Gingivostomatitis

An immune-related condition that affects the mouth.

Overview

Feline stomatitis refers to the severe inflammation within the mouth and is thought to be an exaggerated immune response to plaque. This results in the cat becoming allergic to its own teeth and the development of widespread inflammation within the mouth.

Signs

Cats with stomatitis will show signs of:

Difficulty eating
Weight loss
Decreased grooming
Hypersalivation

On oral examination that may have:

Red and inflamed throat
Severe inflammation where the gum meets the teeth
Inflamed cheeks
Tooth resorption

Management

The current treatment of choice is the removal of the affected teeth. Your veterinarian may perform radiographs to help determine which teeth will require extraction. In severe cases, all teeth may require extraction. By removing the affected teeth, the cat's immune system no longer forms a reaction in the mouth and the pain and inflammation cease. Within a short time after the procedure, the cat heals very quickly and will start eating better than before. The good news is that domesticated cats don't require teeth to lead a happy and healthy life.

Unfortunately, treatment options such as teeth cleaning, polishing, fluoride, corticosteroids, gold therapy, antibiotics, lasers, and daily brushing have been tried in the past only to offer temporary help. Often these cats remain in pain.

It is important to note that although the removal of the affected teeth often resolves the stomatitis in most cases, some cats will require additional medication and therapy to help reduce the pain and inflammation.

For cats that cannot undergo surgery, medical management may consist of:

Anti-inflammatories e.g. corticosteroids, NSAIDs
Immunomodulation/immunosuppression treatment e.g. recombinant feline interferon omega, cyclosporine, corticosteroids, stem cells, lactoferrin
Inhibition of bacterial growth e.g. lactoferrin
Interference with vial replication e.g. recombinant feline interferon omega

Home care

Thorough oral hygiene is essential in preventing further problems, even after surgery. This may include teeth brushing and other oral hygiene products.

Prognosis

In 60-95% of the cases, cats will do well after the removal of all their teeth and not require any further medication.

Only in rare cases will the inflammation and pain continue after a full mouth extraction. In these cases, cyclosporine, feline interferon, or stem cell therapy may help long term.

References

Niemiec BA. How I treat stomatitis in cats. WSAVA proceedings 2018.