Abstract
Feline Chronic Gingivostomatitis Syndrome (FCGS) is a common disease in clinical practice. Among the therapeutic options available, long-acting corticosteroids are frequently used due to their anti-inflammatory and immunosuppressive properties. Although they may improve the clinical symptoms, they can lead to a progressive form of the disease that becomes refractory to treatment. Furthermore, their direct relationship with type II diabetes mellitus (DM) is well known. Consequently, these drugs are controversial and not recommended for routine management of FCGS. Recombinant feline interferon-omega (rFeIFN-ω) is an immunomodulatory compound. Recently, its daily oral administration has been shown to be successful in treating refractory cases of FCGS. This case study describes two clinical cases of type II DM complicated by FCGS. Both animals were calicivirus positive and they had been previously treated with long-acting corticosteroids, which may have been the major cause of DM. The two cats were treated with glargine insulin (Lantus, starting dose 1 IU/cat twice daily (BID)), achieving remission 10 and 18 weeks later respectively. Considering the difficulty with control of FCGS in these animals, an oral daily dose of rFeIFN-ω was started as an alternative to long-acting corticosteroids. In both cats oral clinical signs gradually improved and 60 days after the start of therapy the owners reported a significant relief of pain during mastication. According to the authors’ knowledge, this is the first case report that describes the successful use of rFeIFN-ω in the management of FCGS in type II diabetic cats, in which long-acting corticosteroids are contraindicated.
Highlights
Feline chronic gingivostomatitis syndrome (FCGS) is a multifactorial disease, very commonly seen in clinical practice [1]
Due to the doubtful efficacy of Nonsteroidal anti-inflammatory drugs (NSAID) over the medium term, long-acting corticosteroids are more frequently used in first-opinion clinical practice [2,3,9]
Being a potential cause of type II diabetes mellitus (DM) in cats, long-acting corticosteroid use is controversial in this species in general
Summary
Feline chronic gingivostomatitis syndrome (FCGS) is a multifactorial disease, very commonly seen in clinical practice [1]. The doubtful efficacy of NSAIDs over the medium term, long-acting corticosteroids are more frequently used in first-opinion clinical practice [2,3,9] They are historically described as a good therapeutic approach to FCGS due to the fact that they reduce oral inflammation and control immune-mediated causes, leading to a rapid improvement, an increased appetite and a relief of oral pain [2,3,9]. Case one A 15 year-old castrated domestic short-hair (DSH) cat was presented to the endocrinology service of the Veterinary Teaching Hospital – Faculty of Veterinary Medicine, Techinical University of Lisbon (FMV-UTL) for polyuria/ polydipsia (Pu/Pd), mild anorexia and weight loss Prior to this consultation, the animal had been managed by the referring vet for severe dysphagia and weight loss, secondary to FCGS, diagnosed one year before. Five months after the beginning of therapy, the cat presented with a good clinical condition with less pain on opening the mouth and a concurrent clinical improvement of the FCGS with less extensive lesions, a reduced hypersalivation and a more comfortable mastication
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