Painful Mouth Leads to Chronic Ulcerative Paradental Stomatitis (CUPS)

By: Dr. BreAnn Feldman from Oswego Animal Hospital

Hudson, a seven year old male neutered spaniel mix, presented for a 2-3 week history of reluctance to eat, painful mouth, and a foul odor coming from his mouth.

A physical examination revealed ulcerations along the inside of his lips and along his gum line. He had a foul odor coming from his mouth. It was difficult to examine his mouth without sedation due to the extent of his oral pain and discomfort. No other abnormalities were noted during physical exam.

A diagnosis of chronic ulcerative paradental stomatitis (CUPS) was suspected however blood work and a biopsy were recommended to rule out any other potential causes.

Chronic ulcerative paradental stomatitis (CUPS) is a complex disease process with the specific causes and pathogenesis, or progression, of disease remaining mostly unknown. It seems animal with CUPS are unable to tolerate the presence of bacterial plaque on the crowns of their teeth even in very small amounts. Plaque control and control of the inflammation is key to management of the disease process.

There are two methods of treatment for CUPS. Medical management consists of daily brushing of the teeth, often with special tooth paste, plaque control diets, mouth washes or rinses, and frequent dental cleanings with your veterinarian (every 3-4 months). Dental radiographs can be helpful in assessing the teeth that are affected by periodontal disease and endodontic disease, and these teeth require extracted. Pain medication and antibiotics are also indicated in helping keep the patient comfortable and infection at a minimum. Medical management can often be difficult due to the patient’s significant level of oral pain. It is difficult to brush the teeth of a patient who’s mouth is so sore you cannot get close to it.


The other treatment method for CUPS is a full mouth extraction. While this method is much more aggressive, it also provides far superior results and resolution of clinical signs in both the short term and long term. Extraction of all teeth resolves the inflammation, pain, and infection these patients suffer from.

Hudson had blood work performed that was normal and a biopsy of the ulcerated areas that revealed inflammation consistent with CUPS.

Hudson had a full mouth extraction to alleviate his pain, inflammation, and infection. He has healed well, is eating normally even without his teeth, and is back to acting like a normal healthy dog.

It is important to keep on top of your pet’s dental health. While CUPS is very rare, dental disease and tarter formation is a very common problem with our pets. Please make sure your pet’s mouth is evaluated annually and have them see your veterinarian immediately with any concerns that may arise.