Difference between revisions of "Feline Lymphoplasmacytic Gingivitis Stomatitis Complex"
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| + | {{unfinished}} | ||
| − | + | {{cat}} | |
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==Typical Signalment== | ==Typical Signalment== | ||
| − | No sex, age or breed predilection. | + | *No sex, age or breed predilection |
| + | *Pure breed cats seem to develop disease of greater severity. These include: | ||
| + | |||
| + | <gallery> | ||
| + | Image:Brown_burmese.JPG|'''Burmese'''<br> WikiCommons | ||
| + | Image:golden.jpg|'''Persian''' pelaqitapersians.com | ||
| + | Image:Tabby-point.JPEG|'''Siamese'''<br> gccfcats.org | ||
| + | Image:Abyssinian.jpg|'''Abyssinian'''<br> WikiCommons | ||
| + | </gallery> | ||
| + | |||
| + | *Median age of those affected is 7 years (range 4 months - 17 years) | ||
| + | |||
| + | ==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: | ||
| + | |||
| + | *Hypersensitivity to oral antigens | ||
| + | *Bacteria | ||
| + | **''Porphyromonas'' sp | ||
| + | **''Haemobartonella henselae'' | ||
| + | *Viruses | ||
| + | **[[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) | ||
| + | **Feline coronavirus (FCoV) | ||
==Diagnosis== | ==Diagnosis== | ||
| Line 10: | Line 34: | ||
===Clinical Signs=== | ===Clinical Signs=== | ||
| − | + | *Halitosis | |
| − | + | *Dysphagia | |
| + | *Ptyalism | ||
| + | *Weight loss | ||
| + | *Cachexia | ||
| + | *Bilateral erythematous, ulcerative and/or proliferative lesions of the gingiva | ||
| + | *Submandibular lymphadenopathy | ||
| + | *Variable amounts of plaque and calculus accumulation | ||
| + | *Missing teeth | ||
| + | *Loose teeth | ||
===Laboratory Tests=== | ===Laboratory Tests=== | ||
| − | + | ||
| − | Routine | + | *Virus testing for [[Feline Immunodeficiency Virus (FIV)|FIV]], [[Feline Leukemia Virus (FeLV)|FeLV]] |
| + | *Oral Swab for [[Feline Calicivirus|FCV]] | ||
| + | *Routine haematology and biochemistry to screen for underlying disease. High globulin levels may be indicative of a hypersensitive state. | ||
===Diagnostic Imaging=== | ===Diagnostic Imaging=== | ||
| − | Full | + | Full mouth radiography should be carried out to assess the teeth, alveolar bone and also to identify any broken roots. |
===Biopsy=== | ===Biopsy=== | ||
| − | Biopsies should be taken to rule out any malignant neoplasms ( | + | Biopsies should be taken to rule out any malignant neoplasms (ie squamous cell carcinoma) or other pathology (ie [[Feline Eosinophilic Granuloma- WikiClinical|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: | |
| − | |||
| − | + | *Treat any underlying/existing dental disease | |
| − | + | *Client education of the disease process | |
| + | *Client education in dental homecare (diet and daily teeth brushing) | ||
| + | *[[Antibiotics]] | ||
| + | *Dental scale and polish | ||
| − | + | More advanced cases that have not responded to initial treatments may require: | |
| − | |||
| − | |||
| − | + | *Gingivectomy | |
| + | *Repeated scale and polishing | ||
| + | *Extraction of cheek teeth followed by flushing of the alveolar sockets with saline or chlorhexidine (considered by many to be the most effective treatment) | ||
| + | *Other drug therapy | ||
| − | + | [[Steroids|Corticosteroids]] are often required to control inflammation when there is a hypersensitive response. | |
| − | |||
| + | ==Prognosis== | ||
| − | + | Partly due to our 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. | |
| − | == | + | ==References== |
| − | |||
| − | + | *Tutt, C., Deeprose, J. and Crossley, D. (2007) '''BSAVA Manual of Canine and Feline Dentistry (3rd Edition)''' ''BSAVA'' | |
| − | + | *Merck & Co (2008) '''The Merck Veterinary Manual''' | |
| − | |||
| − | |||
Revision as of 10:05, 25 August 2009
 |
This article is still under construction. |
Typical Signalment
- No sex, age or breed predilection
- Pure breed cats seem to develop disease of greater severity. These include:
Burmese
WikiCommons
Persian pelaqitapersians.com
Siamese
gccfcats.org
Abyssinian
WikiCommons
- Median age of those affected is 7 years (range 4 months - 17 years)
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:
- Hypersensitivity to oral antigens
- Bacteria
- Porphyromonas sp
- Haemobartonella henselae
- Viruses
- Feline calicivirus (FCV)
- Feline herpesvirus (FHV)
- Feline immunodeficiency virus (FIV)
- Feline leukaemia virus (FeLV)
- Feline coronavirus (FCoV)
Diagnosis
Diagnosis of this condition can usually be made on the clinical appearance of the oral lesions and symptoms, together with a lack of response to professional teeth cleaning and home dental care.
Clinical Signs
- Halitosis
- Dysphagia
- Ptyalism
- Weight loss
- Cachexia
- Bilateral erythematous, ulcerative and/or proliferative lesions of the gingiva
- Submandibular lymphadenopathy
- Variable amounts of plaque and calculus accumulation
- Missing teeth
- Loose teeth
Laboratory Tests
- Virus testing for FIV, FeLV
- Oral Swab for FCV
- Routine haematology and biochemistry to screen for underlying disease. High globulin levels may be indicative of a hypersensitive state.
Diagnostic Imaging
Full mouth radiography should be carried out to assess the teeth, alveolar bone and also to identify any broken roots.
Biopsy
Biopsies should be taken to rule out any malignant neoplasms (ie squamous cell carcinoma) or other pathology (ie eosinophilic granuloma) and to confirm the diagnosis. Histologically, dense band-like submucosal lymphocytic-plasmacytic infiltrates are reported with this condition.
Treatment
The aim of treatment of this condition is to improve the hygiene of the oral cavity. Initial treatment can include the following:
- Treat any underlying/existing dental disease
- Client education of the disease process
- Client education in dental homecare (diet and daily teeth brushing)
- Antibiotics
- Dental scale and polish
More advanced cases that have not responded to initial treatments may require:
- Gingivectomy
- Repeated scale and polishing
- Extraction of cheek teeth followed by flushing of the alveolar sockets with saline or chlorhexidine (considered by many to be the most effective treatment)
- Other drug therapy
Corticosteroids are often required to control inflammation when there is a hypersensitive response.
Prognosis
Partly due to our 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.
References
- Tutt, C., Deeprose, J. and Crossley, D. (2007) BSAVA Manual of Canine and Feline Dentistry (3rd Edition) BSAVA
- Merck & Co (2008) The Merck Veterinary Manual