Epulis: a gum problem seen mainly in boxers.

Tilly aged 1 year and Martha aged nearly 11
Tilly aged 1 year and Martha aged nearly 11

Although I love dogs of all shapes, sizes and breeds, I do have a bit of a soft spot for boxers. We have owned one or more for over 20 years.

Personality-wise, you might describe the boxer as a mixture of boisterousness, joyfulness, fearlessness, even brainlessness, but with a huge enthusiasm for everything about life.

All breeds have certain conditions to which they are pre-disposed, that is, more likely to suffer from than their friends of other breeds. One such condition in boxers is epulis, a lumpy overgrowth of gum tissue. Other breeds can get epulis, but not as commonly as in boxers.

Epulis is a benign growth of the gum tissue, which begins as small bumps on the gums and continues to grow, sometimes becoming cauliflower-like and almost enveloping some of the teeth. Unlike a malignant growth, it does not spread to other areas of the body. It can cause problems when the growths become large and when food and bacteria become trapped in the crevices, causing infection, a bad smell and sometimes bleeding. Sometimes the centre of the growth will become quite solid and almost bone-like.

Removal may be necessary if it is extensive or causing these problems. It is carried out under general anaesthetic to prevent pain and to allow access to all the affected areas of the mouth. The growths are simply cut away, either with a surgical blade, or more commonly, by thermocautery or electrocautery. These techniques seal blood vessels as they cut and so prevent bleeding. Thermocautery uses heat to do this, and electrocautery uses an electric current running through the cutting instrument.

Pain relief is usually given after the procedure and any infection will be treated with antibiotics. Examination under a microscope of the removed tissue (histopathology) may be advisable as it can be difficult to distinguish from other types of mouth tumour with the naked eye.

The condition is likely to re-occur given time. Martha, for example, has had two anaesthetics in her life for the removal of epulis, and each time she has also had some minor dental work done. She currently has a lovely full set of nearly-pearly-white teeth and healthy gums.

Jenny Sheriff BVM&S  MRCVS

If you are concerned that your dog may have an epulis you should consult your vet for advice. Use the interactive symptom guide if you are unsure how urgently you need an appointment.


26 thoughts on “Epulis: a gum problem seen mainly in boxers.

  1. im glad i found this info!! i love the internet so i can find REAL info like this!
    im glad its not CANCER of the mouth..i had a small terrier and it started small and grew(HAD IT TAKEN OUT ) and over and over till we had to put him to sleep because of it! it was a long 2yr procress and i WOULD NEVER LIKE TO SEE THIS HAPPEN AGAIN!

  2. Hi Jenny,
    I have a 12 year old boxer who has got a rather large epulis but due to his age I have put off having this removed as I have heard stories of boxers not recovering from the anaesthetic when they are older. Is there any truth in this?
    Kind regards

    1. Hi Adam, thank you for your question, it’s an interesting one. Anaesthesia is not completely risk-free for any patient however there are certain factors which will increase the risk in some patients. In older dogs, their age isn’t per-se the risk factor but the associated disease that may or may not have developed e.g. decreased renal and liver function, heart disease etc. Another consideration is indeed breed. Heart disease, more specifically cardiomyopathy, can be associated with boxer dogs for example. The point really is that all patients should be treated as an individual regardless of age and breed and their anaesthetic ‘risk’ assessed as such. Your vet should make a thorough examination of your dog to determine what anaesthetic considerations apply and they should then tailor their approach to that anaesthetic to account for those considerations. The other thing to consider is the risk-benefit factor. Is the epulis causing discomfort/affecting quality of life and is it likely to in the future? Sadly, your dog’s age is only going in one direction (though we’d love them to be forever young!) and there is the chance diseases associated with old age will develop. You’re right that 12 is a good age for boxer, I recommend that you have a good discussion with your vet about the pros and cons of going ahead with the op. Hope this helps. Best wishes

  3. Please remember when surgery requires Anaesthesia to tell your Vet NOT to use ACEPROMAZINE!!! Boxers have extreme sensitivity to this drug – it can cause 1st degree heart block which is a serious arrhythmia of the heart and also causes profound hypotension (severe lowering of the blood pressure).

