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Oral Ulceration and Chronic Ulcerative Paradental Stomatitis in Cats

One type of oral disease which affects cats is oral ulceration and chronic ulcerative paradental stomatitis (CUPS). It is a disease of the mouth which causes painful ulcers on the gums and mucosal lining of the mouth cavity. The cause of this condition has been determined to be a hypersensitive immune response to bacteria and plaque on the tooth surfaces, and sometimes signs of CUPS will start subsequent to a dental cleaning, when these materials are loosened in the mouth. 

Cats with this condition tend to develop lymphocytic plasmacytic stomatitis (LPS), which is a severe inflammation of the entire mouth. LPS is extremely painful and will interfere with your cat's normal activities. It is indicated by bright red gums (gingiva) and mouth, bleeding gums, and crying out when eating or performing other normal activities with the mouth. While it appears that manipulation and antigenic (substances that stimulate the production of antibodies in the body) stimulation in the oral cavity may trigger stomatitis, it is also believed that such animals would probably have eventually developed the disease anyway. In some cases, the only resolution is to remove all of the teeth, so that the bacteria that is normally found on the surface of the teeth is no longer present in the mouth at all. Somali and Abyssinian breeds appear to be at a higher risk than other cat breeds for developing this disease.

Symptoms and Types

• Bad breat (halitosis)
• Swollen gums (gingivitis)
• Faucitis (inflammation of the cavity at the back of the mouth – the fauces)
• Pharyngitis (inflammation of the back of the mouth, continuous into the larynx – the pharynx)
• Buccitis/buccal mucosal ulceration (tissue of the inner cheeks)
• Thick, ropey saliva (ptyalism)
• Pain
• Loss of appetite (anorexia)
• Mucosal ulceration on the gums that meet the lips – also called "kissing ulcers"
• Plaque on teeth
• Exposed, necrotic bone (alveolar osteitis and idiopathic osteomyelitis)
• Scar formation on the lateral margins of the tongue from prolonged inflammation and ulceration

Causes

Metabolic

• Diabetes mellitus
• Hypoparathyroidism
• Hypothyroidism
• Uremia caused by renal disease

Nutritional

• Protein-calorie malnutrition
• Riboflavin deficiency

Neoplastic

• Squamous cell carcinoma
• Fibrosarcoma
• Malignant melanoma

Immune-mediated

• Pemphigus vulgaris
• Bullous pemphigoid
• Systemic lupus erythematosus
• Discoid lupus erythematosus
• Drug-induced―toxic epidermal necrolysis
• Immune-mediated vasculitis

Infectious

• Retrovirus
• FeLV, FIV infections
• Calicivirus
• Herpes virus
• Periodontal disease

Traumatic

• Foreign body
• Bone or wood fragments in mouth
• Electric cord shock
• Malocclusion

Chemical/Toxic

• Acids
• Thallium

Idiopathic

• Eosinophilic granuloma