Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Kate Richardson — Wed, 06 Feb 2019 20:54:02 GMT

Aine Seavers think it was a class IV,

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Aine Seavers — Wed, 06 Feb 2019 07:26:55 GMT

Hi Kate-which class of K laser and what output if it was a K4? tx Aine

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Kate Richardson — Thu, 31 Jan 2019 10:24:33 GMT

Aine Seavers K laser

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Aine Seavers — Wed, 30 Jan 2019 23:14:25 GMT

Hi Kate-which class of laser did you use and what max output does it have? Am looking at whole laser option at the moment so any personal feedback appreciated,

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Evelyn Barbour-Hill — Sun, 27 Jan 2019 19:04:56 GMT

[quote user="Bob Partridge"]Lactoferrins are presently my go-to treatments[/quote]

Dosed orally? Or mixed with food?

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Bob Partridge — Sun, 27 Jan 2019 17:35:48 GMT

Rachel is absolutely right - this is a great article.

Touching on other previous posts. I tend to think of the juvenile form as a subset of the FCGS. Often effective plaque control, established early and maintained, can be "curative" in these young cats.

I certainly wouldn't be looking at "Blue Juice" at this stage. Yes, I'd scale & polish - if you use plaque disclosing solution you will always see significant amounts especially subgingivally. I will often perform gingivectomies to restore a "normal" pocket depth - usually just using cold steel & pressure to stop capillary ooze. I will use SANOS for these cases. I will also use dental diets (VOHC.org will show you which are proven effective). Post treatment these kittens will often eat dry food 1-2 days post op & will do better long term than on wet IMHO. Healthy Mouth drinking water additive is also proven to reduce plaque levels.

Generally Interferon etc is reserved for older patients, post dental clearances. When it is used it is NOT used for any anti-viral effect, it is the immunomodulation effect that is present in the oral dosing of dilute. Technically Atopica should be used before this option (under the cascade) & I have found similar levels of response between the two. Lactoferrins are presently my go-to treatments & I have been pleased with the results on previously non-responding cases.

One thing that the paper highlights is the lack of good research on this (and many other) dental topics. It is damming of our universities that there is so little interest in paying for full time academics in dentistry that could carry out this work on these common problems ... whereas the weird and wonderful rare neuro disease.... But that is another rant for another time.

All best

Bob

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Rachel Perry — Sat, 26 Jan 2019 12:34:28 GMT

Have a read of this open access systematic review for current therapy in FCGS.

https://www.frontiersin.org/articles/10.3389/fvets.2016.00054/full

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Rob Davis — Fri, 25 Jan 2019 19:37:04 GMT

[quote user="bevs2251"]

Has anyone tried laser therapy for this condition (REM multi-radiance laser device) ? I believe it can be quite effective, for both faucitis and chronic gingivitis.

[/quote]

I'm not aware of any studies to support this and I remain sceptical about the many benefits claimed from these lasers (I admit to being put off by some of the rather enthusiastic marketing which has come my way after speaking to them once at BSAVA congress).

There are some people using surgical CO2 lasers to ablate the proliferative tissue in feline chronic gingivostomatitis cases, though even this is not used as a mono therapy, but usually after total extractions.

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Kate Richardson — Thu, 24 Jan 2019 10:45:44 GMT

[quote user="SER"]

On another note: has anyone used dentisept or Stomodine? The dentisept has a very perculiar texture as it adheres to teeth...the nurses tried it!

I can't imagine animals find it pleasant?..but if it works....

[/quote]

Started using Stomodine over last 6 months, have found it helps in some cases as part of the management in periodontal disease, finding cats take it really well so far which is a plus, but again limited numbers so far, but will keep you posted.

I haven't used Dentisept so can't comment on that.

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Kate Richardson — Thu, 24 Jan 2019 10:43:13 GMT

[quote user="bevs2251"]

Has anyone tried laser therapy for this condition (REM multi-radiance laser device) ? I believe it can be quite effective, for both faucitis and chronic gingivitis.

[/quote]

Yes because I got sucked in by the hype, and no, didn't find it effective, but limited number of cases

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Sara Ramsey — Thu, 24 Jan 2019 01:07:31 GMT

Some of my colleagues have used K laser on these cases. One client thought it helped, one didn't. It is offered as part of the dental exam/treatment when animals under GA.

I am not "committed" to it and find it hard to talk about with clients because I am not 100% on board.

On another note: has anyone used dentisept or Stomodine? The dentisept has a very perculiar texture as it adheres to teeth...the nurses tried it!

I can't imagine animals find it pleasant?..but if it works....

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

bevs2251 — Thu, 24 Jan 2019 00:37:48 GMT

Has anyone tried laser therapy for this condition (REM multi-radiance laser device) ? I believe it can be quite effective, for both faucitis and chronic gingivitis.

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Evelyn Barbour-Hill — Wed, 05 Dec 2018 17:51:53 GMT

With a syringe.

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Sarah Keir — Wed, 05 Dec 2018 16:33:11 GMT

How do you mouth wash a cat? Or even a dog for that matter?

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Rob Davis — Mon, 03 Dec 2018 19:38:32 GMT

[quote user="Evelyn Barbour-Hill"]Xylitol has proven efficacy (as a mouthwash of course, I hope you didn't think I meant putting it in the drinking water)[/quote]

Fair enough, though I've never thought of using aquadent as a mouthwash.

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Rob Davis — Mon, 03 Dec 2018 17:40:13 GMT

[quote user="Evelyn Barbour-Hill"]Xylitol has proven efficacy (as a mouthwash of course, I hope you didn't think I meant putting it in the drinking water)[/quote]

Fair enough, though I've never thought of using aquadent as a mouthwash.

