Integrative approaches to Feline Chronic Gingivostomatitis

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Integrative approaches to feline chronic gingivostomatitis

Two case reports show how homeopathy and TCVM can effectively treat Feline Chronic Gingivostomatitis without the need for full mouth extraction.

Feline Chronic Gingivostomatitis (FCGS) is a frustrating and painful problem in veterinary medicine. According to the Cornell Feline Health Center, the immune system of affected cats overreacts to plaque, causing severe inflammation that can extend to the gingiva and all the mucus membranes of the mouth and oropharynx. Tooth resorption, ulcers, swollen and bleeding gums, hypersalivation and halitosis are common symptoms. Cats may paw at their mouths and have difficulty eating and drinking. As eating becomes too painful, FCGS can become life-threatening, leading to dangerous weight loss and hepatic lipidosis. This article looks at how two alternative modalities – homeopathy and TCVM – can effectively treat FCGS.

Holistic approaches — two cases

1. Homeopathy: Samson, a foul-mouthed feline

Homeopathy is a system of medicine that allows the practitioner to use carefully described current and historical symptoms of an individual patient (not merely those of the presenting complaint) to find the homeopathically-prepared medicine most similar to the
totality of those symptoms. As the patient responds to this meticulously selected, individualized medicine, healing occurs throughout all levels of the patient, resulting in improved vitality and overall well-being in addition to a resolution of the
presenting complaint.

Samson, a five-year-old male Siamese-cross feral cat, was taken in by a foster family after being trapped. They described him as unpredictable – social at times, biting and puncturing their hands at others. He appeared confident and unconcerned, not reacting to any of the other cats in the home. Samson was very thirsty, frequently drinking large amounts of water, and he was able to eat both canned and dry food. His stool was consistently too soft.

His initial physical examination revealed halitosis with a profuse, thick and stringy saliva tinged with pink and green, draining from the right side of his mouth. A dark red ulcerated
swelling of his right mandibular caudal gingiva obscured the cheek teeth. Samson’s nose was dry and pale pink, and his tongue was dark pink to purple. He would not tolerate further oral exam, and the client declined sedation. The rest of his physical exam was within normal parameters.

A homeopathic analysis was performed using the following symptoms characterizing Samson’s unique presentation of his disease:

• Right-sided inflammation
• Excessive thirst
• Soft stool
• Profuse green-tinged saliva
• Red ulcerated gums
• Confident demeanor with tendency towards aggression

Based upon this particular presentation of symptoms, Samson was given one dry dose of homeopathic Mercurius viv 30c. Within two days, his mouth appeared less red and inflamed, with decreased salivation.

A month later, his salivation had begun to increase slightly. There were no new symptoms. Therefore, the same remedy in a higher potency was selected, and Mercurius 200c was
given. The client reported, “His whole demeanor changed almost immediately. He became more vibrant and seemed much happier. Over the next day or two, the green ooze
completely stopped. His mouth looked great.”

Since that time, Samson has become calmer and more relaxed and is no longer biting. The excessive salivation and halitosis have resolved. His gingiva are normal, with no redness or swelling.

2. TCVM: Sassy, a quiet kitty

Traditional Chinese Veterinary Medicine (TCVM) is a system in which the entire individual is
examined and treated based on the knowledge of energy channels in the body (meridians) and points along those channels associated with internal organs. The Qi, or life force, along with blood, flow along the channels to keep the entire being healthy. Blockages or weaknesses in these channels correspond with illness and pain, and are treated with acupuncture, Chinese herbal medicine, diet and Tui-na (Chinese massage techniques), based on the individual animal’s TCVM diagnosis, which is determined by pulse, tongue and full body examination, along with knowledge of the animal’s behavior and environment.

Sassy, a ten-year-old spayed female DSH feline, received TCVM that resolved her Feline Chronic Gingivostomatitis. Prior treatment had included removal of ten teeth. Following surgery, her voice changed, becoming quiet and hoarse. Over the ensuing months, she became a picky eater and lost weight. Because of the post-operative changes, her guardian wished to avoid full mouth extraction if possible. Initial examination revealed red swollen gingiva, warm ears and head, a red dry tongue, a wet cold nose, deep slippery pulses that were weaker on the left, and deep diagnostic points at Bladder 18 and 23, indicating weakness in the liver and kidneys. Her body condition score was 3/9, and the rest of her exam was unremarkable.

