Feline Dentistry

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Feline dentistry lecture by Brett Beckman.

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  • Concurrent oral shedding of feline calicivirus and feline herpesvirus 1 in cats with chronic gingivostomatitis
    Oral Microbiol Immunol. April 2003;18(2):131-4.M J Lommer1, F J M Verstraete
    1 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
    Abstract
    Oral mucosal salivary samples were collected from 25 cats with chronic gingivostomatitis and 24 cats with periodontal disease. Viral culture and isolation of feline calicivirus and feline herpesvirus 1 were performed. Eighty-eight per cent of cats with chronic gingivostomatitis were shedding both viruses, compared to 21% of cats without chronic oral inflammatory disease. Cats with chronic gingivostomatitis are significantly more likely to concurrently shed both feline calicivirus and feline herpesvirus 1 than are cats with classical periodontal disease

  • THE ASSOCIATION OF BARTONELLA SPP. INFECTION WITH CHRONIC STOMATITIS IN CATS. KL Dowers, MR Lappin. Colorado State University, Fort Collins, CO.

    Stomatitis is a debilitating disease in cats that leads to oral pain, anorexia, weight loss, and occasionally euthanasia in intractable cases. The syndrome is thought to have multiple causes; recent work suggests that Bartonella spp. may play a role in some cases. Establishing a causative link between bartonellosis and stomatitis would justify routine testing of stomatitis cases and might suggest use of alternative antibiotic therapies, such as azithromycin. The objective of this clinical study was to determine the prevalence of Bartonella spp. DNA in blood and B. henselae serum antibodies in client-owned cats with histopathologically documented stomatitis as well as age- and geographically-matched healthy control cats.
    Blood and serum samples from 34 affected cats and 34 age-matched healthy control cats were submitted by veterinarians from around the United States. DNA of Bartonella spp. was amplified from blood via a previously validated polymerase chain reaction (PCR) assay and serum antibody titers against B. henselae were determined by ELISA. All cats were tested for FeLV antigen and FIV antibodies. For cases where oral biopsy samples were obtained at the time of blood sampling, the PCR assay was also performed on tissue samples. Survey information regarding housing status (multiple or single cat households), previous FeLV and FIV testing, flea exposure, vaccination history and history of upper respiratory infections (URI) were collected for both affected and control cats, and lesion details and treatment trials were collected for affected cats.
    No significant differences in the prevalence rates for PCR-positive cats between affected (8.89%) and control cats (8.89%) nor for antibody-positive cats between the affected group (67.6%) and the control group (58.8%) were found. The only survey factor with significant correlation with stomatitis was history of URI [p<0.05]. Of the 18 oral tissue samples submitted, only 1 was PCR-positive.
    This study underscores the difficulty of correlating Bartonella spp. test results with clinical disease in individual cats because of the high prevalence rates of antibody-positive animals within the healthy population, as reported in this and other studies. Treatment with anti-Bartonella spp. antibiotics may still be appropriate in refractory stomatitis cases, but a larger scale epidemiologic study should be conducted to further assess the usefulness of Bartonella spp. antibody and PCR testing of cats with chronic stomatitis.
  • FCV has been isolated fro up to 100% of FCGS cases compared with 25 % in healthy cats. (Counts 94)
    Hennet – carrier state may be a prerequisite (2003)
    However when inoculating calici into SPF cats they could not produce stomatitis. (but did produce acute calinvirus.
    Clinical cases of FCGS are not related to distict FCV biotypes but the carrier stateThe role of FCV in the development of
    FCGS is unclear. FCV has been isolated
    from up to 100 per cent of FCGS cases
    compared with up to 25 per cent of cats
    in a healthy cat population (Coutts and
    others 1994), indicating that the carrier
    state may be a pre-requisite for the induction
    of chronic stomatitis (Knowles and
    others 1991, Hennet and Boucraut-Baralon
    2003 7 ). However, FCV isolated from
    cats with FCGS and then inoculated into
    specific pathogen free cats produced signs
    of acute calicivirosis but not FCGS,
    suggesting that other factors contribute
    towards the development of the oral
    inflammation.
    Clinical cases of FCGS are not related
    to distinct FCV biotypes (Poulet and
    others 2000), but the chronic carrier state
    is characterised by the emergence of antigenically
    distant viruses. It is postulated
    that the rapid genetic and antigenic
    change seen in FCV may lead to immune
    escape and the development of persistent
    infections. This would suggest that development
    of FCGS is more likely associated
    with the host immune response to chronic
    FCV infection rather than the development
    of particularly pathogenic distinct
    FCV strains.
    Cats with FCGS have been shown to
    have raised serum concentrations of
    immunoglobulin (Ig) G, IgM and IgA
    and raised salivary concentrations of
    IgG and IgM but significantly lower
    concentrations of IgA (Harley and others
    2003). IgA neutralises pathogens and
    toxins in the oral cavity, inhibits the
    adherence or growth of microorganisms
    on the oral mucosa or teeth and enhances
    non-specific defence factors. It is unclear
    whether the Ig pattern described is a cause
    or a result of the inflammatory disease.
    Histological examination of tissue from
    persistently infected cats indicates that
    FCV replicated only in epithelial cells of
    the superficial tonsilar epithelium or adjacent
    fossa mucosa (Dick and others 1989).
    Localisation occurs in the tonsils in the
    acute phase of FCV infection, possibly as
    a consequence of their function as a filter.
    The degree of tissue damage and viral
    invasion is insufficient to induce signifi-
    cant inflammation (Dick and others
    1989). Most carriers are asymptomatic.
    It is possible that, in cats with some form
    of immune deficiency, the balance of this
    carrier state is affected and increase in virus

