Feline resorptive lesions.- potential new therapy?

Re: Feline resorptive lesions.- potential new therapy?

Luca Poddighe — Thu, 18 Jun 2015 15:45:18 GMT

[quote user="Evelyn Barbour-Hill"]Always said to have appeared post-war, when cats started getting fed on cat food rasther than catsmeat and fish heads, but I don't think this is entirely true.[/quote]

Probably before the war nobody cared to much about cat's teeth

Re: Feline resorptive lesions.- potential new therapy?

Evelyn Barbour-Hill — Wed, 17 Jun 2015 18:57:16 GMT

[quote user="Virginia Campbell"]there aren't any chapters in the Herriot books devoted to him trying in vain to extract an ankylosed tooth! [/quote]

No, though dentistry is just one of the things he had no clue about.

[quote user="Virginia Campbell"]or did they say, "Oh - you've named that thing that happens to cat's teeth"?[/quote]

Well, more or less, yes. We called them "neck lesions". I can't remember the year offhand, but early seventies a seminal paper, a histological study, appeared in Vet Rec: "Feline neck lesions are not caries". (A lot of people had assumed that they were caries).They were certainly familiar when I was a student, 67-72. Always said to have appeared post-war, when cats started getting fed on cat food rasther than catsmeat and fish heads, but I don't think this is entirely true.

[quote user="Virginia Campbell"]The article suggested fluoride gel for mild lesions, but I don't know how old the article was.[/quote]

Yeah, that was an idea around in the early eighties. It didn't work (not surprising, with hindsight). And fluoride gel tastes so hideous that cats either went barmy or sat there drooling (it's quite acid). People were obsessed with fluoride – some Americans still are – when the truth is it has practically no application in veterinary dentistry at all.

Re: Feline resorptive lesions.- potential new therapy?

Virginia Campbell — Wed, 17 Jun 2015 18:37:55 GMT

[quote user="Evelyn Barbour-Hill"] twenty or more years ago, when we knew little about them except that they weren't caries.[/quote]

How long do you think they have "existed" Evelyn? I found an article on the AVDS website that says they were only recognised about 40 or so years ago, and there aren't any chapters in the Herriot books devoted to him trying in vain to extract an ankylosed tooth! When you were a wee stripling vet, were the older vets muttering, "New fangled lesions, never had 'em in my day" or did they say, "Oh - you've named that thing that happens to cat's teeth"? The article suggested fluoride gel for mild lesions, but I don't know how old the article was.

Fraser Hale's website has an interesting article that quotes a study looking at 80 apparently normal teeth from cats that had at least one clinical resorptive lesion elsewhere in the mouth. 100% of these teeth had microscopic evidence of resorption. It doesn't say what the teeth of cats with no RLs looked like microscopically though.

Re: Feline resorptive lesions.- potential new therapy?

Martin Atkinson — Wed, 17 Jun 2015 16:38:54 GMT

[quote user="Evelyn Barbour-Hill"] In fact when the second type is well established the root is anchored by bone rather than by periodontal ligament so "extraction" is not really the term that applies.[/quote]Crown amputation should do.

Re: Feline resorptive lesions.- potential new therapy?

Evelyn Barbour-Hill — Wed, 17 Jun 2015 16:02:58 GMT

[quote user="Julian Earl"] I think the programme referred to creating a framework for odontoblasts to lay down the new enamel[/quote]

Er... odontoblasts lay down dentine, not enamel. And they are in the pulp: they lay down dentine inwards, as it were.

And resorptive lesions are not caries. Odontoclasts are actively eating up the tooth substance. Nobody really understands the pathogenesis of the FORL syndromes fully and properly. One type begins round about just below the gum lineand a bit further down, and that is often associated with gingivitis and periodontitis (not necessarily causatively); the other type begins very much in the root and often runs subtly up and down the root until it busts out, as it were, at the gum line.

This is also why you can't "fill" a resorption like you can a caries lesion. And believe me, we all tried very hard to fill them, twenty or more years ago, when we knew little about them except that they weren't caries.

