Difference between revisions of "Feline Lymphoplasmacytic Gingivitis Stomatitis Complex"
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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). | |
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| − | 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: | ||
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| − | Hypersensitivity to oral antigens | ||
==Typical Signalment== | ==Typical Signalment== | ||
| − | No sex, age or breed predilection. | + | No sex, age or breed predilection. The median age of those affected is 7 years (range 4 months - 17 years). |
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| − | The median age of those affected is 7 years (range 4 months - 17 years). | ||
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==Diagnosis== | ==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. | 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. | ||
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===Clinical Signs=== | ===Clinical Signs=== | ||
Include halitosis, dysphagia, ptyalism, weight loss, cachexia, bilateral erythematous, ulcerative and/or proliferative lesions of the gingiva, submandibular lymphadenopathy and variable amounts of plaque and calculus accumulation. | Include halitosis, dysphagia, ptyalism, weight loss, cachexia, bilateral erythematous, ulcerative and/or proliferative lesions of the gingiva, submandibular lymphadenopathy and variable amounts of plaque and calculus accumulation. | ||
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===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 | + | 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 haematology and biochemistry are also useful to screen for underlying disease. High globulin levels may be indicative of a hypersensitive state. | ||
===Diagnostic Imaging=== | ===Diagnostic Imaging=== | ||
| − | Full | + | 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 ( | + | 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. |
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==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). | ||
| + | More often than not, full mouth extractions performed by a veterinary dentist are required. | ||
| + | Adjunctive treatment includes pain medication, anti-inflammatories and antibiotic treatment. | ||
| − | + | ==Prognosis== | |
| − | + | 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. | |
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| + | {{Learning | ||
| + | |literature search = [http://www.cabdirect.org/search.html?q=title:(%22stomatitis%22)+AND+od:(cats) Stomatitis in cats publications] | ||
| − | == | + | [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== | ||
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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: | + | |
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| + | {{review}} | ||
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| + | ==Webinars== | ||
| + | <rss max="10" highlight="none">https://www.thewebinarvet.com/infection-control-and-biosecurity/webinars/feed</rss> | ||
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| + | [[Category:Oral_Cavity_-_Erosive_&_Ulcerative_Pathology]][[Category:Oral Diseases - Cat]] | ||
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| + | [[Category:Expert_Review]] | ||
| + | [[Category:Periodontal Conditions]] | ||
| + | [[Category:LisaM reviewing]] | ||
Latest revision as of 13:59, 5 January 2023
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 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 (FCV),Feline herpesvirus (FHV), Feline immunodeficiency virus (FIV),Feline leukaemia virus (FeLV) and Feline coronavirus (FCoV).
Typical Signalment
No sex, age or breed predilection. The median age of those affected is 7 years (range 4 months - 17 years).
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
Include halitosis, dysphagia, ptyalism, weight loss, cachexia, bilateral erythematous, ulcerative and/or proliferative lesions of the gingiva, submandibular lymphadenopathy and variable amounts of plaque and calculus accumulation. Additionally teeth are often loose or missing.
Laboratory Tests
Tests to eliminate underlying viral causes include virus testing for FIV, FeLV and an oral Swab for FCV. Routine haematology and biochemistry are also useful to screen for underlying disease. High globulin levels may be indicative of a hypersensitive state.
Diagnostic Imaging
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
Biopsies should be taken to rule out any malignant neoplasms (i.e. squamous cell carcinoma) or other pathology (i.e. 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: Treating any underlying/existing dental disease, client education of the disease process and client education in dental homecare (diet and daily teeth brushing). More often than not, full mouth extractions performed by a veterinary dentist are required. Adjunctive treatment includes pain medication, anti-inflammatories and antibiotic treatment.
Prognosis
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.
| Feline Lymphoplasmacytic Gingivitis Stomatitis Complex Learning Resources | |
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Stomatitis in cats publications |
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(Eighth edition)Merial
 |
This article has been peer reviewed but is awaiting expert review. If you would like to help with this, please see more information about expert reviewing. |
Webinars
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