What is Feline Chronic Gingivostomatitis?

orange cat laying on back covering face with paw

What is Feline Chronic Gingivostomatitis?

Feline Chronic Gingivostomatitis (FCGS) is a severe, painful inflammatory condition affecting the gums and oral mucosa (the mucous membranes inside the mouth) of cats. This disease is characterized by chronic inflammation and ulceration of the gums and other tissues in the mouth, leading to significant discomfort and a range of clinical signs. Here’s an overview of FCGS:

 

Causes and Risk Factors

The exact cause of FCGS is not fully understood, but several factors are believed to contribute to its development, including:

  1. Immune-Mediated Response: It is thought to involve an abnormal immune response to plaque and bacteria in the mouth. It should be noted that this is not a suppressed immune system, but an overactive exuberant immune response. 
  2. Viral Infections: Cats infected with viruses such as feline calicivirus (FCV) and feline herpesvirus (FHV) may be more susceptible and their response to treatment may be less predictable. 
  3. Bacterial Infections: Bacterial infections can exacerbate the condition, but are typically not the primary cause of FCGS in and of themselves. 
  4. Genetic Predisposition: Certain breeds or genetic lines may be more prone to FCGS, particularly certain purebred lines. 

 

 Clinical Signs

Cats with FCGS often exhibit a range of signs indicating oral pain and discomfort, such as:

  • Difficulty eating or reluctance to eat
  • Drooling
  • Bad breath (halitosis)
  • Weight loss due to reduced food intake
  • Pawing at the mouth
  • Bleeding from the gums
  • Swollen, red, and ulcerated gums and oral tissues, particularly in the caudal (back) part of the mouth behind the cat’s teeth

 

Diagnosis

Diagnosis of FCGS typically involves a combination of:

  • Clinical Examination: Observing the oral cavity for signs of inflammation and ulceration.
  • Medical History: Considering the cat’s history of symptoms and any underlying conditions, most notably changes in their eating behaviors. 
  • Laboratory Tests: Blood tests, viral tests, and sometimes biopsies to rule out other diseases and confirm the diagnosis.

 

Treatment

Managing FCGS can be challenging and often requires a multifaceted approach, including:

  1. Medical Management: Anti-inflammatory medications, pain relief, and antibiotics to control secondary infections. While an important part of treating FCGS, medical management by itself will rarely be effective.
  2. Dental Care: Professional dental cleanings and regular home care to reduce plaque and tartar buildup. This is paramount in treating FCGS. Without this modality, there is little chance of controlling the condition. 
  3. Immunomodulatory Therapy: Medications to modulate the immune response, such as corticosteroids or other immunosuppressive drugs. These medications are most often utilized in refractory cases that have not responded to other treatments
  4. Surgical Intervention: In many, if not most, cases, extraction of teeth may be necessary to reduce inflammation and pain. Some cats will only require the extraction of teeth behind the canine (fang) teeth, but many cats require full mouth extractions.

 

Prognosis

The prognosis for FCGS varies. Some cats respond well to treatment and can live comfortable lives, while others may have persistent symptoms despite aggressive management. Regular veterinary care and a tailored treatment plan are crucial for managing this chronic condition.

 

Prevention

Preventive measures include maintaining good oral hygiene, regular veterinary check-ups, and managing any underlying viral infections through vaccination and other preventive strategies. However, most cases arise when a cat is young (1-4 years) of age. In fact, many cases arise when a feline patient is less than 1 year of age. 

Many cat owners whose cats have FCGS are concerned about the possibility of full mouth extractions and how their much-loved pet will be able to eat. Truth be told, most cats with this condition respond well to full-mouth extractions. Their quality of life is better once the teeth with their plaque-retentive surfaces are removed. 

 

Cat Dentist in Colorado Springs

Feline Chronic Gingivostomatitis remains a challenging condition to treat and manage, but continued research is always taking place with the goal of finding a definitive cause and prevention for this painful condition. If you have any concerns about your cat’s dental health or if they’re due for a preventative cleaning, contact Animal Dental Care & Oral Surgery today. Our compassionate team will help your cat maintain excellent oral health. 

 

Images used under creative commons license – commercial use (6/27/2024). Photo by Ludemeula Fernandes on Unsplash

Patrick R. Vall, DVM, DAVDC