Feline chronic gingivostomatitis is sometimes noticed by cat keepers because they notice bad breath, bleeding gums, anorexia or screaming when they try to eat food, especially feed due to its greater hardness. Internally, the cat will present lesions in the mouth that range from tartar, gingivitis, dental alterations, to proliferative stomatitis and ulcers in various locations of the feline oral mucosa that will cause a lot of pain, excessive salivation, weight loss and weakness. The origin of this disease is immune-mediated and certain viruses common in cats and certain anomalies can aggravate the process.
Keep reading this article on our site to learn more about feline gingivostomatitis, its causes, symptoms and treatment.
What is feline chronic gingivostomatitis?
Feline chronic gingivostomatitis is a pathology that has a certain frequency in cats and consists of a diffuse inflammation in the cat's mouth lasting more than six monthsSpecifically it affects the gums and oral mucosa, sometimes it can affect the tongue or soft palate. It is more frequent in adult specimens and there is no racial predisposition, although it seems that the Siamese, Persian, Burmese and Himalayan seem to be more predisposed.
This disease can be mild, moderate or severe and usually presents ulcerations. One of the conditions that characterize this pathology is caudal stomatitis, an inflammation of the deepest part of the mouth, sometimes proliferative, which can also affect the tongue.
It has been called by other terms such as feline ulcerative-proliferative gingivitis, chronic gingivitis-stomatitis-faucitis, caudal stomatitis, plasmacytic pharyngitis stomatitis, chronic gingivitis-pharyngitis, plasmacytic lymphocytic stomatitis gingivitis and chronic stomatitis.
Causes of chronic gingivostomatitis in cats
This disease has been related to a chronic infection by the feline calicivirus, although today it is known that around 70% of cats with chronic gingivostomatitis are positive for this virus, but not all, and the reduction of inflammation responds to therapies that do not reduce the viral load. It is thought that it can favor the entry of other pathogenic agents by damaging cell membranes, which is why it is more aggravating than a cause. Also the feline retrovirusess (feline leukemia virus or feline immunodeficiency virus) can increase the proinflammatory response, predisposing to this disease.
Stress by reducing immunity and in houses with several cats or in colonies of many cats that favor close contact between cats increases the risk of developing chronic gingivostomatitis, due to greater contagion of predisposing or aggravating feline viruses.
Now, the most accepted cause today is of immune-mediated origin, with an exaggerated reaction of the immune system and an alteration in local immunity from feline saliva. Although cats with chronic gingivostomatitis have increased serum immunoglobulins, IgA levels are low in saliva. IgA is responsible for interfering with bacterial adherence and neutralizes pathogens and toxins released by bacteria in the oral cavity.
The oral antigens related to the exaggerated reaction of the immune system are:
- Plaque bacteria (Pasteurella multocida is the most frequently isolated).
- Periodontal disease.
- Feline dental resorption by action of odontoclasts.
- Food allergens.
Symptoms of feline chronic gingivostomatitis
The clinical signs presented by a cat with chronic gingivostomatitis are not only limited to the oral cavity, but the pain caused by the process makes not eat even if they have appetite, with the consequent weight loss; or if they try they have swallowing problems (dysphagia). Mouth pain makes them not grooming causing a bad appearance of the hair.
Feline chronic gingivostomatitis is characterized by the following symptoms:
- Ptyalism.
- Halitosis.
- Bleeding in the mouth.
- Ulcers on the oral mucosa.
- Lip or mouth stomatitis, in the dental alveoli to the mucosa of the gums (gingivitis).
- Caudal stomatitis sometimes with glossopharyngitis and granulation tissue in the caudal oropharynx.
Diagnosis of feline chronic gingivostomatitis
The first thing to do in the presence of signs of gingivitis, ulcerative or proliferative stomatitis, anorexia, oral pain or bleeding is to rule out any cause that could produce these symptoms. Specifically, the following pathologies must be ruled out that can affect felines:
- Feline eosinophilic granuloma complex.
- Oral tumors.
- Trauma.
- Irritation due to ingestion of corrosive substances.
- Periodontal disease.
- Pemphigus.
- Systemic lupus erythematosus.
- Uremic mouth ulcers due to renal failure.
- Mellitus diabetes.
- Hypervitaminosis A.
- Feline immunodeficiency infection or severe feline leukemia.
To do this, a series of diagnostic tests must be applied to identify the antigenic stimuli responsible for the immune-mediated response, as well as to rule out the aforementioned diseases. So it should be done:
- Calicivirus PCR and test to rule out leukemia and feline immunodeficiency.
- Dental X-ray to assess the condition of the teeth and detect periodontal disease or tooth resorption.
- Biopsies of affected tissue for histopathological analysis, which will determine an ulcerated mucosal tissue with a dense inflammatory-type infiltrate in the submucosa with predominance of plasma cells, lymphocytes, histiocytes and neutrophils. They are mainly used to rule out tumors such as oral squamous cell carcinoma.
- Bacterial culture to determine the predominant bacterial flora and antibiogram.
In the case of feline gingivostomatitis, the blood test and biochemistry will show increased immunoglobulins, mild anemia, increased white blood cells with neutrophilia (increased neutrophils) or eosinophilia (increased of eosinophils), while in others lymphopenia (decreased lymphocyte count) is seen. Around 10% of cats with chronic gingivostomatitis have concurrent kidney disease, with altered kidney parameters being seen.
How to cure feline chronic gingivostomatitis? - Treatment
It must be taken into account that feline chronic gingivostomatitis is difficult to treat and therapies are aimed at reducing the accumulation of bacterial plaque, treat dental disease and control inflammation.
The treatment to apply will consist of:
- Analgesia using opiates such as buprenorphine and NSAIDs such as meloxicam.
- Remove the plaque daily by brushing and chlorhexidine, but initially it is not feasible due to the pain that the cat presents.
- Clindamycin as an antibiotic for gingivostomatitis in cats is usually effective, however, what the culture and antibiogram say will be ideal.
- Mouth cleaning.
- Rinses in water with chlorhexidine or apply adhesive gels with this active ingredient.
- Food for cats with gingivostomatitis must be hypoallergenic or a novel diet.
Corticosteroids, despite being useful for reducing inflammation, are not effective because they increase the viral load by causing immunosuppression and are needed in increasingly higher doses.
In mild or moderate cases, an extraction of affected teeth may be performed due to periodontal disease or feline dental resorption, but in more serious cases of chronic gynostomatitis or in which after a few months of the above there is no improvement, an extraction of all molar and premolar teeth should be performed. This extraction is considered the best therapy for this disease, curing 50-60% of cats, some cats are not completely cured but their pain and inflammation are reduced and they eat. In a very low percentage they will remain the same, but mesenchymal stem cells or omega interferon can be used, whether they are positive or negative for feline calicivirus, generally giving good results.
