Inflammation and wound healing in cats with chronic gingivitis/stomatitis after extraction of all premolars and molars were not affected by feeding of two diets with different omega-6/omega-3 polyunsaturated fatty acid ratios

Omega-3 fatty acids as a treatment option in periodontitis: Systematic review of preclinical studies

Background: Periodontitis presents as a chronic inflammatory disease that affects the gingival tissues and structures surrounding the tooth. However, the existing approaches for periodontitis do not allow complete control of the disease. In this regard, an active search is being carried out both in preclinical and clinical studies for new approaches based, among other things, on nutraceuticals. Aim: This systematic review aimed to summarize and systematize data from preclinical studies on the effects of the use of polyunsaturated omega-3 fatty acids in experimentally induced periodontitis. Methods: A systematic search for research articles was performed using electronic scientific databases. Only original in vivo experimental studies investigating the use of omega-3 polyunsaturated fatty acids in experimentally induced periodontitis were included. Quality and risk of bias assessment (Systematic Review Centre for Laboratory Animal Experimentation) and quality of evidence assessment (using the modified Grading of Recommendations Assessment, Development and Evaluation approach) were performed. Results: Nineteen studies were included in this systematic review. It has been shown that omega-3 polyunsaturated fatty acids may decrease the progression of periodontitis with amelioration of alveolar bone loss along with decreased pro-inflammatory response and inhibition of osteoclasts. Despite the promising results, most of the analyzed studies were characterized by low to moderate quality and a significant risk of bias. Conclusion: Based on the retrieved data, the possibility of extrapolating the obtained results to humans is limited, indicating the need for additional studies to elucidate the key patterns and mechanisms of action of omega-3 polyunsaturated fatty acids and their endogenous metabolites in experimentally induced periodontitis.

A diet rich in omega-3 fatty acid improves periodontitis and tissue destruction by MMP2- and MMP9-linked inflammation in a murine model

Periodontitis is an oral-cavity inflammatory disease and is the principal cause associated with tooth loss. Matrix metalloproteinases 2 and 9 (MMP-2 and MMP-9) are important proteases involved in periodontal tissue destruction. The omega-3 polyunsaturated fatty acids (ω-3 PUFA) have been demonstrated to possess immunoregulatory properties in periodontitis. The aim of the study was to investigate the effects of ω-3 PUFA on inflammation and on the expression of MMP-2 and -9 in a murine periodontitis model. Twenty-four male C57BL/6 mice were divided into control mice (Control), control mice treated with ω-3 PUFA (O3), mice with periodontitis (P), and mice with periodontitis treated with ω-3 PUFA (P + O3). ω-3 PUFA were administered orally once a day for 70 days. Periodontitis in mice was induced by Porphyromonas gingivalis-infected ligature placement around the second maxillary molar. The mice were sacrificed, and blood and maxillary samples were collected. Flow cytometry was used to quantify tumor necrosis factor-alpha (TNFα), interleukin (IL)-2, IL-4, IL-5, and interferon-gamma. Histologic analysis and immunohistochemistry for MMP-2 and -9 were performed. The data were statistically evaluated using analysis of variance (ANOVA) and the Tukey post hoc test. Histological analysis showed that ω-3 PUFA supplementation prevented inflammation and tissue destruction and revealed that bone destruction was more extensive in the P group than in the P + O3 group (p < 0.05). Also, it decreased the serum expressions of TNFα and IL-2 and the tissue expression of MMP-2 and -9 in the periodontitis-induced model (p < 0.05). ω-3 PUFA supplementation prevented alveolar bone loss and periodontal destruction, probably by decreasing the expression of MMP-2 and MMP-9 and its immunoregulatory properties.

Dietary omega-3 fatty acids in the management of feline periodontal disease: What is the evidence?

Periodontal disease is an oral disorder with high prevalence in cats from 2 years of age, resulting from an inflammatory response against bacterial plaque. Treatment depends on the stage of the disease and may include dental scaling, local application of perioceutics, tissue regeneration and/or even tooth extraction and periodontal surgery. As multimodal therapy is often required, new strategies have been developed to improve the therapeutic response in these patients. Adjuvant use of omega-3 fatty acids has been reported in humans with periodontal disease, but the current evidence of its effect in companion animals, especially cats, is still considered to be scarce and conflicting. This review describes the state of the art regarding feline periodontal disease and seeks to clarify the potential effect of omega-3 fatty acids on its clinical management in light of the evidence available in the current literature.

Placebo-Controlled Trial of Daily Oral Cannabidiol as Adjunctive Treatment for Cats with Chronic Gingivostomatitis

A placebo-controlled study evaluated the clinical efficacy and safety of a commercially available cannabidiol (CBD) oral formulation as an adjunctive treatment for pain management for feline chronic gingivostomatitis (FCGS). CBD was included in a multimodal treatment routinely performed on client-owned cats with FCGS that were submitted to dental extractions. Twenty-two cats were consecutively included in the study. The first group was treated using a fixed dosage of 4 mg per cat every 12 h for 15 consecutive days, and the second received a placebo of similar features. Treatments began 2 h before dental extractions. Pain and disease severity were assessed at days 0 and 15 using the Composite Oral Pain Scale (COPS-C/F) and the Stomatitis Disease Activity Index score (SDAI). Weight, vital and biochemistry parameters, and analgesic reinforcement needs were also registered at the same time points. In the treated cats, blood was collected after 4, 8, and 12 h to determine CBD serum concentrations using ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS/MS). After data analysis using mixed models, a significant improvement in the SDAI scores of cats medicated with CBD was found. The protocol is safe since severe adverse effects and biochemical changes were not observed during the treatment period. This study suggests that the cats benefited from this treatment.

