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Perplexed by cat’s protruding tongue

[From Tufts June 2011 Issue]

Perplexed by cat’s protruding tongue
Sometimes my male cat sits around with his tongue sticking out of his mouth. What is the reason for this? I have not noticed my female cats doing it.
Mary Ann Myers

Dear Mary Ann: As a feline practitioner, I have heard many stories and have seen my share of cats who, during the normal course of their day, happen to sit around with their tongue sticking out a little. In most cases, there is nothing to be concerned about. It is simply the cat’s own personal quirk, and it is actually kind of endearing.

However, a protruding tongue can also be a sign of significant oral disease. Disorders of the teeth and gums should be considered a possible cause of a protruding tongue. Periodontal disease is very common in cats. Periodontal disease is easily diagnosed during an oral examination, however, determination of the true extent of periodontal disease often requires oral X-rays.

Some cats experience gingivitis or stomatitis (inflammation of the entire mouth) of such severity that they paw at their mouth, refuse to eat hard food, and may stick out their tongue and drool excessively. Biopsy of the gums or other affected oral tissues may reveal a severe infiltration of inflammatory cells. This condition, called “lymphocytic/plasmacytic gingivitis or stomatitis” is usually quite painful. Treatment consists of antibiotics, anti-inflammatory medications, and in extreme cases, extraction of all of the teeth.

Oral tumors can cause misalignment of the teeth and/or jaw, leading to improper closing of the mouth and protrusion of the tongue. Oral trauma and associated pain and discomfort can lead to tongue problems. Broken teeth with resultant nerve exposure, a fractured jaw and temporomandibular joint disorders are traumatic injuries that could lead to pain, inability to close the mouth properly and tongue protrusion.

Kidney failure is a very common condition, especially in geriatric cats. Cats with severe kidney failure may have significant uremia (literally “urine in the blood”). Uremic cats often develop ulcers on the gums, tongue and edges of the lips. These ulcers are painful, and some cats stick their tongues out when they have oral ulcers. These ulcers are readily visible on oral examination. Feline immunodeficiency virus and calicivirus infections can also cause ulcers on the tongue.

I suspect a benign reason behind your cat’s tongue protrusion, but I would play it safe and have your veterinarian do a thorough oral exam to make sure there’s no oral disease. If everything checks out fine, then this is just a cute quirk that your cat has, and I wouldn’t worry about it.
Arnold Plotnick, DVM, DACVIM
Medical Editor

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