by Dr. Seth Oberschlake
Feline chronic gingivostomatitis (FCGS) is a debilitating and painful condition that leads to severe inflammation of a cat’s oral cavity. It can affect the tissues around the teeth, the back of the mouth and throat, and even the tongue and esophagus. Many cats with this condition develop bright red, ulcerated gums that bleed easily and make eating painful or even unbearable.
The exact cause of feline stomatitis is not completely understood and is thought to be multifactorial. It is believed to result from an overactive immune response in which the cat’s immune system begins attacking its own oral tissues. This reaction is often triggered by dental plaque bacteria, and certain viral infections — such as feline calicivirus or feline immunodeficiency virus (FIV) — may also play a role in predisposing cats to this disease.
Cats are remarkably good at hiding pain, so the signs of stomatitis can sometimes be subtle at first. Common symptoms include drooling (sometimes with blood), bad breath, difficulty eating or dropping food, pawing at the mouth, weight loss, and a decrease in grooming. Some cats may also become irritable or withdrawn because of chronic pain.
Diagnosis of FCGS is made through a combination of oral examination, dental X-rays, and sometimes a biopsy to rule out other conditions. Because the disease is so painful, a full oral evaluation is usually performed under anesthesia. Treatment focuses on reducing inflammation and managing pain. In general, the mainstay of treatment is extraction of the teeth, which — depending on the severity and location of the inflammation — can involve removing all the teeth behind the canine (fang) teeth, or in some cases, all of the teeth. This may sound extreme, but it often provides the best chance for dramatic relief and allows cats to return to a more normal, happy, pain-free life.
Not all cats experience full resolution of their stomatitis, even with complete extractions. Some are resistant to treatment and may require additional therapies such as ongoing pain control, immunosuppressants, or immune-modulating medications. Cats that have concurrent viral infections such as feline calicivirus, feline leukemia virus (FeLV), or FIV have an increased risk of being resistant to standard treatment.
Most cats adjust surprisingly well to life without teeth and are often more comfortable and active afterward. Feeding soft food and maintaining regular veterinary checkups will help support their long-term oral health. Though feline stomatitis can be a challenging and frustrating condition, it is not hopeless. With proper diagnosis, treatment, and follow-up care, many cats go on to live comfortable, pain-free lives. If you notice any changes in your cat’s eating habits, drooling, or mouth comfort, contact your veterinarian — early action can make all the difference.
This article was originally published in the December 2025/January 2026 issue of Appleton Monthly Magazine.
