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==Introduction==  

 

Feline lymphoplasmacytic gingivitis [[stomatitis]] complex is a poorly understood condition. It presents as erythematous, ulcerative lesions of the gingiva, buccal mucosa, lips, palatoglossal folds and the lateral pharyngeal walls. No clear aetiology has yet been discovered but many different causes of the condition have been proposed. These include [[:Category:Hypersensitivity|hypersensitivity]] to oral antigens and bacterial infections including those caused by ''Porphyromonas'' sp and ''Haemobartonella henselae''. Certain viruses have also been implemented including [[Feline Calicivirus|Feline calicivirus]] (FCV),[[Feline Herpesvirus 1|Feline herpesvirus]] (FHV), [[Feline Immunodeficiency Virus|Feline immunodeficiency virus]] (FIV),[[Feline Leukemia Virus|Feline leukaemia virus]] (FeLV) and Feline coronavirus (FCoV).

==Description==  

Feline lymphoplasmacytic gingivitis stomatitis complex is a poorly understood condition. It presents as erythematous, ulcerative lesions of the gingiva, buccal mucosa, lips, palatoglossal folds and the lateral pharyngeal walls. No clear aetiology has yet been discovered but many different causes of the condition have been proposed. These include hypersensitivity to oral antigens and bacterial infections including those caused by ''Porphyromonas'' sp and ''Haemobartonella henselae''. Certain viruses have also been implemented including [[Feline Calicivirus|Feline calicivirus]] (FCV),[[Feline Herpesvirus 1|Feline herpesvirus]] (FHV), [[Feline Immunodeficiency Virus (FIV)|Feline immunodeficiency virus]] (FIV),[[Feline Leukemia Virus (FeLV)|Feline leukaemia virus]] (FeLV) and Feline coronavirus (FCoV).

==Typical Signalment==

==Typical Signalment==

No sex, age or breed predilection. Pure breed cats seem to develop disease of greater severity. These include:

No sex, age or breed predilection. The median age of those affected is 7 years (range 4 months - 17 years).

 

 

The median age of those affected is 7 years (range 4 months - 17 years).

==Diagnosis==

==Diagnosis==

===Laboratory Tests===

===Laboratory Tests===

 

Tests to eliminate underlying viral causes include virus testing for [[Feline Immunodeficiency Virus|FIV]], [[Feline Leukemia Virus|FeLV]] and an oral Swab for [[Feline Calicivirus|FCV]].

Tests to eliminate underlying viral causes include virus testing for [[Feline Immunodeficiency Virus (FIV)|FIV]], [[Feline Leukemia Virus (FeLV)|FeLV]] and an oral Swab for [[Feline Calicivirus|FCV]].

Routine[[Feline Haematology| haematology]] and [[Feline Biochemistry|biochemistry]] are also useful to screen for underlying disease. High globulin levels may be indicative of a hypersensitive state.

Routine[[Feline Haematology - WikiNormals| haematology]] and [[Feline Biochemistry - WikiNormals|biochemistry]] are also useful to screen for underlying disease. High globulin levels may be indicative of a hypersensitive state.

===Diagnostic Imaging===

===Diagnostic Imaging===

Full skull radiography should be carried out to assess the teeth, alveolar bone and also to identify any broken roots.

Full intra-oral dental radiography should be carried out to assess the teeth, alveolar bone and also to identify any fractured roots or root remnants.

===Biopsy===

===Biopsy===

Biopsies should be taken to rule out any malignant neoplasms (ie[[Squamous Cell Carcinoma| squamous cell carcinoma]]) or other pathology (ie [[Feline Eosinophilic Granuloma|eosinophilic granuloma]]) and to confirm the diagnosis. Histologically, dense band-like submucosal lymphocytic-plasmacytic infiltrates are reported with this condition.

Biopsies should be taken to rule out any malignant neoplasms (i.e. [[Squamous Cell Carcinoma| squamous cell carcinoma]]) or other pathology (i.e. [[Feline Eosinophilic Granuloma|eosinophilic granuloma]]) and to confirm the diagnosis. Histologically, dense band-like submucosal lymphocytic-plasmacytic infiltrates are reported with this condition.

 

==Treatment==

==Treatment==

The aim of treatment of this condition is to improve the hygiene of the oral cavity. Initial treatment can include the following: Treating any underlying/existing dental disease, client education of the disease process and client education in dental homecare (diet and daily teeth brushing)

The aim of treatment of this condition is to improve the hygiene of the oral cavity. Initial treatment can include the following: Treating any underlying/existing dental disease, client education of the disease process and client education in dental homecare (diet and daily teeth brushing).  

[[Antibiotics]] may also be necessary and a dental scale and polish is recommended.

More often than not, full mouth extractions performed by a veterinary dentist are required.

 

Adjunctive treatment includes pain medication, anti-inflammatories and antibiotic treatment.

More advanced cases that have not responded to initial treatments may require a gingivectomy, repeated scale and polishing and extraction of cheek teeth followed by flushing of the alveolar sockets with saline or chlorhexidine (considered by many to be the most effective treatment)

Additionally [[Steroids|Corticosteroids]] are often required to control inflammation when there is a hypersensitive response.

==Prognosis==

|literature search = [http://www.cabdirect.org/search.html?q=title:(%22stomatitis%22)+AND+od:(cats) Stomatitis in cats publications]

Partly due to the lack of understanding of this condition, feline lymphoplasmacytic gingivitis stomatitis complex is frustrating to treat. Many patients fail to respond to treatment, even after full mouth extraction. In these cases it is thought that the oral bacteria that remain are sufficient to maintain inflammation. In cases that undergo prolonged ineffective medical treatment, the disease appears to become more refractory to further treatment.

[http://www.cabdirect.org/search.html?q=title%3A%28Gingivitis%29+AND+title%3A%28Stomatitis%29+AND+od%3A%28cats%29 Gingivitis and Stomatitis in cats publications]

|Vetstream = [https://www.vetstream.com/felis/Content/Disease/dis00626.asp Gingivitis and Stomatitis]

==References==

==References==

Merck & Co (2008) '''The Merck Veterinary Manual'''(Eighth edition)''Merial''

Merck & Co (2008) '''The Merck Veterinary Manual'''(Eighth edition)''Merial''

[[Category:Oral_Cavity_-_Erosive_&_Ulcerative_Pathology]][[Category:Cat]][[Category:To_Do_-_Caz]]

 

 

 

[[Category:Oral_Cavity_-_Erosive_&_Ulcerative_Pathology]][[Category:Oral Diseases - Cat]]

 

[[Category:Periodontal Conditions]]

[[Category:LisaM reviewing]]