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Old cat with gingivitis - any advice?
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Message 1.Â
Posted by rainbowAlison (U6855649) on Tuesday, 17th November 2009
Wasn't sure whether to start a new thread or post in the Cat Club, but it was all a bit whiffy in there...
Anyway, our old cat (Ernie, 15) has just started having steroid injections to control his severe gingivitis. He had his teeth cleaned a year ago, has had extractions previously, and I've been giving him Plaque Off. Any advice about anything else we can do for him? He might well end up having all his teeth out, but at present we'd just like to keep him as comfortable as possible.
Thanks in advance. -
Message 2
Posted by Rusters (U11225963) on Tuesday, 17th November 2009
rA, has the vet said why Ernie has such severe gingivitis? Some cats build up plaque quicker than others (sometimes, not always, due to diet), and some cats are actually allergic to their plaque. Either (and especially both) will lead to painful and often infected gums.
Contrary to popular opinion, dry food plays no role in helping control plaque and in fact can exacerbate the problem, quite apart from the wretched stuff being bad for cats anyway.
However, much as it pains me to say this, I gather that Hills t/d biscuits, which are large and rock hard - and therefore *have* to be bitten into to swallow, unlike ordinary biscuits - can help shear off some plaque. My vet, who dry food for cats with a passion, nonetheless is happy to advise clients to give 10 of these biscuits - just 10 - a day, and that one can expect to see results within about three months. The t/d biscuits are not a a panacea but can play a role in helping keep teeth clean.
Of course, if a cat has chronically sore gums/toothache, he is unlikely to bite into the biscuits.
I don't know much about Plaque Off but have read cautiously positive things about it, so definitely worth carrying one with, I'd have thought.
Of course, one can clean cats' teeth, using specially formulated (non-foaming) swallowable (is that a word?) toothpaste, which is said to be palatable. Best thing apparently is to use a cat toothbrush or "finger" brush, but if all all else fails, just get the cat to lick it off a plate/their wrists.
Nutritionist vets who advocate a raw food diet would recommend feeding strips of chewy raw meat; also a raw chicken wing two or three times a week. I feed my cats a mostly fresh food balanced diet (raw and some cooked, though not cooked bones), but have to admit I am a bit nervous about the wings.
If Ernie is going to need regular anaesthetics in the future for teeth cleaning (maybe even extractions) anyway, then it might be worth considering having some (all?) his teeth extracted before he gets much older. The older the cat, the less likely the vet is to want to anaesthetise unless absolutely necessary. That said, though, anaesthetics are pretty safe even for old cats nowadays.
I would just worry that there may come a time when Ernie really would benefit from another dental procdure, but the vet isn't keen. That would leave Ernie carrying on as best he can with an uncomfortable mouth.
Cats to very well indeed without any teeth (as I know from experience). They can even manage strips of raw meat, etc. You wouldn't know they were sans teeth.
However, there are underlying conditions, including auto-immune ones and long-term after-effects of cat flu (calici virus) which affect the gums (and even the angles of the jaws where they meat and the tongue and throat), which are separate from tooth and plaque problems - though any tooth and plaque problems are going to exacerbate that underlying condition.
Veterinary opinion has shifted back and forth over decades about whether removing (all the?) teeth will help relieve the symptoms of the main problem.
Again, I'd probably go for extractions before a cat is so aged that it wouldn't be that good an idea to have it undergo anaesthesia.
The other thing is that cats' teeth tend to be very well anchored to the jaws, so unless the tooth is rotten and comes out easily, the vet might not be able/willing to go in for deep excavations.
Steroids can be a boon in keeping cats comfortable and damping down inflammation, but they cannot cure, and do have potential side-effects, some of them serious.
If steroids are what it takes to enhance quality of life, then I'd got for them every time, but if there are things that can be done to make them unnecesary, and/or given in lower doses, and/or given just intermittently, so much the better.
As for all cats with health problems - well, all cats actually - a high quality diet will help boost the immune system and pay dividends in the long run.
And yes, do consider multiple extractions.
Um, sorry to have run on. The above is a distillation of many conversations over many years with many vets (excl mark).
Love to Ernie.
