In honor of National Pet Dental Health Month, this week’s word is stomatitis.
stōməˈtītis, noun. Inflammation of the mucosa of the mouth. Forms include gingivitis (inflammation of the gums); glossitis (inflammation of the tongue); cheilitis (inflammation of the lips).
As you can imagine, stomatitis is a painful condition for any animal, including humans. In our companion animals, both dogs and cats can be affected with this condition. In cats, juvenile-onset stomatitis occurs more frequently in Siamese, Maine Coon, and domestic short-hair breeds. Ulcerative stomatitis is recognized in some lines of Maltese dogs.
What to Look For
A pet with stomatitis may have the following clinical signs:
- bad odor in mouth (halitosis)
- pain, as shown by shying away from petting or growling or snapping when approached
- reluctance to eat or open mouth
- complete anorexia
- bleeding from the gums
- noticeable reddened areas or ulcers in the mouth
- +/- plaque and tartar on the teeth
What is the Cause?
There are many causes of stomatitis, including nutritional, congenital, metabolic, immune-mediated, infectious (bacterial, fungal, and viral), traumatic, toxic, and idiopathic (or unknown). If your pet has stomatitis, you can expect your veterinarian to examine the mouth thoroughly. In some cases, due to the painful nature of the process, he or she may need to sedate your pet to perform the exam. If a systemic cause is suspected, your vet will recommend lab tests and urinalysis. These tests are necessary to identify the root cause and implement effective treatment. Radiographs (x-rays) of the mouth will likely be recommended as well.
How Do We Make It Better?
Many of these animals are not eating and drinking well, so we’ll address these deficits first. In the worst cases, the dog or cat may need IV fluid therapy in the hospital and rarely a feeding tube. Most pets can be managed on an out-patient basis, using subcutaneous fluids and a soft diet. Other therapies may include:
- antibiotics for secondary bacterial infections, +/- antifungal drugs if fungal infection is present
- anti-inflammatory drugs to reduce redness, pain, and swelling
- topical therapy, such as chlorhexidine gel formulated for the mouth
- immunosuppressive drugs if an immune-mediated cause is determined
- thorough dental exam with cleaning and extraction of diseased teeth
I’ll make special mention of the condition in cats known as Feline Chronic Gingivo-Stomatitis (FCGS). There is dramatic inflammation in the mouths of these cats, and it’s usually way out of proportion to the amount of plaque and tartar. Many causes have been investigated but at present we don’t know why some cats develop this extreme inflammation. Treatments, including those mentioned above, only provide minimal or temporary relief. The current recommendation for these cats is to remove all of their teeth, as soon as possible. Although this sounds extreme for the cat, it is the one treatment that gives the cat relief from pain. Since our domestic cats do not need teeth to hunt, they can lead very happy lives eating a soft diet. You can read more about this condition here.
Today I ask that you lift your cat or dog’s lip and look at the teeth and gums. Is it time for a dental cleaning? Many veterinary practices have special pricing on dentistry during February. The teeth and gums are often silent, smoldering sites of infection and pain for pets. When you have your pet’s teeth professionally examined and cleaned (under anesthesia, because we don’t want the procedure to be painful and we need to be thorough), you are taking a major step toward promoting health and well-being.