Ulceroproliferative faucitis

Pet Tales
by Barry B. Burtis D.V.M.

Ulceroproliferative faucitis

I suspect most cat owners do not even know that their favourite feline has fauces, let alone that some cats can develop a very serious problem in this part of their body. The health disorder to which I refer is called ulceroproliferative faucitis (UPFS). Now that's quite a mouthful to say and, it so happens, that's where the condition develops - in a cat's mouth.

The fauces is the archway at the back of the mouth that connects the upper and lower jaw in the region of the molar teeth, the teeth in the rear of the jaws. When UPFS develops it is one of the most painful conditions that can afflict cats, in my opinion. The tissue in this anatomical area becomes severely inflamed. There is a proliferation of this reddened, swollen tissue that is very fragile, and can easily be made to bleed, become raw and ulcerate. When an affected cat opens its mouth to eat or yawn, the inflamed and scarred tissues are stretched causing severe pain.

This pain that results is usually the cause of the symptoms that owners notice in their pet. Cats will vocalize and jump when they yawn or when they open their mouth to eat. Cats will often show "approach-avoidance" behaviour, as they approach their food in hunger, then hiss and run off in anticipation of discomfort. Clients will also describe their cat starting to yawn, then vocalizing loudly and running off to hide. Less attentive cat owners may not recognize these things but when asked if their cat yawns, they may report that it used to do so but not recently. If the condition is severe and of long duration, weight loss may be evident. The disease is slowly progressive and if soft, palatable foods are being fed it may become quite severe before the need for medical attention is recognized. It is often necessary, because of the severe discomfort of the disorder, for veterinarians to administer sedatives or anesthetics to allow full evaluation of the oral cavity of affected cats.

A diagnosis of UPFS, by your veterinarian, will require that a complete history is taken, a thorough examination of the mouth and throat be performed and an evaluation for other possible diseases (such as kidney failure and diabetes) be made. In most cases, a biopsy of the affected tissue that can be examined by a veterinary pathologist will be recommended. Such examination is also necessary to rule out certain cancers and other specific oral diseases that can occur in the area.

The specific cause of UPFS has not been proven. Some studies have shown affected cats are more likely to have an increased incidence of certain oral virus infections than the general cat population. However, currently it is suspected that an immune system disorder causes affected individuals to mount an inappropriately severe inflammatory response to some antigen located on the surface its teeth, including the surfaces of the roots of the teeth and the surrounding ligaments.

A great many different therapies have been used to attempt to treat this disease. Any medication given by mouth is very difficult to administer due the pain caused by opening the mouth. Also, any medication given at this point is likely to be palliative and temporary. Certain steroid medications usually administered by injection often give immediate clinical improvement and alleviation of pain. Unfortunately, this relief is usually only temporary. The medicine becomes progressively less effective and eventually completely fails for most cats. Also it appears that cats who receive this form of treatment, will become less likely to be helped by the currently recommended method of treatment for UPFS.

Extraction of all the premolar and molar teeth and the removal of associated ligaments surrounding these teeth is the only treatment that has been shown to provide long-term relief for many patients suffering from ulceroproliferative faucitis. It appears that the earlier in the course of the disease that extractions are performed, the more favourable the outcome.

If you have questions or concerns about such diseases affecting your cat, consult your veterinarian.