When we look at the reasons why a cat may be presented to us at the vets, dental disease is certainly one of those conditions that ranks high on our list of complaints. In fact, as many as 80% of cats over 4 years of age have tooth and gum disease. In this article, we look at two common presentations, gingivitis and feline chronic gingivostomatitis, and discuss the clinical signs, causes and treatments available.
Posted: 22 September 2020
1. Feline gingivitis
Gingivitis is the term we use to describe inflammation of the gums in the mouth. It’s most often seen on the gum line where the gums meet the teeth, where you might see a red line or even some bleeding. For many cats and their owners, gingivitis can be quite a frustrating disease to manage and is generally difficult to cure.
What are the signs?
Depending on the severity of the disease, cats will show one or more of the following;
Five common causes of gingivitis
A. Dental disease
If dental hygiene is poor, plaque soon starts to build up, with tartar and mineral deposits following. Bacteria will start to damage the enamel of the teeth causing the gums to recede. Within a relatively short period of time, the teeth will become damaged and diseased.
B. Feline chronic gingivostomatitis (FCGS)
This is a particularly aggressive form of gingivitis, caused by a hypersensitivity to the bacteria in the mouth (see below).
C. Viral infections
There are several virus infections that can trigger gingivitis, including;
Diabetic cats are more prone to gingivitis due to the high levels of sugar in their bloodstream. The bacteria that form plaque and cause gingivitis thrive on glucose.
E. Genetic predisposition
Certain breeds of cat are more prone to developing gingivitis than others. Some examples include the oriental breeds such as the Siamese, Persian and Somali cats.
What treatments do we recommend?
The golden rule to remember is, the sooner gingivitis is treated, the quicker it will be controlled. Even with feline chronic gingivostomatitis (FCGS), it has a better chance of being managed well if treated in the early stages.
2. Feline Chronic Gingivostomatitis
What is stomatitis?
Feline Chronic Gingivostomatitis (FCGS), also known as lymphocytic plasmacytic gingivitis-stomatitis, will cause ulceration of the gums. The inflammation can extend to the back of the mouth, onto the tongue and down into the pharynx. The inflammation persists despite antibiotics, steroids and dental cleaning. It’s an oral syndrome characterised by some classic clinical signs;
What are the causes?
The truth is that FCGS is a multifactorial condition. Chronic oral calicivirus is often present, and there also seems to be an inadequate immune response towards oral antigens of bacterial and viral origin. Chronic oral inflammatory processes are also involved.
A thorough examination of the oral cavity needs to be performed. In most cases this can only be completed if carried out;
How is FCGS treated?
A. Dental Extractions
There is often a debate on which teeth need to be extracted. Some vets recommend a full-mouth extraction, whilst others prefer a more selective approach, and only choose to remove the premolar and molar teeth. Some studies have shown that;
B. Control inflammation
Around 80% of cats will show some improvement with the use of anti-inflammatory drugs, including long-acting steroids. There is however no evidence that cats can be cured of FCGS with steroids alone. When using this as a long-term treatment, owners should be warned of possible side effects, including diabetes.
C. Control secondary infections
Antibiotics are frequently used and may be prescribed in a pulse therapy form. Some of the common antibiotics of choice include;
Typically, NSAIDs and opioids are prescribed, as the condition can be extremely painful. For stubborn cases, gabapentin and amantadine are also used.