Feline Stomatitis in Cats ~ Pawprints and Purrs, Inc.

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Feline Stomatitis

Chronic stomatitus is a painful mouth condition that is often very difficult to cure or to control. All cats are at risk of suffering from this condition. This disease is also known as Lymphocytic-Plasmacytic Gingivitis-Stomatitis-Pharyngitis (GSPC). Stomatitis is chronic inflammation and ulceration of the soft tissues in the mouth.

What causes stomatitis in cats?

There are a number of causes of this chronic inflammation in the mouth and gums and may be a combination of factors. The three factors which are receiving the most attention are:

Hyperresponsiveness: Some cats may have a hypersensitivity or allergic reaction to bacterial plaque, called plaque-intolerant. In this disease, the lymphocytes and plasma cells involved in the immune system move into the tissues of the mouth and causes severe inflammation where the tooth meets the gumline.

Another possible cause is an allergy to something else such as food or fleas which may manifest itself as skin and oral lesions called Feline Eosinophilic Granuloma.
Immunosuppression: A cat's immune response may be suppressed for a number of reasons but the most common is viral infections. It is estimated that 15% of cats with chronic oral inflammation are infected with either Feline Leukemia Virus (FeLV), Feline Immounodeficiency Virus (FIV), or both.
Viral or bacterial infections: Feline calicivirus (FCV) can cause oral lesions, and in some studies, Feline Infectious Peritonitis (FIP) and Bartonella henselae have been implicated.

Why are some cats more susceptible?

Outdoor, feral cats, and very young cats can develop this disease can develop when the cat is very young. In younger cats, it is called a "juvenile onset" form of disease. It may occur at 3-5 months when the permanent teeth are erupting and become more severe by 9 months of age.

Cats who are immunosuppressed have a greater tendency to have oral infections which may become chronic.

What are the symptoms of stomatitis?

Stomatitis can cause severe pain and may cause behavioral changes - aggressiveness, depression, irritability, reclusiveness. Other symptoms may be:

Excessive drooling
Halitosis (bad breath)
Bleeding gums
Difficulty eating, loss of appetite, or anorexia (though hungry, the condition is too painful for the cat to eat)
Weight loss
Inadequate grooming

How is stomatitis diagnosed?

During the physical exam, which may need to be done under anesthesia to do it well, multiple lesions are seen. There may be ulcers or proliferative lesions. The lesions can be on the gums, roof of the mouth, back of the mouth, tongue, or lips. The lesions at the gumline surround the whole tooth. Usually, the area around the back teeth, the premolars and molars, is most affected.

FIV and FeLV tests and a chemistry profile should be performed. Radiographs (xrays) of the mouth often show moderate to severe periodontal disease.

A large amount of globulins would be found in the blood since the vast number of plasma cells are producing antibodies (a type of globulin).

A biopsy of the affected areas is often performed to differentiate between stomatitis, eosinophilic granuloma complex and neoplasia (cancer). The biopsy will reveal inflammation with a large number of lymphocytes and plasma cells in the case of stomatitis. Large numbers of eosinophils would be present if the lesions are caused by eosinophilic granuloma complex.

What is the treatment for stomatitis?

If the chronic stomatitis is due to a plaque intolerance, then it is essential that the veterinarian removes all plaque. This is accomplished through:

Regular dental cleaning and polishing
Fluoride application
Extraction of teeth with resorption lesions or severe periodontal disease
Daily home care, including brushing and application of 0.2% chlorhexidine
Antibiotics
Corticosteroids
Good nutrition, often with vitamin supplements since the cat may not eat as much because of discomfort

Unfortunately, even with this intensive care, the disease often progresses and the only way to cure the disease and eliminate the very painful lesions is to extract all of the teeth in back of the large canine teeth (fangs). This may appear drastic, but in almost all cases it is the only alternative. In cases of juvenile onset gingivitis, professional teeth cleaning every 2 months and once- to twice-daily brushing at home for the first year or so of their life, may allow them to revert to a more normal status as they age.

Additional links:
Dental Disease in Cats
Feline Dental Disease

Page URL: http://www.sniksnak.com/cathealth/stomatitis.html

Resource References:
Much, much appreciation to Dr. Raymond Van Lienden, DVM of Clifton, VA USA for his extensive research in locating the material found on this page. Thank you, dear Doctor!