Oral Mukozal Hastalıklar
Özet
Bu bölümde, köpek ve kedilerde görülen oral mukozal hastalıkların etiyopatogenezi, klinik bulguları, tanı yöntemleri ve tedavi yaklaşımları ele alınmıştır. Oral mukozada görülen ülserasyon, proliferasyon, nekroz ve inflamasyon gibi lezyonlar yalnızca lokal hastalıkların değil, aynı zamanda sistemik enfeksiyonların ve metabolik bozuklukların da erken göstergesi olabilir. Kronik gingivostomatitis ve kanin kronik ülseratif stomatitis gibi hastalıklar, şiddetli ağrı, halitozis, iştahsızlık ve yaşam kalitesinde azalmaya neden olurken; viral enfeksiyonlar arasında özellikle feline calicivirus ve feline herpesvirusde oral ülserasyonlar görülebilir. Ayrıca kandidiyazis ve kriptokokkozis gibi fungal enfeksiyonlar ile pemfigus vulgaris ve eritema multiforme gibi immün sistem kökenli hastalıklar da oral mukozada ciddi lezyonlara yol açabilmektedir. Tanıda ayrıntılı oral muayenenin yanında sistemik muayeninde yapılması önem taşmaktadır. Tedavi yaklaşımı; altta yatan nedenin kontrol altına alınması, oral hijyenin sağlanması, medikal veya cerrahi uygulamaların kombine edilmesini içerir.
This chapter discusses the etiopathogenesis, clinical findings, diagnostic methods, and treatment approaches of oral mucosal diseases in dogs and cats. Lesions such as ulceration, proliferation, necrosis, and inflammation observed in the oral mucosa may indicate not only local oral disorders but also systemic infections and metabolic diseases. Conditions such as chronic gingivostomatitis and canine chronic ulcerative stomatitis can lead to severe pain, halitosis, anorexia, and reduced quality of life, while oral ulcerations are commonly associated with viral infections, particularly feline calicivirus and feline herpesvirus infections. In addition, fungal infections such as candidiasis and cryptococcosis, as well as immune-mediated diseases including pemphigus vulgaris and erythema multiforme, may cause severe oral mucosal lesions. In diagnosis, alongside a detailed oral examination, comprehensive systemic evaluation is also of great importance. Treatment approaches include controlling the underlying cause, maintaining oral hygiene, and combining medical and surgical therapies when necessary.
Referanslar
Soltero-Rivera MM, Reiter AM. Diseases of the oral cavity and salivary glands. In: Bruyet- te D (ed.) Clinical Small Animal Internal Medicine. Wiley-Blackwell; 2020. p. 533–546. doi. org:10.1002/9781119501237.ch50
Jennings MW, Lewis JR, Soltero-Rivera MM, Brown DC, Reiter AM. Effect of tooth extraction on stomatitis in cats: 95 cases (2000–2013). Journal of the American Veterinary Medical Associ- ation. 2015;246(6): 654-660. doi.org:10.2460/javma.246.6.654
Gorrel C. Chronic gingivostomatitis. Nind F (ed.) Saunders Solutions in Veterinary Practice: Small Animal Dentistry içinde. Philadelphia: Elsevier Saunders; 2008. p. 77–79.
Arzi B, Mills-Ko E, Verstraete FJ, et al. Therapeutic Efficacy of Fresh, Autologous Mesenchymal Stem Cells for Severe Refractory Gingivostomatitis in Cats. Stem Cells Transl Med. 2016;5(1):75- 86. doi:10.5966/sctm.2015-0127
Harley R, Gruffydd‐Jones TJ, Day MJ. Salivary and serum immunoglobulin levels in cats with chronic gingivostomatitis. Veterinary Record. 2003;152(5), 125-129. doi: 10.1136/vr.152.5.125.
Harley R, Gruffydd-Jones T J, Day M J. Immunohistochemical characterization of oral mucosal lesions in cats with chronic gingivostomatitis. Journal of comparative pathology. 2011; 144(4), 239-250. doi: 10.1016/j.jcpa.2010.09.173.
Lommer MJ, Verstraete FJ. Concurrent oral shedding of feline calicivirus and feline herpesvirus 1 in cats with chronic gingivostomatitis. Oral Microbiol Immunol. 2003 Apr;18(2):131-4. doi: 10.1034/j.1399-302x.2003.00033.x. PMID: 12654105.
Hennet, P. Chronic gingivo-stomatitis in cats: long-term follow-up of 30 cases treated by dental extractions.JournalofVeterinaryDentistry.1997;14(1),15-21.doi:10.1177/089875649701400103
Bellei E, Dalla F, Masetti L, Pisoni L, Joechler M. (2008). Surgical therapy in chronic feline gin- givostomatitis (FCGS). Veterinary Research Communications. 2008; 32(Suppl 1), 231-234. doi: 10.1007/s11259-008-9153-8
Lowe AD, Campbell KL, Graves T. Glucocorticoids in the cat. Vet Dermatol. 2008 Dec;19(6):340- 7. doi: 10.1111/j.1365-3164.2008.00717.x.
Vercelli A, Raviri G, Cornegliani L.The use of oral cyclosporin to treat feline dermato- ses: a retrospective analysis of 23 cases. Veterinary dermatology. 2006; 17(3), 201-206. doi: 10.1111/j.1365-3164.2006.00514.x.
