Mary Allen
Gum and mouth inflammation can be so aggressive that the affected cat has to have all its teeth pulled. This solves the problem in two-thirds of the cases.
Gums and oral mucosa are very red, the cat smells bad and is salivating. As the disease progresses, the cat becomes emaciated and looks shaggy because it can no longer clean itself due to the severe pain in the mouth and throat. “At this stage, the animals look very ill,” says Stefan Grundmann, Head of Dentistry at the Zurich Animal Hospital. This is due to the so-called chronic gingivostomatitis (inflammation of the gums, the mucous membrane of the cheeks, and the throat), which, according to Grundmann, is very common among dental diseases and is correspondingly omnipresent in his department. It also occurs frequently in non-specialized practices and is “very often underestimated”.
It is not entirely clear why a cat gets sick. Grundmann says that three complex causes are currently assumed to play an important role. Viruses such as the Calicivirus are number one. Aggressive virus strains can trigger generalized symptoms affecting the whole animal. In a milder form, they can be partly responsible for the gingivitis-stomatitis complex.
All kinds of immune deficiencies (the body’s own defenses are reduced) and autoimmune diseases (the body’s own tissue is attacked) are added as a second complex of causes. The most common triggers in this group are leukemia (FeLV) and the so-called cat aids (FIV). And thirdly, according to Grundmann, not least all forms of stress are to blame for the outbreak of gingivostomatitis. “It’s always interesting how long the disease/immune system can be in balance before a small change causes the disease to break out,” he says. “Stress” means changes in the environment such as moving, staying in an animal shelter, or the arrival or absence of a “Gschpänli”.
Because the cause of chronic gingivostomatitis has not been finally clarified, its treatment is limited to combating the symptoms, i.e. the inflammation. The most important drug used is cortisone, says Grundmann: “In the vast majority of cases, the inflammation actually goes down. Unfortunately, it usually comes back after stopping the medication.” In addition, cortisone has serious side effects such as diabetes.
Last Solution: Pull Teeth
Another treatment option is to strengthen the reduced immune system, for example with interferons. These are endogenous proteins that play an important role in the body’s natural immune system and limit the spread of viral infections. Grundmann says that success can be achieved with mild inflammation in connection with gingivostomatitis: “In the case of severe symptoms, the body cannot cope with the disease despite the help.” In addition, interferon is expensive. The treatment is therefore not suitable for “simply trying it out”.
So the last and most radical solution is the extraction of the teeth. An intervention that is part of everyday life for Grundmann. Assuming that chronic gingivostomatitis is an autoimmune disease that is attacking the cat’s teeth, you help the body by removing the teeth. As a rule, the four canines are left in during the first intervention – because the removal of the molars is already beneficial.
However, even with this radical solution, there is no guarantee of success. In more than a third of the cases, the extraction of all the teeth is successful, in another third of the cases the cat feels much better afterward and in the last third, the intervention brings no improvement.
If the symptoms can be solved by removing the teeth, there is nothing standing in the way of toothless but happy cat life. “Cats can easily live without teeth,” says Grundmann. Domestic cats no longer have to hunt prey or bite it: “Premixed food is pre-made and does not have to be chewed intensively.”
Effective prophylaxis of gingivitis-stomatitis is still not known, Grundmann continues. It is important to have your teeth and gums checked at the annual vaccination appointment.