Signalment
Species - canine and feline-Hard palate, buccal and tongue ulcers
Breed Predilections - Ulcerative eosinophilic stomatitis affecting three Cavalier King Charles spaniels have been described. The lesions are similar in gross appearance to palatine eosinophilic granulomas, but histologically they lack granuloma formation. Maltese
are prone to oral ulceration caused by periodontal disease.
Mean Age and Range - N/A
Predominant Sex - N/A
Signs - ptyalism, anorexia, painful chewing
Causes - see differential diagnosis, below
Risk Factors - N/A
Differential Diagnosis - periodontal disease, uremia (tongue and buccal mucosa ulcers), lymphocytic plasmacytic stomatitis (feline), viral diseases (calicivirus, herpes virus) in the cat, autoimmune disease (pemphigus vulgaris, bullous disease, erythema multiforme, systemic lupus erythemaosus) gum chewers disease ( chronic chewing of the cheeks), malignancy, trauma, chemical injury, eosinophilic ulceration, and infection (bacterial, viral, and fungal).
Imaging - N/A
Diagnostic Procedures
Exfoliative Cytology - with the help of an applicator stick placed on the lesion then on a microscopic slide for examination.
Oral examination of adjacent teeth for various stages of periodontal disease.
Pathology Findings - depends on etiology
Treatment
Uremic ulcers: pepsid, clindamycin, Carafate...make suspension of 1/4 to 1/2 gm tab in water and give dose s-bid. Promotes oral epithelialization and is a phosphorus binder too. It's important to keep on antibiotics and minimize the azotemia.
Ulcers due to periodontal disease - initial therapy to clean and
polish affected teeth. Extraction of advanced periodontal disease on affected
teeth may be necessary.
Medications
Drugs of Choice - topical antimicrobial and antifunal agents, topical and systemic corticosteroids, carboxymethlycellulose preparations (Orabase). Zinc containing oral rinses are helpful in the healing process.
Contradictions - N/A
Follow-Up - weekly then monthly
Surgical Considerations - be careful to resuture gingiva without tension after extraction.
