Mouth Inflammation and Ulcers (Chronic) in Dogs

Oral Ulceration and Chronic Ulcerative Paradental Stomatitis in Dogs

Oral ulceration and chronic ulcerative paradental stomatitis (CUPS) is a disease of the mouth which causes painful ulcers on the gums and mucosal lining of the mouth cavity. The cause of this condition has been determined to be a hypersensitive immune response to bacteria and plaque on the tooth surfaces, and sometimes signs of CUPS will start subsequent to a dental cleaning, when these materials are loosened in the mouth.

While it appears that manipulation and antigenic stimulation (substances that stimulate the production of antibodies in the body) in the oral cavity may trigger stomatitis, it is also believed that such animals would probably have eventually developed the disease anyway. In some cases, the only resolution is to remove all of the teeth, so that the bacteria that is normally found on the surface of the teeth is no longer present in the mouth at all.

Certain breeds of dogs appear to be at higher risk for developing this disease. Maltese, cavalier king charles spaniels, cocker spaniels and Bouvier des Flandres have been found to have a higher incidence. One of the complications of CUPS is idiopathic osteomyelitis, inflammation of the bone and marrow, which cocker spaniels have been found to be predisposed to.

Symptoms and Types

  • Bad breath (halitosis)
  • Swollen gums (gingivitis)
  • Faucitis (inflammation of the cavity at the back of the mouth – the fauces)
  • Pharyngitis (inflammation of the back of the mouth, continuous into the larynx – the pharynx)
  • Buccitis/buccal mucosal ulceration (tissue of the inner cheeks)
  • Thick, ropey saliva (ptyalism)
  • Pain
  • Loss of appetite (anorexia)
  • Mucosal ulceration on the gums that meet the lips – also called “kissing ulcers”
  • Plaque on teeth
  • Exposed, necrotic bone (alveolar osteitis and idiopathic osteomyelitis)
  • Scar formation on lateral margins of the tongue from prolonged inflammation and ulceration

Causes

Metabolic

  • Diabetes mellitus
  • Hypoparathyroidism
  • Hypothyroidism
  • Uremia caused by renal disease

Nutritional

  • Protein-calorie malnutrition
  • Riboflavin deficiency

Neoplastic

Immune-mediated

Infectious

Traumatic

Chemical/Toxic

  • Acids
  • Thallium

Idiopathic

Diagnosis

You will need to give a thorough history of your dog’s health, onset of symptoms, and possible incidents that might have precipitated/preceded this condition, such as chewing on cords or other inappropriate objects, recent illnesses, and the usual dental care that is provided. Your veterinarian will exam your dog’s oral cavity carefully to determine the extent of the inflammation, or whether any of the teeth are obviously in need of care. Standard tests will include a chemical blood profile, a complete blood count, a urinalysis and an electrolyte panel in order to detect an underlying disease. Diagnostic imaging is also standard in diagnosing dental conditions. X-rays will be taken to determine bone involvement and judge the extent of idiopathic osteomyelitis.

Often chronic antigenic stimulation (from a chronic disease condition) will predispose an animal to development of oral ulceration and stomatitis. (Antigens are substances that stimulate the production of antibodies in the body.)

pharynx

A cavity in the mouth where the respiratory systems and gastrointestinal systems come together

osteomyelitis

A medical condition in which bone and bone marrow becomes inflamed

prophylaxis

Prevention of something

urinalysis

An in-depth examination of the properties of urine; used to determine the presence or absence of illness

vasculitis

Any inflammation of a blood vessel or lymph.

osteitis

A medical condition in which the bone becomes inflamed

stomatitis

A medical condition in which the mouth becomes inflamed

malnutrition

A condition of poor health that results from poor feeding or no feeding at all

gingivitis

A medical condition in which the gums become inflamed

broad-spectrum

a) A type of antibiotic that kills both gram positive and gram negative bacteria.
b) A type of pesticide that is known to kill a whole variety of insects but also tends to affect other wildlife as well.

idiopathic

Relating to a disease of unknown origin, which may or may not have arisen spontaneously

larynx

The voice box; this is one part of the respiratory system

antibacterial

Used to refer to any drug or medical substance that has the ability to slow down or stop the growth of bacteria and other such organisms.

lateral

Moving or located away from the midline; located along the side

necrotic

Having to do with dead tissue

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