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About Eric Barchas, D.V.M.

Eric Barchas, DVM is a veterinarian who lives and works in the San Francisco Bay Area. His emphasis is on small animal medicine, emergency medicine, hospice and wellness. An avid traveler, he has studied lions in Botswana and salmon in southern Chile.

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The contents of this page are provided for general informational purposes only. Under no circumstances should this page be substituted for professional consultation with a veterinarian.

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Stomatitis in Cats

Animals Affected

Cats

Overview

Stomatitis is a markedly painful syndrome in which the gums and mouth become severely inflamed.  The cat's immune system plays a role in most cases of stomatitis.   In these cases, the cat's immune system begins to reject teeth in the mouth.   In other cases, viruses such as FIV or FeLV trigger the syndrome.

Some cases of stomatitis can be successfully managed with medications.  However, the most effective treatment for stomatitis in most instances is extraction of large numbers of teeth.  Although extracting the majority (or, in some cases all) of the teeth in the mouth seems at first to be a very unsavory option, most cats with stomatitis show significant improvement in well-being after the procedure.  Many are completely cured.  Others suffer residual inflammation, and require medications even after removal of teeth.

Symptoms

Many cats that suffer from stomatitis will have visibly swollen and discolored gums, particularly at the back of the mouth.  They may also exhibit the following symptoms.

  • Lack of appetite, difficulty eating, or a preference for soft food.
  • Bad breath.
  • Drooling.
  • Bleeding from the mouth.
  • Increased breathing noise (similar to that which might occur with sinus congestion).
  • Bad smelling or unkempt hair coat.
  • Behavior changes due to pain, including lethargy, decreased displays of affection, hiding, or aggression.

Risk Factors and Prevention

  • Individual susceptibility (likely hereditary) is the major risk factor.
  • Infection with FIV, FeLV, or calicivirus may contribute to the syndrome.

Complications

  • Pain is the leading complication.  Stomatitis is extremely painful, and can lead to a poor quality of life.
  • Weight loss may occur in cats with stomatitis because the pain of the syndrome may make pets hesitant to eat.
  • The cat's bond with the owner may deteriorate if pain may lead to aggression, hiding, or lethargy.

Diagnosis

Diagnosis is made by visually examining the oral cavity.  In some cases the examination is performed under anesthesia.  Dental X-rays often assist in assessing the extent of the syndrome.

Cats with stomatitis should be tested for FIV and FeLV to confirm that the viruses are not contributing to the syndrome.

Treatment

Mild cases of stomatitis may respond to medication with prednisone, cyclosporine, or other drugs that modify the response of the immune system.

For the majority of cases, the most effective treatment is extraction of multiple teeth.  In some cases, all of the teeth in the mouth are removed.  This procedure is called full mouth extraction.

Although the concept of full mouth extraction sounds very unattractive, most stomatitis-afflicted cats benefit tremendously from the procedure.   These cats are unable to use their teeth because of the syndrome, and removing the teeth eliminates the source of pain in their mouth.

During the initial recovery from full mouth extraction, most cats require painkillers and antibiotics such as clindamycin or penicillins.  Once they have healed from the procedure, a large proportion of cats will suffer no inflammation or very low levels of inflammation in their mouths.  For this group of cats, full mouth extraction cures stomatitis.

For a smaller group of cats, full mouth extraction leads to reduced inflammation, but the residual inflammation is sufficient to cause pain and other symptoms.  These cats may require treatment with anti-inflammatory medications (such as prednisone or cyclosporine) and pain killers indefinitely to manage the syndrome.

Follow-up

Regular follow-up veterinary examinations are required to monitor the effectiveness of the treatment chosen.  Cats undergoing full mouth extractions may require several visits in the weeks after the procedure to confirm proper healing of the extraction sites and to assess the response to the procedure.

Many owners notice a marked improvement in their cat's activity and affection levels after successful treatment.  Owners should be aware that appetite may increase dramatically if the syndrome is successfully managed.   Some cats that undergo full mouth extraction gain significant amounts of weight, and may be at risk for obesity.

Miscellaneous

Because stomatitis develops gradually, symptoms such as lethargy appear very gradually. In many cases, owners do not realize how dramatically the syndrome is affecting their cat's behavior and quality of life until successful treatment leads to a pronounced improvement.

Copyright © Eric Barchas, DVM. All rights reserved.
The contents of this page are provided for general informational purposes only. Under no circumstances should this page be substituted for professional consultation with a veterinarian.