How to properly prevent gingivitis in pets

Q: Despite having my cat’s teeth cleaned just three months ago, her gums are all red. How can I keep ahead of this problem?

A: In most pets, inflammation of the gums occurs due to bacteria present in tarter accumulations on the teeth. In certain cats, gingivitis can be a chronic primary disease process. In these cats, even perfectly clean teeth can be surrounded by red, inflamed gums. The inflammation can lead to damage to the teeth and the ligaments that hold them in place. Most cats with chronic gingivitis end of losing most or all of their teeth.

For many of these cats, regular tooth brushing and application of an antiseptic gel will reduce the inflammation. Others respond to “pulsed therapy” antibiotics given the first few days of every month. Some respond to frequent professional cleanings every four to six months. However, there are some cats that continue to experience gingivitis despite these aggressive therapies.

It has been proposed the inflammation may be a type of allergic reaction against dental tarter or oral bacteria. This theory is supported by the fact that extraction of all the teeth frequently resolves the inflammation.

Many chronic gingivitis cats have been found to harbor underlying viruses or bacteria that contribute to the disease. Feline Immunodeficiency Virus (FIV), Feline Leukemia Virus (FeLV), and Calicivirus have long been linked to gingivitis. A more recent discovery, a high percentage of chronic gingivitis cats test positive for a potentially dangerous bacteria called Bartonella. Cats are primarily infected from flea bites. Once exposed, cats can develop a chronic bacterial infection, often with little or no symptoms.

Recent studies have demonstrated 20-35% of cats carry the bacteria. At a nearby clinical investigation site in Falls Church, Virginia, owners were asked about risk factors for Bartonella exposure (history of fleas, spends time outside, came from a shelter). Even in the group of cats declared to have no risk factors by their owners, one in four cats tested positive for the bacteria! In at risk patients, 37% were positive. If there was any evidence of chronic inflammation, including gingivitis, cats had a 42% chance of testing positive for Bartonella.

The most familiar type of Bartonella infection in people is “cat scratch disease” (CSD). The Centers for Disease Control and Prevention estimates 24,000 people are affected annually in the United States. CSD most commonly causes enlarged lymph nodes, fever, headache, fatigue, and a poor appetite. However, “Bartonella originating from cats can infect people and cause at least twenty-four chronic inflammatory diseases and may even cause fatalities,” according to Dr. William Hardy of the National Veterinary Laboratory, Inc. “Immunosuppressed people are more likely to have severe consequences and more likely to die from their Bartonella infection.”

Fortunately, the majority of cats that carry this bacteria can be successfully cleared of the infection. According to Dr. Hardy’s research, treatment is successful in over 80% of cats. He recommends using a Western Blot blood test to test cats before introducing them to a household. He strongly encourages veterinarians to test any cat experiencing chronic inflammation, like gingivitis. If a cat is positive, it should be treated using special types of antibiotics for three to six weeks. Six months after treatment, a repeat Western Blot should detect a drastic drop in antibody titers.

Dr. Hardy also advocates keeping cats inside and using a high quality flea and tick control product on all cats, all year. Bartonella infections in humans generally follow a scratch from an infected cat. However, the bacteria is found in high concentrations in flea feces and there is some evidence that the bacteria could be transmitted to a person through a flea bite. Regular use of veterinary-quality flea control has been shown to inhibit the ability of the bacteria to spread.

For more information on Bartonella in cats, visit NatVetLab.com. For information on effective control of fleas, roundworms, and other cat parasites that can affect human health, visit Revolution4cats.com. The CDC also publishes a list of precautions for pet owners with HIV at cdc.gov/hiv/pubs/brochure/oi_pets.htm. Their suggestions are excellent for everyone, especially households with small children, senior citizens, or immune compromised individuals (diabetes, chemotherapy, autoimmune diseases, etc.).

Dr. Watts is a companion animal general practitioner and owner of Clevengers Corner Veterinary Care. He can be reached through ClevengersCorner.com or by calling 428-1000.