Archive for December, 2012

Feline Gum and Mouth Disease: Lymphocytic Plasmacytic Gingivits Stomatitis

Because few pet owners care for their pets teeth as well as they take care of their own, low grade gingivitis and periodontitis after 3 years of age, is a very common disease in both dogs and cats.  For the most part, daily home dental care care and an annual dental prophylaxis can control such problems.   However there is a much more serious gum and mouth disease of cats known as “Lymphocytic plasmatcytic gingivitis stomatitis (LPGS)” which is difficult to treat and often results in full mouth extractions.    Before I tell you more about this disease, let us define a few words: Gingivitis refers to inflammation of the gums;  Somatitis refers to inflammation of the mouth as a whole:   Periodontitis refers a progressive inflammation disease of the gums where the bone surrounding the teeth starts to recede.

The exact cause of LPGS is unknown but it is most likely a combination of multiple factors which together create chronic inflammation that eventually results in an auto immune disease.   One theory is that some cats are hypersensitive to bacterial plaque which causes the immune system to over react and mount an extreme inflammatory response that drives a large numbers of white cells, mainly lymphocytes and plasma cells, into the oral tissue.   Other theories implicate feline leukemia, feline immune deficiency virus, and a bacteria known as Bartonella.   Environmental stressors that weaken the cat’s immune system must also be considered to play a part in the disease process.   It has also been proposed that there may be a genetic breed predilection.

As LPGS progresses the major symptoms displayed are results of gum and mouth pain.   Cats have difficulty eating and may even stop eating entirely.   Often cats will approach their food dish as if interested in eating but then run from the food because eating is painful.   Other cats may be fearful of having their face touched.    Owners may notice that their cat will drool excessively and that the saliva may be blood tinged.  Still other cats may paw at their mouth.   Some cats stop eating their dry food because it is too painful but may eat canned food if offered.   Owners often misinterpret this behavior and attribute it to the cat being finicky.   Sometimes the gum pain will cause cats to become reclusive, irritable, or aggressive.   Cats with LPGS often have bad breath.

Confirming the tentative diagnosis of LPGS is performed under light anesthesia after a careful oral exam has been completed.   The exam normally shows extremely red swollen gums and gum tissue that bleeds easily when touched.   The gums are the most frequent oral tissue involved. However, other areas of the mouth may also be inflamed such as the roof of the mouth, the tissue surrounding the tonsils and the lips.  Gum recession and periodontitis are often noted.  It should be realized that there are other conditions such as cancer and “eosinophilic granuloma complex” that resemble LPGS because they produce inflammation and swelling of the mouth and gums, however the treatment protocol is quite different. Consequently a surgical biopsy of the oral tissue involved should be performed and the sample sent out to a pathologist for  histopathology.   Dental x-rays should also be taken to rule out other dental diseases such as retained root tips and cavities which are known as “neck lesions” because they occur at the neck of the tooth, just at or under the gum margin.

Once the diagnosis of LPGS is confirmed the question of how to treat the disease remains.   The primary therapeutic approach is to find ways to reduce the inflammation in the cat’s mouth.  If sensitivity to dental plaque is thought to be the cause then a thorough cleaning of the cat’s teeth including the pockets under the cat’s gums should be performed at least three times yearly.  Home dental care by owners is just as important as the professional teeth cleaning and should be performed on a daily basis.   Unfortunately, many cats with this disease have mouths that are so sore that brushing is impossible so dental antibacterial rinses may be all that can be done.   The problem is that even with frequent professional cleanings and conscientious home care the disease may not be alleviated.   Ongoing oral anti-microbial therapy in conjunction with anti-inflammatory steroid therapy may help at first, but many cats become unresponsive to such therapy.   When all else fails extraction of all the cats teeth may be necessary to give relief from this chronically painful condition and allow the pet to eat and live a comfortable life.   Cats that undergo this procedure will recover quite quickly and go on to eating canned cat food without a problem after the gums have healed.    A few cats may need periodic injections of anti inflammatory medication to deal with flare ups even after full mouth dental extractions.   In such cases long acting steroids have been the only solution available to veterinarians who practice only conventional medicine.  On the other hand holistic veterinarians will attempt to manage the disease with a more natural approach that includes laser therapy, herbal anti inflammatory, natural hydrocortisone therapy, Vitamin C, Coenzyme Q 10, DMSO and even low dose cytokine therapy.  Monolauren therapy may be used in place of antibiotics.

No doubt management of this disease is very challenging for both the conventional and holistic veterinarian and clients need to realize that their cat may be facing a life time of more frequent veterinary visit and home therapy. Anything a cat owner can do to be proactive and maintain the oral health of their pet will pay huge benefits in providing their special friend with a longer carefree life.

To learn more about alternative and holistic health care for pets visit        www. doc4pets.com

 

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Woodside Animal Clinic is a unique, very personal,  one doctor practice where, for over 35 years, Dr. Simon has been healing dogs, cats, birds, rabbits, rodents, and reptiles with both conventional and alternative medicine.  Dr. Simon is certified in Acupuncture, Chiropractic and Stem cell therapy.  He is the author  of 4 pet care books, a past president of the Oakland County Veterinary Medical Association and a regular contributor to Natural Awakenings magazine.   Visit us at Doc4pets.com

Woodside Animal Clinic sees pets from all over Michigan but primarily from the greater Detroit  area  including Wayne, Oakland, Macomb, Washtenaw, and Livingston counties.   Cities in these counties including Royal Oak, Berkley, Huntington Woods, Ferndale, Pleasant Ridge, Detroit, Redford, Livonia, Hazel Park, Madison Heights, Warren, Centerline, Clawson,  Troy, Sterling Heights, Southfield, Birmingham, Lathrup Village, Bingham Farms, Franklin, Beverly Hills, Farmington, Farmington Hills, Novi, Wixom, Brighton, Livonia, Plymouth, Commerce, Ann Arbor, Ortonville, Waterford, Clarkston, Union Lake,  Rochester,  Rochester Hills, Auburn Hills, Utica,  Grosse Pointe Farms, Grosse Pointe,  Romeo,  Flint, Hartland,  Lansing, Okemos, Flint, Howell,  Brighton, White Lake, Romeo, Saline, South Lyon, Windsor Canada, Toledo Ohio