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What are Stomatitis?

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.

Symptoms of Stomatitis in Dogs

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.

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Causes of Stomatitis in Dogs

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.

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Diagnosis of Stomatitis in Dogs

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.

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Treatment of Stomatitis in Dogs

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.

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Recovery of Stomatitis in Dogs

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.

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Stomatitis Questions and Advice from Veterinary Professionals

Need pet health advice? Ask a vet

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Mia

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Choodle

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12 Years

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Serious severity

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Serious severity

Has Symptoms

Lethargy
Yelping
Bad Breath
Red Gums
Pain Yawning

My wee dog Mia was dognapped about a year ago and taken away from us for about a week. When she was returned she had bad breath, mouth pain and lethargy. Long story short she has been diagnosed with stomatitis and we have tried for a year to maintain her condition with teeth extractions, regular dentals, steriods, mouthwashes antibiotics, anti-inflamatories and more. She has developed pretty severe anxiety around anyone going anywhere near her mouth so teeth brushing and mouth washes are kind of a no-go now. The vet I see is now suggesting we remove all of her teeth - my question is, can she live a happy and full life with no teeth? Thank you!

April 4, 2018

Mia's Owner

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Dr. Michele K. DVM

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1611 Recommendations

I'm not sure that I understand what might have happened to Mia that caused such severe gum disease after being gone for a week. without knowing more about what is going on with her, i have a hard time commenting on what might be going on with her, but dogs are typically able to live very normal lives with no teeth. She may need soft food to eat.

April 4, 2018

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luca

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king charles

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4

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Moderate severity

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Moderate severity

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my king charles was diagnosed with stomatitis after a biopsy was taken due to yelping when yawning. he was given antibiotics but no improvement - then steroids. still no improvement. vet said his teeth were fine, he eats ok, plays etc and stools ok. He plays ok in dog park etc. But still continues to yelp and ropey drool when upat park. He is 4 years old. I have swapped his food/water bowls for stainless steel, and he eats hypoalargenic food. Any clue as to what is still causing a real yelp of pain -especially when yawning.

Sept. 30, 2017

luca's Owner

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3320 Recommendations

It is possible that Luca has a problem with his temporomandibular joint which is causing pain when he yawns; an x-ray of his mouth may show something with this joint and is worth investigating. This may also explain drooling due to not properly closing his mouth. Regards Dr Callum Turner DVM

Sept. 30, 2017

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Tucker

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Husky/Springer Spaniel

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6 Years

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Serious severity

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Serious severity

Has Symptoms

Limping
Lameness
Ulcerated Mouth Lips And Gums

My dog is 6 1/2 years old, he is a husky/springer spaniel/hound/Australian Shepard mix. He is experiencing symptoms of stomatitis, many ulcers in his mouth. We have already visited our vet, he had a dental cleaning done to remove plaque from his teeth and is on an antibiotic 2x a day for the last three weeks. So far no change in ulcers and he has develop joint lameness first it was his back right leg and now his front right leg has started to have a limp as well. Or vet said he is getting arthritis but I'm worried the lameness is connected with his mouth. Do you have any ideas how we can better treat his mouth and is it possible that joint lameness is a result of stomatitis?

July 26, 2017

Tucker's Owner


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3320 Recommendations

Chronic stomatitis and joint pain may be caused by some infectious disease, but you would see some other symptoms as well: fever, vomiting, enlarged lymph nodes etc… Stomatitis may require additional treatment with an anti inflammatory and with mouth rinses with dilute chlorhexidine. The joint pain is probably due to a separate condition; autoimmune disease may cause both but again you would notice other symptoms as well. Regards Dr Callum Turner DVM

July 26, 2017

My toy dog is a cross breed of chihuahua and shih tszu. I got alarmed when I saw redness around his mouth. But he doesnt show any of the symptms above. What can be the cause of the redness around his mouth?

July 26, 2017

Andrea P.

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Snoopy

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Cavalier King Charles Spaniel

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1 Year

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Serious severity

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Serious severity

Has Symptoms

Lack Of Appetite
Halitosis
Lesion
Auto Immune Response

Snoopy is a Cavalier King Charles spaniel who was referred to a specialist ophthalmologist October 2019. While having treatment for recurrent eye inflation and irritation snoopy underwent surgery. It was discovered that snoopy has a reaction to the GA and also has lesions in his mouth and down his throat. They suspect multiple auto immune disease type illness . The scrapes from snoopys mouth confirmed Eosinophilic Stomatitis and he has been on a royal canin hypoallergenic diet for 3 months. SSnoopy is currently on cyclosporin and steroids as well as anti histamines and omoprazol. All of which give snoopy liquid poo. I feel so cruel watching him hurt to eat and not be able to offer him any relief. He has had pain relief in the past and he then poos blood so he is a very challenging case. If there hope for a dog so young with such adversity. Hes to nice a friend to be kept in pain selfishly for my benefit. I feel hopeless. Snoopy has always been reluctant to eat, drink and often vomits anything he ingests. He is predominantly white in colour and deaf also with lipid formation on his cornea so his alleries in his eyes can only be treated with a brief does of topical steroid due to increased lipid production. Any advice or options will be greatly appreciated.

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Lucy

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Cocker Spaniel

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14 Years

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Serious severity

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Serious severity

Has Symptoms

Halitosis Painful Wet Mouth

I have a soon to be 14 year Young cocker has suddenly developed stomatis. Finding it extremely difficult to manage and after 6 weeks of trying a combination of antibiotics steroids opiates and various other pain killers she has began drooling again with halitosis..I don't want to put her through unnecessary suffering and have had conflicting views on teeth extraction..any advice greatly welcomed she also pants heavily in the evening and has had a few episodes of incontinence..

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Stephanie

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Maltese x

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8 Years

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Moderate severity

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1 found helpful

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Moderate severity

Has Symptoms

Redness
Drooling
Bad Breath
Fungus

I have a 8 year old Maltese/Poodle breed that has had Stomatitis for about a year now. Before being diagnosed with this infection, she had two back to back cleanings and rounds of antibiotics. I changed vets because of not knowing what was wrong with her. November of last year she visited her old vet and he knew right then what she had. Her mouth had fungus on her tongue and her breath smelled like something has died in it. She wouldn't eat, drink and not much social activity. I was worried for her and scared. Now, her treatment is twice a month at the Vet getting Steriod/Antibiotic shots. She has to have a dental cleaning done yearly. Her breath is getting worse. This last cleaning she had 10 teeth pulled. Last year she had 4 teeth pulled. She is grumpy as ever. I am not ready to lose her but I know it is coming. Any advice anyone knows about this please let me know.

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