Elmo and the Total Mouth Extraction
October 6, 2011
I met Elmo, a 5-year-old Domestic Long Hair, in May 2010 as a second opinion for severe oral stomatitis (swelling/inflammation of the gums) which was being managed medically elsewhere, and was in fact part of a study for a new potential treatment for this condition. Elmo was 8 lbs. 10.5 oz., underweight, painful and shy around the head and face. He would not allow a good oral exam and would hiss if you tried to open his mouth.
My first reaction was that he needed all his teeth removed (aka full mouth extraction) and although removing any part of the body should be a last resort, it is sometimes the best/only choice. The appendix or gall bladder in people is a good example. I discussed this with the owner in detail and we reviewed the experimental drug. Elmo was part of a well-conceived double-blind study, (the type we need more of in veterinary medicine) so I don't know what the drug was. We finally decided to proceed with the full mouth extraction. Blood work prior to the dental revealed multiple changes that were associated with the chronic gum disease, however we felt he was stable to proceed with the dental. We elected to put a feeding tube in so Elmo would not need to eat anything until his mouth had healed. By May 22, 2010, only 10 days after the dental, Elmo had gained 5 oz, was trying to eat on his own and would allow me to look in his mouth.
Elmo did have some other issues during his recovery related to kidney issues (which are, in fact, a result of his chronic dental issues), however, he is now over 13 lbs. and is happy and content at home. He is willing to eat both wet and dry food (by nature cats don't chew, they rip and tear their food, so most cats do not chew the dry food anyway), is not shy about his face, and in fact he enjoys a good muzzle rub. He is bold in the exam room and knows he has me wrapped around his paw.