FCGS prevention

RE: FCGS prevention

Rachel Perry — Tue, 07 Jul 2020 18:17:58 GMT

Yes, I can't give you a statistic but that is certainly my experience. I certainly talk about the current Jenning's stats, but warn the client an FIV+ cat is more likely to fall into the non-responding 33%

RE: FCGS prevention

Kate Richardson — Mon, 06 Jul 2020 13:18:08 GMT

Just to clarify Rachel Perry if they are FIV positive are they less likely to respond to full mouth extractions?

RE: FCGS prevention

Rachel Perry — Sat, 04 Jul 2020 16:22:58 GMT

Hi Kate,

Definitely see a lot of young cats referred for FCGS which have no caudal or buccal stomatitis, and also are really happy, playful and eating well. We all know that cats with FCGS are miserable- find chewing and swallowing sore, don't groom, lose weight etc. Often these young cats are calicivirus carriers so I think it can confuse many vets- they see this and inflammation in the mouth and assume it's FCGS and start talking about interferon etc. I often find these cats which test positive are from multi-cat households, so no surprises they're calici virus carriers.

For genuine FCGS cases I agree testing for Calicivirus is pretty pointless as we know 98% + will be carriers. I think ruling out FIV though is important as that will certainly affect the prognosis.

And to answer your primary question, there's no evidence that juvenile gingivitis cases will go onto become FCGS cases. They will often become juvenile periodontitis cases though if there is no intervention.

RE: FCGS prevention

Kate Richardson — Sat, 04 Jul 2020 15:57:53 GMT

Thankyou. Appropriate information sent to client, hopefully will be digested. I see a lot of second opinion dental cases (because I do cats and enjoy it) and find a wide variety in what vets diagnose as FCGS with more not actually being FCGS than are! Many have no inflammation of the palatine folds at all, just severe gingivitis and appropriate dental treatment resolves it. And lots of focus on calicivirus as the cause. Rightly or wrongly I don’t often test for FCV and just assume may be present- what are your opinions on testing? My thinking being it’s not going to change what I do so why spend that money. Similar would love your thoughts on testing for other viruses

RE: FCGS prevention

Norman Johnston — Fri, 03 Jul 2020 10:58:01 GMT

I would agree with this thread. What we know is that it’s not as simple as the cat having FCGS or not. There appears to a sliding scale of intolerance to antigen. Some cats will be highly intolerant and others mildly so. Improved dental hygiene may be enough, especially in the juvenile when the immune system is developing. The purpose of extraction is to remove surfaces on which antigen settles - teeth. Reduction of this burden is often enough for most cats.

So - most cats will have gingivitis or varying levels but this does not make them FCGS cases.

RE: FCGS prevention

Kate Richardson — Fri, 03 Jul 2020 09:02:26 GMT

Rob Davis Evelyn Barbour-Hill

Thank you so much, that's just what I needed to hear and what I thought already, but needed it confirmed- client is a vet nurse and seems to be fixated on extractions, so I just wanted a bit more info to persuade (if necessary) that extractions weren't needed! I will see what I find when I have the cat in!

RE: FCGS prevention

Evelyn Barbour-Hill — Thu, 02 Jul 2020 21:22:09 GMT

I'd class this as juvenile gingivitis from your description.

There's no particular reason to suspect it will develop into feline chronic gingivostomatitis, that I know of. (But, you will be shocked to learn, I don't know everything)

Of course, if you extract all the teeth now the cat will never suffer any periodontal disease in the future.....

Joking apart, there is no reason at all to consider total extraction at this stage. Your client should be concentrating on oral hygiene.There's no reason to fear that would make it refractory to treatment for FCGS, if FCGS should develop.

Of course, if genuine FCGS does develop in the future, the sooner it is properly addressed with extraction of all cheek teeth, the better the prognosis.

RE: FCGS prevention

Rob Davis — Thu, 02 Jul 2020 18:52:52 GMT

[quote userid="6386" url="~/001/veterinary-clinical/small-animal/dentistry/f/expert-help/29189/fcgs-prevention"]Is there any evidence that extractions in a young cat with moderate gingivitis will prevent it progressing to FCGS?[/quote]

The problem with FCGS is that we don't really understand what causes it. There does seem to be an association with calici virus, but most cats with calici do not develop FCGS. It does appear that affected cats are hypersensitive to plaque, so I guess extracting all its teeth is likely to reduce the risk of FCGS, but what is the risk of this cat developing FCGS in the future?

FCGS more commonly affects older cats (median age approx 7 years from memory). If the inflammation in this cat is currently confined to the gingiva then it is likely to be juvenile gingivitis which often resolves by around 2 years of age if oral hygiene can be maintained in the meantime.

[quote userid="6386" url="~/001/veterinary-clinical/small-animal/dentistry/f/expert-help/29189/fcgs-prevention"] Or that by not extracting at this stage but starting oral hygiene post sub gingival cleaning (assuming there is no other reason to extract) will make it more refractive to treatment for FCGS in the future? [/quote]

I can't think of any reason why this would be the case.

If this cat's current oral health problem is confined to the gingiva, then I would not be considering radical extractions at this stage. Oral hygiene measures as far as can be managed and regular rechecks. If the inflammation starts to affect other areas of oral mucosa (especially the palatoglossal folds) and did not improve with oral hygiene measures then I may reconsider, but I would resist for now.