Stomatitis in Cats

stomatitis in cats

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Stomatitis in cats is a chronic condition that results from severe inflammation of a cat’s mouth and gums. Cats of any age or breed can be affected. Stomatitis is an incredibly painful condition. Fortunately, most cats respond well to a combination of medical management, regular oral care, and near full-mouth or complete extraction dental surgery.

What is Stomatitis?

Feline stomatitis is a severe, painful inflammation of a cat’s mouth and gums. Gingivitis is a medical term that refers to inflammation of the gums and is one of the earlier signs of dental disease. Stomatitis refers to a more generalized inflammation of the mucous membranes within the mouth. In most cases, the condition causes painful ulcers and lesions to form in the mouth; these ulcers can involve the lips, tongue, gums, and back of the throat. 

Symptoms of Stomatitis in Cats

One of the most common symptoms is pain in cats with stomatitis is severe pain. This can manifest in a variety of ways. In some cases, a cat suffering with this condition may be in too much pain to open his or her mouth to eat. In other cases, due to the chronic pain, the cat may exhibit behavioral changes such as being withdrawn or irritable. Some cats may stop eating their dry food, due to it being too painful to chew and only eat canned food. This can often result in the cat being described as a picky eater when in fact, they have mouth pain.

Signs of Stomatitis in Cats

  • Drooling 
  • Bad breath
  • Weight loss
  • Pawing at face or mouth
  • Decreased appetite
  • Unkept coat due to grooming being too painful
  • Red and inflamed gums
  • Pain when their faces are touched
  • Lethargy due to pain 

Causes of Stomatitis 

Unfortunately, the causes of stomatitis in cats is not yet completely understood. In many cases, the cause is assumed to be immune mediated, meaning that the cat’s immune system attacks its own oral tissues as an abnormal response to bacteria in the mouth. Many cats with stomatitis are also infected with certain bacteria or viruses like feline calicivirus, feline immunodeficiency virus (FIV), feline leukemia virus (FeLV) and feline herpes virus.  Dental disease (particularly periodontal disease) can also contribute as a cause of stomatitis.  Periodontal disease results from the accumulation of plaque (bacteria) on and around the teeth, which causes inflammation involving the gums and tooth support structures.

How to Diagnose Stomatitis 

If your cat is exhibiting any of the above symptoms, schedule an exam with your veterinarian. Your veterinarian will begin with an exam of your cat as well as basic bloodwork, such as a complete blood count(CBC) and chemistry panel to look for any underlying systematic disease. Your vet will may also recommend specific testing for underlying diseases such as FeLV and FIV. 

Examining the mouth of a cat with stomatitis can be difficult because the cat is reluctant to open his or her mouth due to pain. Your veterinarian may recommend sedation to facilitate a more complete and comfortable examination.

Sometimes, a small sample of tissue from the mouth is submitted to a laboratory for biopsy. However, the diagnosis is commonly based on clinical signs and physical examination findings. A dental examination and dental X-rays can help your veterinarian determine the extent of periodontal disease.

Treatment of Stomatitis

Management and treatment of stomatitis can be challenging due to the cause not being fully understood. Stomatitis treatment will vary depending on the stage and severity of the condition and a cat’s response in an individual case. 

Regular dental care and medical management are typically the first line of treatment. A routine dental cleaning and dental x-rays should be performed under anesthesia to address any inflammatory dental disease, remove plaque and tarter, and clean the tissues beneath the gum line. 

Ideally, cats’ teeth should be brushed regularly after the dental cleaning, however, cats with stomatitis have mouths that are commonly too painful to tolerate brushing. Oral rinses or gels may be of benefit. 

The goal of treatment is to manage pain and to decrease inflammation. Many cats will require broad-spectrum antibiotics, chlorhexidine rinses or gels and anti-inflammatory medications.

If medical management is not helping which includes the above, your veterinarian may recommend extractions of affected teeth or all teeth under anesthesia. This might sound drastic, but cats tend to do very well with their teeth. Tooth surfaces provide areas for bacteria to attach, removing the teeth can help control periodontal disease and minimize the bacteria that provoke the immune system in cats with stomatitis. Cats continue to eat and live very full lives without teeth.