Cats

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Gum Disease (Gingivitis)

The gingiva is the part of the gum surrounding the teeth, and gingivitis is inflammation of this region. It is often seen in association with stomatitis (inflammation of the mouth).

Gingivitis can be very painful and reduced appetite and clawing at the mouth when eating are commonly seen. The cat may appear hungry but unable to eat.

On examination the gum margins may be very red and inflamed, and may spontaneously bleed

Gingivitis can be caused by accumulation of tartar at the base of the teeth, and in time this can lead to gum recession and loss of teeth.

In cats there are however other causes of gingivitis, including viral infections, such as calicivirus and feline immunodeficiency virus, and from the production of toxins as a result of kidney problems.

Perhaps the most common cause of repeated gingivitis in cats is however lymphoplasmacytic gingivitis/ stomatitis.

Lymphoplasmacytic Gingivitis

This condition receives it’s name from the types of cells present in the inflamed tissue, white blood cell types called lymphocytes and plasma cells

The exact cause of this disease is still not known, but is considered to be an immune disease where the cat’s overactive immune system attacks it’s own gums.

The viruses previously mentioned may act as triggers, and also there is some evidence to suggest diet may play a part.

Diagnosis

With lymphoplasmacytic inflammation more aggressive changes, involving the back of the mouth and base of tongue as well as the gums, are common, leading to a generalised stomatitis.

The resultant oral lesions may look similar to other diseases of the mouth such as eosinophilic granuloma (see specific article) or tumours, and to differentiate and also definively diagnose this disease, small biopsy samples are taken and sent for histopathology.

Testing for renal function and possible viral infections is also recommended.

Treatment

In cats with gingivitis merely secondary to plaque accumulation, dental descaling and polishing, and the extraction of any rotten teeth is indicated. Antibiotics are indicated to prevent bacteria spreading via the blood to other organs. Prognosis is excellent after dental cleaning and extractions.

Cats with underlying renal disease or viral infections should be treated accordingly (see separate articles)

Lymphoplasmacytic gingivitis can be a more difficult condition to treat.

- Anti-inflammatories, strong pain-killers, and antibiotics to control secondary infections and routinely used.

- In more serious cases immunosuppressive doses of drugs may be required to control the inflammation.

- Another method of treatment is surgical removal (molar clearance)of all remaining back teeth. Whilst this sounds drastic it can often lead to marked improvement, and the gums quickly harden into bony plates capable of crunching even dried cat food.

Lymphoplasmacytic gingivitis can be very hard to cure, and treatment is often used to control the disease, and keep relapses to a minimum.

Sadly a proportion of cats do not respond to even the highest doses of immunosuppressive drugs or molar clearance, leading to euthanasia as a result of persistent intractable pain.