Feline Chronic Gingivostomatitis (FCGS) is a severe, often debilitating, immune-mediated, oral mucosal inflammatory disease of cats.

FCGS is a frustrating disease to manage owing to its elusive etiopathogenesis. While the etiology, likely multi-factorial, is still unknown response to treatment has improved over the years, even though further research is still needed and on-going to improve the outcome for cats diagnosed with this life-altering disease.

While reviewing treatment options and expected outcomes is very important, we MUST ensure we are getting the CORRECT diagnosis first

Here are some simple tips to help you be certain about your diagnosis.

1. It is much more rare than other inflammatory oral conditions:

   • FCGS has been reported at a prevalence of 0.7 – 12% of cats^1,2,3
   • Feline Tooth Resorption reported at a prevalence of ~26-72% of cats^3,4
   • Periodontal disease reported at a prevalence of 70% of cats⁶
     
     
     

2. It is most commonly seen in middle-aged cats, ages 5-10 years, with the average age at time of diagnosis being 7 years old⁵:

   • IF the patient you are looking at is UNDER 2 years, it is VERY unlikely it is truly FCGS.
   • Aggressive Periodontitis, commonly mistaken for FCGS, is seen in cats as young as 9 months up to 2.5 years (and possibly beyond). The treatment recommendations of these two conditions as well as expected outcomes are VERY different.
     
     
     

3. The diagnosis is based on ANATOMY, not severity:

   • THIS is the biggest TIP I can give to be certain of your diagnosis. STOMATITIS is inflammation of all oral soft tissues: the gingiva AND mucosa. Therefore, inflammation MUST extend beyond the mucogingival margin (see photo below). While the level of inflammation (+/- proliferation) CAN be similar in these two conditions, it is the location of that inflammation that differentiates them.

References:

1. Healey K.A., Dawson S., Burrow R. Prevalence of feline chronic gingivo-stomatitis in first opinion veterinary practice. J Feline Med Surg. 2007;9(5):373–381

2. Winer J.N., Arzi B., Verstraete F.J.M. Therapeutic management of feline chronic gingivostomatitis: a systematic review of the literature. Front Vet Sci. 2016;3:54

3. Girard N., Servet E., Biourge V. Periodontal health status in a colony of 109 cats. J Vet Dent. 2009;26(3):147–155.

4. Mestrinho LA, Runhau J, Bragança M, Niza MM. Risk assessment of feline tooth resorption: A Portuguese clinical case control study. J Vet Dent 2013; 30(2):78-83.

5. Oropharyngeal inflammation. In: Bellows J. Feline Dentistry. 2nd ed. Wiley-Blackwell; 2022:253-324.

6. Wiggs RB, Lobprise HB. Periodontology. Veterinary Dentistry, Principals and Practice. Philadelphia: Lippincott – Raven, 1997, pp 186-231.

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About the Guide: Amy Thomson, DVM, DAVDC

Dr. Amy Thomson is a dentist and oral surgeon, and completed her residency at University of Wisconsin-Madison. Prior to pursing residency, Amy started her career as a general practitioner. She finds that unique experience helps her provide guidance and knowledge that is helpful and applicable for general practitioners that want to provide the best oral care!