Dr Yavor Stoyanov,
Veterinary clinic Bomed
Sofia, Bulgaria
A 6-year-old, neutered male domestic shorthair cat
was presented for dental cleaning due to “bed smell breath”.
No vaccinations history, irregular anthelmintic treatment.
No earlier dental care.
History of cystitis four years ago.
Clinical exam:
The cat was in good physical condition.
Normal temperature, auscultation, palpation.
Facial Exam:
Normal facial and eyes symmetry, no nose or eyes discharges.
No compression discomfort, no swollen regions, lymph nodes – normal, lips with black pigmented zones.
Conscious Oral exam:
The cat was cooperative.
Normal maxillomandibular joint mobility, without pain.
Normal buccal mucous membranes. Lingual, sub lingual, caudal mouth space and roof of the mouth was normal.
Moderate gingivitis, gingival recessions, missing all upper right premolars (106,107,108), left upper first premolar (206), first and third left mandibular premolars (307,308).
All canine teeth were with root exposure.
Many mobility teeth: 207,208,308,403, with root exposure and visual
root resorption and attachment loss.
Plaque index 2.
CBC, Biochemistry was in normal limits, except high globulins level.
Dental X-Ray was unavailable.
Oral exam and treatment under general anesthesia:
Missing all upper right premolars (106,107,108), left upper first premolar (206), first and third left mandibular premolars (307,308).
Moderate gingivitis (gingival index 2).
Gingival and alveolar recessions.
No periodontal pockets. Stage 3 furcation (307, 308, 309, 208)
All canine teeth were with root exposure due to tooth extrusion.
Mobility teeth: 207(M3), 208(M2), 308(M3), 303(M3), 309(M3), 403(M3), with root exposure, visual root resorption and attachment loss.
Pic.1. Dental chart
Diagnosis:
Idiopathic Tooth Resorption
Treatment plan:
Multi teeth simple extraction
Treatment procedure:
Preoperative analgesia: Rheumocam
General anesthesia
Chlorhexidine Rinse 0.12% solution
Simple extraction with elevator and extraction forceps.
In this case because of severe attachment loss I just needed to section only one premolar.
Postoperative treatment:
Rheumocam 24h/3 days
Stomorgil 24h/8 days
Stomodine 12h/14 days
Further treatment:
Dental and oral prophylaxis with Stomodine,
Regular examination every 3 months.
Discussion:
There are many theories about the etiology of Tooth resorption in domestic cats but main cause is still unknown.
Depends of the source, about 25–75% of domestic cats are affected.
There is an increasing prevalence of Tooth resorption as cats get older, with the first teeth becoming affected usually at four to six years of age.
Gender and neutering were not found to affect the prevalence of disease.
Cat owners may report halitosis, ptyalism, head shaking, dropping food
while eating, reluctance to eat hard food, excessive tongue movements,
repetitive lower jaw motions while eating, drinking or grooming,
sneezing, dysphagia, dehydration, anorexia, weight loss, and lethargy.
Clinical findings are various degrees of gingival inflammation, missing
or mobile teeth, gingival hyperplasia or recession, tooth extrusion, tooth
tissue destruction and others.
Earlier and most accurate diagnosis is made by dental X-Ray because
first changes are subgingival.
Depending on changes there are few classification based on severity
(stages 1–5) and radiographic appearance of the resorption (types 1–3).
Tooth resorption can develop with cementation and ankyloses or with
attachment loss and mobility of teeth. In case of attachment loss extraction
is easier.
Conclusion:
Tooth resorption is the most common progressive disease affecting the
dental tissues in domestic cats.
In every regular cat exam (with or without oral or dental abnormality)
Tooth resorption should be routinely suspected.
Choice of treatment – extraction of all affected teeth.
