How can i treat my cat’s refractory gingivitis?

I have an eight-year-old blue silver Maine Coon, Sterling, who for the past several years has had problems with recurring gingivitis of the upper left side of his mouth. Our vet has tried several rounds of antibiotics, and several rounds of monthly cortisone shots. The gingivitis clears up
for a few weeks or a couple of months, and then comes back. Now he’s talking about possibly having to remove all of the teeth from the upper jaw. Do you know of anything else that we can try before making such a drastic decision?

Carol
Albany, IN

Severe, recurrent, refractory gingivitis in cats can progress to a syndrome called stomatitis. In feline stomatitis the mouth becomes severely inflamed (irritated). Feline AIDS and feline leukemia virus may trigger stomatitis, but most cases occur for unknown reasons.

Cats with stomatitis have immune systems that reject their own teeth. For this reason, extracting multiple teeth may cause the inflammation to go away. In my experience, this sort of procedure is effective about 85 of the time.

Some mild cases of stomatitis can be managed with medicines that modulate the immune system. Prednisone and cyclosporine are the most commonly used. Prednisone, in particular, may cause unpleasant side effects.

Although extracting multiple teeth sounds extreme, remember that if the gums around the teeth are severely inflamed the teeth are painful and aren’t being used. In my patients, one complication of multiple tooth extraction procedures is weight gain. After the painful teeth are removed, some cats begin to over eat!

You can read much more about stomatitis here:

https://drbarchas.com/stomatitis

And you can read about milder gingivitis and dental disease here:

https://drbarchas.com/dental_disease

About the photo: Sylvester is showing off his dental arcades. There is no sign of stomatitis!