Puma is a neutered,long haired, bottle raised feral cat with the personality to match. He is 10 yrs old and had always been healthy when he developed a severe mouth ulcer just inside his cheek at the corner of his mouth.

Since he was impossible to medicate orally (very painful) the vet gave the antibiotic Convenia and a steroid shot about every two weeks, and cleaned his teeth. She gave the diagnosis of stomatitis as a last resort as it didn't really look like anything else.

There was no improvement for over a month and I decided to add L-lysine to his diet and the ulcer started to clear. He finally healed and his mucosa looked great. (I kept him on the L-lysine.)

We were weaning him from the steroids when he developed a life threatening tracheal inflammation that closed his throat. Off to the specialty hospital for oxygen support and steroids again and many cultures. Diagnosis, mycoplasma infection and antibiotics to treat that.

He is doing great now and will likely be on some sort of immune modulation for the rest of his life. (Cyclosporine and prednisolone). I would feel better if we knew what started the mouth ulcer in the first place.

The response to L-lysine makes me wonder about an atypical herpes infection. Your thoughts?

Wow…what a scary adventure you both have been through.

It’s true - we are often guessing at this point…even biopsies off all that inflamed tissue doesn't always tell you what the issue was.

Viral? Bacterial? Bartonella? Autoimmune secondary to...?

Even L-lysine fails as much as it works in viral cats. This stuff is evolving all the time…and even the best of the best working on this issue still say inflammation or ulcers in the mouth can be caused by

“an atypical   immune   response   of   unknown   etiology"

Which means your educated guess of herpes sounds reasonable to me.

Thank goodness you found the right combination of treatment for Puma!

Dr. Kris