Q: My cat is drooling. His tongue hangs out. He has a fever. When my cat tries to eat he shakes his paw and acts like he wants to wash his paw but doesn’t. We have checked for obstructions and sores in his mouth. There are none. What could this be?
A: The first step in determining the cause of a cat’s drooling is a thorough oral examination. You said that you looked in your cat’s mouth and found nothing wrong, but this really should be done by a veterinarian. A proper, thorough oral exam may require sedation, tranquilization or even general anesthesia, as cats with mouth pain are often head-shy and won’t allow a comprehensive exam.
Cat mouth disorders, affecting teeth and gums, are a common reason for cats drooling. Your vet will look for the signs below, which might indicate particular disorders.
• Bad breath, difficulty eating: Periodontal disease. Periodontal disease and the accompanying gingivitis, if severe, can lead to halitosis (bad breath), dysphagia (difficulty eating) and drooling. Periodontal disease is diagnosed during an oral examination, however, determination of the true extent of periodontal disease often requires oral radiograph.
• Pawing at the mouth: Stomatitis. Gingivitis or stomatitis (inflammation of the entire mouth) can be so severe that cats paw at their mouth, refuse to eat hard food and may drool excessively. This condition, called “lymphocytic/plasmacytic gingivitis or stomatitis” is usually quite painful. Treatment consists of antibiotics, anti-inflammatory medications and, in extreme cases, extraction of all of the teeth.
• Drooling, pain: Broken teeth, TMJ. Broken teeth with resultant nerve exposure, a fractured jaw and temporomandibular joint (TMJ) disorders are traumatic injuries that often lead to pain and drooling. Cats’ oral trauma and associated pain and discomfort can lead to drooling.
• Malocclusion: Oral Tumors. Evaluate your cat’s mouth to see if the mouth can close properly. Oral tumors are a common cause of malocclusion. In fact, oral cancer is a very common cause of drooling in older cats.
• Ulcers on the gums, tongue and edges of the lips: Uremia. Cats with severe kidney failure may have significant uremia (literally “urine in the blood”). Kidney failure is a very common condition, especially in geriatric cats. Uremic cats often develop painful ulcers, and many of these cats drool foul-smelling saliva as a result. These ulcers are readily visible on oral examination.
Other causes for drooling (if your vet finds your cats mouth to be healthy):
• Liver disease and nausea in general. The liver’s job is to help remove toxins from the blood. If the liver isn’t working properly, the toxins accumulate in the blood stream. Nausea and drooling are clinical signs that can be seen with liver disease. Nausea is the first stage in the process of vomiting. Although liver disease is a well-documented cause of nausea in cats, any disorder that causes nausea can lead to hypersalivation.
• Other diseases that lead to nausea. If your vet finds no liver problem, check for disorders that can lead to nausea. You need a thorough approach for the diagnosis. Once a cause is discovered, your cat’s vet can prescribe specific treatment.