Q: Last fall, our 10-year-old miniature poodle Roxie started avoiding her food and hiding her snacks. She had always been an eager eater. I found her dried-out snacks hidden in the furniture and she often made a mess removing the bigger pieces of her wet dog food from her dish. We took her to the vet because we noticed her mouth was red and thought she may have chewed on an electrical cord. She was given an antibiotic and seemed to improve, but after she finished the meds, her behavior returned. This time the vet put her to sleep to examine her and found her mouth was much worse. It was now a bright red and quite painful. A biopsy of her tongue was sent away. They found severe inflammation, but no cause.
The vet decided it could be an auto-immune disorder and gave her prednisone, which worked for awhile, but now her problem has returned. Her vet thinks it may be an auto-immune disorder that involves only the mouth. We know she isn’t chewing on something that would irritate her mouth.
We would love to find out what the problem is, so we can properly treat it. We would appreciate any help you could give us.
— Jenette Frederick, Ravenna
A: I’m sorry to hear Roxie has been having such a hard time with her mouth.
There are multiple auto-immune disorders that can affect the mouth of dogs. Periodontal disease on its own can cause the symptoms you described, but I wouldn’t expect the prednisone to be as helpful as it was if this were the case with Roxie. Another auto-immune disorder that can cause oral ulcers is Systemic Lupus Erythematosus (SLE). With SLE we expect to see other systemic signs and the oral ulcers are not generally painful.
My best guess for Roxie is Immune Mediated Stomatitis. This is a very painful disorder and would cause her moderate to severe mouth pain. Often biopsies of oral tissue show only inflammation. Controlling Immune Mediated Stomatitis can be difficult and time consuming. The body reacts to tartar on the teeth as foreign, causing local inflammation and ulcers. All oral surfaces coming into contact with tartar can be affected, including the lips, tongue and gums.
Diagnosis of Immune Mediated Stomatitis is determined by clinical appearance, exclusion of other causes and responsiveness to treatment. Only 20 percent of cases will be confirmed by biopsy. Treatment involves regular dental cleanings, brushing teeth daily, oral rinses, chronic administration of prednisone and intermittent administration of antibiotics. In severe cases, it may be necessary to have all teeth extracted. Even with a full mouth extraction, it may take a year for the inflammation and ulcers to resolve.
Starting Roxie on a strict oral hygiene regiment will be essential in controlling her mouth pain. Her treatment plan will likely include steroids and antibiotics as well.
I recommend switching to canned or soft food until her oral health improves and her pain decreases.
— Dr. Connie White Lawless, veterinarian
Pet Vet Animal Clinic,