Rusty
P.S. I'll try and dig out some good sites about teeth and gum problems. -
Message 3
Posted by Rusters (U11225963) on Tuesday, 17th November 2009
The Feline Advisory Bureau is a well-established organisation with close links to the Bristol School of Veterinary medicine. You need to scroll down the page here for the relevant headings "Acute inflammation........."; "Dental problems and Ginvititis"; and "Non-specific Inflammation....".
Extractions are mentioned as a possible... if not cure then help.
My one reservation on the site is when it states:
"It is suggested that the feeding of dry cat food may help to limit the problem. If dry food is fed, free access to water should be allowed to avoid the risk or urinary tract disease."
It is well-recognised in veterinary circles that dry food does NOT help limit the problem and that feeding dry carries risk (including urinaty tract disease, which it mentions). As I said upthread, there is some indication that Hills t/d biscuits are the exception, and they need only be given in small amounts daily, the rest of the diet bieng a high quality wet food.
So, if the blasted site means Hills t/d, why doesn't it blasted well specify? It is prepared to mention drugs by brand, after all. Pah!
Rusty -
Message 4
Posted by rainbowAlison (U6855649) on Wednesday, 18th November 2009
Many thanks, Rusty. The vet did suggest the fabcats site; it wasn't working when I tried it, but I'll give it another go. I've read about the chicken wings, but I'm a bit doubtful. Ernie's mainly on an ordinary "wet" cat food diet, though he still has some urinary dry food to control struvite formation - he had an emergency op for urolithasis some years back - but I don't think he eats enough of it now to make much difference, so I'll probably give him a little of the dental stuff, as you suggest.
The vet said that she thought extractions might be quite difficult; the teeth seem in quite decent condition, though Ernie won't open his mouth enough to let anyone take a proper look!She also said some cats still have the problem even after extractions. There's no way we could physically clean his teeth, but I might try letting him lick some of the paste.
The steroids seem to be working, so we'll continue with them for now and see how things go.
It's most kind of you to respond so fully. Thank you again; Ernie sends you a big purr. He's a lovely big ginger with a beautiful "butterfly" pattern on his back, and of course we're very fond of him. It's always a problem with older cats to know how much medical interference is fair to them, but obviously in this case we have to do our best to keep him comfortable. Fingers crossed.
All the best to you and your cats.
Alison -
Message 5
Posted by GEm (U4356909) on Wednesday, 18th November 2009
My old boy used to get gingivitis quite badly - he was too old to extract the teeth so we used to just keep an eye on it and when he was finding eating tough we got some antibiotics off the vet which sorted him out for about 4-6 months. I tried cleaning his teeth but to no avail, they were also quite fragile so I was afraid of breaking them. Also his breath could kill you dead at 1000 paces when his teeth were hurting so it was easy to spot.
We did give him dry food as a snack to take or leave as he liked and he used to crunch it sometimes - and when he did his teeth seemed better (but that could have been imagination - mine and his).
G -
Message 6
Posted by Rusters (U11225963) on Wednesday, 18th November 2009
Hi, rL, that's the trouble with cat's teeth, unless the tooth and root are actually rotten, it is difficult to extract.
Know what your vet means about extractions not necessarily curing the problem. That said, absence of teeth means absence of the plaque problem as an exacerbation to an underlying problem.
I would definitely consider giving the Hills t/d biscuits and not feeding the dry food for struvite (Hills c/d?), so he is only getting a very little dry overall. I do wish manufacturers wouldn't formulate dry diets for bladder problems*, especially as a good wet diet, with a little extra water added, can often be enough to keep further attacks at bay (or stop them happening to begin with).
If you are worried about struvite, you might ask the vet to give Ernie the wet version of the struvite diet: Hills c/d Prescription tins and/or Royal Canin Veterinary Diet Feline Urinary S/O Pouches, which many cats prefer. Then give that as all, or part of the diet, apart from the Hills t/d biscuits.
I add 5-10 ml water to all (wet) meals for all cats, not just William who had a calcium oxalate stone in his bladder some years ago.
The one advantage the Hills ranges have are that they will reimburse (through your vet) for any food that the cat won't eat or goes off.
