Dear Most Esteemed and Knowledgeable Kitties:

My 7-month-old kitten, Frosty, has gingivitis. Her vet instructed me to brush her teeth daily and come back in 6-12 months to check her gums. I know gingivitis is common in cats, but the vet said it was uncommon in kittens, which worries me. I did have Frosty tested for FeLV (it came back negative) to rule that out as the cause. Her vet said what I feed her won’t make a difference, as long as I stick to a mix of wet and dry food.

I’m considering adopting her littermate, who also has gingivitis. I’m happy to brush both cats’ teeth daily but I can’t really afford expensive dental care if that’s a necessity in the future. Do you think daily brushing will reverse the gingivitis? What is your opinion on the food issue? And do you think I should adopt the other kitten?

~ Afton

Siouxsie: Well, Afton, your letter comes at an opportune time, since it seems I’ve been dealing with a bout of gingivitis lately, too, and it’s been making me quite cranky! Fortunately, Mama took me to the vet and I’m taking medicine which is helping me feel better. And while sore mouths are on our minds, we’re going to give you some information that we hope will help answer your questions.

Thomas: Gingivitis is a periodontal (gum) disease caused by a buildup of plaque, which traps bacteria and causes irritation and inflammation of the gums. Usually the gum tissue on outsides of the teeth are most affected because cats’ tongues and the natural flow of saliva from the inside of the mouth to the outside help to keep the inner surfaces of the teeth clean.

Dahlia: It’s good that your vet tested Frosty for feline leukemia (FeLV) — and, we presume, for feline immunodeficiency virus (FIV), since these tests are usually done at the same time — because these illnesses greatly increase the risk of developing periodontal disease.

Siouxsie: The upper respiratory illnesses feline calicivirus and bordetella have been implicated in the development of periodontal disease. The calicivirus, in particular, has symptoms that include mouth ulcers and gingivitis.

Thomas: Kittens can outgrow gum disease with extensive care, including daily tooth brushing and excellent nutrition.

Dahlia: Any vet will tell you that feeding your cat the best-quality food you can afford is not only likely to help her recover from illnesses but to prevent her from getting sick in the future. Our mama is a strong believer in paying more for top-quality food rather than grabbing whatever’s on sale at the grocery store (which we — and she — would pay for later).

Siouxsie: Sometimes food allergies can cause the development of gingivitis-type symptoms, too. Cats typically don’t tolerate grains like corn and wheat (common in grocery-store cat foods), and artificial colors and chemical preservatives can also lead to allergic reactions. You might try a grain-free canned food to see if that helps Frosty’s mouth feel better.

Thomas: There are vets who tell their clients to feed their cats dry food only because that will reduce the formation of tartar. We think this is as ridiculous as your dentist telling you that you can keep your teeth clean by eating nothing but potato chips!

Dahlia: So, Afton, we definitely recommend premium-quality food. We also suggest that you make sure to give your cat water that’s filtered through a filter pitcher. The filter pitcher eliminates or reduces chlorine and other chemicals that can irritate the mouth or change the natural acid/alkaline balance of the mouth.

Siouxsie: In addition to your daily brushing, give Frosty some chewable treats like these Wysong Dream Treats or Feline Greenies. These would be a great reward to give Frosty after she’s let you brush her teeth.

Thomas: These chew toys from Petstages can be great for helping Frosty fight tartar buildup on her teeth and have fun, too. We’ve got a couple of these dental toys, and they’re indestructible! They’re great to play with, too.

Dahlia: As for the potential expense involved in treating cats with dental disease, it’s not insignificant. You may be looking at a dental cleaning under anesthesia once or twice a year — the price of which can vary depending on where you live — and possibly having teeth removed if the infection gets really bad.

Siouxsie: To get a realistic idea of the cost of these procedures, we’d recommend that you talk to your vet clinic. All clinics have a list of prices for various procedures, and if you ask the people at the office about the cost of a dental cleaning or a tooth extraction, you’ll have a much better idea what you’re getting into.

Thomas: The good news is that since you’re already taking such good care of Frosty and you’re willing to do whatever home care you need to do in order to keep her mouth healthy, the chances are pretty good that she’ll be fine and may never need complicated and expensive surgery.

Dahlia: You asked us if we think you should adopt Frosty’s littermate. Only you can make that decision, Afton. We think that once you figure out what you may be looking at in terms of cost if a worst-case scenario should come to pass, you’ll be able to make a better-informed choice, at least as far as the gingivitis and its treatment goes.

Siouxsie: For some quick tips on how to get your cat used to having her teeth brushed, check out this article on Catster.com.

Thomas: And here’s a video demonstrating how to brush your cat’s teeth:

Dahlia: Good luck, Afton, and many happy brushings!

Dear Most Esteemed and Knowledgeable Kitties:

I have a 14-year-old cat whose gums became swollen, they bled and she had difficulty eating and grooming herself. My vet suggested a dental cleaning, and when they put her under, they discovered that her teeth were in perfect condition. She was then put on antibiotics and steriod injections. The condition kept flaring up and the vet suggested removal of all her molars, which I agreed to.

