Mystery Cat Mouth Disease

CatChannel veterinary expert Arnold Plotnick, DVM, considers reasons why and treatment for a cat whose mouth is infected and bleeding.

By Arnold Plotnick, DVM | Posted: August 13, 2010, 3 a.m. EDT

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Q: The inside of Sammy's, my cat's, mouth has inflamed gums at the top and bottom and his breath is bad. Sammy will turn 1 year old in May, but I noticed this problem when he was eight months old. I went to my vet and the doc said he could have a viral infection of some sort. The vet thought it was strange for a cat that age to have this, and I was given some medicine.
 
Sammy received a Vetalog injection and an antibiotic injection. I was then given some Clindamycin drops for his mouth and told to come back five days later for a re-check examination. His mouth showed no improvement. I was then given Clavamox drops for his mouth and told to come back a week later. Still, no improvement. The vet thought it would get better, but, it did not. When I took Sammy for his re-check, he was given a Baytril injection and a Depomedrol injection and Baytril tablets (cut in half) for Sammy to take. I was told to come back a week later and still no improvement. After the re-check exam, I was then given lysine gel and more Clindamycin drops for his mouth.

Another vet said Sammy may have some kind of viral infection and tested him for FeLV and FIV; both came back negative. The vet said removing Sammy's teeth could help with his mouth and it was to remove his teeth, but didn't suggest it because Sammy was still a kitten. So, my vet really didn't know what this problem was. My vet suggested I come back and have a biopsy done to my cat's mouth to analyze the red inflammation.
 
Sammy continues to eat and play normally and I hoped the inflamation would eventually go away. It still hasn't. I did some research and stumbled across a bacterial disease in cats called Bartonella. The examples showed the same red inflammation. Do you think this might possibly be Bartonella? I am frustrated because I've never had to deal with something like this. I have three other cats in my household and none have the same problem, though my vet said it could be contagious. All of the cats, including Sammy, are up-to-date on their vaccinations.

A: I suspect your cat has a condition called lymphocytic/plasmacytic gingivitis and stomatitis (LPGS), an  inflammatory condition that causes a great deal of discomfort to many cats mouths. Cats with LPGS usually exhibit chronic, severe inflammation and ulceration of the gums, back of the throat and often other structures inside the mouth. The exact cause of LPGS is unknown, but it is most likely a combination of various factors. One theory is that some cats’ gums are hypersensitive to bacterial plaque. Small amounts of plaque will cause the immune system to overreact and mount an exuberant inflammatory response, sending large numbers of inflammatory cells, mainly lymphocytes and plasma cells (hence the description “lymphocytic/plasmacytic”) into the gums and oral tissues. I don’t think this is the case with your cat, because he’s so young; he hasn’t been around long enough to develop significant plaque. Suppression of the immune system has also been theorized as a cause or contributing factor in LPGS. Infection with the feline leukemia virus (FeLV) and/or the feline immunodeficiency virus (FIV) is known to suppress the feline immune system and may play a role in some affected cats, however, your cat tested negative for both viruses. Other infectious causes have been implicated, including feline calicivirus (FCV). A genetic predisposition is likely in some breeds. In most cases, we never identify a cause.

Many attempts have been made to implicate the bacteria Bartonella as a cause of gingivitis in cats, but the evidence  for this is sorely lacking. Many cats test positive for Bartonella and have no gum inflammation at all. Some cats with gum inflammation test positive for Bartonella, but this does not mean that the Bartonella causes the inflammation. In cats with gingivitis who test positive for Bartonella, treating them for Bartonella rarely causes improvement. The antibiotic usually prescribed is azithromycin. I’m surprised your vet didn’t prescribe it. He seems to have thrown every other antibiotic at your cat.

