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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 32871
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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cat has sore mouth not eating. vets, pain relief, antibiotic

Customer Question

cat has sore mouth not eating. vets, pain relief, antibiotic s/c, relieved symptoms. 24 hrs back to same mirtazapine added to oral metacam commenced on 1st visit. no improvement. vets analgesia, steroid s/c massive improvement. 24 hrs back bad pain not eating, waiting for vet to call me back. normally healthy 4 yr old tabby, fully vaccinated + FIV covered. very worried. do not want give mirtazapine to boost appetite. when pain free- eats. on exam all clear bloods nad breath fine. drops food when pain starts. I'm concerened also about giving metacam if not eating. thanks I'm a gastro nurse which makes it worse!!
Submitted: 3 years ago.
Category: Cat
Expert:  Dr. Michael Salkin replied 3 years ago.
Aloha! You're speaking with Dr. Michael Salkin
I'm sorry that your question wasn't answered in a timely manner. Such pain as you've described suggests plasmacytic/lymphocytic stomatitis, endoclastic tooth disease, or TMJ (rare). Stomatitis should be readily visible; inflammation usually involves the gingiva, alveolar mucosa, labial and buccal mucosa, sublingual mucosa, and the area of or lateral to the palatoglossal folds. Various degrees of dental and periodontal disease may be present (tooth resorption as is seen with endoclastic tooth disease, gingival recession, periodontal pockets, and mobile or missing teeth).

Endoclastic tooth disease can exist without stomatitis being present and because so much pathology is subgingival, full mouth dental X-rays are indicated to better assess the extent of this disease - particularly if stomatitis isn't evident but such pain exists. If your cat's vet isn't equipped to take dental films, it's important that you find a vet who can do so. A specialist veterinary dentist should be considered as well. Please see here: and please respond with further questions or concerns if you wish.