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Dear Most Esteemed and Knowledgeable Kitties:

My cat, Rockie, will be 16 in March. He has a few health concerns. To start he has a mouth problem. The vet said the only way to fix this problem is to take about 10 teeth out of his mouth. His mouth gets swollen and it hurts to do everyday things like eating and bathing. The vet won’t do the procedure because Rockie has a heart murmur that has been there for years. He says Rockie will probably die in surgery due to anesthesia. The vet gives him a cortisone shot every 2 months. Lately he’s needed the shot almost every month. I’m concerned that having too much cortisone will have dangerous effects. I want to know if there is anything I can do for my little man. Other than those two health concerns he’s pretty good. I just want to find a way to extend the duration of time between cortisone injections. Any suggestions would be great!

~ Leanne

Thomas: Wow, that’s a tough situation for poor Rockie! Let’s see what we can do to help you.

Bella: First of all, we know a cat that has a mild heart murmur (grade 1-2 of 6) who is able to get his teeth cleaned and any necessary extractions at a clinic that specializes in veterinary dentistry.

Tara: You don’t say how severe Rockie’s heart murmur is, but we’d imagine it’s moderate to severe if your vet is worried about his ability to survive anesthesia.

Thomas: Veterinary dental specialists are specifically trained in risk management, particularly for cats that have other diseases that make the odds of success too low for general-practice veterinarians to undertake.

Bella: So the first thing we’d recommend is to seek out a veterinary dental specialist in your area, because he or she may be able to get Rockie’s teeth removed, which would also remove the need for monthly cortisone shots.

Tara: You are correct to be concerned about regular steroid shots. Although cats tolerate steroids much better than dogs or people, long-term use of steroids can induce diabetes in some cats.

Thomas: But the cats most likely to develop diabetes from steroids typically have other risk factors, particularly obesity, which leads to a 3-5 fold increase in diabetes risk, according to EndocrineVet.com.

Bella: You don’t specifically say which dental condition Rockie has, but if he’s getting regular steroid shots, we’re guessing he has stomatitis, a swelling of the tissues of the gums and mouth.

Tara: According to DVM360, there are a range of treatments for stomatitis including anti-inflammatories like steroids, plus occasional antibiotics as needed. One thing they also recommend is testing for bartonella, because this particular bacteria can lead to stomatitis or worsen the symptoms.

Thomas: Because stomatitis is thought to be caused by an immune overreaction to plaque, the most successful long-term treatment is regular dental cleanings and extractions of teeth with resorptive lesions.

Bella: We’d recommend asking your vet about other ways to control infections and pain, because sometimes vets will prescribe pain medication to severely affected cats.

Tara: And, of course, feeding soft food will help keep Rockie healthy and well-nourished because it’s not as painful to eat as dry food.

Thomas: Best of luck to you and Rockie; we hope you can find a dental specialist who can help you with getting your kitty’s teeth cleaned and the bad teeth removed despite his heart murmur.

Bella: Even if the dental specialist doesn’t feel it’s safe to remove Rockie’s teeth, he or she may be able to offer other treatments to manage Rockie’s dental disease.

Tara: What about you other readers? Do you have a cat with dental disease and a heart murmur? What have you and your vet done to help your cat? Please share your thoughts in the comments!