What is Stomatitis in Cats? Symptoms and Treatments

What is Stomatitis in Cats? Symptoms and Treatments

Cats are so tough and so stoic it can often be difficult to tell when they are in pain. Unfortunately, this often leads to our feline companions suffering for an extended period before they receive medical attention. One common cause of oral pain in cats is feline chronic gingivostomatitis (FCGS)—a severe inflammatory condition of the oral tissues.


What would make you suspect that your cats have feline chronic gingivostomatitis?

Although cats try their best to hide discomfort, there are many symptoms you may notice in cats affected by this condition. For example, you might see that they have a foul odor coming from the mouth or seem to be salivating or drooling more than you would expect or than they have in the past. The saliva may even be blood-tinged. If the stomatitis is very severe, your cat may start eating less or may seem interested in food, try to eat it, drop it out of their mouth, and hiss at the food bowl. Alternatively, you may not notice any clinical signs, but your veterinarian may comment on the severe inflammation in your cat’s oral cavity on an annual exam.


How would your cat get diagnosed with feline chronic gingivostomatitis?

It can sometimes be challenging to differentiate feline chronic gingivostomatitis from gingivitis associated with periodontal disease. During the awake oral examination, your veterinarian will open your cat’s mouth (if your cat is willing!) and evaluate the gingiva and mucous membranes at the back of the oral cavity. Redness or ulceration and sometimes even proliferation of those tissues is a good indicator that feline chronic gingivostomatitis is the cause of the clinical signs.

When you or your vet suspect that your cat may be affected with feline chronic gingivostomatitis, they will likely recommend a comprehensive oral health assessment and treatment, meaning an anesthetized oral examination with imaging. The exam and imaging will help your veterinarian determine with more certainty if FCGS is the cause of the inflammation. 

Based on this evaluation, several treatment options may be recommended, including medical management with oral medications, selective extractions of diseased teeth, extractions of all the teeth behind the canines, or total extraction of all the teeth. Your veterinarian may also biopsy the inflamed and ulcerated tissues during the procedure. The biopsy ensures that the disease process we are dealing with is genuinely gingivostomatitis and not any other condition needing different treatment.


What is the cause of this condition and what are the treatment options?

Despite their best efforts, veterinarians and researchers have not been able to pinpoint the cause of feline chronic gingivostomatitis in cats. A possible link exists between FCGS and various viral infections, with calicivirus being the most likely indicated. However, the disease could also be a product of the individual feline’s immune system or genetics. Studies also show that cats who live in multi-cat households are more likely to be afflicted with feline chronic gingivostomatitis, indicating that environment could play a role.

Finally, we know that the condition often improves by minimizing the bacterial plaque in the cat’s mouth. This can be done in several ways- routine thorough dental cleanings with meticulous home care (meaning brushing daily or multiple times a day, oral rinses, etc.) or by removal of most or all of the teeth.

When you and your vet are trying to decide on the best treatment for your feline companion, it is essential to consider several things. Aside from the statistical likelihood that any particular treatment would work, it’s prudent to keep in mind your own cat’s temperament and handling qualities. Because cats are… well… cats, I doubt any veterinary professional would blame an owner for not being able to brush their cat’s teeth once or twice daily. Cats can also be notoriously difficult to medicate and will often begin hiding if they realize your routine for something they don’t appreciate. 

Additionally, while medications like steroids can offer a considerable amount of immediate and temporary relief, their chronic use can cause patients to develop diabetes, which leaves your cat with a painful mouth and a severe metabolic disease that typically requires daily injections. Although it can often be a hard pill for an owner to swallow, extraction of all or most teeth is the best, fastest, and most kind way to get your cat out of pain.

Statistically speaking, although it can be hard to choose to have most or all of your cat’s teeth removed, this is the most likely treatment to relieve the patient. More than half of the cats affected with feline chronic gingivostomatitis will go into remission (meaning the inflammation in their mouths will resolve and result in a comfortable oral cavity) with extractions alone. Unfortunately, a subset of the remaining cats will need to be medicated with some additional medication for life. A smaller subset will not improve after extractions or extractions + oral medications. These cases are referred to as “refractory” stomatitis.

Refractory stomatitis can be exceedingly frustrating for owners and veterinarians alike. If your cat falls into this category, we understand your despair. However, it is essential to remember that new treatments are always available. A recently developed treatment is feline interferon, an immunomodulatory compound. This medication has been shown to affect cats with feline chronic gingivostomatitis positively. Unfortunately, interferon, like the other treatments for FCGS, does not have a 100% success rate and works better for some cats than others.


Why would my wonderful family veterinarian refer me to a specialist to have all of my cat’s teeth extracted?

Your vet may want to refer you and your cat to a dental specialist for several reasons. First, taking out all of a cat’s teeth can be difficult and time-consuming, and since teeth are all that dental specialists deal with, the cat will likely be under anesthesia for a shorter time in a specialty setting.

Additionally, suppose your cat has other health conditions that make anesthesia riskier. In that case, your vet may recommend being seen by a dental specialist who can work with a veterinary anesthesiologist to ensure the safest drug protocols and monitoring for your companion. 

Finally, it’s important to remember that your family veterinarian has the most challenging job out there- they have to know how to diagnose and treat every condition, and sometimes there isn’t enough of their time to go around!

Whatever the reason you may end up at our door, we are happy to help you and your cat reach a place of the best oral health and comfort possible. It is important to us to communicate closely with your family veterinarian so that when you go back to see them, they are up to date on what treatments were done and what still needs follow-up care. 

That said- unlike in human medicine, you do not need a referral to bring your cat to see us! If you don’t have a regular vet but notice something unusual in your cat’s mouth, we would be happy to take a look and recommend any necessary treatments. Afterward, we can point you toward some of our excellent referring general practice veterinarians for follow-up and general health care.


Veterinary Dentist in Colorado Springs

Feline chronic gingivostomatitis is a frustrating and challenging condition to treat. Still, we look forward to joining the fight with you to relieve your cat’s pain and help them continue living their best lives!

If you have any questions regarding your cat’s oral health or would like to schedule an appointment at our Colorado Springs office, please call us at (719)536-9949. 



Photo by Chewy on Unsplash