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Gingivitis

Published on: April 29, 2021 • By: peter · In Forum: Dogs
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peter
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April 29, 2021 at 08:10am
My 6yo Labrador cross had inflamed gums and signs of tartar, so I recently had  his teeth cleaned by a vet. He also received a 10 day course of antibiotics over this period.  He didn't need any extractions. However, the gum inflammation remains and I can smell some plague from his mouth, which temporarily disappeared after cleaning, has returned. I was expecting the inflammation to go, is this normal? Can gingivitis be caused by anything else on which the antibiotic wouldn't be effective? He recently had blood tests which were normal, however he has also developed a strong smell, possibly from the fur, after licking.  I have twice bathed him with a Clorexyderm 4% Shampoo in the last 2 weeks, but it doesn't remove the smell from his fur. He seems to be healthy and eats well and easily even with tough foods. He does suffer from atopic dermatitis though which can cause inflammation, mainly in the ears, and underside to a lesser extent. He finished a steroid treatment for this last February around the time the general smell started.
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Liz Buchanan BVSc MRCVS
Keymaster
April 29, 2021 at 08:14pm
Hello!   Indeed pets can get gingivitis without bacterial infection.  Ginvigivitis literally translates as 'inflammation of the gum' and gum can become inflamed for all sorts of reasons, including new teeth coming through, allergy, autoimmune diseases, injury and reactions to viruses (the latter particularly notable in cats). Regarding the skin, it sounds as though you have been attempting to treat against bacterial infection (we would advise running the choice of shampoo past your vet) but of course, yeast also live on the skin all the time and can sometimes proliferate.  This would be consistent with a distinctive smell and is common in dogs with atopic dermatitis, as the condition causes scratching, which can allow commensal bacteria and yeasts, which live harmlessly on the skin most of the time, to pass through the scratch-damaged skin into the deeper layers. I obviously can't tell from my armchair what is going on in this case, but hopefully these possibilities illustrate the importance of showing your dogs' skin to the vet for a proper assessment.
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Liz Buchanan BVSc MRCVS
Keymaster
April 29, 2021 at 08:16pm
I would add that whatever the underlying cause of of a dogs' gingivitis, the gum then becomes extremely vulnerable to bacterial infection (bacteria live in dogs' mouths all the time).
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Liz Buchanan BVSc MRCVS
Keymaster
April 29, 2021 at 08:16pm
I hope this helps and please let us know how you get on.
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peter
Participant
April 29, 2021 at 09:43pm
Thanks Liz for a useful response.
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peter
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April 30, 2021 at 06:04pm
Liz I've booked an appointment with the vet on Tuesday.  I'm trying to work out what questions to ask. You mentioned "the gum can become inflamed for all sorts of reasons, including new teeth coming through, allergy, autoimmune diseases, injury and reactions to viruses" Since he's had antibiotics, a deep clean, and has clean blood tests the only one left of those for a healthy 6yo dog is allergy. The vet already thinks this is the likely cause of his skin atopic dermatitis. However, can this be associated with inflamed gums as well as skin?  He certainly eats a lot of grass and earth when out and anything could get in there.
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Liz Buchanan BVSc MRCVS
Keymaster
April 30, 2021 at 11:44pm
Hi Peter   I don't agree with the science of your sentence that begins 'Since.'  First, my list was not exhaustive;  eating physically hard and challenging foods may be enough to make the gums go red without an allergy.  Some of the things I listed may show on bloods or may not;  they may show on biopsy, although this isn't typically done in these cases.  In cats, viral diseases sometimes present as gingivitis-like reactions (this is less clear in dogs).   Because I haven't seen the gums, I cannot help you to list specific differentials and narrow them down - I was more giving some possibilities - but it seems as though a good way forward would be for you to ask your vets (who can see the patient) to list the possible differentials that they think appropriate, and then decide whether you and they feel that it's worthwhile to do diagnostic tests to start pinpointing which of the possibilities it's most likely to be.  The answer to that often depends on the severity of the items on the list and the amount of discomfort present in the mouth.  I hope that that helps.
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peter
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May 05, 2021 at 02:57pm
Hi The Vet didn't think the Gingivitis was severe, although the she could smell mouth odour.  I intend to add Vet Aquadent Anti Plaque Solution in his water from today, which she is happy with. The bare part on his belly has flared up again slightly in the last week, which happens from time to time, so the Vet has prescribed a low dose daily steroid, and to stick with the Clorexyderm shampoo for the time being. I've also given the places he lies on a good clean. If things don't improve the vet suggests switching to Microbex or Douxo Pyos3 shampoo.  I briefly discussed the issue of grass eating and allergies. He's been on anti-histamines (Priton) for 3 weeks, although I doubt if they have much benefit or causes him any side-effects.
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peter
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September 08, 2021 at 08:13pm
Just an update on this. Last month, I agreed with my Vet to use Cytopoint in an attempt to treat the atopic dermatitis.  Initial results are disappointing, he's still licking under his front legs, & around his groin area which flared up yesterday and he's still shaking his ears. The fungus type smell seems to come immediately after he scratches these areas, sometimes there is a lingering smelly sock smell as well. This all seems consistent with Liz's first reply to me and the smell comes from deep inside the skin rather than the saliva as I first assumed.   I shampoo him once a week with Clorexyderm 4% Shampoo but this doesn't seem to give long lasting results. I haven't tried the other shampoo's mentioned earlier yet or an initial de-greasing as suggested here https://vcahospitals.com/know-your-pet/yeast-dermatitis-in-dogs but I'll discuss this with my vet on my next visit. I've also washed his sleeping & lying areas (usually my settee and bed cover!) just in case the fungus or bacteria is re-infecting him from there. He's due for his second injection in a week, hopefully it might work this time.
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