Feline Stomatitis by Dr. Liz Bolton

Has your cat started showing signs of dental disease such as bad breath, drooling, dropping food, or eating with one side of the mouth?  How about changes in appetite or decreased activity levels?  Maybe you’ve noticed reddened gums or tooth discoloration.  Perhaps your kitty won’t even let you touch his mouth but will sometimes paw at it as if uncomfortable.

We know that more than 85% of cats have periodontal (dental) disease.  Cats over 8 years of age are almost all affected by some combination of gingivitis, tartar, and painful tooth resorption (decay) caused by lesions in the tooth enamel. When left untreated, these processes result in chronic inflammation which affects the heart, liver, and kidneys.  However, with appropriate oral health care such as a dental diet and yearly exams/cleaning, this form of dental disease is treatable and cats can live for many years with their pearly whites.

In contrast, stomatitis is characterized by extreme inflammation and pain and thus requires more extreme treatment.  Veterinary dentist Dr. Curt Coffman defines stomatitis as “severe ulcerative oral inflammatory lesions beyond what is commonly associated with periodontal disease”.  Many names have been used to describe this condition with the most common being “feline chronic gingivo-stomatitis” (FCGS).  The swelling and ulceration of the gums noted with stomatitis generally will not resolve if treated solely with preventative measures such as diet, exams, and cleaning.  Furthermore, the tissue inflammation can be found throughout the mouth, making it very painful for our patients to chew and swallow.  Therefore, FCGS requires more investigation into causes and more aggressive treatment in order to care for affected cats.

Research has shown that some infectious diseases can increase a cat’s chances of developing stomatitis.  We strongly recommend testing for feline leukemia virus and feline immunodeficiency virus in all affected cats.  This test requires only a few drops of blood and can be run in-house at Killarney Cat Hospital.  Depending on the individual cat, we may also recommend testing for other infectious organisms such as Bartonella.  Many cats with stomatitis develop an overactive immune response to any plaque or bacteria, making the disease even more difficult to manage.  Sometimes a tissue biopsy to confirm the diagnosis of stomatitis is indicated.

Due to the excessive immune activity, pain, and inflammation present in feline stomatitis, veterinary dentists recommend removal of all or most of the teeth.  This process of full-mouth extraction removes the surfaces where plaque develops and thus removes the stimulus for the inappropriate immune response and inflammation.  Antibiotics and pain medication also play an important role in treatment and maintenance of patient comfort.  These medications may also be used prior to extractions and/or if the patient is not a candidate for anesthesia due to other health concerns.

The good news is that most cats with feline stomatitis (FCGS) do very well after surgical removal of the teeth.  They lead happy, healthy lives and find it much easier to eat without the chronic inflammation and pain present prior to extractions.  If you have any concerns about your own cat’s dental health, please do not hesitate to contact us.  We look forward to working with you to promote overall wellness in each of your feline loved ones!