Acute inflammation of the mouth (stomatitis) and ulceration of the tongue (glossitis)
This can be caused by a variety of microorganisms, but commonly one of the ‘flu’ viruses is responsible. Both feline calicivirus (FCV) and feline herpes virus (FHV) will produce stomatitis but FCV does so more commonly.
FCV can produce mouth ulceration only. The ulcers appear typically on the upper surface and margin of the tongue, although they may occur on the gums, palate and nose. Sometimes the ulcers are associated with mild upper respiratory tract disease (cough/sneeze and some discharge from nose).
FHV (feline herpes virus) is a more severe disease with typical signs of upper respiratory disease, often involving inflammation of the pharynx (back of throat) and tonsils. The presence of tongue ulcers is rare.
In both cases the viral infection may predispose to superimposed bacterial infection. Since there are no usable antiviral drugs, treatment must consist of the use of antibiotics to control secondary infection. Attentive nursing of your cat with frequent removal of secretions is important. Offer your cat liquidised or pureed aromatic foods such as strongly flavoured fish. Sometimes we need to admit cats to put them on intravenous fluids.
Dental problems and gingivitis
True dental caries, the process of decay to which we humans are so susceptible, is very rare in the cat, though occasionally encountered in the back molars.
Dental calculus, also known as tartar, consists of mineral-impregnated bacterial plaque. Tartar is most common on the outer surface of the molars and premolars, it is more often found in cats fed on soft food.
Calculus sits at the junction of the gum with the tooth and, as this occurs, a niche is produced in which bacteria can flourish. As a consequence the gum becomes inflamed (gingivitis) and retracts from the base of the tooth. The gum may also become ulcerated, the retraction of the gum allows infection to track down the outside of the root (periodontitis) and a discharge of pus from around the teeth may result.
In early cases, all that is needed is for the cat to have tartar removed by scaling the teeth under general anaesthesia. In severe cases, teeth might need extracting and a course of antibiotics is prescribed.
Non-specific inflammation of the mouth and gums
Inflammation and ulceration:
Apart from the conditions mentioned above, there remains a large group of oral inflammatory conditions in the adult cat, which are unrelated to dental disease and which are extremely unresponsive to treatment. These conditions present with long-term inflammation of the lining of the mouth, little vesicles and ulcers being present in most cases. This affects most frequently the angles where the jaws meet at the back of the mouth although, less commonly, any other part of the mouth can be affected.
The cause is not fully understood; a number of bacteria have been isolated but their significance remains uncertain. FCV and FHV occasionally cause a short-lived inflammation of the mouth (see above) lasting two to three weeks, although we suspect that FCV may play a role in the chronic condition. It was also found that the condition is more common in pedigree cats (in these cases FCV was also more often isolated). There also is a strong association of FIV and non- specific inflammation, in fact very often if the cat is infected with both viruses then it will have more severe oral lesions.
FeLV (feline leukaemia virus) can also cause immunosuppression, which in turn can cause inflammation in the mouth. We often advise to have cats tested for FeLV/FIV (blood sample) and FCV/FHV (swab of mouth and conjunctiva) when we find chronic inflammation of the mouth.
Treatment consists of long term antibiotics and antiinflammatories and supportive therapy. There are some mixed reports on the use of interferon in cats, which is now readily available and used in cats that test positive for some of the viruses.
Despite the lack of involvement of dental disease, removal of the teeth sometimes helps. Cats do very well without any teeth if they are fed a soft diet.