In some cases of refractory stomatitis, nonsteroidal anti-inflammatory drugs (NSAIDs) will provide relief. One NSAID that has shown effectiveness in cats with refractory stomatitis is piroxicam,⁴ which can be compounded into a liquid and administered at a dosage of 1 mg/cat orally every 72 hours. Side effects of piroxicam include gastrointestinal ulceration. Meloxicam (Metacam—Boehringer Ingelheim) is another NSAID that is not labeled for oral administration in cats but that may help control pain and inflammation. Avoid combining piroxicam, meloxicam, or any other NSAID with corticosteroids because it increases the probability of gastrointestinal ulceration.

Immunosuppressive and immunomodulatory drugs, such as cyclosporine, interferon, and azathioprine, can be used instead of NSAIDS to reduce oral inflammation, although the response varies and can take weeks to produce favorable results. To avoid serious or potentially fatal side effects, appropriate patient monitoring is paramount, especially when using azathioprine.

Laser ablation of the inflamed oral tissue has also been recommended. Tissue that has been treated with a laser has a reduced blood supply and may be less likely to become inflamed.⁵

1. Harvey CE, Emily PP. Small animal dentistry. St. Louis, Mo: Mosby, 1993;151.

2. Wiggs RB, Lobprise HB. Domestic feline oral and dental disease. In: Wiggs RB, Lobprise HB, eds. Veterinary dentistry principles and practice. Philadelphia, Pa: Lippincott-Raven, 1997;482-517.

3. Hennet P. Chronic gingivo-stomatitis in cats: long-term follow-up of 30 cases treated by dental extractions. J Vet Dent 1997;14:15-21.

4. Manfra S, Urbana Ill: Personal communication, 2002.

5. Lyon KF. Gingivostomatitis. Vet Clin North Am Small Anim Pract 2005;35:891-911.

The information and photographs for "Dental Corner" were provided by Daniel T. Carmichael, DVM, DAVDC, Veterinary Medical Center, 75 Sunrise Highway, West Islip, NY 11795.