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By David Levin
Published Jun 2, 2017

It happened almost overnight. While traveling on a long weekend vacation, Stephanie Hammerman got a phone call that no pet owner wants: her four-year-old cat, Jax, was suddenly and mysteriously in terrible pain.

“My roommate called and said Jax was acting really weird. He was rolling on the floor, pawing at his face. He wouldn’t let anyone touch him. When I got home, he was just lying on the bed, bleeding from his mouth,” she says. Whatever was going on with him, she thought, it seemed serious.

At the urging of her vet, Hammerman rushed Jax to Ryan Hospital’s emergency service, where Dr. Kelly Saverino was on call. Saverino, a resident in veterinary dentistry & oral surgery, immediately set to work stabilizing the ailing cat and calming him as best as she could.

“My immediate thought was pain relief; to make him comfortable, and then try to diagnose what was going on in his mouth,” she says.

Dental x-rays reveal problems with Jax's teeth and jawboneIdentifying the source of Jax’s problems wasn’t so straightforward, however. Some of his immediate issues—a broken canine tooth, inflamed gums, and bloody mouth—pointed to severe oral decay and gingivitis, but might also have been the work of a cancer like lymphoma, Saverino says.

“From the recession of bone and gingiva, we knew that the teeth themselves were in bad condition, but sometimes there are two or more things going on,” she says. To find out for sure, Saverino ordered biopsies of Jax’s jawbone and oral tissue, as well as full-mouth dental x-rays.

The results that came back offered both good and bad news. Jax was thankfully tumor-free, letting Hammerman breathe a sigh of relief. His mouth, though, was in terrible shape. The surface of his jawbone had deteriorated, leaving a jagged, irregular edge that couldn’t support his teeth. Inside, the bone seemed spongy, porous, and inflamed—hallmarks of a dangerous bone infection called osteomyelitis. Treating that disorder would mean not only putting Jax on powerful antibiotics, but also removing all of the teeth left in his swollen mouth.

The news came as a surprise to Hammerman. Jax had dealt with minor tooth decay as a kitten, but nothing this severe. Yet as drastic as his condition seemed, Saverino wasn’t alarmed. Gingivitis and tooth decay are common in cats, she says, and they’re good at hiding the illness until the disease is severe. “The signs are subtle,” she says, “so it’s not that unusual that they seem to come out of nowhere.”

Jax's mouth is examined prior to surgeryUnder the Knife

While Hammerman waited anxiously, Saverino rushed Jax into surgery, where students and colleagues helped her prepare. Operating in a cat’s tiny mouth is tight quarters, she notes, so it’s essential to have a skilled team at your side.

“We had a group of anesthesiologists that placed a breathing tube into his trachea and made sure he stayed anesthetized. Students and colleagues helped me get into those small spaces, made sure we had adequate exposure and light, and monitored Jax’s vital signs throughout the procedure,” she says. “Oral surgery in cats can be pretty challenging.”

Meanwhile, Saverino set to work cutting into Jax’s gums, exposing diseased bone and teeth, and gently removing them from what was left of their sockets, stopping periodically to keep Hammerman posted during the three-hour procedure.

All sutured up, the end result of Jax's surgery
“Dr. Saverino was amazing throughout the surgery,” she says, “She was really vocal and attentive to us. She told us exactly what Jax’s mouth looked like once she got in there, and described what she was doing at every step. Even after the surgery, she talked to us on our level, and reassured us when we needed it. We can email her with questions at any time, and she’ll get back to us in a couple of hours,” Hammerman says.

Bouncing Back

Jax has more energy at home and is quite the climberToday, just a few weeks after Jax’s surgery, he’s made an astounding recovery. Once his incisions started to heal and sutures began to dissolve, he was able to go back to his regular diet of dry food. (Even with a full set of teeth, cats often will swallow their food whole, Saverino notes.)

Now, he’s more playful than ever. “His energy has skyrocketed,” Hammerman says. “He’s bouncing off the walls now, eating a ton of food. The surgery hasn’t held him back at all. I do find the idea of a toothless cat pretty hilarious, in a way, though. He still tries to play bite me,” she says, laughing.

“It’s a common concern: ‘my cat doesn't have any teeth; can they eat?’” says Saverino, “They usually do just fine, though. Most of the time, their teeth are creating such a problem that removing them completely changes their attitude. There’s something really gratifying about how much improvement you can see in an animal with just one procedure—their quality of life is drastically better.”

Jax will return to Ryan Hospital a few more times over the next month for follow-up visits and additional treatment for an unrelated ear infection. As far as Hammerman is concerned, after her experience with Dr. Saverino, she wouldn’t bring him anywhere else.

“The great thing about Penn Vet is that they treat the entire animal, not just what you bring them in for,” she says. “We feel really lucky to have that kind of care.”

Jax resting comfortably at homeTable of Contents