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Oral health and retrovirus status in cats

Kornya MR, Little SE, et al. Association between oral health status and retrovirus test results in cats.  J Amer Vet Med Assoc 2014 Oct 15; 245:916-22.

This cross-sectional study included 5,179 cats who were patients at 125 primary care veterinary clinics and residents of 25 animal shelters throughout North America.  Cats with a known history of FIV (feline immunodeficiency virus) vaccination were excluded from the study. The goal of the study was to determine whether seropositivity for feline leukemia (FeLV) or FIV was associated with naturally occurring gingivitis, periodontitis, or stomatitis in cats.

Participating veterinarians were given oral health assessment information based on guidelines created by the American Veterinary Dental College.  The patients were classified as orally healthy, or as having gingivitis, periodontitis, stomatitis, or another oral condition (this group included resorptive lesions, calculi, dental trauma, or oral neoplasia).  Cats with feline chronic gingivostomatitis (FCGS) were assigned to the stomatitis group.  Each cat was tested for FeLV and FIV with a serum sample submitted for either in-house or reference laboratory ELISA.  None of the patients underwent further confirmatory testing for retroviruses.

Of the 5,179 cats tested and evaluated, 237 (4.6%) were FIV positive and 186 (3.6%) were FeLV positive; 12 (0.2%) were seropositive for both retroviruses.  Of the entire group, 40.6% (2,104/5,179) had oral disease of some kind; 1,073 (20.7%) had gingivitis, 576 (11.1%) had periodontitis, 203 (3.9%) had stomatitis, and 252 (4.9%) had other types of oral disease.

Mean age of all cats was 3.6 years; median age was 2.0 years.  A relationship between age and oral health was found in the FIV positive group, so this group was divided into 6 subgroups based on age. In all subject cats except for spayed females prevalence of FIV seropositivity increased from 0-5 years of age, then decreased in cats older than 5 years. In very young cats (<0.4 years) there was no difference in FIV seroprevalence between sexes. In cats <5 years old, FIV seroprevalence in intact males was significantly higher than in sexually intact females, neutered males, and spayed females.  The presence of periodontitis or stomatitis in all groups of cats <5 years old was associated with an increased likelihood of FIV seropositivity. In cats > 10 years old there was no association between oral health status and FIV status.  In all age groups, cats with periodontitis or stomatitis had a higher likelihood of being FIV positive than cats with gingivitis.  Stomatitis was associated with the highest probability of FIV seropositivity. Among patients of all ages, inflammatory oral disease was associated with a significantly higher risk of FIV seropositivity, compared with the FIV seropositivity risk associated with other oral diseases or no oral disease.

In the FeLV positive group, there were no significant interactions of age or sex with oral health. These cats had a younger mean age than the FIV positive cats, probably because FeLV positive cats are more likely to develop clinical signs of illness soon after infection.   Cats with any oral inflammatory disease were more likely than the orally healthy to be FeLV positive.  Oral disease conditions other than inflammation were not significantly associated with an increased risk of retroviral infection.

It is important to note that significant numbers of retrovirus-seronegative cats enrolled in the study also had oral disease.  Of these patients, 978 (20.5%) had gingivitis, 488 (10.2%) had periodontitis, 162 (3.4%) had stomatitis, and 226 (4.8%) had other oral diseases, for an overall disease prevalence of 38.9% (1,854/4,768) of cats, whereas overall oral disease prevalence in retrovirus-positive cats was 246/411 (59.9%).  Increasing age was associated with a higher oral disease prevalence in retrovirus-seronegative cats.  An important conclusion of this study is that the retroviral status of all cats with inflammatory oral disease should be determined and appropriate management initiated. [PJS]

See also:
Hartmann K. Clinical aspects of feline retroviruses: a review.  Viruses 2012;4:2684-2710.

Lommer MJ. Oral inflammation in small animals. Veterinary Clinics of North America Small Animal Practice 2013;43:555-571.