Feline Stomatitis: Causes, Treatments, and Prevention Explained by a Veterinarian

Stomatitis in cats is extremely painful and can leave them unable to eat.

Many cat owners likely find it heartbreaking to see their pet want to eat but be unable to do so due to the pain, or hear them yelp in distress when they try to put food in their mouth.

In this article, we will explain cat stomatitis.

What does feline stomatitis look like?

When people think of mouth ulcers (canker sores), they often picture a few white, circular spots inside the mouth. In cats, stomatitis involves inflammation of the mouth and tongue, leading to redness, swelling, and ulcerations.

Periodontal disease refers to inflammation of the gums, whereas stomatitis involves inflammation of the mucous membranes in the mouth. Symptoms include the following:

Drooling

Pain makes it difficult for cats to swallow, causing them to drool. Not only does their face become sticky with saliva, but they also use their front paws to wipe their mouths, causing the saliva to coat their paws as well.

Because stomatitis can cause bleeding, it is also common to see blood-tinged saliva.

Loss of appetite

Just as we experience pain when food touches a canker sore, cats suffer similar pain when eating, which can lead to a loss of appetite. They may even become unable to drink water because it stings. Cats may yelp in pain when attempting to eat. They may also cry simply from the pain of yawning.

Foul breath

Stomatitis can cause severe bad breath. While a cat's breath typically smells like their food, the breath of a cat with stomatitis is often foul, smelling of rot or ammonia. The saliva itself also carries this odor, so the smell may be present anywhere the cat has wiped their mouth.

Neglecting grooming

If the stomatitis affects the tongue, grooming becomes painful. As a result, the cat may be unable to groom properly, leading to a poor coat condition. The cat’s fur can also become matted and sticky from the saliva left behind when they attempt to groom.

What causes cat stomatitis?

The primary cause of stomatitis is considered to be viral infection.

Stomatitis caused by infection

Viral infections, such as Feline Calicivirus, can cause stomatitis. Periodontal bacteria can also trigger it.

Stomatitis caused by immune suppression

When a cat’s immune system is weakened by conditions like Feline Immunodeficiency Virus (FIV), Feline Leukemia Virus (FeLV), diabetes, or kidney failure, microorganisms in the mouth can proliferate, leading to stomatitis.

When oral microorganisms increase, the body's immune system may overreact, further exacerbating the inflammation.

Can cat stomatitis be cured? What are the treatments?

Treatment for stomatitis focuses on pain relief, but options range from surgical procedures to regenerative medicine.

Medication

Stomatitis is mainly treated with antibiotics, anti-inflammatory analgesics, and interferon. In cases where stomatitis is caused by an overactive immune response to oral bacteria, immunosuppressants may be used.

Since this does not address the underlying cause, symptoms often recur.

Dental cleaning

Dental tartar is a collection of bacteria. These bacteria can damage the oral mucosa and cause stomatitis. In mild cases, a professional cleaning can lead to improvement.

However, even if the bacteria in the periodontal pockets are removed, new tartar will inevitably accumulate, making recurrence possible.

Extractions

Cat stomatitis often presents as widespread red swelling throughout the mouth. Since tartar will continue to build up even after professional cleaning, the stomatitis often recurs. Tooth extraction is a common treatment. By removing the teeth and the periodontal pockets where microorganisms thrive, the root cause is eliminated, effectively treating the condition. It is generally considered important to extract all premolars and molars (full-mouth extraction of molars) or even all teeth (full-mouth extraction). However, because the procedure is long, the risks of anesthesia must be taken into account. Additionally, in about 5–10% of cases, symptoms do not improve even after extraction.

Regenerative medicine

Regenerative medicine involves culturing cells from a healthy cat and administering them to the sick cat. It is believed that substances secreted by these healthy cells help reduce inflammation and regulate the immune system.

Regenerative medicine is promising for chronic stomatitis that does not respond to extractions or other treatments, and some veterinary clinics now offer this as a therapeutic option.

How to prevent cat stomatitis

Once a cat develops stomatitis, it is extremely painful and often recurs repeatedly. Therefore, prevention is key.

Prevent infectious diseases

Cat stomatitis is linked to Feline Calicivirus and FeLV. Because vaccines exist for these viruses, ensure your cat is vaccinated. If your cat goes outside, there is a risk of infection from cats carrying these viruses, so keep your cat strictly indoors to prevent contact with infected animals. If you own an infected cat, isolation and other precautions are necessary.

Practice dental care

To prevent stomatitis, the mouth must be kept clean. Dental care, such as brushing, is crucial.

Dental care methods include brushing teeth directly with a toothbrush or sheet, or using dental chews to prevent plaque buildup. There are also products that can be added to drinking water or applied directly to the mouth to improve oral health. While brushing is most effective for dental issues, few cats enjoy it, so find a method that works best for your pet.

Use supplements

Some supplements have immune-modulating properties. Approaches to supplements can vary among veterinarians, so be sure to consult with your regular vet before using them.

Review your cat's food

Stomatitis can be triggered by periodontal disease. Food debris adheres to teeth and eventually turns into tartar. Wet food is generally considered more likely to stick to teeth than dry food.

Summary

Stomatitis is a very common oral problem in cats. In severe cases, they may stop eating entirely, which can become life-threatening. There are various treatment methods available. While tooth extraction has a high probability of curing the condition, the need for long-term anesthesia can make it difficult for senior cats. If your cat develops stomatitis, we recommend discussing your options thoroughly with your veterinarian to choose the right treatment.