Stomatitis in Cats

If you notice your cat exhibiting unusual behavior or discomfort, especially in and around the mouth, consider feline stomatitis, an aggressive inflammatory disease, as a possible cause. The cause of stomatitis in cats is unclear, but contributing factors include dental disease and immune disease. Symptoms of stomatitis in cats may include decreased appetite, excessive drooling, redness in the gums, and an unkempt coat. While stomatitis in cats is an incredibly painful condition, most cats respond well to medical management, regular oral care, and surgical intervention. If stomatitis is left untreated, it can be life-threatening. If you think your cat may have stomatitis, visit your vet.

What Is Stomatitis?

Feline stomatitis is a severe, painful inflammation of a cat’s mouth and gums. Stomatitis should not be confused with gingivitis, a common, less painful inflammation of the gums. Stomatitis refers to more generalized inflammation of the mucous membranes within the mouth. In most cases, the condition causes painful ulcers and lesions to form in the mouth. These ulcers can develop on the lips, tongue, gums, and back of the throat. 

Symptoms of Stomatitis in Cats

One of the most common stomatitis symptoms is severe pain. This can manifest in a variety of ways. In some cases, a cat suffering from stomatitis may be in too much pain to open its mouth to eat. If your cat can open its mouth, dry food is likely too painful to chew, so wet food is a better option. In some cases, due to the chronic pain, your cat may exhibit behavioral changes such as acting withdrawn or irritable. This can be confused with your cat being a picky eater when in fact, it has mouth pain.

Symptoms of stomatitis in cats may include:

Excessive Drooling

While drooling in dogs is common and perfectly healthy, it is not normal in cats. If you notice your cat drooling, you should take it to the vet for further examination.

Bad Breath

If your cat has unusually bad breath, it could be a symptom of stomatitis. The bad breath can be attributed to mucus membrane inflammation and a build-up of plaque and tartar. It's also possible that the build-up could have preceded the stomatitis, contributing to the development of the disease. In either case, pay attention to the smell of your cat's breath.

Weight Loss

Weight loss in cats is a possible symptom of stomatitis, as severe mouth pain will deter your cat from eating its food. Even if your cat can physically eat, stomatitis can cause loss of appetite.

Pawing at Face or Mouth

If you notice your cat pawing at its face, it may be a symptom of oral discomfort caused by stomatitis. Pay attention to accompanying symptoms that may connect the pawing to stomatitis.

Decreased Appetite

Decreased appetite is a common symptom of stomatitis. In addition to oral pain making chewing too difficult to eat, the pain itself can cause a decrease in appetite.

Unkempt Coat

Your cat may not be keeping up with typical grooming habits. Licking its coat may be too painful. If your cat's coat looks unkempt, or you notice your cat grooming less often or not at all, consider stomatitis and related oral pain as a cause.

Red and Inflamed Gums

Stomatitis in cats can cause severely inflamed, reddened gums as the oral mucus membranes become damaged. Gingivitis can also cause redness and inflammation, so consider taking your cat to the vet to get the correct diagnosis.

Pain When Its Face Is Touched

If your cat has stomatitis, its face will likely be sensitive to the touch. Oral pain from the disease can permeate throughout the face, affecting your cat's response to facial touch.

Lethargy Due to Pain

Chronic pain due to stomatitis can exhaust your cat. Additionally, lack of nutrition following a loss of appetite will lower your cat's energy and lead to lethargy.

Difficulty Swallowing

Difficulty swallowing may be a symptom of stomatitis in your cat. This could be a result of excessive salvation, another stomatitis symptom. Mouth inflammation also contributes to difficulty swallowing.

Causes of Stomatitis 

Unfortunately, the causes of stomatitis in cats are not yet completely understood. In many cases, the cause is assumed to be immune-mediated, meaning that the cat’s immune system attacks its oral tissues as an abnormal response to bacteria in the mouth.

• Dental disease: A variety of dental diseases can contribute to the development stomatitis. For example, periodontal disease results from the accumulation of plaque on and around the teeth, which causes inflammation involving the gums and tooth support structures.
• Infectious or systemic disease: Feline calicivirus, feline immunodeficiency virus (FIV), feline leukemia virus (FeLV), kidney disease, diabetes mellitus, and autoimmune disease can contribute to the development of stomatitis in cats.

Diagnosing Stomatitis in Cats 

If your cat is exhibiting any of the above symptoms, schedule an exam with your veterinarian. Your vet will begin with an exam of your cat and basic bloodwork, such as a complete blood count (CBC) and chemistry panel, to look for any underlying systematic disease. Your vet may also recommend specific testing for underlying conditions such as FeLV and FIV. 

Examining the mouth of a cat with stomatitis can be difficult because the cat is reluctant to open its mouth due to pain. Your veterinarian may recommend sedation to facilitate a more complete and comfortable examination.

The diagnosis is commonly based on a combination of clinical signs and physical examination findings. A dental examination and dental X-rays can help your veterinarian determine the extent of periodontal disease. Sometimes, a veterinarian may recommend submitting a small tissue sample from the mouth for biopsy.

Treatment

Management and treatment of stomatitis can be challenging due to the cause of the disease not being fully understood. Stomatitis treatment will vary depending on the stage and severity of the condition and a cat's response to therapies. 

Regular dental care and medical management are typically the first lines of treatment. Your vet should perform a routine dental cleaning and dental x-rays under anesthesia to address any inflammatory dental disease, remove plaque and tartar, and clean the tissues beneath the gum line. 

Ideally, you should brush your cat's teeth regularly after the dental cleaning. However, cats with stomatitis often have too much oral pain to tolerate brushing. Oral rinses or gels may be of benefit. 

The goal of treatment is to manage pain and decrease inflammation. Some cats will respond to routine dental cleanings under anesthesia and at-home care like chlorhexidine rinses or gels.

If medical management is not helping, your veterinarian may recommend extractions of affected teeth or all teeth under anesthesia. It might sound drastic, but cats do very well without teeth. Tooth surfaces provide areas for bacteria to attach. Removing the teeth can help control periodontal disease and minimize the bacteria that provoke the immune system in cats with stomatitis. Cats continue to eat and live happy lives without teeth.

Prognosis for Cats With Stomatitis

Stomatitis is a challenging (and often expensive) disease to handle. Stomatitis in cats can be difficult to treat and can potentially be life-threatening, but many cats are responsive to treatment. This may include non-surgical therapies, but cats will usually require a combination of surgery and medication. There is no cure for stomatitis in cats, but you can successfully manage it with care and attention. Although it is considered a therapy and not a cure, no additional medical treatment will be necessary if you elect your cat to have a full mouth extraction. If your cat responds well to treatment, you can look forward to an overall improvement in the quality of its life. 

How to Prevent Stomatitis

Unfortunately, stomatitis in cats is difficult to prevent. The most effective ways to protect your cat are maintaining good dental hygiene and attending routine vet appointments. Ensuring your cat is up to date with its vaccinations is essential in preventing associated diseases that may contribute to the development of stomatitis.