The most severe form of feline chronic gingivostomatitis (FCGS) consists of caudal stomatitis and alveolar/buccal mucositis. It is associated with significant pain. The cause is presumed to be multifactorial, with the immune system responding inappropriately to chronic oral antigenic stimulation. Calicivirus may be linked to this syndrome. Medical management of FCGS is difficult and may involve a combination of dental extractions, oral antibiotics, and prednisolone therapy. One major objective of treatment is to alleviate pain.
In a double-blind, randomized, placebo-controlled study, 39 calicivirus-positive cats with chronic refractory disease were treated with either oromucosal administration of recombinant feline interferon-omega (IFN, 0.1 MU Q 24 H for 90 days) or prednisolone (beginning at 1 mg/kg PO Q 24 H for 7 days, then decreasing over another 2 weeks). Cats were examined 5 times over a 90-day period (D0, D15, D30, D60, D90). Behavior (eg, hypersalivation, activity level), clinical signs, and inflammatory lesions were evaluated and scored. No change was noted in body weight between the two treatment groups. Overall improvement trends were noted in both groups. In the IFN group, significant improvements in pain scores were seen at all time-points. Overall lesion scores were decreased at all time-points in the IFN group compared with only D15 in the prednisolone group. Rescue medications were needed in 33% of IFN-treated cats versus 60% of prednisolone-treated cats.
Commentary: This article stresses the multifactorial nature of FCGS and the multifaceted approach necessary to treat severely affected patients. Treating these cases is challenging for veterinarians and can be frustrating for clients. While IFN therapy may show promise in managing disease in populations in Europe, significant challenges remain with gaining access to this medication in the United States and shipping it under ideal conditions. This article supports further investigation into immunomodulatory treatments such as IFN for FCGS management. IFN may demonstrate promise for treatment of FCGS, particularly FCGS cases with comorbid viral conditions.Christopher Snyder, DVM, Diplomate AVDC
Comparative efficacy of a recombinant feline interferon omega in refractory cases of calicivirus-positive cats with caudal stomatitis: A randomized, multi-centre, controlled, double-blind study in 39 cats. Hennet PR, Camy GAL, McGahie DM, Albouy MV. J FELINE MED SURG 13:577-587, 2011.