Relationship between Feline calicivirus Load, Oral Lesions, and Outcome in Feline Chronic Gingivostomatitis (Caudal Stomatitis): Retrospective Study in 104 Cats

Objective

This study was performed to assess the relationship between oral Feline calicivirus (FCV) load and severity of lesions at the time of presentation of cats suffering from feline chronic gingivostomatitis (FCGS) (part 1) and treatment outcome after dental extractions (part 2). We hypothesized that a higher FCV viral load would be positively correlated with the severity of lesions at presentation and negatively correlated with treatment outcome. In addition, the effect of dental extractions on outcome and the influence of preoperative severity of lesions on the outcome were investigated.

Materials and methods

Cats with FCGS were included in the study if they had been diagnosed with caudal stomatitis, had been tested positive for FCV using a real-time reverse transcriptase-PCR test on oropharyngeal swab, and had dental extractions performed within the authors’ department. General practitioners provided all previous medical treatments. Cats with recheck examinations were included in part 2 of the study. Multivariate statistical analysis was performed to assess the relationship between the different parameters.

Results

One hundred four cats met the requirements for part 1 and 56 cats for part 2 of the study. Data collected from patients’ record included patient history, viral testing results, extent and severity of oral lesions, extent of teeth extraction. Signalment, history, preoperative treatment, and severity of caudal and alveolar stomatitis score were not associated with FCV load (P > 0.05). Presence of lingual ulcers was significantly correlated with FCV load (P = 0.0325). Clinical cure (32.1%) or very significant improvement (19.6%) was achieved in 51.8% of cats within 38 days. Concomitantly, 60.7% of the owners considered their cat cured (41.1%) or significantly improved (19.6%). Extent of teeth extraction was not found to influence the clinical outcome (P > 0.05).

Conclusion

The results of this study did not support the hypothesis that FCV oral load is correlated with the severity of oral lesions or with the outcome following dental extractions. In addition, the severity of caudal inflammation was not correlated with healing time or achievement of cure.

Therapeutic Management of Feline Chronic Gingivostomatitis: A Systematic Review of the Literature

Feline chronic gingivostomatitis (FCGS) is a disease characterized by protracted and potentially debilitating oral inflammation in cats, the etiology of which is currently unknown. The purpose of this review is to apply an evidence-based medicine approach to systematically review and critically evaluate the scientific literature reporting the outcome of medical and surgical management of FCGS. Those articles meeting inclusion criteria were reviewed and assigned an "Experimental Design Grade" (EDG) and an "Evidence Grade" (EG) in order to score relative strength of study design and produced data. Studies were evaluated and compared, especially highlighting the treatments, the outcomes, and the therapeutic success rates. This review found a lack of consistency between articles' data, rendering direct comparison of results unreliable. The field of FCGS research, and ultimately patient care, would benefit from standardizing studies by adopting use of a consistent semi-quantitative scoring system and extending follow-up duration. Future researchers should commit to large prospective studies that compare existing treatments and demonstrate the promise of new treatments.

Comparison of inferred fractions of n-3 and n-6 polyunsaturated fatty acids in feral domestic cat diets with those in commercial feline extruded diets

OBJECTIVE

To compare presumed fatty acid content in natural diets of feral domestic cats (inferred from body fat polyunsatrated fatty acids content) with polyunsaturated fatty acid content of commercial feline extruded diets.

SAMPLE

Subcutaneous and intra-abdominal adipose tissue samples (approx 1 g) from previously frozen cadavers of 7 adult feral domestic cats trapped in habitats remote from human activity and triplicate samples (200 g each) of 7 commercial extruded diets representing 68% of market share obtained from retail stores.

PROCEDURES

Lipid, triacylglycerol, and phospholipid fractions in adipose tissue samples and ether extracts of diet samples were determined by gas chromatography of methyl esters. Triacylglycerol and phospholipid fractions in the adipose tissue were isolated by thin-layer chromatography. Diet samples were also analyzed for proximate contents.

RESULTS

For the adipose tissue samples, with few exceptions, fatty acids fractions varied only moderately with lipid fraction and site from which tissue samples were obtained. Linoleic, α-linolenic, arachidonic, eicosapentaenoic, and docosahexaenoic acid fractions were 15.0% to 28.2%, 4.5% to 18.7%, 0.9% to 5.0%, < 0.1% to 0.2%, and 0.6% to 1.7%, respectively. As inferred from the adipose findings, dietary fractions of docosahexaenoic and α-linolenic acid were significantly greater than those in the commercial feline diets, but those for linoleic and eicosapentaenoic acids were not significantly different.

CONCLUSIONS AND CLINICAL RELEVANCE

The fatty acid content of commercial extruded feline diets differed from the inferred content of natural feral cat diets, in which dietary n-3 and possibly n-6 polyunsaturated fatty acids were more abundant. The impact of this difference on the health of pet cats is not known.

Potential adverse effects of omega-3 Fatty acids in dogs and cats

Fish oil omega-3 fatty acids, mainly eicosapentaenoic acid and docosahexaenoic acid, are used in the management of several diseases in companion animal medicine, many of which are inflammatory in nature. This review describes metabolic differences among omega-3 fatty acids and outlines potential adverse effects that may occur with their supplementation in dogs and cats with a special focus on omega-3 fatty acids from fish oil. Important potential adverse effects of omega-3 fatty acid supplementation include altered platelet function, gastrointestinal adverse effects, detrimental effects on wound healing, lipid peroxidation, potential for nutrient excess and toxin exposure, weight gain, altered immune function, effects on glycemic control and insulin sensitivity, and nutrient-drug interactions.