Just Ask the Expert: Are corticosteroids helpful in cats with gingivostomatitis?
Dr. Carmichael welcomes dentistry questions from veterinarians and veterinary technicians.
Unfortunately, medical treatment options include either drugs with poor chances of success or drugs with serious side effects (e.g. high-dose corticosteroids). One drug that is often effective for a "short-term fix" is methylprednisolone acetate given at a dosage of 20 mg/cat subcutaneously every three weeks as needed. Long-term corticosteroid treatment is not ideal because cats can develop serious side effects, including diabetes and iatrogenic hyperadrenocorticism. Avoiding corticosteroids is especially important when treating cats with diabetes, feline leukemia virus infection, or feline immunodeficiency virus infection.
My experience has been that the best chance for long-term success in cats with gingivostomatitis is to perform the extractions as soon as gingivostomatitis is diagnosed so that corticosteroid treatment can be avoided. Extracting all teeth—or sometimes just the teeth behind the canines—has been shown to be effective in curing feline gingivostomatitis. Studies show that from 60% to 80% of feline gingivostomatitis patients treated with extraction of all (or most) teeth were either clinically cured or significantly improved.1 This procedure is labor-intensive and will not be successful if any root fragments are left behind. These cases are commonly referred to veterinary dental specialists.
Daniel T. Carmichael, DVM, DAVDC
1. Hennet P. Chronic gingivo-stomatitis in cats: long-term follow-up of 30 cases treated by dental extractions. J Vet Dent 1997;14:15-21.