Your cat seems to not be bothered by his inflamed gums. As long as your cat is able to eat comfortably and is not showing any signs of oral discomfort (such as difficulty eating, excessive drooling, pawing at the mouth, etc.), I would just have it monitored regularly by your vet. Your cat will need regular dental cleanings to prevent plaque buildup which can exacerbate the problem. If serious problems develop in the future (there’s no predicting), treatment with antibiotics and/or steroids may be necessary. The use of antibiotics and anti-inflammatory drugs, however, offers only a short-term “fix.” Eventually, most cats become non-responsive to medical treatment and will require extraction of all of the teeth except the canines (the “fangs”). In most cases, extraction alone successfully reduces the inflammation and allows the cat to eat and live normally. Cat owners often worry that their cat won’t be able to eat after full-mouth extraction, however, most cats tolerate extractions very well and can eat moist food readily, with many cats able to crunch on dry food after the extraction sites have fully healed.

Cats with LPGS are likely facing a lifetime of frequent veterinary visits and treatments. With vigilant monitoring and conscientious veterinary care, however, cats with LPGS can live comfortable happy lives.

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Reader Comments

Rod    St. Johnsbury, VT

7/7/2013 3:27:33 AM

I have the same problem with my one year old male,Cody. His mouth is inflamed but no sores. He was eating well but lethargic. I took him to the vet and he got an antibiotic and steroid shot. He is feeling much better and is playing with my other cats again.
I am going to try this product, it has good reviews on results that I have seen.

LINK

I will get back and let everybody know how it works.

Chuck    Huntington Beach, CA

4/3/2013 9:18:57 PM

Try cat L-Lysine such as Viralys in the powder not the gel. We went through the wringer with our 2 Maine Coon cats and ultimately found they both have cat herpes, a very common condition that causes oral inflammation and respiratory problems . It is not contagious to humans or other animals. It does cause a great deal of pain and leads to loss of appetite, lethargy, very bad breath, hacking, coughing, and wheezing. Sprinkling the L-Lysine powder into their food as a dietary supplement brought relief within a week and both kitties are back to normal. Vets tried steroids and antibiotics over several months at tremendous expense before we discovered L-Lysine through online research. Hope this helps.

Patti    Anaheim, CA

12/13/2012 3:18:54 PM

I am updating my previous entry in hopes it will help someone. The small Russian Blue type cat I mentioned is now doing somewhat better. We took her for a steroid injection 3 mos. ago and I started feeding her very moist, small bites food. She has difficulty chewing/swallowing large pieces, also drools excessivly and was not grooming herself very well. After all that, she now eats small amounts at a time of mostly Meow Mix, the Tender Bites variety and has improved with the grooming,(coat has improved) gained weight, drools less too. The food is slightly more expensive, but worth it. I have found a good price on the Meow mix at Target or ordering from Amozon, in quanity. She really needs the moisture of gravy or sauce to lap up the food. Hope this helps others.

Billie    La Grande, OR

12/11/2012 6:51:47 PM

I have a relatively young Russian blue fixed male named Early who has this same condition -- inflamed mouth. The inflammation extends from his gums into the roof of his mouth. He was about three years old when I got him, and he had this inflammation of the mouth at that time, along with gas, bloating, and diarrhea. He behaved normally, ate normally, but I tried various things to help, including spirulina, which Early likes to eat. His mouth gradually got worse and worse over the next few years, and recently the vet removed 11 of his teeth, including 1 of his canines, I believe. At my vet's suggestion we switched Early to canned food only, and that seemed to cause an improvement in his digestion and elimination. However, I have been working to feed Early raw meat rather than canned food. As he becomes accustomed to it, he wants it exclusively. I purchase a package of organic chicken thighs, separate them into baggies and freeze them. Then I thaw one in the morning a bit until it's easy to cut through it. I cut it all up, feed him some, and keep the rest in the baggies in the fridge for later. I am hoping this change in diet may help Early. The effects of cooked food on the kidneys of cats is said to be very detrimental, and I know that bad kidneys cause mouth problems. Early doesn't like beef, but he does like turkey and pork. His favorite is this raw chicken. I am encouraged by the effects on Early's health so far, but I haven't yet fed him raw meat exclusively. I'm going to do that now. I will try to write an update here if it has a good benefit to him.

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