Dear Christopher Cat: When our cat Angel starts eating, she cries and runs away from the food. Her veterinarian diagnosed stomatitis and showed me how red and raw Angel’s mouth is. He prescribed pain medicine and recommended that a veterinary dentist extract all her teeth. Won’t this cause more pain? How will Angel eat without teeth?

Christopher Responds: Stomatitis, or mouth (stoma-) inflammation (-itis), is caused by the immune system’s over-reaction to oral bacteria and sometimes other substances.

Cats with stomatitis experience severe mouth pain. They drop food, are reluctant to eat and lose weight. They may have bad breath, rub their mouths, drool or stop grooming.

Treatment is most successful when the teeth are extracted, which minimizes the plaque bacteria provoking the overactive immune response. Of the cats whose teeth are extracted, 55 percent are cured and 35 percent improve markedly. Only 10 percent show little to no improvement and require medication or other therapies to manage the disease.

Before her dental surgery, transition Angel to soft food, which will be easy for her to eat after her teeth are extracted. Pain medicine will keep her comfortable until the extraction sites heal.

I know this treatment approach sounds drastic, but conservative therapies just don’t work well. Regular professional dental cleaning is not effective in these cases, because the bacteria that trigger the immune system quickly repopulate the mouth. Long-term antibiotics also are ineffective.