Abstract
Feline chronic gingivostomatitis (FCGS) is a disease characterized by protracted and potentially debilitating oral inflammation in cats, the etiology of which is currently unknown. The purpose of this review is to apply an evidence-based medicine approach to systematically review and critically evaluate the scientific literature reporting the outcome of medical and surgical management of FCGS. Those articles meeting inclusion criteria were reviewed and assigned an “Experimental Design Grade” (EDG) and an “Evidence Grade” (EG) in order to score relative strength of study design and produced data. Studies were evaluated and compared, especially highlighting the treatments, the outcomes, and the therapeutic success rates. This review found a lack of consistency between articles’ data, rendering direct comparison of results unreliable. The field of FCGS research, and ultimately patient care, would benefit from standardizing studies by adopting use of a consistent semi-quantitative scoring system and extending follow-up duration. Future researchers should commit to large prospective studies that compare existing treatments and demonstrate the promise of new treatments.
Highlights
Feline chronic gingivostomatitis (FCGS) is a painful, often debilitating, condition in cats characterized by protracted oral inflammation typically lasting months to years
A flowchart (Figure 1) modified from the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) (35) guidelines is provided to outline the process by which the search results were narrowed to the 16 articles included in this systematic review
There were 10 forms of medical management evaluated in these studies: Zincreo germicidal astringent obtundent (43), local paramunization with PIND-ORF (38), thalidomide (44), lactoferrin (37, 44), cyclosporine (12, 40), recombinant feline interferon omega (28, 42, 46), prednisolone (28), diet (36), piroxicam (37), and autologous mesenchymal stem cells (10)
Summary
Feline chronic gingivostomatitis (FCGS) is a painful, often debilitating, condition in cats characterized by protracted oral inflammation typically lasting months to years. It is differentiated from gingivitis when the inflammation crosses the mucogingival junction and extends to the buccal and caudal oral mucosa; classically, there are erosive and/or proliferative inflammatory mucosal lesions lateral to the palatoglossal folds (1, 2). Histology is useful to confirm the diagnosis, and is necessary for academic and research purposes. Affected cats may suffer from moderate to severe oral pain, halitosis, ptyalism, decreased grooming, hyporexia, weight loss, irritability, Literature Review of Gingivostomatitis Treatment withdrawn behavior, and/or decreased activity (11, 12). Quality of life can be so severely affected that owners elect for humane euthanasia (3, 10, 13)
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