Vet’s 2025 Guide to Canine Stomatitis (Chronic Oral Inflammation) 🐶✨🩺

By Dr. Duncan Houston BVSc

💡 What is Canine Stomatitis?

Stomatitis is chronic inflammation of the mouth’s mucous membranes—affecting gums, tongue, inner lips, palate, and pharynx—it’s called “chronic ulcerative paradental stomatitis” (CUPS or CCUS) when ulcers form where tissues contact plaque-covered teeth This hyperimmune response causes painful ulcers—even a single tooth's plaque can trigger it Dogs with CCUS often also have periodontal disease, but in ~60% dental disease isn’t primary

🚩 Who Is Affected?

• Any dog can suffer—predisposed breeds include Greyhounds, Maltese, Miniature Schnauzers, Cavaliers, Cocker Spaniels, Labradors, and Bouvier Des Flandres
• Stomatitis often occurs in middle-aged to older dogs but can appear at any age.
• 5–10% of dogs with stomatitis have concurrent immune-mediated diseases

👀 Clinical Signs

• 🗣️ Severe halitosis, drooling (ropy, sometimes blood-tinged saliva)
• 😣 Painful ulcers—"kissing lesions" at cheek/lip contact points
• 🍽️ Difficulty eating, anorexia, weight loss, pawing at mouth
• 😶 Thick mucus, pus-like discharge, exposed or necrotic bone in severe cases

🧪 Causes & Risk Factors

• 🦠 Hyperimmune response—abnormal immune reaction to plaque/bacteria
• 📉 Associated with systemic diseases—diabetes, renal disease, hypothyroidism, metabolic disorders
• 🧪 Nutritional deficiencies impacting mucosal health
• 🦴 Neoplastic or autoimmune conditions—pemphigus, lupus, squamous cell carcinoma
• 💥 Trauma—chemical burns, foreign objects, electric shock

🧪 Diagnosis

1. History & exam under GA: painful mouth, ulcers, plaque, systemic disease context
2. Biopsy & histopathology: differentiate CCUS from pemphigus, lupus, neoplasia
3. Bloodwork & systemic screening: CBC, biochem, endocrine panels rule out systemic contributors
4. Oral imaging: dental X-rays assess bone involvement, osteomyelitis
5. Cytology/culture: identify bacterial/fungal pathogens—less common

🛠 Treatment Strategies

1. Dental Cleaning & Plaque Control

• 🦷 Professional cleaning every 3–4 months under anesthesia—scaling, polishing, subgingival cleaning
• 🪥 Daily home care: brushing, chlorhexidine rinses/gels. Strict hygiene is essential

2. Tooth Extraction (When Needed)

• ✂️ Partial or full-mouth extractions when lesions tied to plaque contact—often dramatically improve signs
• Extraction often resolves ulcers but may not cure immune oversensitivity

3. Medical Management

• 💊 Systemic anti-inflammatories: steroids, NSAIDs to reduce mucosal inflammation
• 💊 Immunosuppressives: cyclosporine or azathioprine for immune-mediated cases
• 💊 Antibiotics or antifungals: if secondary infection suspected

4. Supportive Care

• 🍲 Soft, palatable diet or feeding tube if anorexic
• 💧 Pain control: opioids, NSAIDs, topical anesthetics.
• 🔄 Ongoing plaque control and rechecks.

📈 Prognosis & Long-term Management

• 🟢 Good outcome with plaque control; many dogs improve dramatically after extractions
• 🟡 Guarded if bone involvement, osteomyelitis, or systemic disease
• 🔁 Relapses common—requires lifelong dental hygiene and medical support.

🏡 Ask A Vet App Home‑Monitoring Tools 📲🐶

• 🗓️ Medication & dental cleaning reminders.
• 📊 Track symptoms: drooling, eating, halitosis, pawing.
• 📷 Upload photos of ulcers, plaque, worrisome discharge.
• 🔔 Live alerts for red flags: bleeding, anorexia, worsening drooling.
• 📘 In-app guides: oral hygiene routines, soft diet prep, home pain care.

🔑 Key Takeaways 🧠✅

• Stomatitis is painful chronic oral inflammation—often immune-mediated.
• Diagnosis requires biopsy, imaging, and systemic evaluation.
• Treatment blends cleanings, extractions, medications, and lifelong plaque control.
• Lifelong monitoring essential to manage relapses and systemic contributors.
• Ask A Vet tools support home care, compliance, and early warning alerts.

🩺 Final Thoughts ❤️

In 2025, managing canine stomatitis means a team approach: thorough dental care, precise diagnostics, medical support, and empowered home involvement. Removing plaque, controlling immune response, and monitoring health improves comfort and quality of life. With Ask A Vet, owners stay engaged—tracking symptoms, coordinating care, and receiving alerts so any relapse can be addressed swiftly 🐾✨.

Visit AskAVet.com and download the Ask A Vet app to log symptoms, schedule cleanings and meds, upload mouth images, and stay connected with your vet throughout treatment and recovery. 📲🐶