Mouth Inflammation and Ulcers in Cats

Ongoing mouth inflammation and ulcers in cats is termed feline 'stomatitis', characterized by gradually worsened inflammation of the oral mucosal tissues. Feline stomatitis etiology is assumed to be an immune-mediated disease caused by dental disease and viral infections, such as feline herpesvirus and feline calicivirus. Ongoing mouth inflammation and ulcers only affect about 3 percent of the feline population with purebred cats being the majority of those affected. Feline stomatitis, although rare, is a very serious and painful disease for cats that can eventual becoming life-threatening if it is left untreated. 

Mouth inflammation and ulcers in cats create an extremely painful condition. A cat with this condition may have a difficult time eating or drinking, may have bad breath, drool, and paw at her face. Mouth inflammation often causes a cat’s mouth to develop ulcers on the palate, gums, tongue or lips, which may even prevent the cat from opening her mouth. Mouth inflammation and ulcers are not linked to a single underlying cause, but dental disease is believed to be the main culprit. Mouth inflammation and ulcers in its early stages resembles dental disease and causes pain, making an appointment with the veterinarian essential. 

Mouth inflammation and ulcers in cats is one of the very few conditions that will cause a feline to show obvious signs of pain. It is in a cat’s nature to not freely express pain, but feline stomatitis is so painful cats often cry out in pain with a simply yawn. Cat owners also report a type of behavior veterinarians call, “approach-avoidance.” This behavioral term is used to describe a cat who hungrily approaches her food, only to hiss at her bowl and run away. Approach-avoidance behavior is a symptom that develops over time as the feline anticipates the consumption of food to be painful. Behavioral changes may be the first signs of feline stomatitis a cat owner notices, as inflammation and ulcers in the mouth are not easily seen. The following additional symptoms may also be noted in a cat with mouth inflammation and ulcers: 

• Severe pain
• Vocalization or crying out upon the opening of the mouth
• Dropping food while eating
• Refusal to eat or drink
• Facial pawing
• Weight loss
• Halitosis (bad breath) 
• Dysphagia (difficulty swallowing)
• Ptyalism (hypersalivation, drooling)
• Poor hair coat
• Red, swollen gums and/or mouth
• Visible ulcers or lesions 

The exact cause of mouth inflammation and ulcers in cats is unclear, but what is clear is that the condition appears to be immune-mediated. In other words, feline stomatitis is believed to be an overreaction of the immune system, causing the feline’s own immune system to attack bacteria in the mouth as well as its oral tissues. The immune system is triggered by plaque in the mouth, making feline dental disease the prime suspected cause. Mouth inflammation and ulcers in cats can be caused by dental disease, but also infection and viruses, including: 

• Bartonellosis
  
• Feline calicivirus (FCV)
• Feline herpesvirus-1 (FHV-1)
• Feline immunodeficiency virus (FIV)
• Feline leukemia virus (FeLV)

Diagnosis of mouth inflammation and ulcers in cats begins with an examination of your cat’s medical history, including dental records and procedures to rule out standard conditions of the teeth. A physical examination of the mouth will be completed in order to evaluate the level of ulceration. Sedation or a general anaesthetic may be needed to allow the veterinarian to properly examine the feline’s mouth. A visual identification of mucosal inflammation and ulcers will give the veterinarian a diagnosis, but to determine the cause, further testing will be made including: 

• Systemic disease evaluation (detection of organ disease)
• Virus isolation test (detection of virus)
• Retroviral test (detection of immune-related virus)
• Histopathological evaluation (detection of oral disorders)
• Biopsy (detection of oral neoplasia) 

Treatment of mouth inflammation and ulcers in cats initially begins with pain control and anti-inflammatory medication. Feline stomatitis is an overreaction of the immune system, so your veterinarian may prescribe a steroid or immunosuppressant drug to suppress the immune system, and suppress the disease. Medicated mouth washes and oral antibiotics may also be prescribed. Although effective, treating feline stomatitis with therapeutic drugs is only temporary, therefore, many veterinarians suggest total dental extractions. Sometimes all teeth are removed while, in other cases, the incisors and canines may be left.

Plaque is the known trigger of feline stomatitis. Plaque is a bacteria that only remains in the mouth when it adheres to the teeth. Rigorous dental care at home (regular tooth brushing, feeding a dental diet and the use of certain products like mouthwash) can help keep the disease at bay.

For many, dental extraction is the only potential cure of feline stomatitis. Sometimes, all premolars and molars are removed. In more severe cases, all teeth are taken out. Unfortunately, a total dental extraction is costly, drastic and in the end, may not cure your cat’s stomatitis. 

The refractory nature of mouth inflammation and ulcers in cats makes recovery as well as management of the condition frustrating to both parties. Pain management will be continuous for cats with feline stomatitis to improve the quality of their life. A soft food diet will be required for cats who have undergone total dental extractions and routine dental cleanings may be required of those who have not.

Mouth inflammation and ulcers can be expensive to treat. To avoid high vet care expenses, secure pet health insurance today. The sooner you insure your pet, the more protection you’ll have from unexpected vet costs.