Feline oral diseases Flashcards
(25 cards)
What is periodontal disease (Possibly most chronic disease of cats)
Collective term - variety of plaque induced inflammatory conditions of the peridontium.
Particularly seen in pure breed cats
What are the two main forms of periodontal disease?
Gingivitis - reversible inflammation of gingiva, without migration of the gingiva/ periodontal ligament or bone
Periodontitis inflammation and irreversible destruction of structures supporting the teeth (gingiva, periodontal ligament, cementum, bone).
How do you control gingivitis?
Mostly caused by plaque bacteria in gingival sulcus therefore:
Regular dental home care - brushing (best), diets, chlorhexidine/ other antiseptics
May sometime require scaling
Outline how chlorhexidine works
Broadspec antibacterial properties
Adsorbed onto hard and soft tissues in the oral cavity
Flushing solution/ gel/ toothpaste
What bacteria are present with oral disease?
N.B the actual changes that occur in the mouth is due to the body’s own immune reaction!
Gingivitis - gram positive aerobic
Periodontitis - gram negative anaerobic
What are the important secondary predisposing factors to periodontal disease?
Tooth overcrowding (e.g brachycephalics) FIV/ FeLV Diet FORLs/ fractured teeth Systemic disease
What does early/ later periodontitis look like radiographically?
Treatement - scaling and polishing early teeth, extraction of advanced disease teeth
Early - subtle loss of bone height at alveolar crest
Later on there is more prominent bone loss
What is feline chronic gingivostomatitis? (FCGS)
Intense inflammation of the gingival and non gingival oral mucosa.
2 areas affected - faucitis and Buccal mucosa overlhing the premolar/ molar arches (bucal stomatitis)
What is the aetiology of FCGS?
Up for debate, suggested are:
Plaque bacteria (effective control limits signs)
Calicivirus isolated in up to 100% of cases (cf 25% normal population)
Abnormal immune responses - associated with FIV - most common sign of FIV
How do you diagnose FCGS?
Lack of response to professional periodontal therapy, tooth extraction and at home treatment
Biopsy rarely necessary - only needed if assymmetry or unusual lesions
What does FCGS look like histologically?
Infiltration of plasma cells, lymphocytes, macrophages and neutrophils
(Non specific chronic inflammatory response)
How do you treat FCGS?
Complete dental with extraction of any non viable teeth
Follow up of strict oral care
If this doesn’t work - removal of all molars/ premolars, also the front teeth if inflammation extends to them
Multimodal medical treatment of NSAIDs, oral antispetics, intermittens ABs can be successful but not as much as dental work
Very limited evidence for interferon but is used by some
How effective is tooth extraction in treating FCGS?
One study - Complete resolution in 60% of cats Almost complete 20% Partial improvement needing continued medical management - 13% No improvement 7%
What is Feline Chronic Alveolar Osteitis?
Canine tooth super eruption
Large bulging alveolar bone around a canine - osteitis
Treatment involves non tooth supporting bone shaping and removal of tooth supporting bone to eliminate bony pockets and achieve physiological shape
What is a FORL?
Feline odontoclastic resorptive lesion
More common in older/ purebred cats
What is the aetiology of FORLs?
Unclear
Possibly involved vitamin D and calcium metabolism
May share cause with super eruptions
What does a FORL appear as radiographically?
Loss of tooth substance
Irregularity of adjacent alveolar bone
Changes in dental radiodensity
How do you treat FORLs?
Extraction
Alendronate can arrest or slow progression
Can do crown amputaiton where there is no periodontal disease and root resorption
How does TMJ dislocation present?
Dropped jaw
What are the most common oral neoplasias?
- Squamous cell carcinoma
- Fibrosarcoma
Others - melanoma, osteosarcoma, odontogenic cysts/ tumours are rare
How can you treat oral SCCs?
Excision with wide margin (therefore rostral tumours have better prognosis
Can use radiotherapy but the benefits are unclear
What is the aetiology of nasopharygeal polyps?
Due to chronic inflammation
Originate in the tympanic bulla or eustachian tube
Grow towards pharynx
Seen more in younger cats
How do you treat nasopharyngeal polyps?
Traction and ligation, recurrence common
Bulla osteotomy may provide a better solution when polyp originates from the tympanic bulla.
What are the three forms of eosinophilic granuloma complex? (Associated with allergies)
Rodent ulcers of upper lip or hard palate
Eosinophilic plaques on lower abdomen, groin, neck, toes
Linear granulomas - in the oral cavity and pharynx as raised linear yellowish plaques
