Q: I recently obtained two beautiful shorthaired kittens, sisters from same litter. One is very healthy, but her sister has calicivirus. So far, this kitten has cost me more than $5,000 in veterinary bills. Finding out what has caused the polyps that attack her teeth is the major problem. I’d never heard of such a problem before. The vet removed the kitten’s two back teeth where polyps grew, which is the major solution that we have found to help. What's your input to such a problem with kittens?
A: You provide some confusing pieces of information in your letter, but I have an idea what might be happening. I suspect that your cat has a condition called lymphocytic/plasmacytic gingivitis (LPG), a painful inflammatory condition that causes a great deal of discomfort to many cats. Cats with LPG exhibit chronic, severe inflammation and ulceration of the gums, the back of the throat and often in other structures inside the mouth. The exact cause of LPG 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.
Researchers and vets think immune system suppression might cause or contribute to LPG. Infection with the feline leukemia virus (FeLV) and/or the feline immunodeficiency virus (FIV) can suppress the feline immune system and may play a role in some affected cats, although many other factors including stress and other environmental influences can weaken a cat’s defenses and predispose them to illness. Other infectious causes have been implicated, including feline calicivirus (FCV). I wouldn’t conclude, however, that your calicivirus is the cause of what’s going on in your cat, as no one is really sure of the role calicivirus might play in any individual cat with this condition.
You mention the word “polyps” in your letter, but I think you’re misusing the term. When kittens get “polyps”, they are usually in the nasal cavity or in the ear, and they cause a variety of clinical signs in cat, but they do not affect the teeth. Cats with LPG have dramatic inflammation, not “polyps.”
The goal of treatment is to decrease the inflammatory response. Vets will try to control plaque and tartar, so your vet should perform a thorough dental scaling and polishing. Ideally, you should brush your cats’ teeth regularly after the dental scaling, however, cats with LPG have mouths that may be too painful to tolerate brushing. Oral rinses or gels may be of benefit, but again, many cats find any manipulation of their mouths intolerable. Unfortunately, even with thorough dental scaling and subsequent home care, the condition often progresses. Antibiotics might help some cats during oral pain flare-ups.
Many cats need an occasional short course of anti-inflammatory drugs during flare-ups. Ideally, the anti-inflammatory medication is given at initially high doses to control the inflammation, and then the dosage is tapered to the lowest dose that keeps the condition under control. As stated above, however, most cats won’t allow oral medication. In these cases, an injection of a long-acting steroid is often the only alternative. 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. It sounds as if your vet did extract some teeth, which, again, makes me think your cat has LPG.
The other puzzling part of your letter is that you said this occurs in a kitten. LPG can certainly occur in young cats, but in my experience, most cats are older than 1 year. Ask your cat’s veterinarian if this is what is occurring in your cat. I’m glad that the extractions seemed to have helped.
Cat owners often worry that their cat won’t be able to eat after multiple extractions, 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 LPG likely face a lifetime of frequent veterinary visits and treatments. With vigilant monitoring and conscientious veterinary care, however, cats with LPGS can live comfortable happy lives.