    1. Hi Sandra, thank you for your comments. You’re right that acepromazine should be used with care in boxers though it is not necessarily the case that it shouldn’t be used under any circumstances. There are a few schools of thought on the matter amoung veterinary professionals however, if it is used, generally speaking it will be used at a low dose compared to use in other breeds.

  4. My boxer female boxer Roxie has this, She’s been very reluctant to have her mouth messed with. It dosnt bother her or effect her eating any food. Is it safe to leave as she is.

    1. Hi Tina, it’s great that it’s not bothering her now. What you have to consider is will it grow and become a problem in the future? I’d suggest that you have her examined by your vet who will talk through the pros an cons of acting upon this now. One consideration is the anaesthetic and without knowing her age or health status, some decide that it’s best to deal with the problem while a pet is in good health. It’s weighing up the pros and cons as I said and it’s an individual assessment so your vet is best placed to talk through your specific circumstance. Thanks for getting in touch and best wishes

  5. Hi
    I have a 6 yr old boxer with stinky, inflamed and sometimes bleeding gums. We live approx 600km from a vet so most of her care is done at home with advice from a retired vet. I have been taking her to the beach to clear her mouth with salt water and cleaning her mouth with a cepacol mouthwash ( on advice of vet) it seems to get better but if a couple of days pass without cleaning it flares back up again. She has never been “choppy” but over last couple of years has developed the full droopy boxer chops. Could this be epulis causing these problems? I’m happy to drive her to the vet but she does get stressed with the long trip so avoid where possible

    1. Hi Rachel, it sounds as if a good ‘sort out’ of her mouth is required and as if she might be rather uncomfortable. There could be all sorts of reasons and types of dental disease going on here and therefore it could be worth making the long journey to see a vet. They will likely have the equipment to carry out a dental, scale and polish with extractions if required as well as getting rid of any epulis that might be causing issues. They might also like to prescribe antibiotics if things are getting really bad. What you might find is that by attacking the issue head on, creating a clean, comfortable and ‘well’ mouth, you can keep on top of things with preventative care thereafter at home. Daily brushing is the best way to prevent dental disease and being so far from a vet, this would really pay off for you and your girl. Be sure only to use pet toothpaste for this. Though sea water has traditionally been seen as ‘cleansing’ because of the salt content, in actual fact, there is a great deal f bacteria in it too. It probably won’t have the desired effect and in fact, it could possibly make things worse. Best of luck

  6. Hi I have a female boxer Ruby aged 6 years. She has recently developed epulis and although they do not seem to be causing her any concern at the moment we are very worried about how they could grow as they seem to have grown in the last month. We have taken her to the vet and been monitoring them for approximately 2 months now however the vet is reluctant to operate due to her suffering from a grade 5/6 murmur as she has aortic stenosis and is symptomatic often fainting when over exciting and off leash although not for long periods of time this does happen regularly when immediately excited- it is understandably hard to not allow a boxer dog to occasionally get excited although I try my best. Please can you provide me with some advice about what the best course of action should be the vet has advised leave them until they cause her discomfort due to the risks associated with anaesthetic however I’m worried if we leave it too late they will be too big to operate on and side too much bone damage. She’s not currently on any heart medication as her symptoms have not changed since originally diagnosed at 1 years old. The vet has mentioned a possible referral to a specialist should I request this? Can you recommend anyone in the North East or is Edinburgh our best option? We love her dearly and feel she is still very young in her ways despite her condition we don’t want to give up on her. Thank you for your advice in advance

    1. Hi Claire, thanks for your comment. Deciding whether or not to remove it isn’t in Ruby’s case about the epulis itself, but about her heart condition and the anaesthetic risk. Personally, my advice for a six year old boxer who is already showing frank symptoms (syncopal episodes like her fainting) would be not to worry about the epulis right now, but get her heart condition worked up by a specialist. It may well be that there’s nothing more to be done than your vet already has, but I think it would be worth looking into – there are drugs that can reduce the symptoms and improve life expectancy, and there is a surgical procedure (balloon dilation) that seems to help some affected dogs. I would suggest that you speak to your vets about a referral to a specialist – they will be able to recommend the veterinary cardiologist closest to you (although I suspect that will be in Edinburgh – the RCVS doesn’t seem to list any specialist cardiologists in the North East).
      As you’re aware, boxers with heart conditions are not the most stable under a general anaesthetic, and I would agree with your vets about not performing surgery on her epulis unless/until it’s strictly necessary, but that is a conversation you’ll need to have if/when it does start bothering her.
      I hope that helps!

