Stomatitis

Stomatitis is a severe, painful inflammation of a cat’s mouth and gums. It can be caused by dental disease, certain viruses, and some other inflammatory conditions. Many cats require long-term treatment to control the condition.

Stomatitis is a severe, painful inflammation of a cat’s mouth and gums. Cats of any age or breed can be affected. In most cases, the condition causes ulcers to form in the mouth; these ulcers can involve the lips, tongue, gums, and back of the throat.

There is no single cause of feline stomatitis, but dental disease (particularly periodontal disease) is commonly implicated as a cause of stomatitis in cats. Periodontal disease results from the accumulation of plaque (bacteria) on and around the teeth, which causes inflammation involving the gums and tooth support structures.

The cause is often assumed to be immune-mediated, ie the cat’s immune system attacks its own oral tissues as an abnormal response to bacteria in the mouth. Infection with viruses (such as feline leukemia virus [FeLV], feline immunodeficiency virus [FIV], and calicivirus) and bartonellosis can be associated with stomatitis.

Stomatitis is extremely painful in cats. In some cases, a cat suffering with this condition may be in too much pain to open their mouth to eat. In other cases, the cat may try to eat, but scream and drop the food as soon as it touches the mouth. Other clinical signs may include:

• Drooling (sometimes with blood)
• Unkempt hair coat (because grooming is painful)
• Refusal to eat
• Bad breath
• Weight loss
• Pawing at the face or mouth

Your veterinarian will need to examine your cat’s mouth – this can be difficult because the cat is reluctant to open his or her mouth especially if painful so your veterinarian may recommend for your cat’s comfort sedating your cat so that a more complete examination can be carried out.

Results of basic blood tests, eg chemistry panel and complete blood cell count (CBC), tend to be unremarkable in cats with stomatitis. Your veterinarian may also recommend specific testing for underlying diseases such as FeLV, FIV, and bartonellosis.

Your veterinarian may take a small sample of tissue from the mouth to be submitted to a laboratory for biopsy. However, the diagnosis is usually 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.

As the condition is very painful, initial treatment generally includes giving medication to control pain and inflammation. Antibiotics are also commonly administered. Some cats may be willing to eat soft food, so may be fed pureed canned food until their mouth heals.

Severe periodontal disease has been implicated as a cause of stomatitis. Although stomatitis is difficult to completely cure and treatment tends to be long term, your veterinarian will likely recommend managing dental disease as part of the overall treatment plan. A thorough dental cleaning may be recommended, and many cats do well if the molar and premolar teeth are removed. This can help to control periodontal disease and minimize the bacteria that provoke the immune system in cats with stomatitis. Cats tend to do very well without their teeth.

If the cat has an underlying disease, eg bartonellosis, then treatment for this should be pursued.

Many cats with stomatitis require long-term treatment with anti-inflammatory medications (and antibiotics intermittently) to control the condition. Your veterinarian will likely recommend tooth brushing and other dental care to reduce the accumulation of plaque and associated inflammation in the mouth.