Stomatitis

Question 1

Explain what kind of host response to periodontal plaque is considered aberrant and may be an explanation for FCGS

Answer 1

Cats with idiopathic stomatitis have a tendency to develop an antibody-dominant immune response in the oral cavity, compared with healthy cats where a more balanced or cell-mediated immune response predominates

Question 2

What was revealed by the study of the polyclonal gammopathy

Answer 2

Examination of the polyclonal gammopathy in many cats with stomatitis has revealed that this is due, at least in part, to elevated antibody concentrations against oral anaerobic bacteria
- this finding emphasizes the importance of the oral bacterial flora in provoking inflammation

Question 3

What is the supposed pathomechanism for chronic stomatitis-gingivitis

Answer 3

A persistent source of antigenic stimulation and host “hyper-reactivity” to that stimulus demonstrated by the non-specific plasmacytic-lymphocytic infiltration and the hypergammaglobulinemia
- a local immune response geared towards antibody production at the detriment of cell-mediated mechanisms appears to be one potential component

Question 4

Which cases of CGS will have the most beneficial outcomes with tooth extraction

Answer 4

Cases where chronic gingivostomatitis exists concurrently with moderate to marked periodontal disease are most likely to benefit from total tooth extraction

Question 5

What are the two clinical presentations for FCGS

Answer 5

There appear to be two clinical phenotypes of FCGS: ulcerative and proliferative
- some patients will display both

Question 6

What is the hallmark for FCGS

Answer 6

The hallmark is inflammation that not only affects the gingiva but also extends to the alveolar and buccal mucosa

Question 7

What immunologic finding confirms the implication of an intracellular organism in the pathogeny of FCGS

Answer 7

Memory CD8+ T cells are the principal component of immunity against intracellular pathogens such as viruses
- this means there is an unresolved inflammation in which CD8+ T cells are activated more than once and remain activated

The predominance of CD8+ T cells in lesions and increased circulatory effector memory cells in FCGS confirm that an intracellular organism (most likely a virus) causes inflammation

Question 8

What are the clinical management goals for FCGS

Answer 8

The clinical management goals for FCGS are:
- to decrease or eliminate antigenic stimulation
- to modulate the abnormal immune response