The Trust is a charity that was set up by the Cat Fancy in 1988 and has been working to raise money and fund projects for the benefit of cats. The Trustees decided that their first aim would be to find projects which would benefit cats and would be of particular interest to pedigree cat owners and secondly to make funds available to enable work to be undertaken which might not attract commercial funding.
Two projects have been completed. The first was a PhD research project to investigate methods to provide a ringworm vaccine; this was undertaken at Bristol University by Dr Ann Robinson. The second provided two year funding to The Animal Health Trust to enable Dr Martin Binns to establish a feline genome map.
New projects are always sought from all the Schools of Veterinary Studies and after circulating them with the details of the funds available to support a third project, the resulting applications were considered and the most suitable passed out for expert scrutiny. Initially the funding available for Project 3 was £50,000, and it was decided to offer this sum to be used over a two year period. The chosen project was put forward from the University of Liverpool by Dr Susan Dawson to enable a study to be made of the condition, gingivo-stomatitis, a mouth problem suffered by many cats. A full description of the condition and the start of the research into it, follows. This report has been written by Mrs Kitty Foster, nee Healey who was appointed to undertake the project.
Initially it seemed probable that this project would only be able to be undertaken as a study for a two year Masters Degree. The Trustees were sure that a much better outcome would result if three year PhD. funding could be offered. Early searches for additional funding made by the Trust and the University proved fruitless but the Trustees decided to make an appeal for help to the Animal Welfare Foundation of the British Veterinary Association. Meanwhile, encouraged by the grant being offered by the Trust the University of Liverpool decided to offer a bursary to Kitty. Finally the Animal Welfare Foundation agreed to provide the balance of the funds required to support this three year project. The Trustees have always hoped that if there was not sufficient money available to provide full funding for any project that their initial offer might act as a “pump primer” and encourage others to help and this has proved to be the case.
The Trust’s funds come from the Governing Council of the Cat Fancy, the affiliated Cat Clubs, donations from members of the Fancy and the occasional legacy. It is obvious when a search for a project is undertaken that there is always other useful work to be supported. Please support the Trust with your donations to enable us to offer funding to another project. Donations should be sent to: The Cat Welfare Trust, GCCF, 4-6 Penel Orlieu, Bridgwater, TA6 3PG. Gift Aid forms can be sent on request.
Lesley Pring - Trustee. My fellow Trustees are: Jeremy Potter (Chairman), Eileen Fryer (Treasurer), Susan Moreland, Margaret Walkden, Adrian Seville and Keith Scruton.
This PhD is kindly sponsored by The Cat Welfare Trust, The Animal Welfare Foundation and The University of Liverpool.
Chronic Feline Gingivo-Stomatitis
PhD student: Kitty Foster; Main supervisors: Dr Susan Dawson, Dr Alan Radford, Professor Rosalind Gaskell.
What is Chronic Feline Gingivo-Stomatitis?
Chronic feline gingivo-stomatitis is a syndrome affecting the mouths of cats. It is sometimes abbreviated to “FCGS”, and is also known by other names such as “lymphocytic-plasmacytic gingivitis” or “chronic stomatitis” - these and other similar terms are interchangeable and all refer to the same problem. FCGS is a condition which affects a small but significant proportion of the cat population, and can be a very debilitating and hard to treat problem. “Gingivo-stomatitis” literally means “inflammation of the gums and mouth”, and is a descriptive term for a syndrome rather than the name of a recognised disease. This is because, as yet, no single factor has been proven to be solely responsible for causing FCGS. Despite this, certain viruses are suspected of having a role in the disease process, and variation in susceptibility between individuals is also suspected to play a part.
The severity of the inflammation varies between cats and can range from mild inflammation of the areas of the gums lying adjacent to the teeth to very severe swelling, ulceration and proliferation of much of the mucosal lining of the mouth, extending from the premolar and molar (cheek) teeth and around the inner angle of the jaw (the palatoglossal folds) (figs 1 and 2). The sore areas often tend to bleed easily (fig 3), so sometimes owners will notice their cats drooling blood-stained saliva, or see it staining the cat’s front paws after it has been washing.
Another common feature of the disease is that the inflammation looks disproportionately severe when compared to the level of dental disease present. Illustrating this, the cat in Fig. 3 has very severe ulcerative and inflammatory changes, particularly at the angles of the jaw, but there is no discernable plaque or tartar build up on his teeth.
The longer the duration of the disease, the more the teeth themselves become affected with gum recession and loss of the bone surrounding the tooth roots – this leads to instability of the teeth, and tooth loss. Secondary bacterial infection of the inflamed tissue is also common, which complicates the picture and makes the cat more unwell.
Problems caused to cats by FCGS:
The FCGS lesions can cause physical difficulty in eating and swallowing, and cats may be seen dropping pieces of food when trying to eat; owners of these cats often notice that their cat has bad breath, and may tend to paw at the mouth. Some cats will stop eating altogether, and the resulting weight loss can be marked and in extreme cases coupled with dehydration.
These cats, and even those which are still eating, often have poorly kept coats as the oral pain discourages them from grooming themselves. The discomfort caused by FCGS has serious implications for the welfare of these cats, and owners may notice an overall depression or lethargy in the patient compared with before the problem developed. In some cases an increase in aggression is seen, especially if the head or mouth area is touched. Sometimes, where treatment is not successful in improving the comfort of the patient, euthanasia is the only remaining option.
