Cat with gingivitus, is he in alot of pain?

Question

I asked a question earlier about if i should take my cat Charlie to the vets as he had an ulcer, then decided i would as on closer inspection i thought he had gingivitus. Anyways i took him and he does have gingivitus and has been given synulox tablets for it, how long will these take to clear up his gingivitus and will he be in alot of pain in the meantime? Thanks to everyone for your answers earlier xxx

Answer 1

Gingivitis is inflammation of the gums and it is quite a common problem in cats

Gingivitis can easily be recognised in cats as a red line of inflammation - usually running along the margins of the gum with the teeth. Sometimes the tissue is very friable and bleeds easily if touched. Sometimes there are larger ulcerated areas.



Tartar build up on the molar teeth and gingivitis in a cat

The cause of gingivitis is not known. On histological examination the tissue usually has immune cell infiltrates (especially lymphocytes and plasmacytes) so it is thought to be an immune-related disease. Various micro-organisms may be cultured from the mouths of cats with gingivitis - including calicivirus and anaerobic bacteria, but their role in the disease (if any) is unknown.. Blood samples often contain antibodies to bacteria - again suggesting that infections may be important in the cause of gingivitis.

Gingivitis can occur in any cat but it most commonly affects young and middle-aged cats and no specific breeds are affected, although Abyssinian and Somali breeds are reported to have a higher incidence of mild gingivitis (called "red gum" by breeders) than other cats.

Gingivitis is painful, may cause inappetance, and because it can be so sensitive the cats jaw may "chatter" when the nerves are stimulated, such as during eating. Sometimes the gingivitis is associated with erosion of the teeth roots - called "neck" lesions - as well.

There is no satisfactory treatment for gingivitis in cats. Descaling to remove tartar build up and removal of badly eroded teeth is helpful, but the gingivitis will often recur. Antibiotics and anti-inflammatory or immune-suppressive drugs have all be used and may be beneficial in some cases. Feeding special diets formulated to help prevent dental disease, and regular brushing of the teeth with/without pet toothpaste may also be helpful in these cases. Antiseptic mouth washes have been recommended but they are difficult to administer to cats. Surgical removal of the gum margin, cryosurgery and laser therapy have all been used with variable success, and in the most severe cases removal of all the teeth may be undertaken.

Gingivitis can be a frustrating condition to treat - for both veterinarians and owners, but some cases do resolve with periods of remission between relapses.

Cats are prone to chronic inflammatory diseases of the mouth including gingivitis (inflammation of the gums) and stomatitis (inflammation of the oral mucous membranes).

What causes gingivitis and stomatitis in cats?

There are probably a number of causes of this chronic inflammation in the mouth and gums. It may actually be due to a combination of factors. The three factors which are receiving the most attention are:

Hyperresponsiveness: It is felt that some cats may have a hypersensitivity or allergic reaction to bacterial plaque and are called 'plaque-intolerant.' This results in a disease called lymphocytic-plasmacytic gingivitis stomatitis (LPGS), which affects the entire mouth. In this disease, certain cells involved in the immune system called lymphocytes and plasma cells move into the tissues of the mouth and we see severe inflammation where the tooth meets the gumline. It is this disease which we will focus on in this article.

Another possible cause is an allergy to something else such as food or fleas which may manifest itself as skin and oral lesions called feline eosinophilic granuloma.

Immunosuppression: A cat's immune response may be suppressed for a number of reasons but the most common is viral infections. It is estimated that 15% of cats with chronic oral inflammation are infected with either feline leukemia virus (FeLV), feline immounodeficiency virus (FIV), or both.

Viral or bacterial infections: Feline calicivirus can cause oral lesions, and in some studies, feline infectious peritonitis (FIP) and Bartonella henselae have been implicated.

Are some cats more susceptible?

Some researchers feel certain purebred breeds such as Siamese are more prone to this disease, while others feel it is more common in domestic shorthair cats.

Sometimes this disease can develop when the cat is very young. This is called a 'juvenile onset' form of disease. It may occur at 3-5 months when the permanent teeth are erupting and become more severe by 9 months of age.

Cats who are immunosuppressed have a greater tendency to have oral infections which may become chronic.