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Rob Davis — Mon, 03 Dec 2018 17:19:05 GMT

[quote user="Martin Atkinson"][quote user="Rob Davis"]I have tried interferon in a few of these, but am yet to be convinced that it is useful...[/quote]You have to continue indefinitely so you have to have the client on-board. Be sure you are following the correct protocol and that the client is syringing it straight into the mouth not onto the food! [/quote]

If used, I have always followed the protocol suggested by Virbac and continued for 100 days (one vial diluted down). I haven't continued beyond this as it seems difficult to spend a further large amount on another vial when after 100 days of syringing into a sore mouth there is no apparent improvement!

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Martin Atkinson — Mon, 03 Dec 2018 17:05:33 GMT

[quote user="Evelyn Barbour-Hill"]it won't cure the problem[/quote]No it won't, any more than you can cure a cat with recurrent FHV flu symptoms because the cat is in a FCV carrier state but it will ameliorate the worst of the problems.

[quote user="Rob Davis"]I have tried interferon in a few of these, but am yet to be convinced that it is useful...[/quote]You have to continue indefinitely so you have to have the client on-board. Be sure you are following the correct protocol and that the client is syringing it straight into the mouth not onto the food!

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Evelyn Barbour-Hill — Mon, 03 Dec 2018 14:56:34 GMT

[quote user="Rob Davis"]

[quote user="Evelyn Barbour-Hill"]It shouldn't need scale and polish, surely, at this age? Is there any calculus to scale off?[/quote]

Surely plaque control is essential here,

[/quote]

Sure, and you can use your scaler to remove plaque if you want. I don't call that scaling and it certainly ain't scale and polish. The plaque will be back, of course.

[quote user="Rob Davis"]Aquadent….. really....?! What about chlorhexidine if you want to use something which actually has some evidence of efficacy against plaque.[/quote]

Xylitol has proven efficacy (as a mouthwash of course, I hope you didn't think I meant putting it in the drinking water), so does zinc ascorbate, so does pomegranate juice. So does chlorhexidine of course, though the cat may object.

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Rob Davis — Mon, 03 Dec 2018 11:45:34 GMT

[quote user="Evelyn Barbour-Hill"]It shouldn't need scale and polish, surely, at this age? Is there any calculus to scale off?[/quote]

Surely plaque control is essential here, and even if there is no calculus there will certainly be plaque.

I have tried interferon in a few of these, but am yet to be convinced that it is useful...

[quote user="Evelyn Barbour-Hill"]Use mouth rinses afterwards: zinc ascorbate, or Aquadent, or pomegranate juice[/quote]

Aquadent….. really....?! What about chlorhexidine if you want to use something which actually has some evidence of efficacy against plaque.

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Evelyn Barbour-Hill — Fri, 30 Nov 2018 20:57:26 GMT

[quote user="Martin Atkinson"] why not antibiotics?[/quote]

Why? (A question every one of us should ask ourselves every time we prescribe an antibiotc).

An antibiotic won't reduce the scale of bacterial challenge in the gingival crevice, or if it does the bacterial population will return to its previous state in a day or two as soon as the antibiotic ceases to be given.

In short. an antibiotic is unnecessary, and in addition it is pointless. What your treatment will do is ensure that the bacterial population in the mouth is resistant to that antibiotic for a while.

[quote user="Martin Atkinson"]Interferon[/quote][quote user="Martin Atkinson"]it won't cure the problem[/quote]

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Roland Bulkyn-Rackowe — Fri, 30 Nov 2018 16:12:56 GMT

I would definitely radiograph. I have seen cats at this age with significant periodontal disease, exposed furcations and multiple type I resorptive lesions. One particular cat had every cheek tooth affected and resolution of the problems after extraction. That said in that cat the palatoglossal folds did not appear so severely affected.

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Martin Atkinson — Fri, 30 Nov 2018 14:06:30 GMT

[quote user="Evelyn Barbour-Hill"]

"Bone collapse"?

It shouldn't need scale and polish, surely, at this age? Is there any calculus to scale off? And polishing would do nothing very much of any value but would hurt the inflamed gums.

Survey radiography is always useful.

Some people have faith in interferon. Given the quite likely involvement of calicivirus in the pathogenesis in this cat, it would do no harm to try that.

Please, no antibiotics!

[/quote]OK perhaps not a scale or polish but why not antibiotics? FGS (missed off the initial C as it clearly not yet chronic) is a melting pot of multipathogenesis: immune mediated action to the FCV, secondary bacterial infection, inflammation and poor dental hygiene. Control the controllables. Interferon may also have an immune mediated action as well as antiviral but it won't cure the problem and it is quite expensive as it is often required long term.

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

Evelyn Barbour-Hill — Fri, 30 Nov 2018 12:01:10 GMT

"Bone collapse"?

It shouldn't need scale and polish, surely, at this age? Is there any calculus to scale off? And polishing would do nothing very much of any value but would hurt the inflamed gums.

Survey radiography is always useful.

Some people have faith in interferon. Given the quite likely involvement of calicivirus in the pathogenesis in this cat, it would do no harm to try that.

Please, no antibiotics!

RE: Any New Treatments for Plasmacytic/Lymphocytic Stomatitis ?

George Cooper — Fri, 30 Nov 2018 10:23:44 GMT

would not the humane solution be to administer an appropriate dose of blue juice? Otherwise a sentence for life to being messed about "trying" and enduring lifelong suffering?