Comprehensive Guide to Feline Stomatitis: Causes, Sympt

Types of Feline Stomatitis:

1. Gingivitis:

Gingivitis is an inflammation of the periodontal ligament, alveolar bone, and bone socket, which can lead to the formation of blisters, receding gums, and bone loss.

2. Stomatitis:

Stomatitis refers to widespread inflammation within the mouth, extending beyond the gums to the mucous membranes of the alveolar ridge and even the lips. The inflammation can be found in the posterior part of the mouth, the lateral sides of the oropharynx, and around the palatoglossal arch, with inflammatory lesions and granulomalike growths present.

3. Pharyngitis:

Pharyngitis is the inflammation of the mucous membrane and submucosal tissue of the throat.

4. Eosinophilic Granuloma:

Eosinophilic granuloma is an inflammatory disease related to type I allergic reactions. It is not uncommon for cats to develop eosinophilic granulomas in their mouths.

Causes of Feline Stomatitis:

What causes feline stomatitis? The exact cause remains unknown. Some studies suggest that the condition is due to an inappropriate immune response triggered by antigens in the mouth. There are many potential triggers for stomatitis, and the etiology is multifactorial.

However, it is generally believed that the following common causes are prevalent:

① Infectious Agents:

Pathogens such as feline calicivirus (FCV), feline herpesvirus (FHV), feline leukemia (FeLV), feline immunodeficiency virus (FIV), Pasteurella multocida, and Streptococcus canis can all lead to ulcerative stomatitis.

② ImmuneMediated and Autoimmune Diseases:

Stomatitis is believed to be related to immune factors. It may be that plaque or certain components in the teeth stimulate the oral mucosa, leading to inflammation and causing mucosal ulcers and hyperplasia. Other immunemediated causes of stomatitis include ectoparasites and insects, environmental allergens (such as allergic dermatitis), or food allergies. Lesions can manifest as granulomas, erythema, erosion, ulcers, scales, and crusts.

③ Trauma:

This includes mechanical injury, burns, and chemical corrosion.

④ Systemic Diseases:

Conditions such as anemia, vitamin deficiencies, and malnutrition may also trigger the development of stomatitis.

Symptoms of Stomatitis:

What symptoms do cats with stomatitis exhibit?

When stomatitis is severe, it is quite apparent, as it is often evident from the cat's appearance:

Cats may drool excessively, leaving their mouths and faces sticky and blackened with dirt. They may also show signs of pain in their expressions.

In addition to these, cats with stomatitis may display one or more of the following:

① Excessive salivation with a strong odor.

② Decreased appetite, listlessness, gradual weight loss, pain or severe pain when opening the mouth, difficulty eating, and a shift in food preference from dry to soft foods, with challenges in eating and swallowing.

③ Redness and inflammation of the gums and oral mucosa, tissue hyperplasia, ulcers, and bleeding.

④ Scratching at the mouth or face due to discomfort.

⑤ Painful expressions, often seen in a hunched position like a mother hen, preferring to hide and be inactive, neglecting grooming, and having disheveled fur.

⑥ Some may experience redness and discharge around the eyes.

⑦ Cats may want to drink water but hesitate at the water bowl, potentially leading to dehydration if they do not drink, which can be severe.

Diagnosis of Stomatitis:

Stomatitis can generally be diagnosed based on classic symptoms, such as typical oral lesions, accompanied by drooling and pain.

However, further diagnosis is necessary to determine the underlying cause for effective treatment:

① Blood tests and blood chemistry: These can be used to check for underlying causes.

② Dental examination: This checks for periodontal diseases, resorptive lesions, and other causes of inflammation, and also includes dental Xrays to check for bone socket damage, tooth resorption, and retained root fragments.

③ Oral biopsy or histopathological examination: This is used to rule out tumors, such as squamous cell carcinoma.

④ Viral testing: This includes testing for feline calicivirus (FCV), feline herpesvirus (FHV), and feline immunodeficiency virus (FIV).

⑤ Anaerobic culture, samples can be collected from the gingival sockets.

Treatment of Stomatitis:

Stomatitis is not easy to cure, as it is known for its recurrence and difficulty in根治. This is due to the complex etiology and challenging treatment process.

How to cure feline stomatitis? Here are some treatment measures for stomatitis:

① Medication:

Medication primarily involves chlorhexidine rinses, along with antibiotic and corticosteroid treatments. Appropriately selected antibiotics include amoxicillinclavulanate potassium, clindamycin, and metronidazole for 46 weeks. (Note: Antibiotics alone can only temporarily improve the clinical symptoms of a small number of affected cats.)

Shortterm treatment with corticosteroids is the most effective, with 70%80% of cases cured. Medications like methylprednisolone, prednisolone, prednisone, or prednisolone are used, starting with high doses and gradually reducing them over 46 months to the lowest effective dose, often requiring extended treatment. If oral medication is difficult, injectable steroids can be used, administered every 2 weeks until a clear response is seen, then reduced to every 48 weeks as needed.

② Pain Relief:

Cats with stomatitis experience severe pain, so analgesics such as buprenorphine or fentanyl can be administered orally or by injection, or applied topically to relieve pain.

③ Hydration:

If a cat drools excessively and refuses to drink water, dehydration may occur. Intravenous administration of isotonic glucose and vitamin C can be used based on the degree of dehydration, with 2550 milliliters per kilogram of body weight administered once daily.

④ Topical Treatment for Stomatitis:

Applying topical medications to cats is very challenging, as cats often strongly resist.

Before applying topical medications to a cat's mouth, it is necessary to first rinse the mouth with chlorhexidine. This can be done using a syringe with a removed needle (larger size) to spray water into the cat's mouth, thoroughly cleaning it.

Then, a stomatitis mouth spray (or human oral ulcer powder/ice and borax powder/loquat powder) can be directly applied to the oral lesions.

⑤ Dental Treatment:

This includes the removal of retained root fragments, diseased teeth, or teeth with resorptive lesions. Cats with periodontal disease should have their tartar scraped regularly and brush their teeth frequently.

⑥ Dental Extraction:

This can be fullmouth extraction or halfmouth extraction.

Fullmouth extraction: All teeth in the cat's mouth are removed.

Halfmouth extraction: Only the premolars and molars are removed, while the canines and incisors are retained.

Removing the premolars and molars is an effective treatment for most refractory cases of stomatitis. This is because the onset of stomatitis is closely related to immune factors.

Whether through antibiotics and daily cleaning to control plaque and microbial infections, or with drugs to suppress immune system function, these are not longterm solutions.

By extracting the teeth, the potential for immune stimulation can be removed at the root, leading to the greatest improvement in the clinical symptoms of affected cats. Studies have shown that after extraction, 67.3% of affected cats experienced complete or significant relief of symptoms; 26.3% showed minor improvement; and 6.3% showed no improvement.

Will extraction affect eating?

Actually, it will not. Most cats can still eat normally, but it is best for owners to soften the food or provide wet food.

⑦ Pay attention to nutritional intake and supplement with appropriate amounts of cod liver oil and vitamin B.

Lastly, stomatitis is a truly painful disease, so we should actively prevent its occurrence by strengthening scientific feeding management and regular oral hygiene.