Ch. 10: Feline & Equine Dentistry Flashcards
What are the four diseases more common in cats than they are in other species?
- Feline chronic gingivostomatitis (FCGS)
- Feline odontoclastic resorptive lesion (FORL) aka tooth resorption
- Alveolar osteitis
- Feline oral pain syndrome (FOPS)
Stomatitis definition
Inflammation of the mucous lining of any of the structures in the mouth
In clinic, this should be described as widespread oral inflammation beyond gingivitis and periodontitis
When inflammation extends into the mucosal tissues, what is this known as?
Mucositis
When inflammation extends into the lateral palatine folds, what is this known as?
Caudal stomatitis
Describe Type 1 FCGS
- Alveolar and labial/buccal mucositis/stomatitis
- Can be managable/maintained
Describe Type 2 FCGS
- Caudal mucositis/stomatitis, and w/o alveolar and labial/buccal mucositis/stomatitis
- Is less managable/maintained
What are the trigger factors/causes of FCGS?
Periodontal disease, tooth resorption, pasteurella species, pseudomonas species, tannerella forsythia, chlamydophila felis, plaque bacteria, bartonella species, calicivirus, and herpesvirus
What factors can complicate management of FCGS?
Feline immunodeficiency virus (FIV), feline leukemia virus (FeLV), and dietary antigens
Evidence suggests that FCGS is immune-mediated.
True or False?
True
Treatment for this condition is extensive and long-term. What treatment may be necessary?
Whole-mouth extractions (Some may not respond to treatment at all)
How is FCGS diagnosed?
Clinical appearance and clinical signs may be enough for a diagnosis, but testing for calicivirus, FeLV, and FIV should be done. Also, a chemistry profile and a CBC.
When doing blood work on a cat with FCGS, what levels will you most likely see elevated?
Elevated blood protein (hyperproteinemia), and elevated globulin (hyperglobulinemia)
What may be the earliest sign noted with stomatitis?
Gingival bleeding
Other symptoms include inflamed gingiva, mucosal swelling, cobblestone-textured, bright red, or raspberry like and light touching of the gingiva can result in spontaneous hemorrhage
What procedure can be done to rule other other conditions common with cats?
A skin biopsy can be done to rule out eosinophilic granuloma and squamous cell carncinoma
What diagnosis is difficult to rule out with FCGS?
It is difficult to determine whether it is an allergic reaction to an additive in commercial pet foods
What is the first stage in management of FCGS?
Performing a complete oral health assessment and treatment (COHAT) and intraoral radiographs, any extractions that are needed, and providing medications
What type of drug is mainly used for medical management of FCGS?
Corticosteroids
These work by suppressing the immune system, white cells, and antibody synthesis
What is a positive side effect with corticosterioids?
An increased appetite
What are negative side effects with corticosterioids?
Skin and hair coat changes, muscle wasting, insulin resistance leading to diabetes mellitus, and a decreasing efficacy over time
Long term use of this medication is discouraged
What is stage 2 of the management of FCGS?
All teeth extracted caudal to the canines if client can not perform home care. The canines and incisors can be spared IF:
1. The gingiva and bone are in perfect health
2. Client agrees to brush teeth daily
3. Client knows COHAT will be necessary every 4-12 months
4. Client accepts that canines and incisors may need to be removed in the future
What is stage 3 of the management of FCGS?
If the patient doesn’t respond to treatment, extraction of all the teeth may be necessary. (As an alternative to FME (full mouth extractions) omega interferon, administered as a local injection and daily oral dosing has shown promise, but this is hard to get as it is not approved in the US by the USDA)
What is stage 4 of the management of FCGS?
After FME, if the patient still doesn’t respond, long-term antibiotic and steroid therapy is used to control the patient’s condition.
May also modify diet, provide arithromycin, cyclosporine, bovine lactoferrin, mesenchymal stem cells, and vitamin supplementation
What are some other names for tooth resorption?
Feline odontoclastic resorptive lesion (FORL), neck lesions, cervical line lesions, and cat “cavities”
What is the effect of TR (tooth resorption) on the tooth?
Resorption of the tooth and proliferation of the gingiva or pulp to cover the resulting lesion
What are the signs of TR?
PAIN (may look different with different patients), behavior changes, may be aggressive, hiding behavior, appetite decreases, and animal may drop food or even hiss at it
What is theorized to be the cause of TR?
Many theories have been proposed; an early hypothesis was that they were caused by acids regurgitated with hairballs; the effect on the teeth was compared with that of humans suffering from bulimia
Another theory is that the acids produced by bacteria associated with periodontal disease are responsible
Also, current research indicates that TR may be caused by nutritional problems aggravated by unknown genetic factors
There are conflicting studies regarding correlation between the amount of vitamin D in blood and the incidence of TR in the cat
Which surface of the tooth will lesions most likely occur for humans compared to cats?
In humans, the lesions tend to be on lingual surfaces, whereas in cats they occur on either side
What has been a proven cause of TR in rats?
Excess vitamin D
How is TR diagnosed?
Inflamed gums may initially lead to suspect TR lesions. Some lesions are seen but others may be covered by hyperplastic gingiva
What is necessary to diagnose and treat TR accurately?
Dental radiographs
Why is the AVDC TR staging system controversial?
Because it is not known whether the disease progresses in stages and it may assume that there is one cause for the disease
What is stage 1 TR?
Mild dental hard tissue lost
What is stage 2 TR?
Moderate dental hard tissue lost (Loss does not extend to the pulp cavity)
What is stage 3 TR?
Deep dental hard tissue lost (Loss extends to the pulp cavity) and most of the tooth retains its integrity