DEFINITION/OVERVIEW

• Focal or multifocal loss of mucosal integrity of the superficial epithelial layers in specific areas of the oral cavity

ETIOLOGY/PATHOPHYSIOLOGY

• Metabolic
  
  
  
  • Diabetes mellitus
    
  • Hypothyroidism
    
  • Renal disease: uremia
  
  
• Nutritional
  
  
  
  • Protein-calorie malnutrition
    
  • Riboflavin deficiency
  
  
• Neoplastic
  
  
  
  • Dogs: malignant melanoma; squamous cell carcinoma; fibrosarcoma
    
  • Cats: squamous cell carcinoma; fibrosarcoma; malignant melanoma
  
  
• Immune-mediated (see Chapter 58)
  
  
  
  • Pemphigus vulgaris: 90% have oral involvement
    
  • Bullous pemphigoid: 80% have oral involvement
    
  • Systemic lupus erythematosus: 50% have oral involvement
    
  • Discoid lupus erythematosus
  
  
• Drug-induced: toxic epidermal necrolysis
  
• Infectious
  
  
  
  • Retrovirus: feline leukemia virus (FeLV)/feline immunodeficiency virus (FIV)
    
  • Calicivirus: cats (see Chapter 52)
    
  • Herpesvirus: cats
    
  • Leptospirosis: dogs
    
  • Periodontal disease: dogs and cats
  
  
• Traumatic
  
  
  
  • Foreign body: bone or wood fragments
    
  • Electric cord shock
    
  • Malocclusion
    
  • Gum chewer’s disease: chronic chewing of cheek
  
  
• Chemical/Toxic
  
  
  
  • Acids
    
  • Thallium
  
  
• Idiopathic
  
  
  
  • Eosinophilic granuloma: cats, Siberian huskies, Samoyeds (see Chapter 59)
    
  • Lymphocytic-plasmacytic stomatitis (LPS): cats (see Chapter 50)
    
  • Chronic ulcerative paradental stomatitis (CUPS): dogs; allergic, hypersensitivity reaction to plaque
    
  • Idiopathic osteomyelitis: dogs

SIGNALMENT/HISTORY

• Dogs and cats of any age and either sex
  
• Breed predilection for ulcerative stomatitis (aka CUPS): Maltese, Cavalier King Charles spaniels, cocker spaniels, Bouvier des Flandres (Fig. 30-1)
  
• Feline LPS: may have predilection for Somali and Abyssinian cats (see Chapters 29 and 50)
  
• Idiopathic osteomyelitis: may have predilection for cocker spaniels; complication associated with CUPS

Figure 30-1 Breed predilection for ulcerative stomatitis include Maltese dogs.

CLINICAL FEATURES

• Halitosis
  
• Gingivitis
  
• Faucitis
  
• Pharyngitis
  
• Buccitis/buccal mucosal ulceration
  
• Hypersalivation (thick, ropey saliva)
  
• Pain
  
• Anorexia
  
• Mucosal ulceration—“kissing ulcers”: common in CUPS (Fig. 30-2)
  
• Plaque: with or without calculus
  
• Exposed, necrotic bone: with alveolar osteitis and idiopathic osteomyelitis
  
• Behavior changes secondary to oral sensitivity
  
• Scar formation on lateral margins of tongue: with CUPS (Fig. 30-3)
  
• Note: sometimes these signs will start following a routine dental cleaning on a previously “normal” patient; probably would have occurred eventually, just exacerbated by manipulation in the oral cavity

Figure 30-2 Mucosal ulceration—“kissing ulcers”—at site of contact with tooth surface and plaque.

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