating the pain allows them to eat comfortably again. Many cats gain weight, start to groom again and are much happier. Believe it or not, even with no teeth some cats will eat dry food by using the bony ridges of their palate.

However, even with all the teeth extracted, some cats will still have some inflammation that needs treatment. Continued medical therapy may help. Some cats are helped with laser therapy of the inflamed tissue; other may be helped with oral interferon, a drug used in human cancer therapy. There are many treatment protocols that have been tried and described and they all help some cats, but none have been predictably effective for all cats.

FLPS is a very frustrating disease for veterinarians, veterinary dentists, pet owners, and especially affected cats! Hopefully one day we will understand the cause of the disease and can target our treatment accordingly.”

So, on Friday of last week Maus went in to have every single one of her teeth removed.  When we picked her up, I started crying – I’d never seen a more miserable animal.  She was drooling blood, her eyes were glazed, and she didn’t want to move her head or jaw in the slightest.  She’s been on buprenorphine and cyclimycin three times a day since then.  We made our bedroom into a haven for her, blocking off the cat door so that she could be completely alone and undisturbed by our overly-playful cat and dog and moving a cat box, her food and water, and her favorite shirt of mine into the room for her.  She spend the majority of the next three days curled up in a ball, tucked between our pillows and burrowed under my red flannel shirt.  She was amazingly affectionate throughout this time, seeking comfort and attention every time I was in the room.

Michael chose to sleep on the futon rather than force Cricket to sleep in her cage all night, so at night it was just Sasha and I.  She didn’t leave my side for a minute.  Even when we re-opened the cat door so that she could get out if she wanted but still keeping the dog away from her space, she didn’t want to leave.  Maybe it was the pain medication, which can make even people much more affectionate, but I soaked up the time with her.  Since Michael moved in with me in 2008, Sasha had stopped sleeping with us – she used to burrow under the blankets and sleep curled up against my stomach for the entire night, no matter how much I fidgeted.

The most beautiful news of all, however, is that last night Maus ate dry food! She hadn’t eaten dry food since December of 2009, and now our toothless cat is happily gumming one kibble at a time from the palm of my hand.  It was so very encouraging last night, to see her eating normally (or at least as close to normal as she’s been in a long time).  She’s also been more playful, consistently affectionate, and generally much more relaxed.  She’s grooming herself again (she’d stopped about a week prior to her surgery) and her coat is shiny and beautiful.  It’ll be some time yet until we have her back up at her healthy pre-FLPS weight, but I have very high hopes for our Mauser 🙂

Advertisements

8 thoughts on “The Maus in our Haus

  1. […] Feline Lymphocytic Plasmacytic Stomatitis ) (for a run-down of her surgery and recovery, check out this post over on The Good Life). What really, really kills me is that FLPS can exist and be dormant for a […]

  2. Katy says:

    Thank you so much for sharing your story. I was searching for information about FLPS without knowledge of it’s name, and I stumbled on this posting. I couldn’t remember what the vet had called it, I now realize that he had referred to it as simply “Stomatitis”.

    Our story’s are quite similar, how is Maus doing these days? My sweet boy, Melee, is having his teeth extracted as I type this. He, like Maus, had already had extraction of teeth. They pulled out all of his top molars almost exactly one year ago. Walker, my husband, and I felt so guilty that we hadn’t taken him in sooner.

    It started with Melee running from his food like something was chasing him. At first I thought maybe the dishwasher noise had scared him at some point so I brought the food out of the kitchen. I would periodically move the food to different spots, but nothing would work for long. He also had very bad breath, which we were reminded of often, as Melee has an affinity for licking your face. Then, I noticed when he yawned sometimes he would yelp in pain. Melee and his sister are both super quiet, they very very rarely meow, but Melee would make almost an “Ow!” noise and run away. What sealed the deal was when I noticed how skinny he was and the fact that he just stopped eating altogether.

    We took him to the vet and at first they gave him tests and antibiotics. Nothing changed and nothing was found. So then they recommended a good teeth cleaning with possible extraction, where they ended up taking out the top molars. The vet said that he may or may not need the rest of the molars pulled in the future. Once Melee recovered, he was so much happier. He was playful again and he ate a ton, everything was great. In July however, we moved from Indianapolis to Kansas. That meant a 14 hours car ride with 2 people, 2 cats, and stuff. Melee was obviously stressed, and since we’ve been here I started noticing the signs of his mouth again.

    Melee’s breath was the worst that it’s been, he’s been yelping again, and recently started pawing at his mouth, however he was otherwise very happy. Still eating, still playful. I was thinking we should probably take him in for a check up, but when I heard news of a friend’s cat passing away because she had an infection too long without detection, I sprang into action. I got Melee into a the vet yesterday and was then able to get him in for extraction this morning. However, the vet didn’t know what to expect because melee refused to let anyone look at his mouth.

