Thursday, February 25, 2010

Stomatitis Explained

As we wind down Pet Dental Health Month 2010, we thought we would do a primer on a condition frequently found in cats known as stomatitis. Stomatitis is a general term that refers to inflammation of the oral cavity.

Feline stomatitis is a common, painful and life threatening problem in many cats. Although it does occur in cats of all breeds and ages, there are some breeds in which it develops more frequently such as Himalayans, Persians and Somalis.

Cats with stomatitis suffer from bad breath (halitosis) as well as red and inflamed gums (also known as gingivitis). In time, the inflammation of the gums spreads from areas right next to the teeth to the back of the throat (oropharynx). In some areas, the gums enlarge and block off areas of the oropharynx. This in turn can cause eating and swallowing to become difficult and painful for the cat.

Many cats with stomatitis also have tooth resorption. The inflamed gums may appear to be growing into a tooth or the tooth may appear to have a hole. Teeth so affected are very painful for the cat.

Fortunately, it can be relatively easy to diagnose and treat stomatitis. A history of oral inflammation along with a thorough oral examination are typically sufficient to establish at least a preliminary diagnosis of stomatitis. Chronic oral inflammation with widespread location of tissues involved is typical of feline stomatitis.

However, if the inflammation is not widespread and is localized to a specific area, other diseases should be considered. Allergies, foreign body irritation, periodontal disease or tooth resorption are all possibilities. Therefore, an early, correct diagnosis is very important.

Once established that a cat does indeed suffer from stomatitis, treatment depends on the individual case. Stomatitis affects cats differently depending on the stage of the disease, the severity of the progress, and the individual cat's pain tolerance. The owner's ability to provide home care such as daily teeth brushing is also a factor in treatment planning. Long term treatment is often a combination of medical, surgical and combination therapy. Medical therapy on its own does provide short-term control for feline stomatitis, but the long-term results are unsatisfactory. Surgical therapy has offered remarkable immediate pain relief with effective long-term control.

Often the cause of stomatitis is a reaction of the gingival tissue to the teeth themselves. Therefore, the surgical procedure involves meticulous dental extractions with excision of the inflamed mucogingval tissues. Dental radiology is absolutely essential in performing surgical excisions on cats suffering from stomatitis. Leaving any portion of the tooth, such as the root tips, defeats the purpose of performing the surgical treatment. Radiographs help determine if the teeth have been removed completely. It is also essential to remove the inflamed tissue because bacteria and viruses can hide within the swelling. This causes continued stimulation of the cat's immune system and propagates further inflammation. This in turn contributes to chronic oral pain reducing the quality of life.

If inflamation remains after all teeth have been extracted, long-term medications such as antibiotics and anti-inflammatories may help some. In some refractive cases, strong immune suppressants may be needed. Laser therapy of the inflamed tissue has shown some success as well.

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