What is Feline Gingivitis?
Gingivitis simply means an inflammation of the gums (Ginga in Latin). Food debris and bacteria accumulate on the teeth and gums to become plaque. Left untreated, the layer of plaque hardens and turns into tartar (also called calculus). The layer of tartar is often visible in the form of yellow residue along the line where teeth meet gums.
The tartar can cause an inflammatory reaction in the gums and they become tender and reddish in color. Mild forms of gum disease are very common in cats. They are not limited to senior cats. Young cats and even kittens are also susceptible to Gingivitis.
Plasmacytic-Lymphocytic Stomatitis (LPGS)
Plasmacytic-Lymphocytic Stomatitis (or LPGS) is a severe form of Gingivitis affecting the cat’s entire mouth tissues. Stoma is Latin for “an opening” and in this context, it stands for the cat’s mouth. The words “Plasmacytic” and “Lymphocytic” refer to the white blood cells which the cat’s body secretes as part of the actual immune reaction in the gum tissues.
FGS is another term sometimes used to describe this syndrome and it stands for Feline Gingivitis Stomatitis.
LPGS is a condition unique to cats. It is a type of Gingivitis where the gums have an extreme reaction to the plaque on the teeth, resulting in severe inflammation of the gums and surrounding tissues. Over the years we have seen quite a few LPGS Kitties in the TCS community, with Gingivitis and LPGS often being the topic of threads in the Cat Health Forum.
What Causes LPGS?
Nobody knows for sure why some cats are affected by this syndrome while others are not. It seems that some cats just have a strong immune reaction to plaque while others do not. While many afflicted cats have other immune-related diseases such as FIV, FeLV and Feline Diabetes, in some cases it may just be a genetic predisposition. Certain infectious agents are also under investigation as possible contributing factors to LPGS. Bartonella and feline calicivirus are two such suspects.
Feline Gingivitis/Stomatitis Symptoms
Advanced stages of Gingivitis and LPGS have similar symptoms:
- Inflamed, red and swollen gums.
- Halitosis (bad breath).
- Gums may tend to bleed when touched.
Pain is obviously an issue, but cats can show their pain in various ways. Affected cats may avoid food or prefer canned food over kibble. Some cats drool or paw at their face and others may stop grooming their coat, resulting in an unkempt appearance. Pain can certainly cause cats to become aggressive and generally agitated.
Many cats may not show the pain in any visible way and may chomp away merrily on their food even with inflamed gums. Such was the case with Mr. Poe, a 2-year-old neutered male belonging to TCS forum member Catapult. Mr. Poe’s Gingivitis wasn’t diagnosed until it was time for his annual checkup and the vet’s examination revealed red gums. “Mind you, he'd been eating well, in fact, eagerly would better describe his appetite,” says Catapult.
Diagnosing Gingivitis and Stomatitis in cats
Your vet will look for layers of tartar on the cat’s teeth and inflamed gums and mouth tissues as well as other signs of dental and periodontal diseases. If LPGS is suspected, your vet is likely to perform a biopsy and possibly take X-rays as well. Your vet may suggest looking for underlying causes such as Feline Diabetes or FIV, which may require additional blood tests.
Treatment of Gingivitis and Stomatitis
Usually, the first step of treatment is to reduce the amount of tartar and plaque by performing a complete dental scaling and polishing. Ideally, this should be followed by a strict dental home care routine including daily toothbrushing or at least rinsing. In reality, many owners cannot effectively clean their cat’s teeth, even more so when it comes to orally-sensitive LPGS cats.Lucy drooling following her extraction
In some cases, it is possible to temporarily control LPGS with medications, including antibiotics and steroids (anti-inflammatory drugs). This is not a good long-term solution due to the side effects of steroids, but it does offer instant relief for the cat. Lucy is an LPGS cat treated with steroids in the form of Depo-Medrol shots. Her owner, TCS member txcatmom describes the first time Lucy had her shot: “...the results were dramatic. Four hours later I saw her give herself the most amazing all over bath.”
In many cases of LPGS the only long-term solution is to extract the teeth to prevent any accumulation of plaque in the mouth. Some cats do well with a partial extraction, where the canine teeth, and sometimes the small front teeth as well, remain intact. However, in many cases the only course of action is a full mouth extraction.
Surprisingly, cats do very well without any teeth at all. If you’re concerned with the effects of a complete extraction of a cat’s teeth you should read this article: Can Cats Manage without Teeth.
The Effect of Nutrition on Gingivitis and LPGSBugsy's mouth mid-treatment - note the thin red line between the teeth and gums
While there are no published studies at this time pertaining to nutrition and LPGS, it is clear that feeding kibble does not prevent the accumulation of plaque/tartar. It is worth mentioning that many of our community members report significant improvement in both Gingivitis and LPGS after switching to eating raw food.
Long-term forum member and raw-feeding advocate Carolina can testify to the effects of Raw Feeding on her Bugsy’s LPGS. It was a fairly severe case of Stomatitis, as she describes: “blisters on the roof and the back of the mouth, going on the throat, and the gums were very inflamed”. Bugsy was treated with several kinds of medications and was eventually switched to raw food. Several months after discontinuing medication and following a strictly raw diet, Bugsy’s mouth is beautifully pink with just a trace of Gingivitis left.
If you wish to look into raw feeding please educate yourself on the risks as well by reading this article: Feeding Raw to Cats - Safety Concerns. Keep in mind that all leading veterinary organizations object to raw feeding. With that in mind, TheCatSite does not in any way or form advocate raw feeding.
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