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 dental plaque. This results in the cat becoming hypersensitive to its own teeth, leading to widespread inflammation within the oral cavity.
Predispositions
Feline stomatitis is more commonly observed in certain breeds, including Siamese, Burmese, and domestic shorthairs. Additionally, cats with feline immunodeficiency virus (FIV) or feline leukaemia virus (FeLV) may be at higher risk.
Signs
Cats with stomatitis will show signs of:
- Difficulty eating
- Weight loss
- Decreased grooming
- Hypersalivation
- Bad breath (halitosis)
- Vocalisation due to discomfort
On oral examination, affected cats may exhibit:
- Red and inflamed throat
- Severe inflammation where the gums meet the teeth
- Inflamed cheeks
- Tooth resorption
- Ulceration of the oral mucosa
Causes
The exact cause of feline stomatitis is not fully understood, but it is believed to involve an abnormal immune response to dental plaque and bacteria. Other contributing factors may include viral infections, such as FIV or FeLV, and underlying dental disease.
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 need to be extracted. By removing the affected teeth, the cat's immune system no longer reacts to the dental structures, leading to a cessation of pain and inflammation. Cats typically heal quickly after the procedure and often resume eating better than before. It is important to note that domesticated cats can lead happy and healthy lives without teeth.
Unfortunately, treatment options such as teeth cleaning, polishing, fluoride treatments, corticosteroids, gold therapy, antibiotics, lasers, and daily brushing have been tried in the past but often provide only temporary relief. Many cats continue to experience pain despite these interventions.
It is crucial to understand that while the removal of affected teeth often resolves stomatitis in most cases, some cats may require additional medication and therapy to help manage pain and inflammation.
For cats that cannot undergo surgery, medical management may consist of:
- Anti-inflammatories, e.g. corticosteroids, NSAIDs
- Immunomodulation/immunosuppression treatments, e.g. recombinant feline interferon omega, cyclosporine, corticosteroids, stem cells, lactoferrin
- Inhibition of bacterial growth, e.g. lactoferrin
- Interference with viral replication, e.g. recombinant feline interferon omega
Home Care
Thorough oral hygiene is essential in preventing further problems, even after surgery. This may include regular teeth brushing and the use of other oral hygiene products recommended by your veterinarian.
Prognosis
In 60-95% of cases, cats will do well after the removal of all affected teeth and will not require any further medication. However, in rare cases, inflammation and pain may persist after a full mouth extraction. In such instances, treatments such as cyclosporine, feline interferon, or stem cell therapy may provide long-term relief.
Important Reminders
Regular veterinary check-ups are essential for monitoring your cat's oral health. Early intervention can prevent the progression of dental diseases and associated complications.
References
1. Niemiec BA. How I treat stomatitis in cats. WSAVA Proceedings 2023.
2. McGowan R, et al. Feline stomatitis: A review of the literature. Journal of Feline Medicine and Surgery, 2024.
3. Dearnley M, et al. Advances in the management of feline stomatitis. Veterinary Clinics of North America: Small Animal Practice, 2025.