An update on epidemiological features, etiopathogenesis and therapeutic approaches of feline chronic gingivostomatitis

Feline chronic gingivostomatitis (FCGS) is a severe, immune-mediated, inflammatory disease affecting the oral mucosal of cats. It is characterized by ulcerative and/or proliferative lesions, most commonly located lateral to the palatoglossal folds. Clinically, FCGS can lead to severe malnutrition and dehydration in critical cases. The pathogenesis of FCGS is poorly understood but it is considered a multifactorial disease, likely involving infectious agents and other parameters. FCGS seems to be a manifestation of an aberrant immune response to chronic antigenic stimulation. Disturbance and im balance of the oral microbiota also may play a role in the development of FCGS. Because of its unknown pathogenesis and long disease course, it is difficult to treat and has a high recurrence rate. The current standard of care involves dental extractions of at least all premolar and molar teeth, often in combination medical therapy. Standalone medical management has shown limited long-term efficacy. Emerging regenerative therapies, such as mesenchymal stem cell treatment, offer promising alternatives for management of FCGS.