Nine Lives, But Only One Set of Teeth
George, an 8 year old Domestic Short-hair cat, is in my practice today for a full-mouth extraction. This is an oral surgery that involves removal of all of his teeth.
George is a very fine young man, who to all outward appearances is the picture of health, with a beautiful shiny black coat. However, he has a very ugly mouth. George was brought in to see me because he was drooling. My exam showed that George had severe dental disease including loose teeth, teeth that were broken, and very severe wide-spread inflammation in his mouth called stomatitis. His gums were swollen, raw, and bleeding.
Just because your cat doesn’t act sick or painful doesn’t mean that they’re not, and haven’t been so for a very long time, as George has been. On occasion, my clients will tell me ‘My cat has never been to a vet before,’ or ‘But, she doesn’t act sick,’ or opine that ‘Cats don’t need regular check-ups.’ I inwardly cringe, when I hear such statements, as I reflect on the silent and needless suffering that I’ve witnessed in my patients over the years, George included.
Many cat owners fail to bring their cats in for regular exams, because, to their eyes, their little rascal appears to being going through life with stoicism and equanimity. These little creatures that we share our lives with, unfortunately, do a poor job of telling us when they are sick or in pain, and this is especially true of cats who suffer with hidden oral disease and its associated pain.
One very common condition that affects cats is a tooth resorptive lesion. Tooth resorption is a slow, painful, and irreversible process of destruction of the tooth. It leads to exposure of the sensitive inner structures on the tooth in a process that plays out over months to years, eventually leading to the tooth breaking. Pain in affected teeth is the theme throughout this process.
In addition, cats can suffer similar gum and periodontal diseases that affect humans. These may lead to problems in other areas of the body by providing a chronic source of infection and inflammation. Oral tumors and cancers can also occur. Catching these early problems is essential before they become major problems or before it becomes too late.
Cats may have nine lives, or appear to, but they only have one set of teeth.
Maintaining the health of your cat’s teeth and gums is one of the most important things that you can do to increase the quality and length of your cat’s life. When was the last time you looked in your cat’s mouth? How would you know if she had a loose tooth, a hole in his tooth, severe pain, gingivitis, bleeding and swollen gums, or the beginnings of an oral tumor?
By bringing your cat in for regular and thorough exams, and addressing dental concerns as needed, not only will you be doing your part to lengthen his or her life, but you will also be going a long way to providing an improved quality of life.
I have experienced MANY instances of clients telling me how taking care of their cat’s mouth pain has changed their cat’s lives, attitude, and personality. Comments such as ‘She’s a totally different cat,’ and ‘He’s much more playful,’ are like music to my ears. As I watched George recover from his surgery, in our pediatric incubator earlier today, I felt good in the knowledge that he could look forward to a future without the pain of his past.
To Feed or Not To Feed – Canned Food – That is the Question!
Part 1: A Hefty Debate
Last year, a study including 450,000 cats was released called “State of Pet Health 2011 Report”. In that study, obesity ranked in the top three diagnoses for cats. The study also found that the incidence of diabetes in cats over the last five years has increased by 16% – not surprisingly, the two are related. They are both related to diet, as are several other medical issues we see in cats. This makes a cat’s diet one of the most important parts of good preventive health.
Over the past few decades, with increasing vigor, veterinarians and animal nutritionists have been debating the merits of dry foods (kibble) versus canned foods. One downside to feeding dry foods is that even though all commercially available diets are formulated to meet certain nutritional standards, dry food is quite the opposite of what cats naturally need. (Click here for more on feline obesity and diet from Dr. Lund.) The best way to encourage weight loss in a cat is to minimize the dry food and feed most calories as canned foods. Two recent studies were released this year demonstrated that the addition of water to similar diets resulted in weight reduction and increased activity1, 2
The bottom line: Canned food is more like a cat’s natural diet in consistency, nutritional content and caloric density. Canned food will help your cat lose weight and keep it off. And most cats just plain like canned foods better!
Part 2: The Tooth of the Matter
In the past, many veterinarians made the recommendation to switch from feeding canned diets to feeding dry kibble for the sake of cats’ dental health; a canned-food-only diet was the prime suspect for the poor dental hygiene seen in the majority of cats. In 2011, in the “State of Pet Health 2011 Report”, the number of cats with dental disease surpassed the number of healthy cats seen after age 3 (over 50% of cats!), making it the most common feline disease.
The reality of feline dental disease is that genetics has a large part to play in your cat’s oral health, just as it does in humans. While canned food really does not help eliminate plaque and tartar, neither do many of the commercially available dry foods, either! Most of the commercially available dry diets have kibbles that are small enough that cats will gulp them down whole. More recent research has shown that in order for a dry food to help with dental care, a larger-sized kibble, typical in special diets designed specifically for oral health, is required3. Larger kibbles allow for more tooth penetration and “scraping” of the tooth. Some of these special diets also have anti-plaque additives that help. Some diets advertise anti-calculus agents, too, but these do not seem to help. Once the plaque has hardened, it seems a professional dental cleaning is the best way to get the teeth clean again.
If you try out a dental diet, you will notice that your cats are significantly noisier when they eat – suddenly, you will be able to hear the crispy crunching sound of food being chewed, when before, the only dinnertime sound was the tink-tink-tink of kibbles being pushed around in the bowl.
The bottom line: Canned food is not your cat’s oral enemy, and not just any dry food will help keep their teeth healthy. A combination of special dental-focused diets and annual oral exams by your veterinarian are the best team for cats’ teeth.
