Gingivostomatitis (inflammation in the mouth) is a very common feline problem. It is often under-recognised because, let’s face it, how many of us would or could regularly look closely inside our cat’s mouth?!

These photographs show just how sore Phineas’ mouth was before the surgery

Gingivostomatitis is an under-recognised problem in cats. Not only can it be difficult to look in a cat’s mouth, but cats are ‘masters of disguise’ and they don’t readily show signs of pain, until they really can tolerate it no longer.

One of the most common presenting signs of gingivostomatitis in cats is not eating, or obvious discomfort on trying to eat. Sadly, this just represents the tip of the iceberg; once a cat stops eating because of gingivostomatitis it is likely to be in severe pain. We all know how painful toothache and mouth ulcers can be, and often there isn’t much to see in our mouths, so just imagine the discomfort that a cat must be in when it has severe inflammation inside its whole mouth.

Phineas was lucky to have a very observant owner, who worked within a veterinary practice and realised the severity of his mouth problems early on. She sought the best treatment and witnessed the dramatic improvement in Phineas’s whole lifestyle following treatment. Phineas’s owner, Stephanie Cowling, tells the heartwarming story of this special little cat and this debilitating condition.

‘Like many people working in veterinary practice I have a myriad of animals at home that need feeding when I return from work! However one July day, Fitz, my 9 kg male Maine Coon rescue cat, would not come in from the garden. His pacing and vocalising finally made me go out and investigate. There was a very small (140 g) newborn kitten that had been abandoned. Tiny, but complete and crying for food, this kitten immediately touched my heart with his sheer helplessness; what other choice did I have but to do everything I could to keep him alive?

‘Hand-rearing a kitten is challenging because it needs feeds every two hours around the clock; the surrogate ‘mum’ is responsible for toileting and grooming, keeping him warm and making him feel secure and, of course, avoiding total panic when for some reason he won’t feed!

‘Thankfully, with the complete support of my colleagues at work, with sometimes daily health checks, advice, lots of cartons of cat milk and bottles, Phineas, as he came to be called, soon worked his way into everyone’s heart. Next came the challenge of weaning him onto ‘cat’ food — you see he never realised he was a cat as it were, and much preferred snuggling up with warm bottles of milk with his surrogate human ‘mum’ or even my Chihuahua dog. With time he learned that the food was for eating and not rolling in (although the puppy preferred it when he rolled in it as he then got to groom it all off him). Next came climbing, exploring and learning to stay home with his animal friends instead of coming into work for all the cuddles and attention.
‘Sadly though, at around 10–11 months of age, Phineas developed a very sore mouth. Treatment began with pain relief and a course of antibiotics. Thankfully our vet knew him well enough to know how this affected his health and character and looked for the best solution. Months of antibiotics, pain relief and changes in diet to hypoallergenic food still had little effect and the ulcerated areas in his mouth became worse. My special little cat became quiet and subdued and no longer had the desire to explore the woodlands behind my house. Instead he nibbled at small amounts of food, lived on strong pain relief and just snuggled up to his teddy and blanket for comfort. Research into further treatment advised a full dental scale and polish with interferon injections into the gum margins and continuing doses in his food for weeks, continued hydrolysed diet, pain relief, daily tooth brushing, and mouth washing following every meal. I don’t know how an owner of your average cat would ever be able to undertake this course of treatment, but thankfully Phineas trusted me to do anything to him — I was ‘mum’ after all, so it must be for the best. This treatment didn’t produce the response we had hoped for and the ulcerated areas grew to include most areas of his tongue and mouth. My little friend was suffering and living from dose to dose of his painkillers. It broke my heart to see this special cat suffer. My vet knew that removal of all teeth that are near the inflamed areas can be an effective, albeit quite drastic solution. In Phineas’s case, as is often the case, the teeth themselves were not diseased, and removing otherwise healthy teeth from cats can be a very tricky and time consuming procedure.

‘A referral was made to the University of Bristol, to be assessed by FAB Lecturer, Andrea Harvey, and dental expert, Lisa Millela. Andrea and all the staff there soon realised what a unique character Phineas really was. They agreed that removing a large number of his teeth was the most hopeful solution. During hours of surgery that day his molars on both sides, top and bottom, and his lower incisors were removed. The care he received was fantastic and, although the first week or so was very difficult with pain levels and trying to eat, he was soon showing signs of his playful character returning. He would sit in the window watching the birds and squirrels, but still didn’t feel like going outside. This didn’t last long though and two months after the operation he was back to his normal, playful, mischievous character. A post-op check back at Langford introduced the staff to the Phineas that I knew before — the loving, cuddly little character that was now ready to enjoy life again!’