Red or Spotted Gums (Petechiae or Ecchymosis) in Cats

Key Takeaways

In cats, gums normally appear to be smooth with a salmon-pink color. Red gums or gums spotted with a brown, bright pink, red, or purple coloration are caused by hemorrhage of the mucosal surface called petechiae or ecchymosis.

• The three main causes for this symptom are failure to coagulate blood, excessively leaky vessels, and traumatic injury to the vessels

• Many serious conditions are associated with red or spotted gums including injury, immune-mediated disease, envenomation, liver disease, infectious disease, sepsis, cancer, drug reactions, and poisoning

• Diagnostics include a complete physical evaluation, bloodwork, diagnostic imaging, and specific testing of blood coagulation rate

• Treatment varies according to the underlying condition and might include antibiotics, anti-inflammatories, medications to help coagulation, blood transfusions, and supportive therapy

• Prognosis depends on the underlying cause, severity, and response to treatment

A Closer Look: What are Red or Spotted Gums in Cats?

This symptom is rare in cats, but it always indicates an emergency.

Red or spotted gums usually indicate a problem in the blood clotting process or damage to the small blood vessels of the mucosal lining. This is often life-threatening and requires urgent veterinary attention.

Possible Causes

Red or spotted gums usually indicate a clotting disorder or damage to the small blood vessels. Thrombocytopenia (decraesed circulating platelets) is the most common cause of this condition in cats.

The three main causes for this symptom are:

• Failure to coagulate the blood

• Excessively leaky blood vessels

• Trauma or injury to the vessels

Possible underlying conditions associated with the symptom include:

• Sepsis

• Thrombocytopenia

• Auto-immune disease such as FIV

• Feline infectious peritonitis (FIP)

• Liver diseases

• Anaplasmosis

• Panleukopenia

• Feline leukemia virus (FeLV)

• End-stage kidney disease

• Rodenticide toxicity

• Cancer

• Panleukopenia

• Mycoplasmosis

Risk Factors

The two main presentations of red or spotted gums are called petechiae (small dots) and ecchymoses (similar to bruises). They both indicate that blood is leaking from the vessels, but the manifestation of one over the other can help in the diagnostic process. Symptoms often progress and become more severe if the underlying cause goes untreated.

Changes in gum color are always a medical emergency.

Testing and Diagnosis

Diagnostics include:

• Physical examination

• Diagnostic imaging such as ultrasound

• Bloodwork

• Coagulation time testing

Treatment largely depends on the underlying cause and might consist of:

• Antibiotics

• Blood or plasma transfusion

• Supportive care

• Anti-inflammatories

• Specific medications that help coagulation

Similar symptoms

Red or spotted gums can be easily mistaken for mouth ulcers. The main difference is the usually smooth appearance of petechiae or ecchymoses, as opposed to ulcers that usually present with raised borders and a central depression.

Some cats may have pigmentation in their mouth, which could be entirely normal for them.