Bad Breath (Halitosis) in Cats

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Bad Breath (Halitosis) in Cats

Also known as 'halitosis', bad breath is most commonly caused by dental problems, however sometimes internal diseases can lead to bad breath in cats.

No cat's breath is going to smell or roses, but the odour should not be offensive. Most often will be somewhat similar to whatever food he has recently eaten, however, if the breath has a strong, unpleasant odour, there is usually something causing it which should be checked out by your veterinarian.

Unhealthy teeth and gums have greater impact on the body than just causing bad breath, pain and infection. As the gums have a rich blood supply, bacteria are quickly transported to other organs including the liver, heart and kidneys, causing damage and even organ failure.

What causes bad breath in cats?

As we have said, there are a number of causes of bad breath in cats, many relate to the oral cavity, however some systemic diseases can also lead to bad breath in cats. Gingivitis and gum disease are the most common causes of bad breath in cats.

Oral causes of bad breath in cats:

Stomatitis - A disease characterised by inflammation and ulceration of the mucous membranes in the mouth.
Gingivitis - Inflammation of the gums and ligaments.
Gum disease - Left untreated, gingivitis can lead to infection of the gums and ligaments. Bacteria eat away at the gums (forming pockets) and bones, resulting in weakness and eventual loss of the teeth.
Tooth abscess - A walled off pocket of infection in or under the tooth.
Foreign body trapped in the mouth. This is less likely to occur in cats than it is in dogs, but sometimes objects such as bones can become lodged in the mouth.
Smelly foods - It may sound obvious, but strong smelling foods such as tuna are going to result in odorous breath.
Teething - Kittens begin to lose their baby teeth around 3-4 months of age. In some cases, your kitten will develop bad breath, this is usually transient, and goes away on its own, but should be monitored.
Polyps - Benign tumours which can grow in nasal passages and back of the eustacian tube and pharynx (the cavity behind the mouth).

Other causes of bad breath in cats:

Diabetes - The most common type of diabetes in cats is type 2, this results in the cells don't respond to insulin, a hormone which is needed to enable glucose (obtained from food) to enter the cells. Aside from regular bad breath as a result of diabetes, a fruity odour to the breath is also a common symptom of diabetes in cats.
Reflux - A medical condition in which the gastric juices 'reflux' back into the esophagus.
Respiratory tract infections can cause sinus infections or lung infections which often result in bad odour from the mouth.
Kidney disease - There are many causes of kidney disease in cats, it can be acute (sudden onset) or chronic (slow and progressive) but both 'types' result in a build up of toxins in your cat's blood that can lead to bad breath.
Liver disease
Cancers of the mouth - 10% of cancers in cats are oral cancer, with the most common being squamous cell carcinoma.
Gastrointestinal problems (obstructions, cancer, infection).

What are the symptoms of halitosis?

This is hard to answer because as stated above, as each disease has its own symptoms. Obviously, the main symptom is an unpleasant odour from the mouth. If the problem is dental, your cat may also have the following symptoms:

Redness along the gum lines and bleeding (gingivitis or gum disease).
Unwillingness to eat due to pain.
Drooling.
Poor coat condition, pain and discomfort can result in a reluctance to groom.
Tartar (calculus) deposits on the teeth.
Pawing at the mouth (foreign body).
Loss of weight.

Non dental causes may produce the following symptoms:

Increased thirst and urination (diabetes).
Weight loss.
Lethargy.
Diarrhea.
Vomiting
Enlarged liver or kidneys.
Lump in the oral cavity which may or may not be ulcerated (tumour).
Facial swelling (dental abscess, tumour).

How is bad breath in cats diagnosed?

Your veterinarian will perform a complete physical examination of your cat, including a careful examination of the oral cavity. Diagnosis may be made upon physical examination, or your veterinarian may wish to run some further tests including:

X-ray - To check the condition of the dental roots and bones and look for abscess or tumours.
Ultrasound to evaluate the size of the liver and kidneys, look for foreign bodies in the gastrointestinal tract.
If there is no problem within the mouth, your veterinarian will want to run some baseline tests such as complete blood count, biochemical profile and urinalysis to evaluate organ function and check for infection.
Diagnostic tests to determine liver and kidney function.
Endoscopy - A thin tube with a camera on the end is used to evaluate the digestive tract for signs of damage due to reflux or look for foreign bodies, tumours.
FeLV and or FIV tests.

How is bad breath in cats treated?

Treatment depends on the underlying cause of bad breath, dental problems such as gum disease and gingivitis are generally treated as follows:

Remove calculus from the teeth and polish. This will be performed under general anaesthetic.
Extract any diseased teeth.

Other treatments may include:

Polyps will be surgically removed.
Tumours may be surgically removed in some cases and/or chemotherapy.
Liver disease treatment depends on the cause but usually includes supportive and nutritional care, in some cases surgery will be required.
Kidney disease is managed by diet and medications to manage symptoms.
Corticosteroids and long term antibiotics may be required for stomatitis. In severe cases, removal of all the teeth may be required.
A dental abscess will need to be lanced and cleaned out. Antibiotics will be prescribed. In some cases, your cat may need to have the affected tooth extracted.
Low protein, low fat diets may be recommended, along with feeding less food, more often for cats with reflux, along with medications to protect the esophagus.

Home dental care for your cat:

There are several ways to care for your cat's teeth at home.

Regularly check your cat's teeth and if you do notice any redness, bleeding, lumps, bumps, bad breath see your veterinarian immediately. The earlier your cat is treated, the better. If your cat doesn't like it, don't force the issue. Try again the next day, just a few seconds at a time to get him used to having his mouth and teeth handled. Give him a reward afterwards.
Daily brushing. This will need to be done with a special cat toothbrush and toothpaste. Never use human toothpaste on cats, it is toxic. Start when your cat is young, so he gets used to having his teeth cleaned. Plaque is a sticky film which builds up on the cat's teeth, if it is not removed, by brushing and/or diet, it forms tartar, which is a hardened, calcified deposit which requires removal by a veterinarian.
Dental rinses or gels containing chlorhexidine can also be of benefit in controlling plaque.
Dental diets which are designed to reduce plaque and tartar formation. One such food is Hills T/D which can be purchased through your veterinarian.
Diet. Avoid feeding your cat a tinned food diet exclusively. I have always been a fan of feeding a varied diet, including tinned, dry and raw. Cut up chunks of human grade (I am not a fan of pet quality meat) beef. Cheap cuts such as chuck steak are perfect. This gives your cat the opportunity to really chew at the food, keeping his jaw and bones strong.
Feed raw chicken necks or or wings. These are a great way to reduce plaque and tartar formation, however there are risks associated with feeding raw bones to cats. Speak to your veterinarian for his/her opinion on feeding raw chicken necks and or bones. Most people recommend one or two chicken necks or wings twice a week. Never feed your cat cooked bones of any kind as they are more brittle which can cause them to splinter.
Annual check up. Make sure your cat sees a veterinarian once a year for a check up to stay on top of any possible health and dental problems.