[Sorry, you didn't ask about that, but I can't help it: I Did Cats while most people had exciting careers, families, travelled widely.......]
It is always a fine balance about how much to do with old cats, and a good vet who one trusts and has time to talk and answer questions is invaluable. I just with they were all like that.
Ernie sounds gorgeous - One of my first rescues was ginger George, and he was an absolute sweetheart, happy and purry to the point of drooliness.
Sorry to say I think it was imagination about the ordinary dry food helping, GEm. But anyway, a little of what you fancy does you good, especially when you are old (as long as it doesn't trigger a nasty reaction).
I'm going to email the FAB to clarify what they mean in the link I gave upthread about dry food and dental health. Shurely Shome Mishtake.
Rusty -
Message 7
Posted by Rusters (U11225963) on Wednesday, 18th November 2009
..... and that asterisk in para. 3 above was supposed to lead to a footnote on the drawbacks of a dry diet for any cat, apart from a *very* small amount for a very specific purpose - like t/d.
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Message 8
Posted by greensparklybejewelledone (U2283175) on Thursday, 19th November 2009
Thu, 19 Nov 2009 00:26 GMT, in reply to Rusters in message 7
<..... and that asterisk in para. 3 above was supposed to lead to a footnote on the drawbacks of a dry diet for any cat, apart from a *very* small amount for a very specific purpose - like t/d.>
I suppose the only exception I would highlight is for diabetic cats. I was just looking at again (to send to a friend, along with the stuff) and noticed again the 'no exceptions ever' mantra. The carbs/cereals are just too high to risk it, even if a diabetic cat is in remission, as Pucci was (thanks to the high protein diet and her protocol).
However that advice is for a diabetic cat that's been on her protocol and in remission, but is a healthy principle for any cat. I'd be willing to try the t/d, but I wouldn't go over the set no. of pieces per day.
HTH,
gj
x
HTH,
gj
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Message 9
Posted by greensparklybejewelledone (U2283175) on Thursday, 19th November 2009
Thu, 19 Nov 2009 00:29 GMT, in reply to GEm in message 5
GEm, the problem is that unless dry food is made specifically to help with teeth, it isn't of a sufficient size or hardness to make an impact. Even the dry food companies don't offically claim that it helps - that's a complete urban myth. Raw bones (never, ever cooked) are the best thing, actually, esp chicken wings, but many people believe there are risks there too. For those who are worried about splinters, chicken necks are good, but they are hard to come by.
gj
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Message 10
Posted by greensparklybejewelledone (U2283175) on Thursday, 19th November 2009
Thu, 19 Nov 2009 01:41 GMT, in reply to greenjewel in message 8
Sorry, the first link (#8) should have been .
gj
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Message 11
Posted by rainbowAlison (U6855649) on Thursday, 19th November 2009
Thanks again, Rusty.
On the subject of dry cat food, I have to say that a Royal Canin brand called Sensible Choice based on chicken and rice (no longer available here, I think)) seemed to work wonders for our previous cat. He was a stray, judged to be about 8 when we took him in, and in a pretty grim state. His coat had lost its outer layer, and he had persistent skin lesions; the vet thought he might have an allergy and recommended we try this food. We didn't like it so we gave it to the cat (sorry) and his coat recovered remarkably. However, I've never been happy about feeding a totally dry diet - it's obviously completely unnatural, and designed for owners' convenience rather than cats' well-being - so we introduced wet food too and he was fine after that until age took its toll nine years later.
I presume the chicken wings suggestion is an effort to reproduce a cat's natural diet, which of course would include bones and would naturally help to clean the teeth. I don't think Ernie's at risk of struvite any more - his dry food is also Royal Canin - but the wet food sounds as if it might be a good option just in case. It had never occurred to me to add water to wet food - I'll try it.
You're a mine of information and most helpful. I hope your cats know how lucky they are!
