equis - Articles
Mouth: ulcers
Synonym(s): Oral ulceration, stomatitis, vesicles
Introduction
- Disruptions in the integrity of the oral mucosa.
- Cause: infectious, toxic, caustic, traumatic, neoplasia.
- Signs: ptyalism, inappetence/anorexia, visible ulcers/vesicles/bullae/crusts.
- Diagnosis: physical and oral examination, other procedures dependent on inciting cause.
- Treatment: dependent on inciting cause.
- Prognosis: dependent on inciting cause.
Presenting signs
- May be preceded by vesicles, crusts or bullae.
- Variable depending on inciting cause.
- Excessive salivation
. - Inappetence/anorexia.
- Depression.
Geographic incidence
- None.
Age predisposition
- Any age.
Breed/Species predisposition
- None.
Public health considerations
- Vesicular stomatitis Vesicular stomatitis is zoonotic.
Cost considerations
- Dependent on inciting cause.
Special risks
- Dependent on inciting cause.
Pathogenesis
Etiology
- Viral, eg vesicular stomatitis Vesicular stomatitis .
- Infection, eg habronemiasis Habronemiasis .
- Drug-induced, eg phenylbutazone Phenylbutazone .
- Chemical/toxin-induced, eg caustic burn (mercury blister), plant toxin, cantharidin toxicity (Blister beetle toxicosis), uremia Kidney: renal failure .
- Food impaction, eg dental problems Teeth: dental disease - overview
, facial paralysis Facial nerve: trauma . - Direct trauma, eg tooth damage Teeth: fracture .
- Oral foreign body.
- Endocrine, eg pituitary adenoma Pituitary pars intermedia dysfunction (PPID) (rare).
Pathophysiology
- Variable, depending on inciting cause.
Viral
- Virus invades mucosal epithelium producing vesicles which rupture to leave ulcers.
Phenylbutazone Phenylbutazone
- Inhibits prostaglandin synthesis → ?vasoconstriction of microvasculature of GI mucosa → ischemia → ulcer formation.
Cantharidin
- ?interference with mitochondrial oxidative enzymes → cell membrane damage → acantholysis + vesicle formation → ulcers.
Chemical
- Direct action of the chemical on the oral mucosa → chemical burn → mucosal slough → ulceration.
Food impaction
- Can → infected food material → infected + abrased oral mucosa → ulceration.
Direct trauma
- Can → abrasion and ulceration.
- Excessively long or broken teeth Teeth: fracture .
- Sharp foreign bodies in feedstuff.
Timecourse
- Dependent on inciting cause.
Epidemiology
- Cases with viral causes may be part of a contagious epidemic, eg vesicular stomatitis Vesicular stomatitis .
- Chemical/toxin induced ulcers may affect several animals in the same paddock, eg contaminated water trough, infested grazing.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Johnson P J et al (2012) Ulcerative glossitis and gingivitis associated with foxtail grass awn irritation in two horses. Equine Vet Educ 24 (4), 182-186 VetMedResource.
Other sources of information
- Mair T, Divers T & Ducharme N (2002) Manual of Equine Gastroenterology. W B Saunders.
- Brown C M & Bertone J J (2002) The 5-Minute Veterinary Consult Equine. Lippincott, Williams & Wilkins.