Difficulties encountered in the treatment of FCGS:
There are a number of treatment options in cats with FCGS. The very fact that many different treatments are available is a reflection that while some work very well in some cases, there is a core of cats which remain refractory to all of the recognised therapies. Common approaches include the following, but the routine maintenance of dental hygiene (see below) is also an important part of any treatment regime:
• Antibiotic treatment. This is commonly administered in the form of short courses repeated as required. The main goal of this treatment is to control the secondary bacterial infection and the worsening of the lesions this causes. Steroid treatment (in the form of injections or tablets). The aim of steroid therapy is to reduce the level of inflammation in the mouth - if this is brought under control, the cat’s comfort levels improve immediately. However, these side effects are usually tolerated if the steroid treatment leads to clinical improvement of the FCGS.
• Routine dental treatment. This is a dental hygiene procedure performed under a general anaesthetic where the teeth are scaled and polished. This process removes tartar (which acts as a refuge for bacteria), and cleans plaque from the surface of the teeth, which are then polished to even out any roughness. This is the cornerstone of treatment of FCGS, because if any dental disease (as opposed to gum disease) is present, it will independently aggravate the gingivitis and stomatitis already present in a cat with FCGS. Plaque and tartar will immediately tend to reform after a dental though, so oral gels containing antiseptics are often used to maintain the clean state of the teeth for as long as possible. Brushing can also be used in cats whose gums are very much improved, but often will prove too painful for cats with refractory gingivitis.
• Radical dental surgery. If a scale and polish is being performed, as discussed above, any unhealthy teeth will usually be extracted as a matter of routine. However, some cats with FCGS who don’t respond satisfactorily to medical management may improve dramatically if all the teeth apart from the incisors (very front teeth) and canines (“fangs”) are extracted, whether the teeth themselves are healthy or not. This is a very radical treatment, but may give the best long term improvement of the therapies available, and cats usually manage surprisingly well without any teeth.
• Interferon treatment. A veterinary pharmaceutical company has recently gained a license for the therapeutic use of interferon, which is a substance which acts on the immune system. So far, however, its license only incorporates the treatment of cats affected by two specific viruses (feline immunodeficiency virus and feline leukaemia virus), but there have been reports of cats affected by FCGS responding well to this treatment when included as part of a treatment regime.
In addition to the above, there are other treatments that are used to try to improve the condition but many of these are either in trial stages or have side effects that preclude their routine use.
The problem of treatment is not helped by the fact that actually medicating cats with sore mouths is a big challenge – many of these cats’ mouths are so painful that they will even show aggression to their owners if they try to administer a pill directly, and if the cat is not eating, hiding medications in food will not work. This leaves the option of repeat visits to the vet for injections, at least until the inflammation improves enough for home medication to become viable, but these visits will add to the cat’s stress and fear.
Ultimately, however, the crux of the problems with treatment is that all current protocols are directed at managing the symptoms, i.e. treating the clinical signs of FCGS rather than the underlying cause, as this is not known.
The PhD project at The University of Liverpool:
From the above, it is evident that a lot of work is required to gain some baseline factual information about FCGS in the cat population in order to work out how common it is, whether its prevalence varies between different sexes and breeds, whether there is an age predisposition, and whether there are any specific factors which seem to make a cat more likely to end up developing the disease (or recovering successfully from it).
The study at The University of Liverpool is aiming to answer two main questions:
How common is FCGS?
This is being investigated in a survey looking at cats going to veterinary surgeries for routine consultations. The age, sex and breed of every cat that sees a vet is recorded, and a note is made of those affected by FCGS. From this, we hope for the first time to be able to get a reliable estimate of the prevalence of FCGS in the cat population in the Liverpool and Manchester area. We will also be hoping to examine any trends which become apparent in age, sex and breed. This study is in the final stages - we are currently in the process of collecting data from the participating practices, and will be analysing the results over the summer.
Why do some cats get FCGS and others not?
This is again subdivided into two parts: one study in veterinary practices, and one study in colonies/households of pedigree cats. In this type of study, every cat with stomatitis (a “case”) will have samples taken and analysed, plus information gathered about its history and lifestyle. For each “case”, two or more “control” cats (cats from the same population but without FCGS) will have the same samples and information collected. The existence of controls is very important, because of the need to compare cats with FCGS to cats which are “normal” for that population.
The analysis in the case control study includes culture for any viruses or bacteria, and also DNA analysis of a specific molecule located on cat cells (called the Feline Leukocyte Antigen, or FLA). This immunological molecule exists in many different forms depending on the genetics of the cat, and we intend to look into whether cats with one version of the molecule are more or less susceptible to FCGS compared to cats with another version of the molecule.
The long term aims of these studies are to increase our knowledge on the possible causes of FCGS, including possible breed and other genetic associations, and to enable improved advice to be given on the prevention and control of the problem, ultimately reducing its prevalence.
Acknowledgements:
This project is in collaboration with: Cripps P, Gaskell CJ, Burrow R, Hart CA, Pinchbeck GL (University of Liverpool); Kennedy LJ, Ollier WER (University of Manchester); Addie DD (University of Glasgow)
