Felis ISSN 2398-2950

Gingivitis and stomatitis

Synonym(s): Faucitis, feline gingivitis - pharyngitis, plasmacytic-lymphocytic gingivitis, caudal stomatitis, mucositis, chronic stomatitis

Contributor(s): David Crossley, Alex Smithson

Introduction

  • Cause: multifactorial - excessive inflammatory response. Periodontal disease, viral infections, systemic disease, immunosuppression eg FeLV Feline leukemia virus disease or FIV Feline immunodeficiency virus disease.
  • Signs: inflammation of gingiva and oral mucosa, bleeding gingiva, oral pain.
  • Diagnosis: identification of underlying cause.
  • Treatment: depends on etiology - often surgical.
  • Prognosis: guarded for resolution, poor if underlying disease.
    Print out the Owner factsheets on Dental disease Dental disease in your cat and Feline stomatitis Feline stomatitis to give to your client.

Pathogenesis

Etiology

  • Idiopathic.
  • Multifactorial likely.
  • Altered immune response with severe (exaggerated) inflammatory reaction to plaque pathogen antigenic factors.
  • Primary:
  • Secondary:
    • Immunocompormise - viral (FeLV, FIV).
    • Systemic compromise, eg chronic renal failure Kidney: chronic kidney disease, diabetes mellitus Diabetes mellitus.
    • Increased blood urea levels, eg chronic renal failure.
    • Altered local immunity, eg salivary IgA.

Predisposing factors

General

  • Concurrent infection/disease.
  • Concurrent compromise.
  • Stress.
  • Poor oral hygiene.
  • Dental lesions and plaque retentive factors.
  • Reactive lesions, eg root remnants.
  • FeLV and FIV may predispose to concurrent disease.
  • Renal failure (elevated blood urea), but does not predispose to chronic gingivostomatitis.

Specific

  • Viral infections but of unknown significance.

Pathophysiology

  • Dental plaque   →   periodontal disease   →     plaque retentive factors, eg pockets Periodontal pockets  →   environment conducive to further multiplication of pathogenic plaque bacteria   →    inflammatory response in gingiva and other periodontal tissues.
  • Elevations of salivary [urea] in renal failure   →   bacterial infections and urea breakdown to ammonia   →   acute ulceration.

Timecourse

  • Months to years.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Harley R, Gruffydd-Jones T J & Day M J (2003) Salivary and serum immunoglobulin levels in cats with chronic gingivostomatitis. Vet Rec 152 (5), 125-129 PubMed.
  • Williams C & Aller M S (1992) Gingivitis/stomatitis in cats. Vet Clin North Am Small Anim Pract 22 (6), 1361-1383 PubMed.

Other sources of information

  • Loprise H (2012) Five-minute Veterinary Consult Clinical Companion Small Animal Dentistry. Wiley-Blackwell.
  • Niemiec B (2010) Small Animal Dental, Oral and Maxillofacial Disease. Manson.
  • Gorrel C (2008) Small Animal Dentistry. Saunders Elsevier.
  • Gaskell C J, Knowles J O & Gaskell R M (1988) Chronic stomatitis in the cat. Veterinary Annual 28th Edition. Grunsell CSG, Raw ME, Hill FWG pp 246-250.


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