    UNCORRECTED
    PROOF
    replication and invasion stimulates a more
    severe immune response. The most common
    reported clinical sign associated with
    FIV is gingivostomatitis (Tenorio and
    others 1990, Willia 8 ms and Aller 1992),
    supporting the supposition that immune
    deficiency is an important factor in the
    development of FCGS.
    This case demonstrated a clear relationship
    between initiation of treatment
    with FeIFN, cessation of shedding of
    FCV and resolution of FCGS. This supports
    the view that FCV is an important
    factor in the development of FCGS
    (Addie and others 2003). However, the
    fact that FCGS often resolves in FCVpositive
    cats after the extraction of all teeth
    and the consequent reduction in dental
    plaque suggests that other antigenic stimuli
    are involved in the pathogenesis of the
    disease.
    As far as the authors are aware, this is
    the first case where the FCV status of
    a cat has been monitored before, during
    and after treatment with FeIFN and that
    FCV shedding ceased rapidly after the
    initiation of treatment.
    It is unclear whether the cessation of
    shedding is related to immunomodulatory
    or antiviral effects of FeIFN. One hypothesis
    is that, through its immunomodulatory
    effect, FeIFN reduces the
    inflammation associated with FCGS
    which eliminates the chronically inflamed
    tissue that FCV requires to replicate. This,
    however, ignores the fact that most cats
    shedding FCV are asymptomatic, with
    little or no oral inflammation, suggesting
    that chronic inflammation is not a prerequisite
    for the FCV carrier state or viral
    shedding. Therefore, it remains possible
    that the antiviral effect of FeIFN is more
    significant.
    FCGS resolves in many FCV-positive
    cats following full-mouth extractions
    without any specific antiviral treatment,
    supporting the hypothesis that a number
    of factors are involved in its development.
    Teeth provide the main surface for plaque
    accumulation in the oral cavity. Multiple
    tooth extraction will therefore greatly
    reduce oral plaque levels. It is possible that
    it is the sum of the total antigenic stimulation
    from plaque bacteria and viruses
    that is significant for the development of
    FCGS.
    Five other cases of FCGS (all of which
    were FCV positive, FeLV and FIV negative
    and had had surgical extraction of
    at least all premolar and molar teeth) have
    been treated with FeIFN in a similar way
    by the authors. FeIFN was given at 1 mega
    unit/kg by subcutaneous injection on
    alternate days for five doses, and this
    was repeated 30 days after the first injection.
    No oral FeIFN was given. Three of
    the five cases resolved. One cat improved
    but needed long-term management by
    flushing the oral cavity with 012 per cent
    chlorhexidene gluconate daily. The fifth
    case relapsed soon after the end of the
    treatment. Interestingly, this case has since
    completely resolved after a single treatment
    with intra-lesional injections of 5
    mega units of FeIFN.
    No adverse effects following administration
    of FeIFN were noted in any of
    the above cases.
    FCGS is a common and debilitating
    condition in cats. Approximately 80 per
    cent of cases resolve with multiple tooth
    extraction. Treatment of the 20 per cent
    of non-responsive cases can be frustrating.
    The clinical improvement seen in the cases
    reported here would suggest that FeIFN
    therapy may be useful in cases that are
    refractory to surgical treatment.
    Retrospective Study of Full Mouth Extractions for Treatment of Chronic Stomatitis in 60 Calicivirus-positive Cats N. Girard, Ph. Hennet
     
    Sixty cats were included in this retrospective study. Cats included in the study were referred for treatment of so-called feline chronic gingivo-stomatitis. All cats were under medical treatment at the time of inclusion. Inclusion criteria were presence of “palatoglossitis” lesions (caudal stomatitis), chronic Calicivirus oral carriage (detected par PCR), extraction of at least premolar and molar teeth, and at least 6 months of clinical follow-up following dental extractions. Various factors were statistically analysed (effect of disease duration, effect of previous treatment, effect of remaining inflammation, effect of dentakl treatments etc…). The main result on curing rate (Success Rate) can be summarized as such:
    §         SR Score 0 (cats do not take any treatment anymore):  50% of the cats
    §         SR Score 1 (cats take a lesser amount of medications than prior to dental treatment):    37% of the cats
    §         SR Score 2 (cats take same amount of medications than prior to dental treatment:  13% of the cats
     
