Therapeutic Management of Feline Chronic Gingivostomatitis: A Systematic Review of the Literature

Winer, J. N.; Arzi, Boaz; Verstraete, Frank J.M.

doi:10.3389/fvets.2016.00054

Cited by 57 publications

(87 citation statements)

References 41 publications

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“…Periodontal disease is one of the most commonly reported diseases in companion animals [3,4]. In cats, it produces pain, inflammation, dysphagia, halitosis, weight loss and oral hemorrhage; fullmouth extractions are commonly required as treatment [5]. However, behavioral signs of oral disease-induced pain have not been systematically investigated in cats.…”

Section: Introductionmentioning

confidence: 99%

Pain behaviors before and after treatment of oral disease in cats using video assessment: a prospective, blinded, randomized clinical trial

2020

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Background: Specific behaviors associated with pain in cats with oral disease have not been consistently studied. The aim of this exploratory study was to identify pain-induced behaviors in cats before and after treatment of oral disease using video assessment. Twenty-four cats (6 ± 3.3 years old; 4.9 ± 1.7 kg) were included in a prospective, blinded, randomized clinical trial. Cats were equally divided into minimal (G1: minimal dental treatment) or severe (G2: multiple dental extractions) oral disease groups. After acclimation at day 0, they underwent oral examination, radiographs, scaling, and dental extractions under general anesthesia (anesthetic protocol: acepromazine, hydromorphone, propofol, isoflurane, meloxicam, and local anesthetic blocks; day 1), and were discharged at day 6. Cats were filmed remotely for 10 min using a wide-angle glass lens camera before surgery (baseline) and throughout the study at different time points (36 h of video recording). The videos consisted of four parts namely general, playing, feeding and post-feeding behaviors. A board-certified behaviorist evaluated the duration/ frequency of different behaviors based on an ethogram, which were analyzed using linear mixed models and a generalized linear model, respectively (p < 0.05). Results:In comparison with baseline, duration of "not pawing the face" was significantly shorter at day 3 in G2. These cats spent significantly longer time "standing" and "laying" at days 3 and 6, respectively; G1 spent significantly less time "walking" and "standing" at days 3 and 4, respectively and significantly longer time "immobile" at day 3. Duration of "no/slow tail movement" was significantly longer in G2 than G1 at day 5. Duration of "pawing the ribbon" (playing) was significantly shorter in G2 than G1 at day 1. Feeding and post-feeding behaviors with soft food were not significantly different between groups or over time. Frequency of "difficulty grasping dry food" was significantly higher in G2 than G1 up to day 6. Frequency of post-feeding "head shaking" was significantly higher in both groups at day 6 when compared with baseline.Conclusions: This study identified pain-induced behaviors in cats undergoing treatment of oral disease. These behaviors may be used to differentiate painful versus pain-free cats in clinical practice.

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Section: Introductionmentioning

confidence: 99%

Pain behaviors before and after treatment of oral disease in cats using video assessment: a prospective, blinded, randomized clinical trial

2020

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“…FCGS is a painful and debilitating severe oral mucosal inflammatory disease of cats that is estimated to affect 0.7%-12% of the general cat population [10][11][12][13][14][15]. Clinical signs are moderate to severe oral pain and discomfort, including inappetence, reduced grooming, weight loss and ptyalism [11,12,16].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Efficacy of Fresh, Allogeneic Mesenchymal Stem Cells for Severe Refractory Feline Chronic Gingivostomatitis

