Feline chronic gingivo-stomatitis (FCGS), or stomatitis, is a chronic condition that affects up to 10% of cats. Though it’s incredibly common, veterinarians are unsure why so many cats suffer from this mysterious malady.
“Feline stomatitis is a painful condition of the mouth in cats that causes severe inflammation of the gums and mucous membranes in the oral cavity,” says Dr. Rhiannon Koehler, veterinarian and veterinary expert at TeachMe.To.
Unlike other oral diseases, feline stomatitis is not caused by poor dental hygiene. In fact, veterinarians are not sure what causes this condition. Though this diagnosis can leave you with more questions than answers, veterinarians explain that there are several avenues of treatment to relieve your cat’s pain so they can enjoy meal time again.
What exactly is stomatitis?
In cats with stomatitis, the entire mouth can become inflamed, including the gum line, tongue, lips, cheek linings and roof of the mouth. Soft tissue surrounding the back teeth are most commonly affected. Red, sore, sometimes bleeding gums make it painful for the cat to open their mouth, chew and swallow.
“Many cats show no signs initially even though inflammation is present. Many times, this initial inflammation is discovered after a routine veterinary exam.”
— Dr. Marc Smith, veterinarian
Symptoms of stomatitis in cats
Stomatitis symptoms can mimic those of other conditions, so it’s important to see your veterinarian as soon as you notice any unexplained changes in your cat’s behavior or eating habits. Symptoms to look out for include:
- Excessive drooling. While it’s normal for some cats to drool happily while being cuddled, those with oral pain may produce extra saliva, which may be tinged with blood.
- Difficulty eating. This can manifest as dropping food out of their mouth while attempting to eat.
- Extreme halitosis. A foul odor is often one of the first signs pet parents notice.
- Unexplained weight loss. Unexplained weight loss in cats is a warning sign that your cat is not well, whether it’s the result of oral pain or another undiagnosed health issue.
“Cats may turn their head to the side, salivate profusely and some cats even appear frustrated from the pain and oral inflammation,” says Dr. Marc Smith veterinarian at Natchez Trace Veterinary Services in Nashville. “However, many cats show no signs initially even though inflammation is present. Many times, this initial inflammation is discovered after a routine veterinary exam.”
Your veterinarian can examine your cat’s mouth to determine if there are swollen, painful sores indicative of stomatitis. They may sedate your cat for a tissue biopsy to rule out other issues like oral cancer.
Why do cats develop stomatitis?
While you can protect your cat from other dental diseases like gingivitis with daily dental brushing, stomatitis is not so simple to prevent. Veterinarians suspect that stomatitis symptoms may be a result of the cat’s immune system overreacting to plaque on their teeth, akin to an extreme allergic reaction.
“Cats with stomatitis generally have some other physiological reason, either a suppressed or hyperreactive immune system, that underlies the development of stomatitis,” says Smith. “Most of the underlying diseases are viral, including feline leukemia, feline immunodeficiency virus and feline calicivirus. Cats with oral disease are more than twice as likely to test positive for retrovirus infection as the general cat population.”
Age may be another risk factor. Though they can be diagnosed at any age, veterinarians are noticing stomatitis cropping up most often in adolescent cats. “Typically, I’m diagnosing stomatitis in young adults and I’ve even had several patients affected from as young as 6 months of age,” says Dr. Linda Simon, resident vet at Pooch & Mutt.
How to prevent stomatitis in cats
- Keep your cat indoors. Allowing your cat to roam and interact with other cats greatly increases their risk of being exposed to viruses that may make them more susceptible to stomatitis.
- Vaccinate your cat. Vaccinations can prevent many of the viruses linked to stomatitis, including feline calicivirus, a highly contagious upper respiratory infection.
- Schedule yearly wellness visits. Early diagnosis and treatment are key to minimizing unnecessary pain and suffering. If your cat has a risk factor like an underlying viral condition, your veterinarian can monitor them for early signs of stomatitis.
How is stomatitis in cats treated?
If your cat has been diagnosed with stomatitis, their treatment options will depend on the severity of their condition and whether they are currently fighting off a viral infection.
Medications and pain management
“Alleviating the virus may slow or mitigate stomatitis but there is no guarantee,” says Smith. “High-dose oral vitamin C has shown some effectiveness in viral control. Other immunotherapies for viral control have been tried and evidence is lacking.”
Though treatment options vary, veterinarians agree that the first priority after diagnosis is managing pain so the cat can eat again. “Once diagnosed, treatment is generally going to involve strong anti-inflammatory and pain relief medication, as well as antibiotics if warranted,” says Simon.
Improving dental hygiene
As stomatitis is a reaction to plaque, dental care can help control symptoms. Since the cat’s mouth will likely be too painful to tolerate brushing at home, professional dental cleaning under anesthesia is often recommended.
“Feline stomatitis tends to be chronic and will not resolve on its own without veterinary treatment.”
— Dr. Marc Smith
Dental extractions
Though it may seem like an extreme measure, full dental extraction is highly recommended for cats whose pain is not managed with medication or dental cleaning.
“Removal of affected teeth, which sometimes means all teeth, is the best chance of easing pain. Some cats may continue requiring immunosuppressants or pain medications after removal of teeth,” says Koehler.
Simon agrees, adding, “Up to 90% of cats who have partial (usually all of the back teeth) or full-mouth dental extractions will go into remission.”
Is stomatitis in cats life-threatening?
Smith stresses that this condition can quickly become debilitating and requires professional care. “Feline stomatitis tends to be chronic and will not resolve on its own without veterinary treatment.”
“It also can be severe leading to abscessed teeth, hyperplastic gums, tooth loss and the inability to chew food properly,” Smith adds. “While rarely fatal in and of itself, stomatitis can lead to profound morbidity and little quality of life if left untreated.”
Bottom line
Stomatitis is a common and somewhat puzzling ailment that can affect cats of any age. Though it’s heartbreaking to watch your cat struggle with pain, there is hope. Koehler advises pet parents whose cats are undergoing treatment to look forward to a pain-free future, even if that means a full extraction.
“While it can be daunting to hear that your cat may need all their teeth removed, pet parents should know that indoor cats with no teeth usually do very well. As long as the inflammation and pain of stomatitis are controlled, the cat should have no problem eating canned food. Some will even continue to enjoy kibble!”
