Stomatitis is is one of the most painful and frustrating conditions cats can develop. Buckley suffered from this condition; a severe inflammation of the oral cavity in cats in which the affected cat essentially becomes allergic to her own teeth. The outward signs of this condition are red, inflamed, and often ulcerated gums, and this can be very painful for the cat.
The exact cause of stomatitis is not known. The most commonly held theory is that stomatitis is caused by an abnormal reaction of the immune system. Some cats appear to be hypersensitive to their own plaque, and even small amounts will cause the immune system to mount an exxagerated inflammatory response by sending lymphocytic and plasma cells into the cats’ gums and oral tissues. For this reason, the condition is also referred to as lymphocytic plasmacytic gingivitis stomatitis.
Cats with feline leukemia and/or FIV may be predisposed to stomatitis since their immune systems are already compromised by these respective viruses. Another theory suggest that the calici virus or the Bartonella bacterium may be possible causes. There may also be a genetic predisposition in some breeds.
- Oral pain, often quite severe. Unfortunately, cats are masters at masking pain, so by the time a cat shows signs of pain, the pain has most likely reached a level that would send a human screaming to the emergency room.
- Refusal to eat, drooling out of the side of the mouth, holding head at odd angles while eating. These are all signs of pain.
- Extremely red, swollen, often ulcerated gums.
Stomatitis is diagnosed by a thorough oral exam. Typically, other dental disease such as gingivitis, resportive lesions or retained tooth roots may also be present. Dental x-rays are crucial for a complete diagnosis. If the cat has never been tested for feline leukemia or FIV, testing should be performed at this time. Oral biopsies should be taken when the cat is anesthesized to confirm the diagnosis and rule out other conditions, such as cancer, that may require different treatment.
Treatment of this condition can be very frustrating. The goal is to control the inflammatory response. In many cases, a complete resolution of the problem may never be achieved.
The teeth must first be cleaned of all plaque and tartar accumulation both above and below the gum line. This can be accomplished only under anesthesia. Cats may be given antibiotics and anti-inflammatory steroids; however, they usually only offer short term relief. Eventually, most cats will require extraction of all of their teeth.
This approach sounds daunting to most cat parents, but if it is done by an experienced veterinary dentist, with proper pain control protocols, most cats tolerate the treatment well and recover quickly. Most cats have no problem eating without teeth; in fact, they feel so much better once the inflammation is gone that they may even happily gum dry treats.
Some cats will still need treatment even after complete tooth extraction. Ccyclosporine therapy has shown some moderate success. There are some homeopathic remedies that may work for stomatitis. Work with a veterinarian trained in homeopathy to determine the correct remedy.
A cat with stomatitis will require frequent veterinary visits and treatments over her lifetime. The prognosis for a long-term cure is guarded.
Buckley was initially treated with periodic steroid injections, but eventually had all her teeth extracted. She did well after the treatment, but since she ultimately died because of her heart disease, it’s impossible to tell whether full extraction would have been a longterm cure for her.
Photo of Buckley ©Ingrid King