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FELINE CHRONIC GINGIVOSTOMATITIS: SURGICAL LASER REMOVAL OF INFLAMED ORAL TISSUES
Up to 20% of cats that have whole mouth extractions for gingivostomatitis do not completely improve. Some of these non-responders will get better with a more extended time after extractions; we have seen delayed recoveries as long as several months to a year after extractions.
Some of the cats do not need additional treatment while they are making their prolonged recovery from extractions and some do. For the cats that need help we typically use medical therapy (long-acting cortisone injections, etc) and sometimes we also use our surgical laser to debride (remove) the inflamed tissue; this laser procedure is the subject of this article.
The patient is placed under general anesthesia and all of the inflamed oral tissues are removed with the laser. The procedure is usually well tolerated, producing only minimal swelling and pain post-operatively. Many cats will eat the same day of the procedure, but some take a day or two to start to eat again. Most patients are on medical therapy for pain at the time of the procedure, but if they are not we will provide it.
The theory behind the laser debridement is that the inflamed tissue is replaced not by normal oral tissues, which would simply become inflamed again, but by fibrous tissue, similar to a smooth scar. This fibrous tissue is much less likely to become inflamed.
To date (2013) there have not been any controlled studies to prove this theory, but we have seen a positive response to this treatment in a good percentage of our patients, and similar positive responses have been reported by other veterinary general practitioners and veterinary dentists.
When laser therapy works well, patients might need only one treatment and some patients might need multiple procedures. We typically space the procedures 3 weeks apart, and continue to repeat them if we seem to making progress.
We are convinced that laser surgery is an appropriate worthwhile follow-up treatment for cats that do not respond to whole mouth extractions. Unfortunately, just like some cats do not respond to the whole mouth extractions, some cats do not respond to the laser surgery.
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