  7. Hi, we have a 12 year old boxer who has this. We are worried about a huge vet bill to remove it. Like many other comments we are also worried that surgery could be to much for him. Any more info would be great. Thanks

    1. Hi Steven, we would suggest an initial consultation with your vet so that they may examine his mouth and chat through the options. Explain your financial situation and what you can and cannot afford and try to make a plan. Age itself isn’t a disease and a reason not to anaesthetise a patient. It’s about considering the risks to the individual patient based on actual disease and weighing up the pros and cons of anaesthesia and surgery. We hope this helps, it is a very individual thing. We wish your dog all the best.

  8. I have a seven year old boxer ruby, thankfully she is healthy with no problems, however I had the vet check her teeth this week due to bad breath, he diagnosed epulis and explained the procedure however I can’t remember if he said she would have stitches, also our pet insurance through the AA at £30 a month for seven years do not cover this condition as it is classed as dental as it’s in her mouth, what would happen if she developed a mouth cancer scary to think the insurance won’t cover the costs as it’s her mouth.!!!!!

    1. Hi Lisa. The price of this will vary according to things like the size of your dog (for example, the amount of anaesthetic/pain relief/antibiotics needed will be worked out by his weight) and the number of epulis that need to be removed. I’d recommend giving your vet a call as they’ll be happy to provide an estimate for you before you have the procedure.

  9. My 8 yr old boxer has a mouth full of gum boils and can’t manage any hard treats anymore and sometimes drools. He’s already on codeine for his arthritis and the vet seems happy to not operate, but I worry she’s just considering my financial position (on benefits). I rub coconut oil on his gums after meals and have just started using pet safe aloe Vera tooth gel too. Is there anything else I can do for him? He also has acupuncture and is on onsior for his joints.

    1. Hi Sam. I can appreciate your concerns and it sounds like you’re doing absolutely everything you can for your boy! I’d recommend having another chat to your vet and see what she recommends now that they’re causing him more of a problem – she may discuss surgery with you further, or be able to recommend further medical treatments that could help (she’ll be able to advice more accurately based on his clinical history). If you’re considering surgery, your vet should be able to give you a rough estimate of costs so that you know what to expect should you decide to go down this route.

    1. Hi Lyn. We can’t give a rough estimate of costs unfortunately as it varies with vet practices and will also depend on his weight/how many need removing etc as they will use his weight to calculate how much anaesthetic and medication such as pain relief/antibiotics he would need. If he’s also suffering from smelly breath, I’d recommend popping him in to see your vet for a checkup to make sure there are no other problems. They will then be able to recommend something like a mouthwash if they think it’s necessary and would also be able to give you an estimate for removal of the epulis, depending on how bad the problem is.

  10. I have an 11 year old Boxer who has this problem. He has horrible breath!! Needless to say, our vet recommended opting out of any surgical removal due to his age and the recovery from anesthesia. With that being said, I have been searching for a quality dog food for him. I’ve heard that buying large morseled food (quarter or nickel sized) can help with general plaque control but I feel like my Boxer seems to struggle with larger morsels, causing his gums to bleed. So because of this, I have been purchasing food that have small morsels (size of Skittles) thinking it would be easier for him to eat it since most of his teeth are covered by gums. Is there truth behind the size of the dog food and should I stick with the smaller morseled food or look for some larger or “common” sized food??

    1. Hi Kendra. The larger kibbles can help with teeth as, in theory, the whole tooth has to penetrate the biscuit to break it up, and as it does so, that action can help to scrape any build-up off the tooth. In your dog’s case, I would say it’s best to find a diet that is easiest for him to manage – you may even find that wet (tinned) dog food may be better, as this will be softer on his gums. You can then add in some kind of enzymatic gel/water additive to help keep his teeth clean – as much as possible in his case. If you’re not sure what to use, or which diet is most suited to your dog, give your vet or vet nurse a quick call – they know his history, and they will be more than happy to advise you on the most appropriate diet for him, given the extent of his problem.

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