What are the signs of chronic gingivitis and stomatitis?

Chronic gingivitis and stomatitis can cause severe pain. The animal's behavior may change - irritability, aggressiveness, depression or reclusiveness may be seen. The cat may drool excessively, have difficulty eating or not eat at all. Some cats will go up to the dish as though they are very hungry (which they are) and then run from the food dish because eating is so painful. They will often have bad breath (halitosis) and may not be grooming themselves adequately. Their gums bleed very easily.

How is this disease diagnosed?

During the physical exam, which may need to be done under anesthesia to do it well, multiple lesions are seen. There may be ulcers or proliferative lesions. The lesions can be on the gums, roof of the mouth, back of the mouth, tongue, or lips. The lesions at the gumline surround the whole tooth. Usually, the area around the back teeth, the premolars and molars, is most affected. Sometimes resorption lesions are seen.

Radiographs (x-rays) of the mouth often show moderate to severe periodontal disease.

In LPGS, a large amount of globulins would be found in the blood since the vast number of plasma cells are producing antibodies (a type of globulin).

A biopsy of the affected areas is often performed to differentiate between LPGS, eosinophilic granuloma complex and neoplasia (cancer). The biopsy would reveal inflammation with a large number of lymphocytes and plasma cells in the case of LPGS. Large numbers of eosinophils would be present if the lesions are caused by eosinophilic granuloma complex.

What is the treatment for chronic stomatitis/gingivitis?

First, let us review what plaque is. Bacteria play a major role in the formation of plaque. Bacteria live on remnants of food in the mouth. When bacteria combine with saliva and food debris in the channel between the tooth and gum, plaque forms and accumulates on the tooth. When bacteria continue to grow in the plaque and, as calcium salts are deposited, the plaque hardens to become a limestone-like material called tartar.

If the chronic stomatitis/gingivitis is due to a plaque intolerance, then it is essential we remove all plaque and keep it off. This is accomplished through:

regular dental cleaning and polishing by your veterinarian
fluoride application by your veterinarian
extraction of teeth with resorption lesions or severe periodontal disease
daily home care, including brushing and the application of 0.2% chlorhexidine
antibiotics
corticosteroids
good nutrition, often with vitamin supplements since these cats may not eat as much as they should because of the discomfort
Unfortunately, even with this intensive care, the disease often progresses and the only way to cure the disease and eliminate the very painful lesions is to extract all of the teeth in back of the large canine teeth (fangs). This may appear drastic, but in almost all cases it is the only alternative. In cases of juvenile onset gingivitis, professional teeth cleaning every 2 months and once- to twice-daily brushing at home for the first year or so of their life, may allow them to revert to a more normal status as they age.

Left untreated, gingivitis can progress to periodontitis. Infection and inflammation spreads from the gums (gingiva) to the ligaments and bone that support the teeth. Loss of support causes the teeth to become loose and eventually fall out. [1]




Unhealthy teeth & gums have greater impact on the body than just causing bad breath, pain & infection. As the gums have a rich blood supply, bacteria is readily transported to other organs (such as the liver, kidneys etc.) in the body causing damage & even organ failure.

What causes gingivitis?

Dental disease: Gingivitis is caused by a build up of plaque (bacteria & food debris). In the early stages plaque forms on the teeth. Plaque which isn't removed from the teeth hardens & becomes tarter (also known as calculus). Tartar is yellow in colour & is seen along along the gum, where it meets the teeth.

Plasmacytic-Lymphocytic Stomatitis (LPGS): This is a severe form of gingivitis causing extreme pain. The cause is still unknown. It appears to be a hyperactive immune response. Feline calicivirus, FIV & FeLV have all been implicated.

What are the symptoms?

Bad breath (halitosis)

Drooling

Red or swollen gums, especially along the gum line.

Gums which bleed easily, especially when touched

Receding gumline

Difficulty & or reluctance to eat

How is it diagnosed?

Your veterinarian will perform an examination of your cat's mouth for signs of gingivitis such as a build up of tartar, red & inflamed gums, bad breath.

Full mouth x-rays may be recommended to determine the extent of the disease.

Plasmacytic-Lymphocytic Stomatitis: A biopsy is required to diagnose this condition.

Your veterinarian may also wish to do a FIV & FeLV test to rule out these two diseases as a cause of gingivitis or plasmacytic-lymphocytic stomatitis.

How is it treated?

This depends on how far advanced the gingivitis is. Early cases of gingivitis which haven't progressed far may possibly be treated at home with regular dental cleaning. Some treatments your vet may perform include:

Descaling to remove tartar build up

Plasmacytic-Lymphocytic Stomatitis:

Regular descaling by your veterinarian

Diligent home dental care in the form of regular brushing of your cat's teeth.

Anti-inflammatory drugs such as prednisone

Interferon and other immune modulators

Antibiotics

If these treatments don't work, the only option is to extract the affected teeth.

How is it prevented?

There are several ways to prevent gingivitis. The key is to prevent tartar build up in the first place.

Regularly brushing your cat's teeth. This will need to be done with a special 'cat' toothbrush & toothpaste. Never use human toothpaste on animals.

You can purchase special diets which are designed to reduce plaque & tartar formation. One such food is Hills T/D which can be purchased through your veterinarian.

Feed raw chicken necks or bones. This is a somewhat controversial topic. In Australia it is quite commonly recommended as a way to reduce plaque & tartar formation, however there are risks associated with feeding raw bones to cats. Speak to your veterinarian for his/her opinion on feeding raw chicken necks & or bones.

Summary:

Any case of gingivitis be it mild or severe requires veterinary attention.

References: [1] Medline Plus

Please note:

The medical articles on this site have not been written by a veterinarian & should not be considered a replacement for a veterinarian visit. The articles are provided for informative purposes only.

Always seek immediate veterinary advice for any problems (health or behavioural) in your pets.

While great care has been made in the creation of these articles, we cannot guarantee the accuracy or omissions on these pages. If in any doubt whatsoever, seek professional medical advice.

Answer 2

Often your vet will take a dental pick, and scrape the gums. If your cat struggles, or the harm is too deep, you may need to have your cat's teeth cleaned under anesthesia. Often then, besides caring for your cat's teeth, they will do a fluoride treatment, and also a sealant. My cat had problems, and after the cleaning, removing decayed teeth and a sealant, things are fine. (It was pricey however, but it is nearly three years later.). There are things like CET chews that are supposed to help, and there are some foods that are formulated for tartar control.

Often, after a thorough cleaning by your vet, your cat will act like a kitten again. Remember, cats are very stoic and don't show pain. In the wilds, showing pain could be fatal.

Untreated, gum problems can result in greatly diminished health and a shortened lifespan.

As far as the synolux treatment, I am not familiar with it.

Answer 3

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RE:
Cat with gingivitus, is he in alot of pain?
I asked a question earlier about if i should take my cat Charlie to the vets as he had an ulcer, then decided i would as on closer inspection i thought he had gingivitus. Anyways i took him and he does have gingivitus and has been given synulox tablets for it, how long will these take to clear up...

Answer 4

Just keep looking for an emergency vet. DO NOT give him any more food or water. If he cant go to the bathroom now that means there is something blocked up so eating or drinking is just going to put more pressure where it hurts. I know the earliest you can get into a normal vet is probably gonna be 8 (although they are usually there bout 1/2 hour earlier than opening) so you got quite a wait so just drink some coffee and put on a movie and try to keep him in your lap and make him comfortable

Answer 5

Sorry to say but, yes he is probably in pain. You did exactly the right thing in taking him to the vet. The tablets will clear the problem and Charlie will be fine with the medication. Just be aware though that he will probably act like he has only hours to live, just so that he gets lots of kisses, cuddles and petting - they're VERY good at that.

Answer 6

Feline Juvenile Gingivitis

Answer 7

Hi! Yes Gingivitis is pain ful and cats do not show pain. They are excellent at hiding it. I would ask the vet for some pain meds for him. My dog had gingivitis and was put on pain pills and antibiotics and in 2 weeks had a good teeth cleaning and 5 loose teeth pulled and continued on pain pills and antibiotics for another week.
Good Luck. Bonnie

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Answer 11

yes it is painful. I am glad you took your cat to the vet, we can offer alot of advice and suggestions on here, but the vet is the only one that can help your pet.