Feline Chronic Gingivostomatitis
Feline Chronic Gingivostomatitis (FCGS) is a severe inflammatory condition affecting the gingiva and oral mucosa in cats. Symptoms include severe oral pain, dysphagia and morbidity. Control or cure is often difficult.
Typical appearance of FCGS shoeing severe inflammation of gingival and non-gingival oral tissue
Typically the gingiva and mucosa of the glosso-palatine folds are affected though the inflammation can extend sublingually and also affect the tonsils and palatal mucosa.
A diagnosis of FCGS is usually reached when severe oral inflammation does not resolve following the diagnosis and conventional treatment of evident oral pathology which may include accumulated plaque, periodontitis, feline odontoclastic resorptive disease and other chronic inflammatory oral conditions. Treatment at this stage may have involved routine scaling and polishing, diligent homecare and extraction of affected premolars, molars and often canine and incisor teeth.
Essentially it is believed that FCGS represents an abnormally severe inflammatory reaction to what are common antigenic stimuli in cats including plaque bacteria and feline Calici virus. The aim of treatment should be to reduce antigenic stimulation to a level which does not cause significant inflammation.
A study by Philippe Hennet in 1997 showed that about 80% of cases with FCGS resolved with complete extraction of all pre-molars and molar teeth (and sometimes canines and incisors) and this is standard treatment for FCGS today. The response to elective surgical extraction is technique dependent and it should be done under radiographic control to ensure the extraction of all root remnants.
Cases that are refractory to elective surgical extraction can be managed in a number of ways. We are currently injecting Feline Omega Interferon (Virbagen) sub-mucosally in the affected areas under general anaesthetic. Our experience is that response to treatment is slow but we have had promising results in many cases to a single treatment. An alternative to interferon is to use a variety of anti-plaque and anti-inflammatory drugs to reduce antigenic stimulation from plaque and control inflammation. This might include oral Chlorhexidene preparations, non-steroidal anti-inflammatory drugs and intermittent use of antibiotics. Steroids should be avoided.
A case of FCGS which was refractory to elective surgical extraction of all pre-molars and molars
The same cat following treatment with Feline Omega Interferon