Stomatitis in Cats: When Mouth Inflammation Becomes Serious

In this guide

Stomatitis is one of the most painful conditions that can affect a cat's mouth, and it is often confused with ordinary gum disease. Knowing the difference matters, since the two conditions are treated quite differently.

How it differs from gingivitis

Gingivitis is inflammation limited to the gumline, usually caused by a build up of plaque and tartar, and generally responds well to a professional dental clean and better home oral care. Stomatitis is a far more widespread and severe form of inflammation that can affect the gums, inner cheeks, tongue, and the back of the throat. It is thought to arise from an exaggerated immune reaction to the bacteria in dental plaque, rather than being simply a worse case of ordinary gum disease.

Signs of stomatitis

• Severe bad breath
• Heavy drooling, sometimes blood tinged
• Reluctance to eat despite clearly being hungry, or crying out while eating
• Pawing at the face or mouth
• Reduced grooming, leading to a dull or matted coat
• Visible red, ulcerated tissue at the back of the mouth

Diagnosis

A full oral examination, usually under anaesthesia because the mouth is too painful to examine while a cat is awake, is the starting point. Vets often recommend dental X-rays, and sometimes a biopsy of the affected tissue, to rule out other causes of mouth lesions such as cancer or an autoimmune condition, as well as blood tests to check for viral infections like FIV or FeLV, which can contribute to stomatitis in some cats. These viral tests are particularly relevant for cats with a street or community background, where exposure to FIV and FeLV through fighting or mating is more common than in cats that have always lived strictly indoors.

Treatment

Because stomatitis stems from an immune reaction to plaque, and plaque can never be completely eliminated from a cat's mouth, the condition cannot be cured in the traditional sense. The single most effective treatment, sometimes surprising to owners, is the surgical extraction of most or all of the cat's teeth. Without teeth for plaque to accumulate on, the majority of cats see dramatic and lasting relief. Medication such as anti-inflammatories, pain relief and sometimes immune modulating drugs support recovery and manage cases where extraction alone is not fully effective. It sounds drastic, but cats adapt remarkably well to eating without teeth, and most owners report a much happier, more comfortable cat afterwards. Full mouth extractions are a specialised procedure, so your regular vet may refer you to a veterinary dentist or a larger animal hospital in your city if this level of care is not offered in house.

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