Fungal Stomatitis In Dogs – Causes & Treatments

Fungal stomatitis is an “inflammation of the soft tissues inside the pet's mouth” due to hyperimmune response and overgrowth of the fungus Candida albicans.

The etiology of stomatitis is not yet properly understood. This is thought to be a hyperimmune reaction that results in an unnecessary local inflammatory response to the bacterial biofilm in the mouth. Candida albicans is a rare cause of oral stomatitis in dogs as it is part of the regular GI tract flora.

Fungal Stomatitis caused by Candida albicans is called ‘thrush’ in humans. Fungal stomatitis is also called paradental stomatitis and Canine Chronic Ulcerative Paradental Stomatitis (CCUS).

Stomatitis is mostly a paradental disease rather than a periodontal disease. This means that it typically affects soft, fleshy structures inside your dog’s mouth and usually, it does not affect the supportive tissues in the dog’s jaw that attach the tooth to the socket (periodontal ligament, gingival, alveolar bone, and/or cementum).

Stomatitis refers to an immune-mediated disease of the mucous membranes within the mouth and may involve the oral mucosa, gums, tongue, the floor and roof of the mouth, and/or inside of the cheeks. These promptly become extremely sore, making it difficult for your dog to drink, eat and even swallow.

• Bad breath (halitosis)
• Bleeding gums
• Red or swollen gums
• Gingival recession and gingivitis.
• Difficulty or pain with chewing.
• Pus/mucous along the gum line, in nasal discharge.
• Lethargy
• Dehydration
• Excessive drooling

The Treatment depends upon the underlying cause and extent/severity of the problem.

Medications for medical conditions should be provided only as required.

• Oral or cutaneous candidiasis: Topical application of amphotericin B or Nystatin ointment or 1% iodine solution.
• The dental cleaning procedure includes a complete dental examination, after that a dental scaling using traditional hand scalers and ultrasonic cleaning equipment to scrape off the plaque and tartar from the surfaces of the tooth. Cleaning under anesthesia is recommended to be done twice a year.
• Gingival curettage is the removal of infected, inflamed, necrotic, or damaged tissue from the periodontal pocket.
• Immunosuppressants or Corticosteroids to reduce inflammation.
• Application of antibiotic medications to resolve gum infections.

When your dog is in a vulnerable group due to a situation or condition, providing required medications and feeding a diet with supplements can be helpful in preventing tartar from forming.

• Protect your dog from infections, ingestion of toxins, and hyperacidity.
• Use pain relievers regularly for dogs with caution.
• Use NSAIDsthat are less likely to cause ulcers.
• Avoid extreme exertion (sled dogs or other working dogs) as it can increase stomach acid that can overwhelm the mucosal barrier.
• The simple way to prevent plaque/tartar accumulation is by brushing the tooth using pet-safe enzymatic toothpaste that is specially formulated for dogs at least 2-4 times each week.
• Dental wipes, chewing toys for dogs, treats or oral rinse may also help decrease or delay plaque/tartar by reducing the build-up of saliva, food, and bacteria on the surface of the teeth and gums.
• Some exclusively formulated pet foods are used as dental diets with proven tartar-reducing ingredients. Water additives interfere with plaque development.

Maltese, Greyhound, Cavalier King Charles Spaniel, German Shepherd, Rottweiler, Siberian Husky, Alaskan Malamute, Pug, Chihuahua, Labrador Retriever, Miniature Schnauzer

1. Causes:

Apart from hyperactive immune response and overgrowth of the fungus Candida albicans, there may be other causes too.

• Autoimmune disorders
• Viral or bacterial infection
• Allergies / Adverse drug reaction
• Chronic gastritis
• Gastrinoma (gastrin secretion causing tumor in pancreas or duodenum).
• Exposure to certain drugs, especially long-term medications like NSAIDs or corticosteroids.
• Eosinophilic granuloma
• Helicobacter (chronic inflammation in the stomach).
• Hyperacidity of the stomach.
• Irritable bowel syndrome
• Ingestion of poison or toxin.
• Osteomyelitis
• Tooth malocclusion

2. Types:

To determine the severity of periodontal disease in dogs, Vets have a separate grading scale.

The scale ranges from 0 to 4:

• Stage 0: Gums are pink and flat, and teeth are clean.
• Stage 1: Subtle signs, inflammation of the gums (Gingivitis) - alveolar margins appear normal, No attachment loss to teeth supporting structures.
• Stage 2: Starting stage periodontitis - < 25% of the tooth’s attachment to the supporting structures is lost (measured by Dental x-rays or clinical probing).
• Stage 3: Intermediate periodontitis - 25% - 50% of the tooth’s attachment to supporting structures is lost.
• Stage 4: Advanced periodontitis - > 50% tooth support is lost.

3. Diagnosis:

• Routine dental exam
• Dental X-rays

4. Mortality:

There is no mortality associated with fungal Stomatitis documented yet.

5. Prognosis:

Dogs with Stage 1 and Stage 2 periodontal disease prognoses are good as long as they receive the appropriate dental care. Also, the prognosis of Stage 3 dogs is fair when advanced dental procedures are performed. In Stage 4 of periodontal disease, the prognosis is poor when greater than 50% of the tooth’s attachments are lost.

Time to visit the vet clinic for an examination, if you notice any of the following:

• Bad breath (halitosis).
• Bleeding / Red or swollen gums.

Foods to avoid:

• Chewy, sticky, and hard candy.
• Starchy foods can get stuck in the mouth.
• Crackers, Popcorn
• Rice and potato-based dental sticks.

What to feed?

• Bland diet: Boiled chicken, cooked rice, tofu, low-fat cottage cheese, boiled hamburger, canned tuna, etc.
• Provide easily digestible lean cuts of meat (boiled and drained off excess fat).
• Semi-moist pet food with boiled chicken or Meat-flavored baby food.
• Low fat, Plain yogurt
• Avoid hard treats, kibble, and biscuits.
• High-fiber foods: Whole grain bread, rice, cereal, green beans, peas, Beet Pulp.

The etiology of stomatitis in dogs is still unknown but may be caused by a hyperimmune response of the gum tissues to dental plaque antigens.

When there is an underlying reason for your pet’s stomatitis, such as a disease or infection, then your vet may recommend further diagnosis as that condition must be treated in addition to the stomatitis itself.

Mostly, stomatitis is treatable and is not fatal to the dog. However, untreated stomatitis may lead to other complications like periodontitis and loss of teeth. When treated appropriately, stomatitis won't cause danger to the pet’s life in most cases.