Arzi

Clark

Sundaram

et al. 2017

Stem Cells Translational Medicine

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115

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Mesenchymal stem cells (MSCs) have potent immunomodulatory functions and are a promising therapy for immune‐mediated inflammatory disorders. We previously demonstrated the efficacy of fresh, autologous, adipose‐derived MSCs (ASCs) to treat feline chronic gingivostomatitis (FCGS), a chronic oral mucosal inflammatory disease similar to human oral lichen planus. Here, we investigate the use of fresh allogeneic ASCs for treatment of FCGS in seven cats. Radiolabeled ASCs were also tracked systemically. Each cat received two intravenous injections of 20 million ASCs, 1 month apart. Oral inflammation, blood lymphocyte subsets, anti‐fetal bovine serum antibody levels, ASC crossmatching and serum proteins and cytokine concentrations were determined. Four of the 7 cats (57%) responded to treatment [complete clinical remission (n = 2) or substantial clinical improvement (n = 2)]. Three cats were nonresponders. Prior to therapy, most cats had increased circulating CD8+ T cells, decreased CD8lo cells, and a decreased CD4/CD8 ratio, however clinical resolution was not associated with normalization of these parameters. Nonresponders showed more severe systemic inflammation (neutrophilia, hyperglobulinemia and increased interferon gamma and tumor necrosis factor alpha concentration) prior to ASC therapy. Clinical remission took up to 20 months and no clinical relapse has occurred. A higher fraction of radiolabeled ASCs were identified in the oral cavity of FCGS affected cats than the control cat. The administration of fresh, allogenic ASCs appeared to have lower clinical efficacy with a delayed response as compared to the fresh, autologous ASCs. In addition, the mechanism(s) of action for autologous and allogenic ASCs may differ in this model of oral inflammation. Stem Cells Translational Medicine 2017;6:1710–1722

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“…In this study, of the 43 cats with oral lesions, 28 (65.1%) presented solely PD, one (2.32%) had solely FCG, and 14 (32.5%) showed PD and FCG. It is also worth noting that of the 15 cats with gingivostomatitis, 14 (93.3%) presented concomitant periodontal disease, which reiterates the hypothesis of PD being a cause of FCG (Gioso 2003, Winer et al 2016. Progression of PD is determined by the microorganism's virulence combined with the host's immunological response (Nisengard et al 2006).…”

Section: Discussionmentioning

confidence: 85%

Oral lesions and retroviruses in shelter cats

et al. 2019

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Oral lesions are common problems in feline medicine worldwide, and may be associated with different causes, such as infectious agents. There are only a few studies reporting the chief oral diseases and the results for retrovirus tests in shelter cats in Brazil, especially in the South region. This study aimed to identify the main inflammatory oral lesions in shelter cats and verify the test results for feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) infections. Forty-three felines from private shelters in the central region of Rio Grande do Sul state (RS) that presented clinically evident oral lesions, regardless of age, breed, sex, and neuter status, were used in this survey. Serological tests for FIV and FeLV were performed in all cats, and data regarding the rearing system were collected. Sixteen cats (37.2%) were reared in a free system, whereas 27 (62.8%) were kept under a restrict system. Of the 43 cats with oral lesions, 29 (67.44%) presented only one type of lesion, characterized as periodontitis (n=22, 51.16%), followed by gingivitis (n=6, 13.95%), and stomatitis (n=1, 2.32%). Concomitant stomatitis and periodontitis were found in the 14 remaining cats (100%). With respect to the test results for retrovirus infections, nine (20.93%) of the 43 felines were positive for FIV alone. Co-infection with both viruses was observed in seven cats (16.28%). No cat was seropositive for FeLV valone. None of the six cats that presented gingivitis was positive for FIV and FeLV; one cat with stomatitis was positive for FIV and FeLV; of the 22 cats with periodontitis, six (27.27%) were FIV positive and two (9.09%) were FIV/FeLV positive; and of the 14 cats that presented stomatitis and periodontitis, three (21.43%) were FIV positive and four (28.57%) were FIV/FeLV positive. As for diagnosis, 28 cats (65.1%) presented solely periodontal disease (PD), one cat (2.32%) had feline chronic gingivostomatitis (FCG) alone, and 14 (32.5%) had both PD and FCG. The results obtained show that the main oral lesions found in shelter cats in the central region of RS were gingivitis, stomatitis, and periodontitis. Periodontitis, in association or not with stomatitis, was the most frequently observed oral cavity lesion in FIV- and/or FeLV-positive cats. Other factors may contribute to installation of inflammatory oral diseases in shelter cats because most cats with oral cavity lesions tested negative for retrovirus infections.

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Therapeutic Management of Feline Chronic Gingivostomatitis: A Systematic Review of the Literature

Cited by 57 publications

References 41 publications

Pain behaviors before and after treatment of oral disease in cats using video assessment: a prospective, blinded, randomized clinical trial

Pain behaviors before and after treatment of oral disease in cats using video assessment: a prospective, blinded, randomized clinical trial

Therapeutic Efficacy of Fresh, Allogeneic Mesenchymal Stem Cells for Severe Refractory Feline Chronic Gingivostomatitis

Oral lesions and retroviruses in shelter cats

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