Stomatitis in Dogs

Stomatitis is the inflammation of the gums and mucous membranes of the mouth and may be caused by several circumstances, including allergies to the biofilm on the patient’s teeth, reactions to certain types of medications, or a response to an underlying condition like a bacterial infection. Dogs that develop stomatitis form severe swellings and lesions on the inside of their mouth that make both grooming and eating extremely painful. This disorder is often resistant to attempts at treatment and in many cases, leads to an extraction of all of the teeth in order to return the animal to a manageable quality of life.

Stomatitis, or the inflammation of the gums and mucous membranes, can be caused by a number of disorders and illnesses in canines.

Stomatitis can occur in any breed or age of canine, and the animal is likely to be very resistant to having its mouth examined. Symptoms of stomatitis can include:

• Bleeding gums
• Bloody saliva
• Difficulty eating
• Excessive drooling
• Severe halitosis
• Grossly inflamed gums 
• Lesions on gums 
• Loss of appetite
• Pawing at mouth 
• Reluctance to groom
• Unkempt appearance
• Weight loss

In severe cases, the lesions can extend down to the back of the mouth and the throat areas. 

Types

Stomatitis that is caused by things like caustic chemicals or temporary infections can affect any canine and generally clears up once the underlying cause is removed. Although there are no primary breed predispositions for chronic stomatitis, certain breeds may be more likely to develop disorders that may lead to secondary forms of stomatitis. Some of these breeds can include:

Greyhounds, Miniature Schnauzers, Labrador Retrievers, and Maltese which are prone to Osteomyelitis of the bones in the jaw. 

Cavalier King Charles Spaniels, Rottweilers, German Shepherd, Italian Greyhounds, Siberian Huskies, and Alaskan Malamutes are prone to Eosinophilic/Hypereosinophilic syndrome, of which stomatitis is a symptom.

The basis for this particular disorder often remains unknown, but it is rarely a primary condition  in dogs. Prevailing causes and theories include oral contact with a caustic substance, an autoimmune disease or an allergy that causes the dog’s body to reject the proteins that make up either the biofilm or plaque found on the teeth or possibly even the teeth themselves, bacterial or fungal infections in the mouth, or severe reactions to medications such as the canine antibiotic Trimethoprim-sulfamethoxazole.

The oral examination that is required to get a preliminary diagnosis of this disorder is typically completed while the patient is under anesthesia as it is painful for the dog otherwise. The symptoms of this disease may be instigated or exacerbated by a number of issues, and any underlying issues will also need to be addressed. Tests that are used in the diagnosis of stomatitis can include:

• Bacterial culture - Your veterinarian may choose to run a culture of bacteria taken from the animal’s gumline
• Biopsy - A biopsy of the lesions and the area around them may be evaluated to eliminate the possibility of cancerous growths
• Blood tests -. Standard blood tests may also detect underlying conditions such as kidney disease or bacterial infections such as bartonellosis 

Additionally, X-ray imaging will be utilized. The imaging of the oral cavity by radiograph is of particular importance when dealing with stomatitis. This is typically done at the diagnostic stage to determine the viability of the roots and to determine if any of the teeth have been reabsorbed. If the teeth are extracted, it is crucial that no portion of the tooth is left behind. In some cases, just a few roots of the teeth can lead to the reoccurrence of the symptoms.

Several treatments can be attempted to ease the symptoms of this disease, although in many situations the full extraction of the teeth is required to restore the canine’s quality of life. Treatments that may be attempted to save the teeth include:

Antibiotics - Antibiotic therapy is known to give some relief to animals with stomatitis, but in many cases, the relief is short-lived; antibiotics are also useful after a tooth extraction in order to reduce the possibility of future infections

Cleaning - Both rigorous daily care and frequent professional cleanings are required for this form of therapy to have a chance, and even exacting oral cleaning regimens are rarely enough to curb outbreaks adequately to maintain a satisfactory quality of life

Immunosuppressant Drugs - Immunosuppressants have shown to be useful on a small percentage of the canine population with this disorder; side effects from this type of treatment can be problematic, however, including symptoms such as severe anorexia and bone marrow suppression

Steroid Treatments - Steroids are typically most helpful for symptoms of stomatitis if given over the long term; unfortunately,  steroids become less efficient in treating stomatitis over time, and long-term steroid use in dogs can lead to a higher incidence of other infections and a predisposition to diabetes

When these measures are ineffective, or if they are simply not feasible, the final treatment is usually the extraction of all of the teeth. Full tooth extraction sounds drastic, but it is frequently required, and it is generally successful in clearing the symptoms, and most canines are able to live a full and pain-free life afterward.

If your dog requires a full tooth extraction, ensuring that they have a quiet, calm location to return home to will help speed recovery. Patients that are recovering from anesthesia may have coordination difficulties at first and are often initially confused and disoriented. Isolation from children and from other pets may be advised until the medication has fully cleared your companion’s system. Dogs that have lost their teeth are unable to chew their food as effectively as dogs with teeth, and a diet of commercial wet dog food, dry food moistened with broth, or unseasoned human grade food such as chicken is recommended to facilitate eating.