Stomatitis in Cats

stomatitis in catsStomatitis in cats, sometimes called gingivostomatitis, plasma cell stomatitis, or lymphoplasmacytic stomatitis, is a very painful condition affecting the tissues in the mouth. The cause of this condition remains unknown.  It may be an immune-mediated process or it may be associated with viral or bacterial causes.  No one knows at this time.

Stomatitis is characterized by extreme inflammation, ulceration, and pain in the gums adjacent to the teeth, especially at the premolars, molars, and the corners of the mouth where the upper and lower jaws meet.  Very bad breath (halitosis), drooling, and anorexia (refusal to eat) are symptoms that coincide with these lesions.  Normal periodontal disease (of the teeth and gums) is not necessarily present.  A change in attitude toward people and other pets – hiding, cowering, or aggression – is also common.

Feline Stomatitis should be differentiated from other ulcerative lesions that affect the teeth and gums by performing a biopsy under anesthesia.  It may be very difficult for the veterinarian, and uncomfortable for the cat, to adequately examine the mouth without a general anesthetic, in fact.  A thorough scaling and polishing of the teeth, and disinfection with a chlorhexidine solution, should be performed at this point; and at least short-term improvement will most likely result while a pathology report is pending.  Long-acting cortisone injections may be helpful in relieving some of the inflammation and pain.  Some cats’ stomatitis can be managed fairly successfully by scheduling teeth cleanings regularly and by using cortisone injections and antibiotics symptomatically.  The majority of cats however, will require more aggressive therapy as they will become too painful to eat.

Obviously, oral medications may not be practical for these very uncomfortable patients.  Attempting to give anything by mouth can result in a nasty bite wound from even the most docile cat who suffers from stomatitis.  Repeated cortisone injections carry their own risks.  There are some other medications and rinses that can be tried if the cat will tolerate being handled around the mouth.  These include Interferon-alpha, lactoferrin, and chlorambucil.  Each offers mixed and limited results.

Most cats affected by stomatitis will eventually require complete tooth extraction.  Usually, the canine teeth (fangs) are spared, if possible, to keep the tongue from hanging out of the mouth.  This is a radical approach, but it is often the only method to alleviate pain adequately so that the cat can continue to eat.  And yes, they can eat fine without teeth.  Canned food is recommended, but some cats will still prefer their kibble – just swallowed whole instead of chewed.