Monday, September 10, 2012

Cats Rule... and Drool!

Recently, I was presented with an 8 year-old cat with a relatively sudden onset of drooling.  The owner said that her cat, Lulu, would sit with her mouth open and her tongue sticking out a little bit, and there would occasionally be some saliva coming from the cat’s mouth.  Every now and then, she said, the cat would shake her head, and some saliva would come flying out.  I asked if the cat was able to eat and drink, and she said yes, this was no problem.  I asked if she thought the cat was having any pain or discomfort with the teeth, and she said she didn’t think so, because years ago the cat had most of her teeth extracted because of severe dental disease.  There were really not many teeth left to be causing any problems, she thought.  There were just the four big canine teeth left, as well as a few tiny little incisors.

I took a look at Lulu.  Sure enough, as she sat on the table, her mouth was open  a little bit, and her tongue protruded a little.

A closer look, however, clearly revealed the problem: 

Lulu only had a few teeth left, mostly the canines.  You can see that her left upper canine (on the right side of the photo) has shifted.  Normally, the upper canine is positioned laterally to the lower canine on that same side.  Lulu’s left upper canine has shifted medially, affecting the  way the teeth  mesh.  This abnormal bite is called malocclusion.  Why did the tooth shift?  If you look at the top of the tooth, you  can see the yellow tartar at the gum line, with a little bit of pus.  Notice how the gums above the tooth are red and swollen.  This is severe periodontal disease. The tooth was loose, and it was painful for the cat when the tooth was touched.

Normally, we like to schedule our dental procedures in the mornings, in advance.  But poor  Lulu was uncomfortable, and this couldn’t really wait.  After some quick blood and urine tests, Lulu was taken back to our treatment room, anesthetized, and that loose, diseased tooth was extracted.  Her right upper canine was diseased as well, although not as badly as the left one.  It, too, needed to be extracted.

A few years ago, I wrote an article entitled When Cats Drool”.  I decided to write it because I had never seen an article specifically on drooling, and I thought the  uniqueness of the topic would make it appealing.  It turns out that of all the articles I’ve written, the drooling article get the most hits.  In the article, I distinguish between true ptyalism (increased production of saliva) and pseudoptyalism (the cat is making a normal amount of saliva, but can’t keep it inside the mouth because the  mouth cannot close properly).  Lulu is a great example of pseudoptyalism.

Lulu is at home now and is doing well.  Even though she now has even fewer teeth (maybe four total, in her entire head), she is obviously prone to dental problems, and we’re going to have to keep an eye on those few remaining teeth, to make sure the same thing doesn’t happen again.
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