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Small Animal Section: No. 13CHRONIC GINGIVO-STOMATITIS / PERIODONTITIS IN CATS Periodontitis is common in cats, more so than in dogs. Four clinical syndromes are described, based on age of onset (if known), and clinical course : Feline juvenile gingivitis Adult onset periodontitis Juvenile onset periodontitis Chronic gingivostomatitis in adult cats Diagnostic work-up A thorough diagnostic work-up is necessary, including · Routine haematology and blood biochemistry : It is helpful to have an idea of the health status of cat, to exclude underlying factors such as diabetes mellitus and chronic renal failure. A distinction should be made between the immunosuppressed patient and the hyperresponsive one. · FIV and FeLV status is relevant for treatment planning. FIV positive cats are more regularly affected than FeLV positive cats. · Biopsy : to confirm the diagnosis and distinguish the lesions from the squamous cell carcinoma and eosinophilic granuloma, especially if the lesions are unilateral. Chronic gingivo-stomatitis is characterized by infiltration of the submucosa with large numbers of lymphocytes and plasma cells, as well as abundant antibody-filled Russell bodies. Ulceration is common. Treatment : “A chronically inflamed mouth is non-specific, clinical manifestation of multiple, different immune dysfunctions. Inconsistent success with one treatment is due to trying to treat multiple disease with just one cure.”* Informing the client that making the patient comfortable is the main aim of the treatment, and not necessarily one with a full dentition. · Broad spectrum antibiotic treatment as well as corticosteroid treatment can be used for short term relief or adjunct treatment to surgery, but will never give long term cure. · Where only the gingiva is affected, cases will benefit greatly from professional periodontal treatment, extraction of all teeth with pathology and an aggressive homecare regime. Include a chlorhexidine mouthrinse or gel. · In the event that the fauces, glossopalatine folds or pharynx are involved, treatment of choice is extraction of all teeth and tooth bits caudal to the canines. If however the canines are also affected, a full dentectomy is indicated. · Chronic gingivostomatitis in adult cats is the most difficult to treat. These patients usually present with a chronic infection / inflammation that may include any of the following structures, or even all of them : gingiva, glossopalatine arches, fauces and tongue. Other treatment options used comprise laser therapy, aurothioglucose, bovine lactoferrin, cyclosporin, azothioprine, NSAIDS, Alpha interferon, antihistamines and Levamisole. All with intermediate to poor results. * Rochette J. 2001 Treating the inflamed mouth. In. Proceedings of the 26th World Small Animal Congress, Vancouver Canada For further information contact:
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