Plaque Allergy in Cats

When a cat becomes allergic to the plaque around his teeth it is known as lymphocytic-plasmacytic gingivitis stomatitis (LPGS) or feline chronic gingivostomatitis. The condition is a serious oral disease where the plaque allergy presents as significant inflammation where your cat’s teeth meet the gum line. 

Plaque is the thin layer of bacteria that is usually present on the teeth’s surface. In LPGS, your cat’s immune system will overreact to the presence of the plaque, leading to significant inflammation in the gingiva. This will begin around the tooth that is affected and then move to the tissue surrounding it.

An allergy to the plaque present on a cat’s teeth can occur when the cat’s immune system mounts an overly aggressive response to the plaque, causing severe inflammation.

Should your cat develop this condition, the following symptoms may be seen:

• Mouth pain
• Gums that are swollen, ulcerated and bleeding
• Disinterest in eating or inability to eat
• Weight loss
• Over-salivating
• Blood in saliva
• Bad breath
• Pawing at his mouth

Your cat’s teeth can look normal or have a large amount of tartar on them; this will depend on the disease’s stage. Once the inflammation is noticeable, there is a good chance that it has spread past the tissue around the tooth that is affected, possibly involving the tissue that is beneath the tongue and in the back of the mouth.

Types 

LPGS is often seen in cats with viral diseases, particularly feline immunodeficiency virus (FIV). Bacterial infections are also common in cats with LPGS as are nutritional and hormonal conditions. While there is not a causal relationship between these and LPGS, the conditions can cause an abnormal immune system response in your cat to the plaque on his teeth.

The cause of this condition is not clear; it is thought to be an abnormal immune response to plaque. While the condition is diagnosed more often in cats with particular viral diseases (for example feline immunodeficiency virus (FIV), bacterial infections and nutritional and hormonal conditions), there has been no established causal relationship between those issues and the condition. The conditions themselves, however can cause an abnormal immune response to plaque. The condition is most often seen in cats between ages 3 and 10; however, it can occur at any age.

Should you notice symptoms in your cat, you will want to take him to your veterinarian for an evaluation. Your veterinarian will ask you for information regarding the symptoms you have seen, when they first became apparent and any changes you have observed. An examination of your cat’s mouth will be conducted; in LPGS, your veterinarian may observe lesions under your cat’s tongue or on his lips, in the back and roof of his mouth and around multiple teeth. Inflammation will be seen of the oral mucosa and the gingiva; typically, the gingivitis that is seen is much more severe than the minor amount of plaque would warrant.

In some cases, a biopsy of tissue in your cat’s oral cavity will be required to confirm the diagnosis, though in most cases (about 85%), the condition is clear through an oral exam.

There are two options for treating the condition and some cats will require both methods of treatment; it will depend upon the extent of the disease. One method involves cleaning the teeth above and below the gingiva (and removing those with grades 3 and 4 periodontal disease) and using medication to suppress your cat’s immune system and to control the growth of bacteria in his mouth.

The second option involves surgery, typically removing all of your cat’s teeth. Removing your cat’s teeth will remove the bacteria. Your veterinarian will “smooth down” the alveolar socket prior to re-suturing the gingiva after the teeth are removed. Upon the completion of surgery, your veterinarian will likely apply fluocinonide 0.05% (Lidex gel) to your cat’s gingival margin as it will help to facilitate healing. Should your cat have a secondary infection, an antibiotic will be recommended.

If your veterinarian recommends managing the condition with medication, follow up appointments will likely be necessary so that he can check on how treatment is working for your cat and make any necessary changes. Should your cat have all of his teeth removed, his recovery time will be five to ten days. After recovering from the surgery, most cats do well, and have a high quality of life. As they will experience minimal inflammation, medication will not be necessary. Should your cat be experiencing this condition, you will want to avoid brushing his teeth, as it will cause him significant pain.