Alison -
Message 12
Posted by greensparklybejewelledone (U2283175) on Thursday, 19th November 2009
Thu, 19 Nov 2009 16:33 GMT, in reply to rainbowAlison in message 11
Well, not really, as reproducing a prey diet is a bit more complicated. Even when you include bones (and how to get the right proportion of bone is very difficult) you have to add many other supplements. When I was feeding a raw diet it was more or less this recipe , with a different recipe for Scamp based on his blood results given to me by Dr P. ( For various reasons I chose the one without bones - partly because I couldn't get a heavy enough grinder to deal with them.
The chicken wing (and neck) recommendation was mostly for teeth - cats that eat muscle meat and bones tend to have very strong, white teeth. The more carbs and sugar they eat, the more dental damage they will have.
gj
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Message 13
Posted by rainbowAlison (U6855649) on Thursday, 19th November 2009
Thanks, gj - another mine of info!
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Message 14
Posted by Rusters (U11225963) on Thursday, 19th November 2009
<"I hope your cats know how lucky they are!">
Nah, rA, they tell me the luck is all mine to have *them*!
There's no doubt that some dry food is worse than others, but Royal Canin is one of the "better" ones. Certainly Go-Cat was nicknamed Gone-Cat by vets, particularly because they saw so many (esp. male) cats with life-theatening bladder problems while on it. It's not so bad now, but still vets flinch if one mentions it - er, in passing, I'd never feed it.
That Royal Canin formulation obviously didn't have anything in it to trigger your ex-stray's allergies, which is good. However, one is still left with the underlying risks of feeding any dry though.
In a way (no, not really) I wish cats would get immediately ill when fed dry because then it would be obvious *that* was the problem. As it is, problemst can be insidious and take a while to manifest themselves. Therefore people don't - and some vets don't/won't - make the connection between the diet and anything from lack of optimum health to serious illness such as bladder and kidney problems and diabets.
Of course there are some cats who manage okay on an all-dry diet, especially if it is a reasonable quality and just as importantly are naturally big drinkers. That muddies the waters but doesn't change the facts. We need more vets to wake up and smell the - er, um..... cat food.
It's not possible to completely replicate a natural diet for cats unless you present them with a freshly killed (or still alive) mouse or small whole bird several times a day. We have had discussions in the Cat Club and Good Food for Cats threads about buying them snake and raptor food from specialist suppliers (frozen mice etc), but my nutritionist vet wasn't sure it would be safe or balanced. I mean, the hygiene levels in - er - production might not be to the standards needed for mammals, for instance.
Chicken wings don't really have enough flesh on them to be given as a *significant* part of the diet, but are useful as a small add-on for teeth.
If one is going for a balanced fresh meat diet, one has to be careful to add the right amount of bone (or calcium supplement), plus a little liver, and various vitamins, minerals, trace elements, Taurine and Omega 3 (fish) Essential Fatty Acids to make the meals as close to a whole mouse as possible.
Sounds complicated, but once you know what, and how much, to add to a weighed piece of meat, it's easy enough. Just wish the products were easier to source in the UK, rather than having to order them from the US.
Oh ah, while I've been bashing away here, I see that gj has posted. Oh well, not going to waste this. So here yer are.
Rusty -
Message 15
Posted by greensparklybejewelledone (U2283175) on Thursday, 19th November 2009
Thu, 19 Nov 2009 17:13 GMT, in reply to rainbowAlison in message 13
You're welcome, and I didn't mean it to sound so offputting! It is worth it - the difference to Pucci especially, but all of them really, was dramatic. There is an easier way to feed a raw diet and that's with a ready-made supplement mix, TC Instinct from Feline Future -
Some cats love it, and some don't, so it's worth starting with a small batch initially.
Best of luck, rA.
gj
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Message 16
Posted by greensparklybejewelledone (U2283175) on Thursday, 19th November 2009
Thu, 19 Nov 2009 17:16 GMT, in reply to greenjewel in message 15
And a little treat - while looking at the Feline Future website I saw this, and my heart melted as it always does:
gj
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Message 17
Posted by Rusters (U11225963) on Thursday, 19th November 2009
Shiny as patent leather, aren't they? Reminds me of my beloved Siamese X, Kim (RIP), and his tiny doppelganger Katina (RIP).
Rusty -
Message 18
Posted by greensparklybejewelledone (U2283175) on Thursday, 19th November 2009
Thu, 19 Nov 2009 18:01 GMT, in reply to Rusters in message 17
Would love to see pics of those two, Rusty. S'pose that ain't gonna happen.