Sassy’s TCVM diagnosis was Yin deficiency with Qi deficiency (loss of voice) and local stomach (mouth) heat. Often, an animal presumed to have excess heat on initial
examination is later found to be Yin deficient, so be sure to perform a full TCVM exam of the patient each time.

Sassy presented differently than most cats, with excess heat in the mouth, as she was older and Yin deficient. She was lacking coolness, rather than having excess heat. Excess might be seen in a younger cat with a strong voice and strong pulses. The following acupuncture points were selected:

• SP 6 and BL 60/KID 3 to aid Yin deficiency
• ST 36 to strengthen Qi and help the mouth
• LIV 3 to relieve pain
• LI 4 could have been used to relieve local heat and stagnation in the mouth, but was not due to her Yin deficiency; ST 6 or 7, local points for the mouth, could also have been used, but were not because of Sassy’s age, vitality and temperament.

Aggressive use of acupuncture on weak animals can exacerbate the weakness for a couple of days following treatment, so a conservative approach was selected for Sassy. In addition, using the minimum number of points necessary helps earn a cat’s cooperation during future treatments.

Due to processing, dry kibble contains no Yin, so Sassy’s dry food was discontinued. Her diet was changed to canned food with cooling ingredients such as turkey. BPA-free cans
were recommended to prevent increasing Sassy’s risk of hyperthyroidism.

In Yin deficient animals, cooked or puréed dark leafy greens or microalgae can be added to the diet to add Yin – cooling and moistening the body, including the gums. Microalgae such as BioPreparation Core can be given by mouth or sprinkled into the food. For a cat, beginning with 1/8 to 1/4 of a capsule per day is enough, and is often taken readily in canned or raw food.

Other Yin tonics include seaweed, kelp, clams and mackerel. Because our oceans are over-polluted with mercury, radioactive iodine and other substances, it is imperative to evaluate sourcing. Laboratory-made supplements may be safer options. Aloe vera juice (labeled for human consumption) can also be given in the food, or on a cotton swab to relieve pain and locally cool the mouth. Begin with no more than 1/2 tsp per day, as more may lead to
loose stool. George’s brand of aloe vera juice by Warren Laboratories has no taste and cats tend to accept it mixed in canned or raw food.

Sassy’s guardian was instructed to use the Tellington TTouch™ technique. Often, TTouch in a cat with FCGS begins on the top of the head in front of the ears on the midline (a calming
spot), and if the cat allows, is moved down to the mouth area. This can help relieve pain, promote circulation and improve appetite. TTouch was performed around Sassy’s mouth (this can include the lips and even gingiva if the cat allows) with one or two fingers very gently moving clockwise in one-and-a-quarter circles. Of course, avoid painful areas.

Two further acupuncture treatments resolved Sassy’s FCGS symptoms and prevented further tooth extractions. Her guardian performed TTouch daily, continued with the canned food, and added a microalgae supplement, which aided in her healing. She did well for two years until she was lost to follow-up.

For clients interested in non-traditional options – and if it is in the best interest of the patient to avoid tooth extractions and drugs – the modalities described in this article offer alternatives for resolving this painful and debilitating condition. If you are not yet trained in homeopathy or TCVM, offer them as options for Feline Chronic Gingivostomatitis by referring clients to colleagues with experience in these methods of treatment.

Conventional diagnosis and treatment

Conventional diagnostics for Feline Chronic Gingivostomatitis have included testing for FeLV, FIV, calicivirus and bartonellosis, all of which can complicate the inflammation but have not been found to be the primary etiology. The latter remains unknown, and is most likely multifactorial. Comprehensive oral cavity examinations under anesthesia, with full dental radiographs, are
required for an accurate conventional diagnosis.

Treatment is challenging, often starting with antibiotics, anti-inflammatories, pain medications and dental cleanings, and progressing to full mouth extractions. According to Cornell, 40% of feline patients continue to experience inflammation and pain, even with correctly-performed, radiographically-confirmed full mouth extractions, requiring continued
medical intervention. Occasionally, pre-existing conditions present an obstacle to safe anesthesia for affected cats, eliminating the option for full mouth extractions.