Feline Stomatitis Complex

THE ORAL PLAGUE OF CATS: STOMATITIS, TREATMENT & PREVENTION

It may sound like a stomach ailment, but it’s actually a painful oral disease that can seriously affect your cat’s overall well- being by leading to years’ of suffering until diagnosed because so few cats receive an annual or even every 2-3 year Wellness Examination, which many veterinarians will do in-home. Few cat care givers ever look into their cats’ mouths and any cat with the beginnings of stomatitis will fight having the mouth opened because it is so sore. Here’s what you need to know about it, and how to keep your cat healthy.

Does your cat have bad breath, or trouble chewing? Does s/he rub head or face, or have difficulty grooming? If so, your cat may be developing stomatitis. It’s an inflammation of varying degrees of severity that afflicts various parts of a cat’s mouth. Stomatitis is an all too common feline malady that left unattended can mean much suffering and heartache, as well as expense. As the condition progresses, cats have great difficulty eating, may become anorexic, feverish, drool and even have blood in their saliva.

What causes it?

The degenerative dental disease called feline caries or feline odontoclastic resorption lesions is all too common in cats and is often coupled with kidney problems in older cats. The condition may be triggered by periodontal disease, herpes or other chronic viral infection and excess vitamin D in the diet. It causes much discomfort, making eating difficult unless a mushy food is provided, and the associated bacterial infection can spread to internal organs.

Where there is kidney disease in cats, dental problems often follow, a common condition called “rubber jaw” may develop. There will be abnormally higher levels of the phosphate in the blood and abnormally low levels of the calcium. For definitive diagnosis, your veterinarian will perform measurements of serum PTH ( parathyroid hormone) concentrations. Low to normal concentrations of calcium in the blood will help in confirming a diagnosis of secondary hyperparathyroidism. Bone X-rays are also helpful in determining bone density, especially around the teeth. Treating the underlying kidney disease is a major goal of therapy in patients that have been diagnosed with secondary hyperparathyroidism. Abnormally high levels of phosphorous in the blood is treated by using chemicals that bind to the excess phosphorous in the blood, and the diet is controlled to limit phosphorous ingestion by way of food.

A less common condition called allergic stomatitis, or feline lymphocytic-plasmacytic stomatitis, usually involves inflammation, infection and ulceration of the gums, the roof of the mouth and throat regions. It can be caused by an underlying viral infection such as feline immunodeficiency virus (FIV). This infection may trigger an autoimmune reaction that results in the production of antibodies that attack the delicate cells lining the mouth and around the gums. Other viral infections may also be involved, notably feline herpes, calicivirus and feline leukemia virus (FLV).

Feline specialist Dr. Elizabeth Hodgkins (co-author with myself and Professor Marion E. Smart of Not Fit for a Dog: The Truth About Manufactured Dog and Cat Food), avoids what many veterinarians do in severe cases of stomatitis: removing most if not all the cat’s teeth. She contends that in many cases a food hypersensitivity may be involved, compounded by the high acidity in the spray applied to most commercial dry cat foods to enhance palatability. The net result of inflammatory reactions in the mouth, and possible disruption of the healthy bacterial population, is an invasion of harmful bacteria and even fungi, the production of inflammatory substances called cytokines, and abnormal proliferation of gum tissue that may have to be removed with laser surgery along with loose and decaying teeth, all under general anesthetic.

Treatment plan

Stomatitis can be so painful that the cat must be anesthetized to be properly examined. Extensive oral inflammation and infection, adverse reactions to anesthesia and even death make these high risk patients for even the most experienced veterinarian.

Dr. Hodgkins’ approach is to transition cats onto a moist, meaty diet, ideally home prepared, and to treat them with clindamycin and cyclosporine.

I also recommend this integrative approach to help reduce inflammation and infection, along with a good quality fish oil supplement that has potent anti-inflammatory properties.

Dysbiosis, a disruption of healthy bacterial populations in the oral cavity and digestive system, can be aggravated by high-cereal content diets and genetically engineered corn and soy ingredients. So part of the treatment regimen for cats with stomatitis is to correct dysbiosis by giving them probiotics.

Prevention tactics

Until recently, dental problems in both cats and dogs were a neglected aspect of home health care. These problems include the buildup of tartar or scale on the teeth, gum inflammation or gingivitis as well as stomatitis, and serious periodontal disease and tooth root abscesses. Not only do affected animals develop nauseating halitosis and find it painful to eat, but the inflammation in their mouths can cause a spread of bacteria and cytokines into the bloodstream and internal organs. This can damage the heart, causing serious and often fatal heart disease, and also harm the kidneys, pancreas, liver and other internal organs.

These inflammatory substances are also produced from body fat in overweight and obese cats. Obesity and dental problems are associated with highly processed manufactured commercial pet foods, especially those high in cereals.

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Stomatitis is an uncomfortable and difficult disease that can lead to serious health problems. Neglecting a cat’s oral health care maintenance can mean that when stomatitis takes hold and dental cleaning and tooth extractions are called for the cat my die under general anesthesia. The good news is that vigilant dental hygiene and quality nutrition go hand in hand in preventing it and keeping your kitty happy and pain-free.