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Oliver's Oral Issue

Oliver's Oral Issue
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Gingivitis is a term to describe inflammation of the gums, where stomatitis is inflammation of any of the other soft tissues within the mouth, including lips, back of the throat, tongue etc. Combined they lead to a painful and often debilitating disease in cats called Chronic Feline Gingivostomatitis, where they are often too painful to eat anything.

Oliver is a lovely cat who was presented to Pennard Vets with an uncomfortable mouth, and had started to go off his food. Nothing was found on the physical exam to explain this sudden dislike to food, until we opened his mouth.

With Oliver it is clear the oral soft tissues are very red and inflamed, with ulceration, swelling and a concurrent infection (Picture 2). The combination of these lead to Oliver becoming reluctant to eat. Other signs of oral pain seen in cats include shying away from chin scratching, gagging when eating, drooling, reduced grooming and appetite.

Cats which suffer from this disease often develop periodontal disease, where the inflammation affects around their teeth, causing damage to the underlying bone. In severe cases, this can lead to teeth falling out. In Oliver’s case, significant dental disease had not developed yet, so we decided to take a proactive approach to help prevent this.

Usually cats are older than 6 years old when diagnosed with Feline Gingivostomatitis, however can occur at any time from eruption of the adult teeth.

Cause :

The exact cause if still relatively unknown. It is thought to be a hyper-immune reaction to oral plaque and bacteria, but has also been very closely linked with Calici virus. All of this stimulation causes the severe inflammation, and progression of worsening periodontal disease.

Oliver was tested for Calici virus which came back negative. Therefore, his reaction was presumed to be one of a hyper-immune response to his own mouth bacteria.

Treatment :

The ideal treatment for Gingivostomatitis is to make sure we do not have any underlying cause of inflammation. This may be through checking routing bloods - haematology and biochemistry, and checking for underlying FIV / FeLV / Calici virus infections.

Next is to make them more comfortable – through pain relief and if infection is present treating this with appropriate antibiotics. This management tends only to help for very short periods of time, and is thought to worsen the long-term prognosis.

Normally the best responses are seen with removal of all molar and pre-molar teeth under general anaesthetic. From then it is making sure the mouth is clean, and free of periodontal disease – through brushing, diets etc. In most cats this will allow the cat to live a happy life. However, there are some cases which still will not respond. In these cases, the removal of the rest of the teeth in the mouth is seen to have the best results.

In rare cases they do not respond to a full mouth extraction, there are other therapies available, however these are many are still in the early stages of research, and specialist opinion maybe beneficial.

Oliver was lucky and was seen to respond well to the removal of just his pre-molars and molar teeth in all quadrants. He now lives a life without oral pain, with very infrequent flare-ups, which we have been able to manage with pain relief alone, with the occasional need for antibiotics.

If you would like any further information about Gingivostomatitis then please do not hesitate to contact us.