This has still not stopped the problem. She was put on steriod injections every 6 weeks, but after a while the injections only lasted 3-4 weeks. We then tried steriod tablets, a quarter to half a tablet a day when needed. Yet again, after a few months these became ineffective. She went in last week to have x-rays to see if the problem was in her gums or jaw bone. The tests came back clear. She has been tested for every disease relating to the immune system and nothing shows up. Can you suggest some new avenues for me to explore?

~ Akua

Siouxsie: Since your vet has tested for every disease we can think of, Akua, we think you should investigate the possibility of an allergy or environmental sensitivity.

Thomas: Cats can be extraordinarily sensitive to chemicals in their environment or in their food. This can cause any number of symptoms from skin itching and swelling to diarrhea and many others that can’t be explained by a disease process.

Dahlia: Although gum swelling and bleeding are not listed among the commonest symptoms of allergies, we still think it could be a possible indication of environmental stress.

Siouxsie: Your cat’s situation is one of those where we feel that a referral to a holistic veterinarian may be a great help. It seems to us you’ve taken pretty much every route your conventional veterinarian has to offer you, and perhaps going an alternate route will result in healing or better management of your cat’s condition.

Thomas: We must point out that we mean no disrespect to Western vet medicine, by the way! Mama relies on our conventional veterinarian to keep us healthy and diagnose and treat any conditions that may arise, and we’d never advise anyone to stop taking their cat to a regular vet.

Dahlia: But sometimes you run out of options. And trust us, when vets don’t know what else to do, they get frustrated too! They don’t like to see animals hurting and feel as though they can’t help the pain to stop.

Siouxsie: Anyway, Akua, you may want to find a holistic veterinarian in your area. You can do so by talking to friends who have used holistic vets or by consulting the American Holistic Veterinary Medical Association‘s practitioner directory. If you live in the US or Canada, this directory is pretty complete; if you live elsewhere, there are probably equivalent organizations with similar listings.

Thomas: Once you locate a holistic vet in your area, you may be able to use review sites like Yelp or VetRatingz to find out more about clients’ experiences.

Dahlia: Of course, ultimately it’s going to come down to your (and your cat’s) preferences when selecting a vet.

Siouxsie: In the meantime, try to think of anything in your cat’s environment or diet that changed before her symptoms started. Did you have a carpet replaced? Change laundry detergents? Buy a different cat food or litter?

Thomas: If not, it may be that her system just got fed up with a whole bunch of small irritants. We’d recommend making your house as chemical-free as possible by eliminating things like plug-in air fresheners, heavily scented detergents, fabric softeners and kitty litter, and — of course — if anyone smokes in your house, this would be a great time to tell them they have to go outside!

Dahlia: Buy your cat the highest-quality food you can afford. The less grain, the better, because grains have a tendency to irritate cats’ digestive systems; we are, after all, obligate carnivores, and our bodies aren’t designed to be able to digest grains all that well.

Siouxsie: We would recommend that you undertake a search for a holistic vet pretty soon. Long-term steroid use, particularly at high doses, can have pretty serious health consequences for cats, including weakening the immune system and potentially causing diabetes, liver disease, and other endocrine system disorders.

Thomas: Akua, we hope that if you do decide to pursue holistic care in addition to your regular vet care, that your cat finds some comfort and relief soon so she can enjoy the rest of her life.

Dahlia: Please let us know how things turn out.

Dear Most Esteemed and Knowledgeable Kitties:

What causes a cat’s fur to stay wet after they groom themselves? The cat also has a fishy smell on her breath. (She doesn’t eat anything fishy.)

~ Emily

Siouxsie: Emily, one of the reasons our fur stays wet for a little while after we groom ourselves is because saliva is a main component of our grooming.

Thomas: Also, we cats don’t sweat, so it’s important for us to have a way to keep ourselves cool. By dampening ourselves with our saliva, the evaporation of that saliva helps to cool us down on hot days.

Dahlia: But we do want to talk a bit more about your cat’s fishy breath.

Siouxsie: As you know, cats don’t brush their teeth. This can lead to a build-up of tartar on the outsides of our back teeth, which can cause our breath to be a little bit smelly.

Thomas: The trouble with tartar build-up, aside from the cosmetic issue of smelly breath, is that it contributes to dental disease.

Dahlia: Because the mouth is warm and moist, it’s an ideal place for bacteria to set up camp. The tartar gives these bacteria lots of places to hide in. The tartar can also build up to the point where it starts irritating the gums.

Siouxsie: This condition, called gingivitis, is marked by red areas at the gum line.

Thomas: Healthy gums are pink in color. If you have a black cat or a cat that has any black on its body, there may be areas of black pigment on the roof of the mouth or the gum tissue.

Dahlia: I have a black spot on the roof of my mouth!

Siouxsie: Oh yeah? Well, so do I! Anyway, Emily, check to see if your cat has gingivitis. Lift her lips by her molars. If you see yellow-brown gunk on her teeth, that’s tartar.

Thomas: Unlike dog tartar, cat tartar can be pretty easy to remove. If there’s tartar buildup but no gingivitis, you may be able to remove some of the tartar by plucking it off with your fingernail.

