Lymphocytic/Plasmacytic Gingivitis Stomatitis in Cats
Cats can suffer from lymphocytic/plasmacytic gingivitis
(LPGS) or feline gingivitis stomatitis (FGS), a condition that is unique to
their species. These terms refer to a severe inflammation that can affect the
entire mouth as well as the gums. The gums will be very red and bleed easily if
chafed. Some cats will have lesions that proliferate along the gums. Affected
cats will have bad breath and may drool a great deal. These cats have extremely
painful mouths and often will simply lick at their food, making no attempt to
pick up pieces or chew.
Although most cats with this problem are middle-aged or older, there is a
form that affects kittens just 3 to 5 months old. The kittens may outgrow the
problem with extensive care, but most older cats do not. Abyssinians, Siamese,
and Persians seem especially prone to the juvenile form of this problem.
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The disease itself seems to be an immune reaction against dental plaque
and/or the actual dentin of the teeth (the substance just under the enamel).
The definitive cause is unknown. It appears to be an allergic or immune-based
problem. About 15 percent of cats with LPGS will be positive for feline leukemia
virus or feline
immunodeficiency virus. An earlier exposure to calicivirus is considered to
be a factor as well. The Bartonella species of bacteria are also
A biopsy may be needed to definitely diagnose this condition and rule out
other similar problems that can result from renal
cancer. The fact that the lesions tend to be bilateral and symmetrical
makes cancer less likely, but it should be considered and definitively ruled
out. X-rays should be taken to check for tooth problems, including root
resorptions (dissolving roots) and abscesses.
Treatment: Cats with LPGS will need to be treated for the inflammation with
oral or injectable steroids. Antibiotics should
be added, at least initially, to prevent bacterial overgrowth. Pain
medications, such as a fentanyl patch, can be important to keep the cat
comfortable. Laser surgery may be done to remove proliferative areas of
inflamed tissue. Bovine lactoferrin (an iron-binding protein with
immunomodulation capabilities) can be compounded for cats and used to flush the
mouth. This product may act against calicivirus, as well, so it may be a
Cats with plaque and tartar buildup need to have that problem addressed.
This may require cleanings under anesthesia as often as
every four to six months. In addition, a diet for tartar control, such as
Science Diet Oral Care,
Purina D/H, Hill’s Prescription Diet Feline t/d, or Royal Canin Feline Dental
DD 27, may be helpful. CET Oral Hygiene freeze-dried meat chews for cats may
also be useful.
Home care includes keeping the mouth and teeth as clean as possible with
daily brushing and mouth washings. Switching from plastic or rubber to
stainless-steel or ceramic food and water bowls may help some cats. Also,
switching to a hypoallergenic, limited protein source diet, such as Royal
Canin’s Hypoallergenic HP 23, may be beneficial.
In many cats, LPGS will not clear up despite aggressive treatment and they
will remain in discomfort until all of their teeth-or at least all of the teeth
except the canines-are removed. Although this may seem a bit drastic, the cats
do extremely well, regain lost weight, are clearly more comfortable and have no
trouble eating-even dry kibble, in most cases.
WebMD Veterinary Reference from "Cat Owner's Home Veterinary Handbook"