Cat canker sores defying treatment & getting worse. Hope me?
August 10, 2014 7:22 AM   Subscribe

Pointy cat, an 8 year old neutered male, has been treated for 4+ years for canker sores (sometimes called "rodent ulcers") in his mouth. This past few days, he has become much worse. Many details follow.

He was started on prednisone shots, then oral Atopica (cyclosporin) when the shots stopped working; he has been on the Atopica for more than 4 years. 2 years ago I took him to the allergist who put him on an elimination diet which did nothing - vet said it he didn't think it was food related. Most recently, he has had four courses of antibiotics (several kinds) with no positive results. Cat is flea free and indoor only. We have other cats now but onset was when he was an only cat. We have hardwoods/tile, no carpet. We have changed litter too in case that was the allergy. Nothing helps.

In the past 5 days - sores bigger, cat lethargic and he is over-grooming. Oddly, he still craves the dry kibble (which I would think would be painful) perhaps even more than his wet food. The vet has suggested another allergy panel and a biopsy. This is going to cost about $1,000 before any treatment - and that is if the allergy is something we can identify & reasonably restrict (apparently it is possible to be allergic to himself or humans?). If we can identify it, we may have to try to give him shots - this is a 15 pound very strong, sometimes aggressive cat.

We have spent $$$$ on cats before - rescued the neighborhood stray who was hit by a car. A grand later, she is a happy lap cat. We spent $2k when the other girl kitty (then a stray, now also, you guessed it, an indoor kitty) had a botched spay from the free spay/neuter place. But this could be a money pit with no relief. I'm torn.

Some background: Pointycat is bonded to me (and he loves my housemate too) and I love him dearly. I got him from a kill shelter right after my divorce and from the very first night, he jumped on my bed to sleep. But. He has had behavioral treatment for aggression (both my housemate & I have scars from his now very rare but sometimes fierce attacks). He sprays (neutered late may be the cause). He has herpes from being at the animal shelter (runny eye that the vet says just is what it is). The Atopica gives him loose stools and he poops on the floor.

So what to do? Pay the allergist? (I can barely afford this - I feel so guilty for paying for an upcoming vacation recently.) Accept this is nature's way of saying my cat is too sick and this is a Sign the End is Near (I want to cry just typing that)? Something else?

Any ideas? All I ask is that you please be kind in your responses; this is very hard for me.
posted by pointystick to Pets & Animals (6 answers total)
I'm a vet, so I know this is a really, really difficult thing to have to go through. Let me just say that even if your ultimate decision is saying goodbye to Pointy cat, you have already done more for him than many cat owners would have.

One option that you may want to think about is just having the biopsy to start with. (The allergy tests can always be done later.) The biopsy will be able to tell you and the vet whether you are still just dealing with rodent ulcers, or if this is a different disease process (unfortunately I'd be worried about something like mouth cancer, especially if the ulcers had previously been fairly well-controlled for awhile). With that further information then you may feel in a better place to make the next set of decisions.

Again I'm a vet, but I'm not your vet and this is not veterinary advice.

Please take care. *Hugs*
posted by peanut butter milkshake at 7:45 AM on August 10, 2014 [7 favorites]

I can't tell what he is on now, but my lost lamented George had horrible rodent ulcers -- it curled up and covered parts of his nostrils -- and what helped him, finally, was a very very high dose of daily antibiotics plus a super high dose of steroids (as I recall, he got 6 pills a day of steroids and 2 of antibiotics, split into two doses). I forget how long he was on the antibiotics, I think 2-3 weeks, but he was on the high dose of steroids for a month after the antibiotics, then I slowly weaned him down (one pill fewer a day, wait a few weeks) on the steroids. It took a while to notice a difference, but when it did it was startling.

I'm not clear if you've been giving both antibiotics and steroids concurrently, but George needed to be on antibiotics to clear out all the infection in his lip and mouth, and on steroids to reduce the sores, and neither of them alone did anything at all.

The rodent ulcers, surprisingly, never hurt Georgie at all, and you could touch them no problem. He also was fine with dry food. He did overgroom, because when they were bad he also got sores on his legs. He also drank massive amounts of water because he was always drooling, so be sure he is getting enough water in.

That said, I knew eventually this would kill George, though in fact he ran away instead (probably because he hated the pills so much). You are doing everything you can for Pointy Cat, and it is okay if you do not want to do these tests, and it is okay if you do the allergy test and then stop, because sometimes animals get sick far too young.
posted by jeather at 8:32 AM on August 10, 2014

Sounds like you may have tried some or all of this already, but here is a Dr. Fox question/answer on a similar issue.
posted by gudrun at 9:26 AM on August 10, 2014

I'm just going to throw this out there ... When my cat had a lesion on his mouth I googled it and several people said to quit using plastic bowls. I switched to glass and it went away and has not returned. Worth a try if you use plastic bowls.
posted by BoscosMom at 1:20 PM on August 10, 2014

My deepest sympathies! My sweet kitty has those too, and my awesome vet came up with a topical ointment that works WONDERS. You mix equal parts of children's liquid benadryl, Maalox, and liquid lidocain (your vet can prescribe this -- it's cheap) and then swab a bit directly onto the sores once or twice a day. They always clear up in a day or two. I keep the ointment in a little jar and use it as needed. I know it sounds weird, but it totally does the trick. He may not like the taste but the sores do clear up fast. The lidocain is really just for pain relief, the magic combo is the benadryl and maalox, so theoretically you could skip the lidocain, but it's so inexpensive and seems to bring a lot of relief right away.

For serious outbreaks, I will take him in for a shot of steroids. But since I stated using the ointment, I haven't needed to do this in many years.
posted by ananci at 1:35 PM on August 10, 2014 [1 favorite]

Hi all, a follow up! Thank you so much for your kind answers!
The slurry ananci recommended helped - when I asked my vet about it, she suggested a similar mixture as well as oral pain meds.
The pain meds made a difference immediately so we did go to the specialist vet. Neither vet thought a biopsy was necessary (I was surprised) but I sucked it up and did the allergy panel - blood and skin tests. In the meantime, cat continued Atopica, antibiotic, and a different steroid (oral, not injected).

It took a bit longer than expected, but so far Pointycat is improving a lot. The ulcers are smaller, he is grooming less, and he is snugglier and more playful. I started the allergy serum shots as well. It will be a while before we know if they take effect but he is not having adverse reactions so hopefully we can wean him off the other meds in the future if the shots are effective.

I am hoping things will work out!
posted by pointystick at 5:06 AM on September 10, 2014 [1 favorite]

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