Oral Examination - Other Diagnostic Tests

Blood Tests

Biochemistry and Haematology - Useful to identify any underlying problems eg. kidney disease, diabetes. May be useful to assess any underlying organ pathology as a contraindication for use of certain medications.

In some predisposed breeds, a clotting profile (or a buccal mucosal bleed time) may be advisable prior to certain procedures. For example oral oncological surgery or in some cases even a surgical extraction.

Viral Tests

FIV/FeLV

Viral isolation - Calici virus and Herpes virus have been implicated in certain oral conditions affecting cats with chronic gingivostomatitis.

Microbiology

Bacterial culture and sensitivity is not usually useful from samples taken in the mouth. Many of the pathogens are anaerobic and difficult to culture. There is also a large proportion of naturally occurring, non-pathogenic bacteria and results are not always representative, therefore the majority of the information obtained is of little value. However in long term cases that are non-responsive to treatment, or in cases with an unusual presentation, culture should be considered.

Cytology and Biopsy

Any mass in the mouth should be biopsied. The mouth is the 4th most common site for tumours. Many tumours in the mouth do not exfoliate well, so cytology is of limited benefit. The information you gain from the histopathologist is only as good as the sample you send.

The following steps should be followed in order to obtain a good diagnostic sample:

• A full thickness wedge biopsy should be taken wherever possible
• The biopsy should be of sufficient size
• Take a deep biopsy, including underlying bone where indicated
• Avoid ulcerated/inflamed areas – this may compromise interpretation
• Avoid tissue trauma or heating the tissue (rough tissue handling with rat-tooth forceps or cautery)
• Where a mass is near any underlying bone, an intra-oral radiograph should be taken to assess bone involvement
• Send your sample to an experienced oral pathologist or one with a particular interest in oral pathology
• If the results don’t match the clinical picture, discuss this with the pathologist and re-biopsy if necessary