Oral Agony in Cats Lymphocytic Plasmocytic Gingivitis Stomatitis Syndrome

Oral Agony in Cats
Lymphocytic Plasmocytic Gingivitis Stomatitis Syndrome

By Dr. Ed Mapes
Stonebridge Animal Hospital
McKinney, Tx

Mild to moderate inflammation of the gums occurs due to the accumulation of dental plaque, and is very common in our pets. Cats are sometimes afflicted with a much more severe condition that involves not only the gums, but involves most of the oral cavity. This is termed Lymphocytic Plasmocytic Gingivitis Stomatitis (LPGS), and it’s an extremely painful condition in these cats.

Figure 1:  LPGS in this cat severe.

Figure 1: LPGS in this cat severe.

LPGS in this cat is severe. Note the extremely inflamed gums and other structures of the oral cavity.

Due to the pain, some cats will stop eating altogether or pick at their food gingerly, often causing weight loss. They may begin to shun dry food, and come to prefer canned food. There can be excess salivation that sometimes contains blood. Cats may paw at their face, and may resist having their faces touched. They may become reclusive and even aggressive. They sometimes stop grooming themselves, and develop an unkempt appearance.

This syndrome is sometimes associated with several microorganisms that may cause or exacerbate the condition: I always test for Feline Leukemia Virus, Feline Immunodeficiency Virus, Calici Virus, and the bacterium Bartonella henslae as a first step in diagnosis. This may lead to treatment with specific antibiotics, anti-inflammatory medication, and interferon. Treatment can be very successful in controlling or eliminating the disorder.

Absent involvement of these organisms, the next step is to examine the mouth while the patient is anesthetized. We obtain dental radiographs to assess tooth root involvement, may biopsy questionable areas, and then clean the teeth thoroughly. Specific causes can be found during this exam; for example broken sections of root, teeth fractured near the gumline, and a condition called tooth resorption are examples.

Treatment can then begin once the diagnosis is made, or may be delayed until results of testing are received.

Many cases are confirmed as LPGS. The extreme inflammation of this disorder is thought to be due to an over-exuberant reaction by the body’s immune system stimulated by plaque on the teeth. Since plaque accumulates every day, and because the cats experience such oral pain, ordinary means of keeping the teeth clean simply don’t work.

Surgery to remove all involved teeth is usually the answer, though laser treatment alone is sometimes curative in certain conditions. Sometimes all of the teeth must be extracted; we can occasionally leave the canine and incisors intact and still get satisfactory results. Laser therapy sessions are used to aid in healing and decrease pain/inflammation following surgery. Treatment with surgical laser is sometimes used to control inflammation in refractory cases.

Home care post-op is very important, and is often required to fully control the inflammation and pain seen with this condition. The specific measures needed to maintain oral health vary, but may include a variety of medications and oral health products that will be discussed after the procedures.

Cats with this condition are in need of veterinary care. Any cat with redness of the gumlines or other portions of the mouth should be examined so that appropriate measures can begin to bring them relief.

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