Lecture 6 4/15/25

Question 1

Which oral diseases can both cats and dogs get?

Answer 1

-periodontal dz
-endodontic dz
-neoplasia
-autoimmune conditions
-infectious oral dz

Question 2

What are the specific feline dental diseases?

Answer 2

-tooth resorption
-feline gingivitis/stomatitis syndrome

Question 3

What is tooth resorption?

Answer 3

resorption of the hard tissue of the tooth due to odontoclastic activity

Question 4

What is the signalment for tooth resorption?

Answer 4

-affects 25 to 72% of cats
-typically cats over 2 years of age
-prevalence increases with age
-no reported breed or sex predisposition

Question 5

What causes tooth resorption?

Answer 5

-excessive activation of odontoclasts
-cause of odontoclast activation is unknown

Question 6

Where are tooth resorption lesions located?

Answer 6

-at or below the cemento-enamel junction
-typically on the buccal surface
-most commonly on the premolar and molar teeth
-often multiple lesions

Question 7

What are the two classifications for tooth resorption?

Answer 7

-stage
-type

Question 8

What are the characteristics of tooth resorption staging?

Answer 8

-condition is progressive
-stage of tooth resorption is a marker of disease progression
-need to take rads to stage

Question 9

What is stage 1 tooth resorption?

Answer 9

lesion confined to enamel or cementum

Question 10

What is stage 2 tooth resorption?

Answer 10

lesion extends into dentin

Question 11

What is stage 3 tooth resorption?

Answer 11

lesion extends into pulp

Question 12

What is stage 4 tooth resorption?

Answer 12

majority of tooth structure lost:
A: crown and root equally affected
B: crown > root
C: root > crown

Question 13

What is stage 5 tooth resorption?

Answer 13

only remnants of tooth are visible/”ghost tooth”

Question 14

What are the potential treatment options for tooth resorption?

Answer 14

-crown amputation
-surgical extraction

Question 15

What is type 1 tooth resorption?

Answer 15

-focal or multifocal radiolucency
-normal root opacity
-normal PDL

Question 16

What is the only treatment option for type 1 tooth resorption?

Answer 16

surgical extraction of all tooth material

Question 17

What is type 2 tooth resorption?

Answer 17

-radiolucency of part of the tooth (crown and/or root)
-loss of PDL space

Question 18

What are the characteristics of crown amputation treatment for type 2 tooth resorption?

Answer 18

-remove the crown (part causing pain)
-allow resorption of the roots to continue

Question 19

What are the contraindications to crown amputations in type 2 tooth resorption?

Answer 19

-stomatitis
-endodontic dz

Question 20

What is type 3 tooth resorption?

Answer 20

-type 1 and type 2 present in the same tooth
-one root has normal PDL
-the other root has loss of PDL

Question 21

What is the treatment for type 3 tooth resorption?

Answer 21

-surgical extraction of the type 1 root
-crown amputation on the type 2 root

Question 22

What is the recommended follow up for cats with tooth resorption?

Answer 22

COHAT, oral charting, and rads every 9 to 12 months; cats with tooth resorption in one tooth are predisposed to developing more lesions

Question 23

What are the characteristics of stomatitis?

Answer 23

-generalized inflammation of the mucous membranes of the mouth
-characterized by varying degrees of excessive immune response leading to inflammation in the oral cavity of cats

Question 24

What are the clinical signs of FCGS (feline chronic gingivostomatitis)?

Answer 24

-oral discomfort
-preference for soft food
-halitosis
-unkempt coat
-ptyalism
-head shy
-decreased appetite/anorexia

Question 25

What are the possible lesions seen in FCGS?

Answer 25

*range from mild inflammation to severely inflamed, proliferative, and ulcerative lesions of the: -caudal mucosa -alveolar mucosa -soft palate -dorsal tongue -sublingual mucosa -labial mucosa -hard palate

Question 26

What is the signalment for FCGS?

Answer 26

-affects 0.7 to 12% of cats -median age of 6 to 7 years -no sex predilection -more common in siamese, abyssinian, persian, himalayan, and burmese breeds

Question 27

What causes FCGS?

Answer 27

-exaggerated immunologic processes to an antigenic stimulus is suspected -current theories on potential stimuli include infectious dz, dental plaque, and tooth material/PDL

Question 28

Which infectious diseases are thought to be stimuli for FCGS?

Answer 28

-calicivirus -herpesvirus-1 -FELV/FIV -Bartonella henselae

Question 29

What are the characteristics of dental plaque vs tooth material/PDL as a possible stimuli for FCGS?

Answer 29

*dental plaque: -clinical signs improve in some cats with professional cleaning and removal of plaque-retentive surfaces *tooth material/PDL: -clinical signs persist with retained root material

Question 30

What are the differentials when cats present with signs similar to FCGS?

Answer 30

-uremia -chemical exposure -electrical cord injury -eosinophilic granuloma complex -neoplasia -vesiculobullous dz

Question 31

Which diagnostics are done in cats with suspected FCGS?

Answer 31

-CBC: shows chronic inflammation -chem: shows hyperglobulinemia -FeLV/FIV testing -full mouth rads: looking for periodontal dz and tooth resorption -biopsy: histopath. shows lymphocytes, plasmacytes, and PMNs

Question 32

What is the goal of FCGS treatment?

Answer 32

decrease antigenic stimulation and modulate abnormal immune response

Question 33

What are the components of medical treatment for FCGS?

Answer 33

*decrease antigenic stimulation -professional cleaning every 4 to 6 months -home care *immunomodulation/anti-inflammatory -pred. -cyclosporine -doxycycline -NSAIDs *analgesia -buprenorphine -gabapentin -fentanyl patch -NSAIDs

Question 34

What are the surgical options for FCGS treatment?

Answer 34

-full mouth extractions -extractions of all premolars and molars only (caudal to canines) *must remove all tooth material*

Question 35

What are potential treatments for refractory FCGS?

Answer 35

-immune-modulating drugs -laser ablation -essential fatty acids -interferon -stem cells

Question 36

Why is it important to avoid oversized mouth gags in cats?

Answer 36

excessive opening and tension on the maxillary artery can lead to blindness