    A couple hours ago I got the call. The vet wanted to remove ALL of his teeth (I never even knew this was a possibility as the last vet only referred to removing the rest of the molars). Everything was a big shock and I feel helpless for my poor little guy. However, while trying to find more information, this story has helped me calm down. We’ve put melee on a health plan (funny he gets health insurance before his mom and dad do!) so hopefully we can monitor his progress easier after today. I really and truly hope extracting his teeth will solve his issues that he can live a happy and healthy life. He’s only 3 years old.

    • Lauren says:

      Oh I wish you the best of luck…it’s such a miserable thing for the cat, and such a helpless feeling for the owner.
      It sounds like you’ve been going through exactly what we experienced…Maus was around three when it first started, I believe. And ditto the stress – for our little cat, it seems to get worse when she’s stressed for any reason.
      The surgery was miserable. I can’t sugar coat it for you…when she came home, I cried for her because it looked so painful. Imagine having that done. We were given liquid pain medicine to give her, which seemed to help but also made her very woozy, very out of it.
      I’m not sure if you have kids or other pets, but it might help to keep Melee separate for a while. I put a littler box in our bedroom and kept the door closed, and spend most of my time there when I was home. She seemed to like the company and the quiet, and I think it helped her heal more quickly.
      As for Maus, she’s doing very well now. Unfortunately, she was one of the 20% of cats for whom the surgery isn’t entirely effective, and her gums still get sore. However, it’s not NEARLY as bad as it used to be, and it takes much longer for the problem to crop up. The routine now is that every 12 weeks or so she goes to the vet for a steroid injection. So far, that’s been frequent enough and we don’t see a recurrence of her symptoms. At first we tried waiting a bit longer, and she started to be in pain and afraid of her food again.
      I don’t regret taking her teeth out, though, and even as horrible as it was to see her right after the surgery, it’s worth it now when she’s her sweet, happy, loving self. She was so miserable, and so grouchy back when it was at its worst, and now she’s like the kitten I knew when we first found her.
      I’m so, so sorry that you’re going through this. I hope you’ll keep me posted? And if I haven’t answered your questions, or if there’s anything else you want to know, just let me know. You can comment here or you can email me, lauren@resourcetec.com, and I’m happy to talk about it. I’ve never ‘met’ anyone else who went through this, so I’m glad you contacted me.
      Again, I hope for the best. And know that no matter how much it hurts to see him tonight after he’s through with surgery, and in the coming days of recovery, know that it really is what’s best for him. He’ll be able to live a happy, healthy life because of the surgery.

      • Katy says:

        Thank you for the support! I recently received and update, he’s in recovery now. Everything went fine, he has looseness in his jaw in one spot but the vet is confident that that will heal nicely, but we’ll monitor it closely. Otherwise he’s waking up and I can pick him up in 2 hours.

        I’m taking your advice and I’ve already informed my husband that I will transforming our bedroom into a recovery sanctuary for him this weekend. I do have one other cat, his sister from his litter. She has a very strict “open door policy” in this house, but she is just going to have to deal with it. I plan on reading my book and sitting with my Melee while he recovers.

        I remember exactly what he was like when he had the extractions last year, it was horrifying watching him all drugged up, drooling blood and puffy, I can only imagine what he will be like today. I’ve already cried a few times about the whole ordeal. Unfortunately, my husband tried to leave work early to help out and give support, but not everyone understand how a pet really is a member of the family and their pain is important. So I will try to be as strong as possible when I pick him up. The best I can do is have a nice soft and safe place for him to retreat to, and be at his side for endless cuddles and coos if he desires it.

        It’s nice to know we have a friend or type of support group for this terrible time! I decided to respond his way so that if anyone else were to go searching for answers like I did, and stumble upon this posting, they can see our stories and updates as well.

        I’m very sorry to hear the Maus still has to undergo treatment with steroid shots, but I’m glad that you have at least found something to keep her otherwise happy and healthy! I sure hope we can have success with Melee. He really is the sweetest and most loving/snugly cat I’ve ever had the pleasure in knowing. It’s so sad that such a sweetie has to go through this. The hardest part for me is that I can’t explain to him whats happening to him and why.

      • Lauren says:

        How is Melee doing?

  3. Katy says:

    He is progressing very well. His appetite seems to be officially back today, but he is still very grumpy. He’s not very trusting of walker and me right now. I’m looking forward to his recovery so I can have my love bug back. Right now he’s just pretty upset about everything and prefers not to be touched. But everyday is a little better than the last! We have an appointment on Thursday to make sure his jaw is healing appropriately.

    • Katy says:

      Another update, Melee is doing so much better! Yesterday he really started to eat well, he comes to the kitchen and asks for his meals now. He also started to be lovey again! Yesterday he licked my face raw, this morning he woke up my husband to the same treatment. We had a great visit with the vet today and then he napped in my arms. Onward and upwards! It’s nice to have him back.

      • Katy says:

        A friend of mine may have a kitty going through the same thing. I remembered this blog and I thought I would update that Melee is in perfect health. He is like a whole new cat. He is so sure of himself and loves to play and snuggle. He eats dry food just fine and he loves life!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: