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Feline chronic gingivostomatitis is more prevalent in shared households and its risk correlates with the number of cohabiting cats

Mar 12, 2019

Peralta S, Carney PC. Feline chronic gingivostomatitis is more prevalent in shared households and its risk correlates with the number of cohabiting cats. J Feline Med Surg. 2019 Jan 21;:1098612X18823584.

Feline Chronic Gingivostomatitis (FCGS) is a severe oral disease in cats characterized by severe, chronic inflammation, ulceration, and secondary infection of some combination of the gums, lips, tongue, fauces, and other oral tissues. Cats experience significant pain associated with this that may lead to difficulty eating and grooming, halitosis, lymphadenopathy, and in severe cases complete anorexia. The underlying cause of this condition is unknown, and though there has been a reported association with retroviruses, calicivirus, and other oral pathogens, an autoimmune etiology has also been suggested. Treatment options have included steroids, antibiotics, pain control, interferons, and even stem cell therapy. While full mouth extractions have shown the most promise managing this disease, they are not 100% effective and are associated with significant cost. Understanding the etiology and epidemiology of FCGS may help to prevent its occurrence.

Many of the pathogens reported to be associated with FCGS are highly contagious and so are more prevalent in multiple cat households. The purpose of this study was to determine if there is an difference in incidence and response to therapy for FCGS for cats in single or multi-cat households or cats with or without outdoor access. The study was designed as a retrospective observational analysis of the medical records of Cornell University’s veterinary dental service between 2013 and 2018.

Patient signalment information was collected from medical records. A student blinded to the reason for the study performed a phone interview and recorded number of cats cohabitating at the time of diagnosis, whether cats had outdoor access, and history of upper respiratory disease, as well as history of FCGS in other household cats. A control group of cats with periodontal disease and no FGCS was used for comparison. Cats who had received surgical therapy answered additional questions regarding response to therapy (or lack thereof).

Seventy-six cats were recruited, 36 with FCGS and 40 controls. Median age was 6 years, with 42% female and 58% male. 1% of FCGS cats had surgical correction; Full mouth extraction (FME) in 79% and caudal extractions in 21%.

Cats with FCGS were more likely to come from multi-cat households than controls (OR 7.29), and had a significantly higher number of total cats per household (3.5 for FCGS vs 2 for control). Cats in multi-cat households had higher odds of historical upper respiratory infections (OR 9.56) and each additional cat increased the odds of these infections by 30%.  In multivariate analysis, each additional cat in the household increased the odds of FCGS by 72%.

The number of cats and history of URTI was not associated with response to surgery. Full vs partial extractions had no effect on long-term outcome.

The authors suggest that based on the results of this study, cats in multi-cat households are at higher risk of FCGS. This may be related to historical or recurrent upper respiratory infections, or to the stresses inherent with multi-cat housing. 17% of households containing a cat with FCGS reported a veterinary-diagnosed additional cat with FCGS, suggesting some communicable or infection etiology ay play a role.

There are several limitations to this study. The retrospective nature may have induced some degree of bias to owners and observers, and limits normalization of therapies between cats. The lack of retrovirus testing in this group is also a limitation, as FeLV may be associated with FCGS and multi-cat environments.

While further work is needed to elucidate the role of multi-cat lining in FCGS, this study should prompt veterinarians to be more aware of the risks of FCGS in multi cat environments, and prompt oral examination in cats cohabitating with animals diagnosed with FCGS.  (MRK)

See Also

Healey KA, Dawson S, Burrow R, et al. Prevalence of feline chronic gingivo-stomatitis in first opinion veterinary practice. J Feline Med Surg 2007; 9: 373–381.

Jennings MW, Lewis JR, Soltero-Rivera MM, et al. Effect of tooth extraction on stomatitis in cats: 95 cases (2000–2013). J Am Vet Med Assoc 2015; 246: 654–660.

Belgard S, Truyen U, Thibault JC, et al. Relevance of feline calicivirus, feline immunodeficiency virus, feline leukemia virus, feline herpesvirus and Bartonella henselae in cats with chronic gingivostomatitis. Berl Munch Tierarztl Wochenschr 2010; 123: 369–376

Retrovirus FCGS Full Mouth extraction

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