Canine Stomatitis (CUPS & CCUS)

Canine stomatitis is a spontaneous oral inflammatory condition affecting dogs. It falls into the category of immune-mediated oral diseases, although the exact cause remains unproven. Canine stomatitis presents in two main forms: chronic ulcerative paradental stomatitis (CUPS) and canine chronic ulcerative gingivostomatitis (CCUS).

Chronic ulcerative paradental stomatitis (CUPS) is classified as a contact stomatitis, where inflammatory lesions develop at sites where the mucosa comes into contact with teeth. CUPS is believed to result from an inflammatory response triggered by persistent plaque bacterial biofilm (oral bacteria adhering to teeth), causing damage to the oral mucosa. This condition responds well to rigorous plaque control measures, such as daily tooth brushing and frequent professional dental cleanings performed by a veterinarian. These lesions are often referred to as "kissing lesions" or contact ulcers.

Canine chronic ulcerative stomatitis (CCUS) represents a more widespread inflammation within the oral cavity, often involving contact CUPS lesions. However, CCUS also affects sites that do not have direct contact with teeth, such as gingival and palatal mucosa. Similar to CUPS, it is considered an immune-mediated disease, but the exact cause remains uncertain. Unlike CUPS, CCUS does not respond favorably to aggressive plaque control measures, like daily tooth brushing and regular veterinary dental cleanings.

Dogs with stomatitis often exhibit concurrent periodontal disease, although the extent and severity of inflammation may not necessarily correspond to the amount of plaque or dental calculus present. Certain dog breeds, such as Greyhounds, Cavalier King Charles Spaniels, and possibly Maltese dogs, appear to be more susceptible to this condition.
Mild cases of canine stomatitis may not exhibit obvious symptoms at home. In contrast, severe cases can be extremely painful and debilitating, with affected dogs showing signs such as drooling (with thick, ropy, and occasionally bloody saliva), halitosis (especially foul breath), difficulty in grasping hard food and chew toys, and reluctance to eat. It's important to note that dogs with stomatitis typically don't completely stop eating, but their eating behaviors may change. 

Diagnosis and assessment are based on findings from oral examinations, dental radiographs (X-ray pictures), and biopsies of abnormal tissues. Treatment options can vary widely, ranging from daily oral hygiene practices and regular professional dental cleanings to medication or tooth extractions.