Dental disease in cats is an exceedingly common health concern for parents. One of the more frequently encountered problems is stomatitis, a generalized inflammation of the oral cavity. Also called gingivostomatitis, this condition is extremely painful without prompt and proper treatment. This week I share some fun facts about stomatitis to ensure you have the information you need for your feline fur babies. Happy reading!
Stomatitis – What is it?
The simple answer is we don’t fully understand what causes stomatitis in cats. Several studies have indirectly implicated some infectious diseases as contributing factors to developing oral inflammation. Infections that may play a role in development and progression of this disease are:
- Feline calicivirus (FCV)
- Feline herpes virus-1 (FHV-1)
- Bartonella
- Feline immunodeficiency virus (FIV)
There is also evidence suggesting the inflammation is the result of an abnormal reaction to the bacteria (or their products) in dental plaque. Elevations in certain immune proteins called immunoglobulins are elevated in the blood and saliva. This finding tells us the immune system is involved in the marked oral inflammation in these pets.
Stomatitis – What does it look like?
Cats with stomatitis have several potential clinical signs, including:
- Bad breath (called halitosis)
- Drooling (called ptyalism)
- Discomfort while eating
- Pawing at the face
- Reduced (or loss of) appetite
- Weight loss
- Lethargy
Many cats with stomatitis prefer soft food and resent having their faces touched. The disease affects cats of any age, and males and females are equally affected. Although any cat breed can develop stomatitis, some appear predisposed:
- Himalayans
- Persians
- Somalis
Physical examinations performed by veterinarians reveal some serious changes. Most cats have abundant dental plaque covering the teeth, and regions like the gums (called the gingiva and alveolar & buccal mucosa), back of the throat (called the pharynx) and sublingual tissue (under the tongue) appear reddened, raised, and/or ulcerated. Inflammation in the pharynx is called caudal stomatitis, caudal mucositis, and faucitis. The lips may also be ulcerated, and mandibular lymph nodes may be enlarged.
Stomatitis – How is it diagnosed?
A long-standing history of inflammation within the oral cavity and consistent physical examination abnormalities allow for a preliminary diagnosis of stomatitis. A veterinarian will also recommend running some non-invasive blood and urine tests to assess overall systemic & metabolic health, as well as to screen for important infectious diseases like FIV, FeLV, and Bartonella. A biopsy of the inflamed oral tissue helps differentiate stomatitis from various oral cancers like squamous cell carcinoma. If inflammation is not widespread and rather is localized to one region, then one should consider other disease possibilities like allergies, periodontal disease, and tooth resorption. Collaborating with a board-certified veterinary dentist can be helpful for establishing an accurate diagnosis in an efficient and cost-effective manner.
Inflamed gingiva (gums) in a cat with stomatitis
Stomatitis – How is it treated?
There are many potentials ways to reduce the inflammatory response to dental plaque, including:
- Tooth brushing
- Antibiotics (both topical & systemic)
- Anti-inflammatory therapy
- Immune system modifying drugs
- Laser treatments
- Professional dental cleaning
Tooth brushing helps reduce dental plaque
Many patients with severe stomatitis benefit from partial- or full-mouth tooth extractions. Following this procedure, approximately 60% of cats experience complete resolution of clinical signs and another 20% ultimately have minimal non-painful oral inflammation. Thirteen percent improve but need continued medical interventions, and only 7% have no improvement following extractions. Many pet parents worry about their cats’ ability to eat comfortably and adequately following partial- or full-mouth tooth extractions. Thankfully, most cats tolerate this procedure well, and eat moist and dry food comfortably without teeth. Partnering with a board-certified veterinary dentist can be invaluable for determining the most appropriate treatment modality for your cat.
The take-away message about stomatitis in cats…
Stomatitis is a common painful problem in many cats regardless of age or breed. The true underlying cause is not truly understood, but an adverse reaction to dental plaque, various infections, and the immune system all appear to be involved with the development of this condition. Prompt identification and treatment are key to maximizing the likelihood of a pain-free high quality life.
To find a board-certified veterinary dentist, please visit the American Veterinary Dental College.
Wishing you wet-nosed kisses,
cgb