Stomatitis In Pets

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Stomatitis is an inflammation of the mucosal layer of the oral cavity, inner lining of the lips, and cheek. Blisters or vesicles and ulcers are also visible in the oral mucosa. Stomatitis is often accompanied with inflammation of gums or gingivitis, tongue or glossitis, and pharynx or pharyngitis.

Causes

Causative factors include immune mediated response; ingestion of toxins or caustic substances; trauma to oral mucosa; underlying metabolic conditions resulting in uremia related ulcers and infectious agents, such as overgrowth of normal bacteria of the mouth; herpes and distemper virus; Leptospira; and mycotic stomatitis due to Candida albicans in small animals, while viral diseases, for example vesicular stomatitis, foot and mouth disease, and blue tongue, commonly affect cattle, horses, pigs, sheep, and goat.
Feline caudal stomatitis (FCS) is a serious oral disease with an unknown primary cause. Infection with feline calicivirus is the most common secondary or underlying cause of FCS. Chronic ulcerative paradental stomatitis (CUPS) affects Greyhounds that are highly sensitive to oral bacteria present within plaque, and this is evident by a heightened inflammatory response.

Clinical Signs

Animals with stomatitis are unable to eat or drink with subsequent weight loss. The mucosal layer

appears swollen and painful. Ptyalism or excessive salivation and bad breath are also observed. Saliva may be tinged with blood. Regional lymph nodes are enlarged. In CUPS, severe inflammation and recession of gingival tissue is observed along with ulcerations of the oral mucosa. “Kissing ulcers” is a term used to define ulcers that are formed on the inner lining of the lip or cheek where it touches or comes in contact with the affected tooth.

Diagnosis

Stomatitis is diagnosed initially based on history and clinical signs. A physical exam of the oral mucosa is carried out. Manual restraint is necessary, as animals may be in pain due to the inflammation. In larger animals, light sedation is administered to allow for examination of oral mucosa. Serological tests or virus isolation tests are carried out if viral infection is suspected. Biopsies and pathologic exam is carried out if stomatitis is due to tumors or inflammatory diseases.

Treatment

Treatment for stomatitis is mostly symptomatic. Specific therapy is considered if an underlying cause is identified. Animals are fed soft and palatable food; an antibiotic course is recommended in chronic cases or with recurrent infections; fluids therapy if animal is anorexic; anti-inflammatory medication; and flushing the oral mucosa with antiseptic solutions, such as 0.1 percent chlorhexidine. If stomatitis is due to periodontitis or other dental disease, regular teeth cleaning with plaque removal is recommended. Owners are advised to brush their animal’s teeth at least two times a day to prevent buildup of plaque. In extreme cases, teeth extraction is considered, and all premolars, molars, and periodontal ligaments are removed.

Prevention

Preventative measures include maintaining oral hygiene with regular brushing and teeth cleaning as well as access to soft, palatable food and water. Prognosis depends on the underlying cause, with untreated and complicated conditions having a poor rate of prognosis. Once the causative factor is removed, stomatitis resolves on its own.