Bonno, a big Burmese boy, burst into the surgery this morning shaking blood all over his carrier. He had pawed and scratched at his tongue so much that he had cut it. His frantic carer told us that this was not the first time she’d seen him licking, chewing and rubbing at his face, but it was the first time he’d drawn blood.
We had a close look at his mouth after we’d sedated him and found that he had erosions in two of his molars (also known as FORLS). We extracted both teeth and scaled and polished the remaining ones.
Because Bonno is Burmese and has had previous episodes of distress we were very suspicious that he has a facial pain syndrome known as feline orofacial pain syndrome or trigeminal neuralgia. In people it is known as burning mouth syndrome and I think this is how it must feel to affected cats, too.
The trigeminal nerve transmits touch and pain from the face and mouth to the brain. In affected cats the trigeminal nerve doesn’t process the sensory input properly. The cats have episodes of distress and seem to recover only to relapse whenever there is a trigger.
Triggers include dental disease especially FORLS, mouth ulcers, and dental treatment especially extractions. Stress (as defined by the cat!) is also a common trigger.
We have started Bonno on pain relief after his extractions and an anti-epileptic drug to control the neuralgia. Nobody wants to see him in such a distressed and distressing state again.