Resolution of Chronic Diarrhoea Following Treatment of Periodontal Disease in a Cat

An association between periodontal disease and comorbid disorders, including gastrointestinal signs, has been reported in cats and investigated in humans, where a bidirectional relationship between oral and gastrointestinal microbiomes exists. A 5-year-old neutered female domestic shorthair cat was presented with a 2-year history of small-bowel diarrhoea. The cat's appetite was reduced, and coat quality had deteriorated. On examination, the cat was found to have periodontal disease affecting multiple teeth and a matted coat. Biochemistry revealed mild hyperproteinaemia, haematology was unremarkable, cobalamin was normal, folate was elevated, and retroviral testing was negative. Abdominal ultrasound showed diffuse muscularis thickening without other abnormalities, and dental examination and radiography revealed missing teeth, a root remnant, stage 4 periodontal disease, and tooth resorption. Multiple extractions were performed, and multimodal analgesia was provided, including locoregional dental blocks. The cat's appetite, body condition, energy levels, and coat quality improved after the procedure, and the diarrhoea completely resolved within a month of the procedure without any changes in diet, physical, social environment, or the use of any medications, and did not recur during the following 7 months. This case illustrates the potential role of periodontal disease in the development of gastrointestinal disease and the benefits outside the oral cavity of managing dental disease in cats.