Esophagitis in Cats with Stomatitis

In the Literature

Kouki MI, Papadimitriou SA, Psalla D, Kolokotronis A, Rallis TS. Chronic gingivostomatitis with esophagitis in cats. J Vet Intern Med. 2017;31(6):1673-1679.

The Research …

Feline chronic gingivostomatitis (FCG) can be frustrating to owners who want to know why their cat is affected and clinicians wondering why some patients respond to treatment whereas others do not. Interest levels are raised when new studies describe possible comorbidities that might play a role in this disease; however, it is important to remember to interpret these reports critically.

In this study, physical, oral, and endoscopic examinations were performed on 58 cats with clinical signs of stomatitis and 12 healthy control cats. A significant majority (57/58) of cats with stomatitis had concurrent esophagitis. It was concluded that cats with FCG should undergo endoscopy and, if inflammation is noted, be treated for esophagitis because it may aggravate the FCG. However, none of the cats with FCG showed signs specific to esophageal disease, and endoscopic examination to evaluate whether esophagitis responded after treatment was performed in only 3 of the 57 cats. 

In addition, the study authors stated that current FCG treatment options are unrewarding due to the multifactorial nature of the disease, suggesting that there are few effective treatment options for FCG. However, 2 studies that have investigated prognosis with surgical extractions—the recognized standard of care¹—have found that approximately 70% to 80% of cats will respond to full or partial mouth extractions, whereas only 5% to 6% of cats are refractory to treatment.^2,3

The finding that cats with FCG may have concurrent esophagitis is interesting. However, there does not appear to be enough evidence of a relationship to warrant focusing on esophagitis.

… The Takeaways

Key pearls to put into practice:

• Extraction of all teeth/tooth roots in areas of inflammation should be performed in all cats with FCG as a first-line definitive treatment.

• Cats with FCG have severe oral inflammation and often show signs of oral pain. Medicating these patients can be challenging, and the decision to prescribe additional oral medications should be carefully considered.

• Referral to a veterinary dental specialist is recommended for refractory cases.