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Feline Chronic Gingivostomatitis (FCGS)

Cat disease FCGS

The last article mentioned that the two most common dental problems in cats are “tooth resorption” and “Feline Gingivostomatitis”. This time we would focus on FCGS.

What is FCGS?

Feline Chronic gingivostomatitis (FCGS) is a very painful disease in cats. The wording “Gingivostomatitis” are conducted by “Gingivitis” and “Stomatitis”. Gingivitis is inflammation of the gingiva, also known as the gum tissues, that surround the teeth. Stomatitis is also inflammation, but is inflammation affecting the other soft tissues in the mouth. This can include the insides of the lips, the back of the mouth, under the tongue, and the tongue itself.

When the two terms are combined, gingivostomatitis, this refers to a unique syndrome in cats. However, it is generally called “oral inflammation” as a local name in Hong Kong.

What Causes FCGS?

The exact cause of FCGS is still unknown. But it seems that cats with FCGS have a hyper-immune reaction to plaque and oral bacteria that leads to this inflammation.

In addition, although the cause of FCGS remains elusive, there are a multitude of conditions and infectious agents have been implicated, including infectious pathogens such as feline calicivirus (FCV), feline herpesvirus (FHV-1), feline immunodeficiency virus (FIV), feline leukemia virus (FeLV), and various bacteria, as well as other factors such as dental disease, environmental stress, and hypersensitivity.

As for the link between FIV and gingivostomatitis, the immune system’s inflammatory response is so abnormal in FIV-positive cats that their bodies just aren’t up to dealing with routine oral infections.

The clinical signs of FCGS

  • Weight loss and/ or reluctance to eat
  • Dropping Food
  • lack of appetite
  • Hypersalivation
  • blood in the saliva
  • teeth with a lot of tartar
  • Bad breath

In these cats the oral soft tissues can appear ulcerated (weeping), bloody, swollen and infected. This severely painful condition can result in signs of oral pain, such as pawing at the mouth, acting head-shy, gagging when scratched under the chin, excessive drooling, decreased appetite and decreased grooming. This can be severely debilitating for your cat.

The Outcome of FCGS

Cats with feline chronic gingivostomatitis often develop severe periodontal disease, as the inflammation around their teeth spreads into the underlying bone, damaging structures supporting the teeth and leading to bone loss.

The inflammation can be so severe that teeth may fall out, your cat may stop eating, and cause other health problems, therefore aggressive therapy is required to stop the inflammation.

How to treat FCGS?

In general, there are 2 approaches to the treatment of FCGS: surgical and medical. It depends on the extent of the disease:

1. Medical Management:

As already mentioned, because FCGS is an immune-mediated inflammatory disease, the basis of medical therapy has been immunosuppression or immunomodulation. Using drugs to suppress the immune system and control the proliferation of bacteria in an affected animal’s mouth.

2. Surgical Management:

For long-term results, treatment of FCGS requires the minimization of oral bacteria, which is likely need partial or full mouth extractions. Dental extraction in areas of oral inflammation provided substantial improvement or complete resolution of stomatitis in more than two-thirds of affected cats. The effectiveness of extractions has been shown to be: 55% cure, 35% markedly improved, and 10% no improvement.

Since cases are different, it depends on the condition to decide which treatment should be used, so it’s better to discuss with your veterinarian to find the most suitable plan for your cat.

The longer the inflammation is allowed to continue, and the farther back in the mouth inflammation spreads, the slower and less complete the recovery from surgery. So, if your cat is suspected of having FCGS, it is important to see the veterinarian as soon as possible.

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