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Help, My Dog Has a Gum Boil (Epulis)

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Dog Has a Gum Boil

If your dog has a gum boil (epulis), you may be wondering whether it's a problem and what can be done about it. First of all, you should pat yourself on the back for noticing it, gum boils in a dog's mouth are not always readily noticeable, especially when they are small. Many times it takes an attentive owner to discover them. These gum boils in dogs are often noticed when the owner brushes a dog's teeth or inspects the dog's mouth. As with any bumps or lumps on a dog's skin, any growths, swellings or boils on a dog's gums should be checked out by a vet.

Gum Boils in Dogs

wet puppy

Gum boils, formerly known as epulides and now medically known as peripheral odontogenic fibromas, are benign tumors that usually grow on the dog's gums mostly concentrating in the area of the dog's front teeth by the incisors and canines. This type of tumor affects the dog's periodontal ligament, that lining of connective tissue fibers that holds the dog's teeth in place.

Gum boils are the most common types of benign tumors found in the oral cavity affecting dogs. While they can be virtually found in dogs of any age, they appear more often in middle-aged and senior dogs.

These slow growing tumors in dogs can present in different shapes and sizes. They can appear as small little bumps or quite large growths. They can be pedunculated, which means that they present on a stalk or they may present as smooth, non-ulcerating boils. If these growths manage to get quite large, they can be traumatized from the teeth on the opposite side of the jaw, causing bleeding.

While epulides are benign tumors that do not spread to other organs, they can cause problems locally. Some may grow to an extent of causing the teeth to shift and become displaced and some can even cause facial deformities. Large epulides can cause teeth misalignment due to the space they are occupying. Some epulides may bleed and can cause bad breath, drooling, painful eating and weight loss.

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Types of Gum Boils in Dogs

When it comes to growths in the dog's mouth, these can be benign, meaning that they do not spread to other parts of the body, or they can be malignant, which means that do spread and are therefore metastatic. It is impossible for the vet to determine exactly what a growth is by visual inspection alone. There are different varieties of benign and malignant tumors in dogs and even among the category of epulis there are several types.

As mentioned, epulis can come in different shapes and sizes. Based on their "composition" dog gum boils are classified in three different types: fibromatous epulis (smooth, pedunculated pink growths that do not invade bone), ossifying epulis (slow growing, calcified growths with a larger base of attachmentand acanthomatous epulis, now known as acanthomatous ameloblastoma (locally aggressive cauliflower-like.growths that tend to bleed easily, invade bone and cause tooth displacement).

At the Vet's Office 

The tissue sample taken from the liver is checked under a microscope.

A pathologist looks at tissue under a microscope.

Your vet will ask several questions about the growth, such as when it first appeared and if your dog seems affected by it. He or she will then take a look at the growth through a careful oral inspection. X-rays of the mouth may be taken to check whether the growth has involved the bone and x-rays of the chest may be taken as well to rule out a cancer that may have spread to the dog's lungs.

The best test though to rule out or confirm an epulis in dogs, consists of a biopsy. A biopsy can determine the exact type of growth. Without a biopsy, you can't be 100 percent sure of the type of growth it is.

The biopsy procedure is minimally invasive and consists of taking a small piece of tissue. What usually happens is the dog is given a quick acting sedative (like dexdormitor) and a tissue sample is cut off .

The tissue sample is then sent out to a pathologist who has special training in evaluating tissue samples under a microscope and reveal what the growth is. If the growth turns out being an epulis and it is not too large, the vet may suggest to just keep an eye on it. Certain types of epulides or large growths that are large, invasive and interfere with eating, may be surgically removed. Malignant growths are obviously also removed through surgery.

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Keeping an Eye on Things

Some vets may feel comfortable telling dog owners to keep an eye on the growth and report back if there are any changes such as the growth getting bigger or changing color. Many vets though prefer to take the "better safe than sorry" approach and suggest taking a biopsy or straight off removing the growth and then sending a sample to pathology.

Can epulides in dogs fall off? That's a good question. According to veterinarian Dr. Michael Salkin, this is possible and can happen when the epulis gets traumatized by teeth and it loses its blood supply. In that case, the growth may turn purple and appear as if hanging on a thin thread. The epulis will therefore die and fall off and the dog may swallow the growth or it may fall out and end up somewhere.

While an epulis falling off may sound like a good thing, the bad news is that the root may still be present which means that it will likely grow again, explains veterinarian Dr. Loretta. 

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Surgery to Remove Dog Epulis

Because epulides can turn out being troublesome (they can grow large and can become locally invasive), surgical intervention is often recommended. Something to keep in mind is that the smaller the epulis the easier the removal. Surgery may be pretty easy for small epulis, but it can get particularly challenging for the larger ones that cover multiple teeth.

Dogs, just like humans, have gum tissue that surrounds the teeth in a scalloped fashion. If the epulis has invaded this area, surgically removing these parts could lead to severely receded gums, up to that point of causing some root exposure.

The vet may therefore have to "debulk" it in an effort to leave behind as much functional amount of gum as possible so to prevent ending up with exposed roots, explains veterinarian Dr. Z. Debulking simply means "shaving down" the epulis to the level of the gum line. Laser surgery offers the advantage of decreased pain, decreased bleeding and decreased swelling. Ask your vet about this option.

It is always best to have x-rays done before the procedure. The x-rays may show whether there may be bone involvement which would require a more aggressive surgical approach (like wider margins).

In many cases, it might be a good idea to have a dental cleaning done while the epulis is being removed. When an epulis grows by the gum margin, its presence may facilitate the accumulation of food debris and tartar, and epulis and dental problems seem to go hand in hand, explains veterinarian Dr. Peter.

After surgery, it's important to have the vet send the tissue removed out to a pathologist so to ascertain that the growth was benign and not cancerous. There is always a chance for epulides to grow back after surgery requiring several surgeries.

Cost to Remove Dog Epulis

Dog ACTH test costs

Dog ACTH test costs

Dog owners who do not have pet insurance may be wondering how much it costs to remove a dog's epulis. As with other medical conditions, the costs may vary greatly from one location and another. The best option is to always call around to get price quotes. Vets are often willing to do price estimates.

Generally, prices to remove a dog's epulis will need to include pre-anesthetic bloodwork, the anesthesia and hospitalization fee (which is more costly in large dogs), the surgery, IV fluids, and associated medications. Costs as mentioned may vary from one place and another but roughly the cost to remove a dog epulis may be anywhere between $300 and 750 or higher. Costs for sending the tissue to be evaluated by histopathology may cost an additional $100-15o.

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References:

  • DVM360: Oral pathology and anatomic abnormalities (Proceedings)
  • DVM360: Oral pathology (Proceedings

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