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Wednesday, April 18, 2012

Stinky, Slobbery Mouth

Here's a good question from Ra...

I have a 2 year old Lhasa apso. She's a bit flat, she's really vocal though, and shes salivating alot, like her chin is always wet. Plus her breath reeks and it never did before. I tried to open her mouth and look in before and she wanted to bite me-she yelped. there was alot of chewed up food (biscuits) just sitting at the front of her teeth. London is littered with chicken bones-what do you think, maybe there is a chicken bone stuck in her mouth somewhere? P.s.I took her to the vet and they found nothing...yet I'm not sure they thoroughly checked her mouth as I wasn't there.

There are several things that can cause a foul odor, excessive salivation, and a painful mouth.  One of the most common is periodontal disease.  Severely infected gums and teeth will lead to these symptoms and can be quite painful.  I've seen many cases where the infection is so bad I will literally have my stomach churn as I'm looking at the mouth and then extracting teeth.

However, there are certainly other causes of these symptoms.  Oral tumors as they become necrotic can look like this.  And then there are foreign objects in the mouth, such as bones, sticks, and so on.  Something stuck in the mouth is a real concern.

Unfortunately it can be difficult to figure out what is in the mouth in some patients.  Most of them don't like us opening the jaws and sticking fingers or probes in the mouth, especially if it's painful.  It's common for pets to swing their head around and generally try to keep us from doing a good exam.  With a very well behaved and tolerant patient we can get a good look in the mouth.  Otherwise it's pretty tough.  If we really need to do an extensive exam in a resistant or aggressive patient, we're going to need to use a sedative of some sort.

If this was my patient and I couldn't get a good enough look on a routine exam, I would recommend a short-acting immobilization agent such as propofol or Dexdomitor.  Once the dog is fully asleep we can look and probe all we want.  It may also be necessary to take x-rays of the jaw and skull if the problem isn't very obvious.

Talk to your vet more about this, Ra.

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