Stomatitis in Cats: Signs and Treatment of Feline Dental Disease

Stomatitis in cats is a feline dental disease that results in inflammation of the mucosal tissues of the mouth. It is closely related to gingivitis, which is inflammation of the gums along the base of the teeth. Learn some of the signs of stomatitis in cats, as well as how to treat this feline dental disease.

What are the signs of stomatitis in cats?

Stomatitis shows up as red and proliferative tissue in the mouth — often in the back corners. Because feline stomatitis is an extremely painful condition, cats who have it often won't eat, they might paw at their mouths, and they might have personality changes. They also might have bloody saliva and lose weight.

What causes feline stomatitis?

There is no single cause of stomatitis in cats. The most prevalent belief is that it is caused by chronic viral infections, such as calicivirus and herpesvirus. Cats with weak immune systems — which can be the result of FIV or FeLV infections — are prone to having chronic viral infections. 

Other things that can lead to feline stomatitis include immune-mediated diseases, ingestion of irritants, foreign bodies such as plant debris, and systemic diseases such as kidney failure. One reported cause of stomatitis is the bacterium Bartonella henselae, which is certainly present in some cats with stomatitis but is also present in a lot of cats without stomatitis.

How do you treat stomatitis in cats?

There are many ways to treat stomatitis in cats. The ideal way, in most cases, is the extraction of all teeth that are associated with the inflammation. Often, this is all of the teeth in the cat’s mouth. Cats do very well without any teeth; many cats without teeth can eat both dry and canned food without any problems.

The reason for extraction of the teeth is that it removes the sites to which plaque can attach. Plaque harbors bacteria that can lead to the immune response and inflammation. Scaling and polishing the teeth is often not enough because the plaque comes back very quickly. However, if it's not possible to have all of the cat’s teeth removed, scaling and polishing is an alternative as long as it is followed up with extensive home care. Brushing the cat’s teeth can decrease plaque formation, but it is nearly impossible to brush the teeth of a cat with stomatitis because they are so painful.

Along with teeth extraction, long-term antibiotics are often important to get rid of bacteria that contribute to the inflammation. The antibiotics might need to be given for up to six weeks. This is also an important step if someone is unable to have all of the cat’s teeth removed.

Does removing a cat's teeth cure stomatitis?

Often, removing the cat's teeth and long-term antibiotics are not enough to cure the stomatitis. In this situation, an anti-inflammatory drug (typically prednisone) is often needed. Prednisone can be given in oral form or as a long-acting injection. Many veterinarians have more success with the long-acting injection. 

Unfortunately, there are significant side effects to long-term prednisone administration in cats, including predisposing the cat to diabetes and congestive heart disease. Cyclosporine is another medication that can decrease the inflammation caused by the body’s response to the gum tissue. With either medication, frequent follow-ups are required to make sure the medication is not causing any problems.

Sometimes, this treatment is still not enough and the stomatitis persists. In this case, some veterinarians have success with oral antiseptic rinses — with the antiseptic chlorhexidine in a 0.12% solution. Also, some veterinary dentists will perform laser surgery on the inflamed tissue. Mixed success has been reported with the laser procedure, and it is very expensive.

What is the prognosis?

In short, stomatitis in cats can be a very frustrating disease for both people who have cats and veterinarians — and of course for the cats themselves, too. It can be expensive to treat and often won't go away completely. With that said, for people who cannot afford full-mouth extractions, there are options such as frequent antibiotic and prednisone administration that can provide a good quality of life for a cat for several years.