Part 3: Litter-ally a Matter of Concentration
If you consider the cat’s natural diet, a rodent is about 70-78% water. Dry food contains about 10% water. Cats are descended from desert animals, so their instinct is to take in water from their prey versus looking for water sources. While a cat will noticeably drink more water when feeding a dry food versus a canned food, they never drink enough to compensate for the lack of moisture in their food, and will exist in a perpetual state of mild dehydration. In fact, their water intake is about ½ that of a cat that eats canned food, even if you have a cat fountain, give your kitty a “princess cup”, put ice in the water bowl, or let your cat drink from the faucet.
Mild dehydration, while not life threatening on its own, does mean that cats produce less urine than if they are well-hydrated, and that urine is more concentrated. Overly concentrated urine has been linked to urinary issues such as bladder stones or urinary crystals. Urine concentration is a measurement of how much “stuff” is in the bladder. The more “stuff” there is floating around in there, the more likely it is to stick together. The more it sticks together, the bigger it gets, until it starts to irritate the lining of the bladder as it sloshes around. Blood may or may not be visible in the urine. This irritation makes urinating an unpleasant event and may cause your cat to choose to eliminate somewhere other than the litterbox. (More information about litterbox issues from Dr. Colleran.) If the “stuff” gets too big, it may even cause a blockage in the urethra, which can become an emergency very quickly.
The bottom line: More water is better for your cat’s urinary health, and the best place to get it is from a canned diet.
1. Cameron KM, Morris PJ, Hackett RM, Speakman JR. The effects of increasing water content to reduce the energy density of the diet on body mass changes following caloric restriction in domestic cats. J Anim Physiol Anim Nutr (Berl). Jun 2011;95(3):399-408.
2. Wei A, Fascetti AJ, Villaverde C, Wong RK, Ramsey JJ. Effect of water content in a canned food on voluntary food intake and body weight in cats. Am J Vet Res. Jul 2011;72(7):918-923.
3. Clarke, DE, et al. Effect of Kibble Size, Shape and Additives on Plaque in Cats. J. Vet. Dent. Summer 2010; 27(2): 84-89
Not Grooming after Eating
One of the main reasons cats groom themselves after eating is that in the wild, cats want to protect themselves from predators, and want to eliminate any traces of blood that might have collected on their furs as they were hunting or eating. So, today’s domestic cat carries on what its ancestors did by tidying up after eating. If you find that your cat is not spending time sprucing up its appearance after a snack or a meal, it is possible that something is wrong.
Dental disease can lead to a decrease in how much a cat grooms, if not a complete stoppage of hair care. Cats will often continue to eat when they have painful teeth, because many, many cats swallow their food, chewing very little if at all. But once they have satisfied their bodies need for food, the discomfort they experience from having unhealthy gums or diseased teeth can lead to their deciding it just hurts too much to keep their fur clean.
Older cats who suffer from cognitive dysfunction and stressed out kitties, who are having trouble sharing their homes with other cats, can also not groom after eating like they should. Your senior cat might need some help in the grooming department and your sensitive cat might need for you to make sure it eats by itself and has some private time when it won’t have to worry about sharing its space with another cat.
If you have a cat that doesn’t groom after eating, it is possible your kitten or cat skipped that class in kitten school, making it normal for your cat not to groom after eating, To be safe, discuss the fact that your cat doesn’t clean up after eating when you take your cat to your veterinarian for its regular semi-annual or annual visit. Your veterinarian should perform a thorough physical exam; including taking a good look at your cat’s teeth and gums.
Dental Problems
Have you or someone you loved ever had problems with their teeth? Dental pain from abscesses, tooth fractures and deep cavities can make life miserable for anyone, including our cats. Pain can be sharp and stabbing, a dull ache, or associated with pressure on contact with hot or cold foods.
Our cats can’t tell us when their mouths hurt. Instead, they may eat less, refuse hard kibbles, or tilt their head back and forth to avoid the sensitive spots when eating. They may drop food. Chronic pain can cause your friendly and happy cat to become irritable or reclusive.
I rechecked one of our dentistry patients today after he had some major dental work done last week. This wonderful cat, who we will call Oscar, was brought in to see us because he had not been as interactive as usual and was hiding quite a bit. On physical examination, we could see that Oscar had quite a bit of inflammation in his mouth but no obvious fractures of his teeth. Oscar seemed uncomfortable when his mouth was examined. We scheduled Oscar’s dental teeth cleaning for the next day.
Cats frequently develop cavity lesions at the gum line or underneath the gums. Consequently, obtaining dental X rays is very important to evaluate every cat’s mouth. Any dental work in cats and dogs needs to be performed under anesthesia as they will not sit there and open their mouths for us to work on!
Oscar had 2 abscessed teeth (both of his lower canine teeth) and 3 additional teeth with large cavity lesions. All 5 teeth had to be extracted. Oscar was treated with antibiotics and pain medication.
At today’s follow up examination, Oscar is now pain free. He is eating his dry kibble with gusto and is no longer painful when handling his mouth. Oscar’s extraction sites are healing well. Oscar’s family is amazed that he is now back to his normal social self less than a week after major extractions were performed. Oscar is a great example of how important good dental health is for our cats. Oscar will now be having his teeth brushed and will be eating a prescription dental diet to help prevent future problems. What are doing to help your cat’s teeth? Oscar says to have your cat’s teeth evaluated by your veterinarian now!
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