Acute Necrotizing Ulcerative Gingivitis (ANUG)
(
Necrotizing ulcerative gingivostomatitis, Ulceromembranous stomatitis, Necrotizing ulcerative stomatitis, Vincent’s stomatitis, Trenchmouth) |  |
| This relatively uncommon disease of dogs is characterized by severe gingivitis, ulceration, and necrosis of the oral mucosa.
Fusobacterium
spp
and spirochete organisms (
Borrelia
vincenti
), normal inhabitants of the mouth, have been suggested to cause this disease after some predisposing factor increases their levels or decreases the local resistance of the oral mucosa. The role, if any, of these organisms in causing disease is unknown. More recently, it has been found in humans that
Bacteroides
melanogenicus
intermedius
may play a more important role. Other potential factors are stress, excess glucocorticoid administration in susceptible dogs, and poor nutrition. |
| The disease appears first as reddening and swelling of the gingival margins and interdental papillae, which are painful, bleed easily, and may progress to gingival recession. Extension to other areas of the oral mucosa is common, resulting in ulcerated, necrotic mucous membranes and exposed bone in severe cases. Halitosis is severe, and the animal may be anorectic due to pain. Ptyalism may be present, and the saliva may be blood tinged. Differential diagnoses include severe
periodontal disease, autoimmune skin disease, uremia, neoplasia, and other systemic disease associated with oral lesions. |
| Diagnosis is made by exclusion of other etiologies. |
| Treatment of periodontal disease, debridement of lesions, oral hygiene, antibiotics (amoxicillin-clavulanate, ampicillin, clindamycin, metronidazole, tetracyclines), and oral antiseptics (0.1% chlorhexidine solution or gel) are indicated. |