Interesting that FF too say that they're always the last to be taken at shelters. I'm beginning to think I'll have to make a colour-based decision after all, when the time comes.
gj
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Message 19
Posted by rainbowLaure (U8486235) on Thursday, 19th November 2009
Rusty, have you ever posted any instructions for a raw food diet and would it be practical for someone who works full time? My two spurn uncooked meat and I'd really rather they had at least some in their diet.
Also, are chicken wings really ok? I was always told never to give chicken bones to cats because they splinter dangerously. -
Message 20
Posted by greensparklybejewelledone (U2283175) on Thursday, 19th November 2009
Thu, 19 Nov 2009 18:34 GMT, in reply to rainbowLaure in message 19
*RAW* bones are good, rL, (sorry, I'm not Rusty but I've done this a good bit too) but cooked bones are not OK, because they /do/ splinter. I do give mine chicken wings but I always supervise, just in case.
When I was doing raw food I did it à la Dr Pierson (with whom I've spoken), and made a big batch for the freezer, then taking out one tupperware box at a time. It takes a bit of preparation, but once you've got it organised it's not difficult. I always found it easier with two people - one to wash the chicken while the other mixes the supplements, and then one to chop and one to mince, and then two to clean up. The cleaning up is at least half the work.
Of course, if you buy ready-minced raw rabbit it's easier, and with the TC instincts it's a doddle.
There are other ways to do the fresh food diet but I found that the most time-effective.
gj
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Message 21
Posted by greensparklybejewelledone (U2283175) on Thursday, 19th November 2009
Thu, 19 Nov 2009 18:41 GMT, in reply to greenjewel in message 20
rL, there's a good amount of info on the Good Food for Cats threads:
First one:
Current one:
I'll have a look for relevant posts, but they're in there somewhere.
gj
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Message 22
Posted by rainbowLaure (U8486235) on Friday, 20th November 2009
*RAW* bones are goodÂ
Of course, that makes sense gj. -
Message 23
Posted by rainbowLaure (U8486235) on Friday, 20th November 2009
Thanks for all the info, gj. I'll check it out at the weekend - when I'm not organising the hall for the darned CP Xmas Fayre.
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Message 24
Posted by greensparklybejewelledone (U2283175) on Friday, 20th November 2009
Fri, 20 Nov 2009 13:10 GMT, in reply to rainbowLaure in message 23
First things first, rL. Good luck with the CP Fayre.
gj
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Message 25
Posted by rainbowLaure (U8486235) on Friday, 20th November 2009
Thanks - let's hope the weather doesn't make everyone stay at home.
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Message 26
Posted by rainbowLaure (U8486235) on Saturday, 21st November 2009
Just wondering, if you give occasional chicken wings, how often is occasional?
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Message 27
Posted by Rusters (U11225963) on Saturday, 21st November 2009
rL, just seen your posts about fresh food diets. Was thinking it would be a good idea to post in the Good Food for Cats thread a step guide to making a balanced fresh food diet, if people don't want to go down the route of getting a heavy duty mincer to crush bones - or at least not to do so in the first instance.
I think gj and I are going to have to discuss this behind the scenes first, because of blips re sourcing some of the essential supplements.
Re occasional chicken wings: I can't remember exactly (haven't done it for a while), but I think somewhere between two a week, or one three times a week, spaced out. Anymore than that might upset might mean too much bone to meat ratio (wings don't have much flesh on them).
As far as I know it isn't so much that you might be giving them too much calcium (unless they are getting far too much), more that eating too much bone can cause constipation. Also, if the cats are eating lots of bone it fills them up at the expense of eating the (meat) protein they need.
I always gave the cats a chicken wing each after they'd had something to eat (maybe not a full meal, as the chicken wing would be part of it). Just instinct, but I thought they would be less likely to gobble the bone too quickly if they weren't *too* peckish.
Rusty -
Message 28
Posted by rainbowLaure (U8486235) on Saturday, 21st November 2009
Thanks, Rusty. Exactly the advice I needed.
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