     
    ·        Relationship Between Oral Calicivirus & Herpesvirus Carriage & Palatoglossitis Lesions. Ph. Hennet, C. Boucraut-Baralon
     
    Abstract of the paper: Sixty cats presented for treatment of “chronic gingivo-stomatitis” and showing inflammation of the mucosa lateral to the palatoglossal fold (caudal stomatitis) and 30 cats presented for the same condition but without caudal stomatitis were studied. Location and severity of oral lesions were recorded and oral calicivirus (FCV) and herpes virus (FHV) carriage was assessed through PCR technology. Buccostomatitis was observed in 83% of the cats presenting with caudal stomatitis. Prevalence of FCV carriage and FHV carriage in cats with caudal stomatitis was respectively 97% and 15% versus 30% and 14% in cats without caudal stomatitis. In cats without caudal stomatitis, prevalence of FCV carriage was 10% when cats with other Calicivirus-related oral lesions were excluded. FCV detection was significantly correlated to the presence of caudal stomatitis (p<0.0001). FHV carriage was not correlated with caudal stomatitis neither in cats non infected with FCV nor in cats coinfected with FCV. We suggest that chronic caudal stomatitis may be a calicivirus-associated lesion. Cats with chronic gingivo-stomatitis should be assessed for the presence or absence of caudal stomatitis.





















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  • To isolate ASCs, first the veterinarian performs a lipectomy in one of a number of locations including the thoracic wall. The fat sample is shipped in validated boxes to our lab. Through a process of enzymatic digestion, washing and centirfugation, the stromal vascular fraction is isolated. The SVF is a heterogenous mixture of cells including….next page

  • Used in conjuction with probing, GR and bone loss.




























































  • Oral SCC Therapy:
    Single modality therapy = 60-90 days
    NC Postorino et al; JAHHA Sept ‘93
    Mandibulectomy and RT = 12-14 months
    CA Hutson et al; JAVMA Sept ‘92
    Controversial amongst oncologists
    Not been able to be reproduced
    Most oncologists feel median survival = 4-6 months
    Tri-modality therapy (sx/RT/chemo)
    Being investigated presently
    Anecdotally appears to be 6-9 months
    1 year survival rarely exceeds 10% in cats following any modality.
  • Oral SCC
    Generally POOR - GRAVE prognosis
    Human HNSCC (head & neck SCC)
    Also extremely invasive w/poor prognosis
    Overexpress EGFR (epidermal growth factor receptor)
    Increased growth rate
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    Increased radioresistance
    EGFR inhibitors alone in people = responses
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  • Leaf-cutter ant
    Scientific name: Atta cephalotes
    Country: Trinidad and Tobago
    Continent: North America
    Diet: Fungus - Fungivore
    Food & feeding: Herbivore
    Habitats: Tropical rainforest
    Conservation status: Not Threatened
    Relatives: Honeybee
    Description: Leaf-cutter ants have powerful jaws which vibrate a thousand times a second to slice off pieces of leaf. Size for size, their bodies are amazingly powerful, able to carry pieces of leaf that weigh at least 20 times their own body weight - that's the same as a human carrying a one ton load. Like bees, their colonies contain different sorts of workers. Soldier leaf-cutters have huge jaws, strong enough to cut through leather and gardener leaf-cutters work beneath ground and process the pieces of the leaf that the harvesters bring back. The nest also contains a queen and she lays all the eggs needed to keep the colony supplied with new workers.
    Lifestyle: Leaf-cutting ants cannot eat leaves. Instead, they carry the cut pieces back to the nest and use it as compost to cultivate the fungus. The fungus cannot survive outside the nest or reproduce without the ants help. Amazingly, if the ants collect plant material that is toxic to the fungus, the fungus seems to release a chemical signal which stops the ants collecting that particularly plant material.
    Family & friends: There can be three to eight million ants in a single colony, which can measure 15 m across and 5 m deep.
    Keeping in touch: The ants forage for leaves some distance from their nest. They find their way home by producing and laying down pheromone (scent) trails as they move away from the nest. These pheromones are so powerful that each ant produces only one billionth of a gram. One gram of this pheromone would easily be enough to make an ant trail all around the world.

    Leaf-cutter ant
    Leaf-cutting ants harvest more greenery in South American forests than any other animal. In fact, within the rain forest, leaf-cutter ants consume almost 20% of the annual vegetation growth! In its lifetime, a colony of these ants may move over 20 tons of soil.











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