Mucosal inflammation in a cat 104/204

RE: Mucosal inflammation in a cat 104/204

Norman Johnston — Fri, 27 Nov 2020 14:51:25 GMT

Nice to hear. Have you any perception from the owner about comfort level changes? Did they stick with meloxicam? I agree that it is unlikely to improve gross appearance but welfare has got to be better when the pain is moderated

RE: Mucosal inflammation in a cat 104/204

Kate Richardson — Fri, 27 Nov 2020 14:20:21 GMT

Update- after a month of Stomodine gel 1-2 times daily, Plaque off and some dental diet added in, the inflammation is reduced. Not resolved, but much better, so we will continue along this route and recheck in another couple of months.

RE: Mucosal inflammation in a cat 104/204

Kate Richardson — Thu, 05 Nov 2020 14:38:50 GMT

Thanks. I agree re metacam, that's my impression too.

RE: Mucosal inflammation in a cat 104/204

Evelyn Barbour-Hill — Thu, 05 Nov 2020 01:17:53 GMT

[quote userid="6386" url="~/001/veterinary-clinical/small-animal/dentistry/f/expert-help/29449/mucosal-inflammation-in-a-cat-104-204/226451#226451"]remove the root fragment[/quote]

Of 207 you mean? To be honest I think that's one thing you don't need to be worrying about.

[quote userid="6386" url="~/001/veterinary-clinical/small-animal/dentistry/f/expert-help/29449/mucosal-inflammation-in-a-cat-104-204/226451#226451"]don't feel there is significant change on 104/204 root apex,[/quote]

I can't see any.

Giving it time and Stomodine I would think a good plan. Do please tell us how it gets on.

Just as an aside, meloxicam relieves oral pain, but I don't think it ever convincingly reduces the visible signs of inflammation. I can't produce concrete evidence, but that's my impression.

RE: Mucosal inflammation in a cat 104/204

Kate Richardson — Wed, 04 Nov 2020 21:38:22 GMT

Thanks Evelyn Barbour-Hill I didn't see your initial post so nothing to disregard!

The thing is the inflammation wasn't present like this 6 weeks ago when I performed the dental treatment; I guess the amount of inflammation now present on 208 despite a fairly recent scale and polish supports this all being plaque related. I guess I could GA again, re xray and remove the root fragment, repeat subgingival cleaning and apply Sanos this time. If both you and Norman Johnston don't feel there is significant change on 104/204 root apex, then I'm inclined to leave these alone ie not extract at this stage, but will consider extracting 208. Currently the owner is instigating some oral hygiene (limited to applying Stomodine gel twice daily and dental biscuits plus continuing meloxicam with a review due in a week or 2. Will update then.

RE: Mucosal inflammation in a cat 104/204

Evelyn Barbour-Hill — Thu, 29 Oct 2020 14:46:06 GMT

If you read the post I made 37 minutes ago, please disregard it. I misread the dates on the radiographs. I do apolgise.

Fresh radiographs of the left mandible could be very useful.

Subject to radiographic findings, I might at least consider debriding bone in the 308 and 307 sites, increasing the depth to which the bony sites are buried. You can do this by slitting the soft tissue and reflecting the edges a little, before burring with a sterile round diamond (my choice, anyway) bur. Or you can with a high speed diamond bur go straight down through the soft tissue to the bone. Radiographs to check what you are doing.

There's quite a hefty gingivitis on 208, it seems. So my guess is that the inflammation adjacent to the upper canines, in that valley just behind the bulge of the alveolus, is a matter of oral hygiene.

If you are unsure or nervous about debriding the mandibular bone as I suggest, certainly leave that till you have attended to oral hygiene in the upper jaws, as that might resolve the mandibular inflammattion too. I think the first step would be another GA hygiene session, get all the teeth but especially 208 squeaky clean, and apply Sanos at the end. Then see what can be done by way of mouthwash or the equivalent. Eventually and if necessary consider extraction of 208 (bit of a last resort).

PS It may be no coincidence that the upper 8 with heavy gingivitis is the one on the side with no mandibular cheek teeth.

RE: Mucosal inflammation in a cat 104/204

Norman Johnston — Thu, 29 Oct 2020 11:48:08 GMT

I wonder if the 204 has exposed pulp? It has lost quite a lot of the crown tip. Sometimes you can only enter the pulp chamber with a very fine pathfinder file in a watch winding motion. Having said that I can't see much on the rads at the apex. Lack of radiographic apical change does not always mean lack of pathology as I can attest to myself. Around the 208 it looks like gingivitis so may well be a local hygiene issue. Might be tough to resolve