Dahlia: If your cat will tolerate it, that is. I won’t let Mama get anywhere near my mouth … unless she’s petting me right behind my whiskers, that is.

Siouxsie: You’ll want to put your fingernail just below her gum line and use it like a soft chisel. If you do it right, you may dislodge a chunk of tartar.

Thomas: However, if you see red areas at her gum line, your cat already has dental disease, you really should see your vet. If there’s a lot of red or if the tissue is really swollen, a more serious infection could be setting in. Set up an appointment and have him or her take a look at your cat’s mouth.

Dahlia: If your cat’s tartar buildup is very severe, your vet may recommend that she have a dental cleaning. This procedure is done under general anesthesia because cats won’t tolerate that much stuff going on in their mouths. It also helps if there’s a lot of swelling and pain, because the cat won’t jump or pull away.

Siouxsie: Cats can and do get tooth decay as well. This is usually a result of untreated gum disease. But where humans tend to get cavities on the chewing surfaces of their teeth, cats get cavities along the gum line.

Thomas: If your cat has teeth that are very decayed and causing pain, your vet may recommend that they be removed. Cats can do quite well if they’re missing some teeth. In fact, we know of cats that have no teeth at all and still have a great quality of life.

Dahlia: Believe us when we say that we’d rather have missing teeth and no pain than a mouth full of rotten, sore teeth!

Siouxsie: One thing vets recommend to keep your cat’s mouth in good shape is regular brushing. Yes, believe it or not, you can brush your cat’s teeth.

Thomas: A cat usually has to be trained to accept brushing, and you should never use human toothpaste on your cat. There’s stuff in human toothpaste that’s toxic to cats.

Dahlia: We wrote an article a while back on how to clean your cat’s teeth. Check it out for some instructions.

Siouxsie: We’ve written a few articles about dental disease, as a matter of fact. You can find more information about other causes of mouth problems there.

Thomas: In any case, we do think it would be a good idea to call your vet and see what they think about bringing your kitty in for a checkup.

Dahlia: Please let us know how things turn out. We’d love to find out what the vet told you.

Dear Most Esteemed and Knowledgeable Kitties:

My cat is 4 or 5 years old and has lost all her teeth, and I don’t know why. Should I have her put down? Is what she has contagious to my other cats?

~James

Siouxsie: The first thing you need to do, James, is take your cat to the vet — sooner rather than later. It’s not an emergency, but you don’t want to put off that visit. There are a number of reasons why your cat could lose all her teeth, and only your vet can give you a diagnosis.

Thomas: Your vet will be able to tell you if your toothless cat has a condition that’s contagious to your other cats, too.

Dahlia: If your cat hasn’t been tested for feline immunodeficiency virus (FIV) or feline leukemia virus (FeLV), you should have your vet do that. If your cat has tested negative before but she’s been exposed to or bitten by another cat, you should have her re-tested.

Siouxsie: Once your vet tells you what’s wrong, you can discuss your cat’s present and future quality of life and come to an informed decision as to whether euthanasia is a humane option.

Thomas: If your cat lost all her teeth due to dental disease or an allergic-type condition, rest assured that cats can enjoy a good quality of life even without teeth.

Dahlia: Feed your toothless cat canned food because it’s easier for her to eat. Many cat experts say it’s healthier for cats to live on an all canned food diet than on kibble because wet food provides the right amount of moisture, protein, and other vitamins and minerals that they need. Toothless cats should not be let outdoors because they lack one of their basic defenses against hostile animals.

Siouxsie: Toothless cats can eventually adapt to eating kibble. It will take a while for her gums to be able to tolerate hard food, especially if she lost her teeth due to gum disease or infection. These conditions leave the gum tissue very inflamed and sensitive and she’ll need time to heal from that before she eats dry food again.

Thomas: If it turns out that your cat has a chronic illness and her health is reasonably good right now, but you can’t financially or emotionally afford any ongoing treatment she needs, ask your vet if he or she can help you find a home with someone who can. There are people who make a point of adopting cats with special needs, including cats infected with FIV or FeLV, because they have the desire and the means to give these cats a good home for as long as they live.

Dahlia: Don’t bring a cat with a chronic disease to an animal shelter. Shelters can’t take in cats with FIV, leukemia, or any other highly contagious diseases. Even if you know and don’t tell them, they’ll immediately suspect something since she’s so young and has no teeth. All cats brought to shelters are tested for FIV and FeLV, and if they’re found to be positive they’ll be put down — even in a “no-kill” shelter — because the risk of disease transmission is too high to allow them to live with other cats.

Siouxsie: In the US, there are animal sanctuaries that will take in sick cats, but they can be hard to find. The internet can be a good resource for information about these sanctuaries, though.

Thomas: So, James, don’t rush to the conclusion that euthanasia is the only solution for your cat’s condition. Take her to your vet and get a diagnosis. Once you know what’s going on, you can decide how you want to deal with the situation.

Dahlia: Cats can and do enjoy a good quality of life even without teeth, and there are re-homing options available if it turns out your cat has a contagious illness and you’re concerned about your other cats’ health.