Cat extractions need patience and the correct instruments, but they become terror-inspiring only when resorptions are present. In fact when the second type is well established the root is anchored by bone rather than by periodontal ligament so "extraction" is not really the term that applies.

Re: Feline resorptive lesions.- potential new therapy?

Virginia Campbell — Wed, 17 Jun 2015 15:18:03 GMT

Once there's a decent hole visible above the gumline the tooth is probably quite stuffed though.

I don't want a treatment, I want to know what causes them and how to prevent it. So depressing when you take out that lower premolar, owner all delighted...then you explain to them that you will more than likely be repeating the process with another premolar next year; and maybe a few more or a strip on one side the time after that....and the time after that....and the fact that " but he only eats dry food" is not going to prevent it.

There's no feeling quite like the one you get when it's a quarter to lunchtime, you've got consults booked at 2pm and it cannot be denied that the probe has just scraped into a dent just below the gumline of a mandibular canine and the cat's jaw has chittered...

Re: Feline resorptive lesions.- potential new therapy?

Julian Earl — Tue, 16 Jun 2015 22:12:06 GMT

[quote user="Bob Russell"]

[quote user="Hannah Wynne Richards"]

That's me depressed for the day! A simple treatment for feline neck lesions would have been wonderful.

Wynne

[/quote]

There is a simple treatment. Works every time and 100% cure. Called extraction!

Ho-ho- Hannah, [ that sounds like a song?] feline extractions are rarely simple especially when the roots are healthy. CPD on flaps and so on made life rather easier, but they are always astressful. The only simple extractions are dogs with roots so purulent that the teeth are so desperately loose that one barely needs forceps to pull them out. I cannot recall ever seeing a cat with teeth that loose. So I thought a drop of liquid on a lesion made life much simpler, with no GA involved either. I think the programme referred to creating a framework for odontoblasts to lay down the new enamel ( Evelyn) so I don't doubt your comment but I do hope this is a realistic option: easier/cheaper/ no fractured crowns and hopefully effective? Watch this space?

[/quote]

HTH

Re: Feline resorptive lesions.- potential new therapy?

Hannah Wynne Richards — Tue, 16 Jun 2015 18:29:23 GMT

This unilateral blephrospasm is reaching epidemic propotions.

Wynne

Re: Feline resorptive lesions.- potential new therapy?

Evelyn Barbour-Hill — Tue, 16 Jun 2015 16:05:07 GMT

[quote user="Bob Russell"]There is a simple treatment. Works every time and 100% cure. Called extraction![/quote]

Or, if you read some of the American literature, optimal therapy of the condition is performed thru exodontia.

Re: Feline resorptive lesions.- potential new therapy?

Hannah Wynne Richards — Tue, 16 Jun 2015 11:46:29 GMT

PS We'll have some helpful soul giving us both advice on the treatment of unilateral blephrospasm!

Wynne

Re: Feline resorptive lesions.- potential new therapy?

Hannah Wynne Richards — Tue, 16 Jun 2015 11:44:21 GMT

Simple?

Wynne

Re: Feline resorptive lesions.- potential new therapy?

Bob Russell — Tue, 16 Jun 2015 10:49:57 GMT

[quote user="Hannah Wynne Richards"]

That's me depressed for the day! A simple treatment for feline neck lesions would have been wonderful.

Wynne

[/quote]

There is a simple treatment. Works every time and 100% cure. Called extraction!

Re: Feline resorptive lesions.- potential new therapy?

Hannah Wynne Richards — Tue, 16 Jun 2015 08:22:36 GMT

That's me depressed for the day! A simple treatment for feline neck lesions would have been wonderful.

Wynne

Re: Feline resorptive lesions.- potential new therapy?

Evelyn Barbour-Hill — Mon, 15 Jun 2015 23:47:51 GMT

I've not heard of this stuff but I don't believe anything can stimulate enamel to be deposited – enamel is formed on the tooth before it erupts; no more can be deposited, because there aren't any ameloblasts there to deposit it. There are ways of encouraging re-mineralisation of early caries lesions – is that what this was about?

Anyway, sorry, but feline resorptive lesions are not caries and they arise in a completely different way. Sorry.