Feline Chronic Gingivostomatitis (FCGS)

Feline chronic gingivitis stomatitis (FCGS), is a term describing an ongoing inflammation in a cat's mouth. It manifests as a combination of chronic stomatitis and gingivitis. In this context, stomatitis refers to inflammation not only in the gums and surrounding tissues but also extends into the deeper layers of the mouth, reaching deep submucosal tissues. The prevalence of FCGS among cats attending veterinary practices ranges from 0.7% to 12%, showing some geographical variations. 

Clinical manifestations of FCGS encompass signs such as reluctance to open the mouth, difficulty in eating, loss of appetite, halitosis, weight loss, drooling, teeth grinding, pawing at the face, reduced grooming, and a deteriorating hair coat.

The exact etiology of FCGS remains elusive, but it is believed to stem from a dysregulated immune system influenced by factors like genetics, environmental stress, diet, viral infections (e.g., feline calicivirus and feline leukemia virus), and bacterial infections (e.g., Pasteurella multocida). While the precise mechanism is not fully understood, it is widely accepted that dental plaque, characterized by oral bacteria adhering to the teeth, plays a role in triggering and exacerbating the inflammation. Cats with FCGS often present with moderate to severe periodontal disease and tooth resorption.

Addressing FCGS is a complex challenge, as there is no straightforward medication for effective treatment, and cats may resist rigorous oral hygiene due to pain. Consequently, full-mouth or nearly full-mouth tooth extractions are often deemed necessary, with associated remission rates ranging from 70% to 80%. Even among those without surgically curative outcomes, most show significant improvement but require medication for a better clinical result. Anecdotally, delayed surgical intervention of FCGS can be a complicating factor in cases of incomplete remission.

Optimal surgical technique is crucial for favorable outcomes in FCGS cases, necessitating the complete removal of every tooth and tooth fragment from the mouth. The surgery can typically be performed in one session if the pet tolerates anesthesia well. However, concerns about anesthesia may lead to the procedure being split into two visits to minimize stress on the pet's overall health.

An essential point to convey is that post-operative recovery for FCGS cases is often more intensive and/or prolonged compared to routine oral surgery. The resolution of inflammation may take 1-3 months postoperatively, though improvements in comfort are often noticeable sooner.