Cunha E, Tavares L, Oliveira M. Revisiting Periodontal Disease in Dogs: How to Manage This New Old Problem?. Antibiotics (Basel). 2022;11(12):1729. Published 2022 Dec 1. doi:10.3390/ antibiotics11121729
Wiggs RB, Lobprise HB. Clinical oral pathology. Veterinary Dentistry: Principles and Practice. Philadelphia, PA: Lippincott-Raven; 1997.p.104-139.
Harvey CE, Emily P. Small Animal Dentistry. St Louis, MO: Mosby;1993 p.146
Anderson JG, Peralta S, Kol A, Kass PH, Murphy B. Clinical and histopathologic characteri- zation of canine chronic ulcerative stomatitis. Veterinary pathology. 2017; 54(3), 511-519. doi: 10.1177/0300985816688754.
Bellows J. Chronic ulcerative paradental stomatitis of dogs. Clinician’s Brief. Available from: ht- tps://norwichterrierclub.org/wp-content/uploads/2016/09/CB_Chronic-Ulcerative-Paraden- tal-Stomatitis-of-Dogs.pdf (Accessed: 20/12/2025)
Reiter AM. Oral inflammatory and ulcerative disease in small animals. In: MSD veterinary ma- nual. Kenilworth, NJ, USA: MSD; 2014. https://www.msdvetmanual.com/digestive-system/di- seases-of-the-mouth-in-small-animals/oral-inflammatory-and-ulcerative-disease-in-small-a- nimals (Accessed 7/12/2025)
Pedersen NC. Inflammatory Oral Cavity Diseases of the Cat. Veterinary Clinics of North Ame- rica: Small Animal Practice.1992; 22(6):1323–1345. doi: 10.1016/s0195-5616(92)50130-9
Lobprise HB. General oral pathology. In: Lobprise HB, Dodd JR (eds.). Wiggs’s veterinary den- tistry: principles and practice. 2nd ed. USA: Wiley-Blackwell; 2019. p. 155–157
Arzi B, Anderson JG, Verstraete F. Oral manifestations of systemic disorders in dogs and cats. J Vet Clin Sci. 2008;1(4), 2-13
Niemiec BA. Oral mukoza patolojileri. In: Küçük hayvanların dental, oral ve maksillofasiyal hastalıkları. Deprem O, Yeşildere T (Çev. Ed.). Ankara: Nobel Tıp Kitabevi; 2013. p. 194–195. (Çevirmen: Mobay D.)
Pesavento PA, Maclachlan NJ, Dillard-Telm L, Grant CK, Hurley KF. Pathologic, Immuno- histochemical, and Electron Microscopic Findings in Naturally Occurring Virulent Systemic Feline Calicivirus Infection in Cats. Veterinary Pathology. 2004;41(3):257-263. doi:10.1354/ vp.41-3-257
Gaskell R, Dawson S, Radford A, Thiry E. Feline herpesvirus. Veterinary Research. 2007; 38 (2), pp.337-354. doi:10.1051/vetres:2006063. hal-00902876
Baker MK. Ulcerative glossitis-a facet of feline panleukopenia. Journal of the South African Veterinary Association. 1975;46(3), 295-297.
Radford A, Coyne K, Dawson S, Porter C, Gaskell R. Feline calicivirus. Veterinary research. 2007; 38(2), 319-335. doi: 10.1051/vetres:2006056.
Dosenberry C, Arzi B, Palm C, Vapniarsky N, Soltero-Rivera M. An update on oral manifes- tations of systemic disorders in dogs and cats. Frontiers in Veterinary Science. 2025;11. doi: 10.3389/fvets.2024.1511971
Boy S, Crossley D, Steenkamp G. Developmental structural tooth defects in dogs–experien- ce from veterinary dental referral practice and review of the literature. Frontiers in veterinary science. 3:9. doi: 10.3389/fvets.2016.00009
Stiles J, Townsend WM, Rogers QR, Krohne SG. Effect of oral administration of L-lysine on conjunctivitis caused by feline herpesvirus in cats. American Journal of Veterinary Research, 2002; 63(1), 99-103. doi: 10.2460/ajvr.2002.63.99.
Ozkanlar Y, Ulas N, Sozdutmaz I, Ozkanlar S. Clinical evaluation of antiviral combination tre- atment in cats with feline herpesvirus-1 infection. Polish journal of veterinary sciences. 2023 Dec 12 ;26(4):705-713. doi: 10.24425/pjvs.2023.148290.
Hussein IT, Menashy RV, Field HJ. Penciclovir is a potent inhibitor of feline herpesvirus-1 with susceptibility determined at the level of virus-encoded thymidine kinase. Antiviral Research, 2008; 78(3), 268-274. doi: 10.1016/j.antiviral.2007.10.015
Maggs DJ. Antiviral therapy for feline herpesvirus infections. Veterinary Clinics: Small Animal Practice. 2010 Nov;40(6):1055-62. doi: 10.1016/j.cvsm.2010.07.010.
Keyte S, Taker S. Bölüm 21.2. Enfeksiyöz hastalıklar. In: Schaer M, Gaschen F, Walton S (eds.) Köpek ve kedilerin klinik hekimliği. 4. Basım. Ankara. 2018. p. 930–934. Çeviri editörü: Altuğ N. Çevirmenler: Muz D, Muz MN. P. 930-934
Hofmann-Lehmann R, Hosie M J, Hartmann K, Egberink H, Truyen U, Tasker S, Belák S, Boucraut-Baralon C, Frymus T, Lloret A, Marsilio F, Pennisi M G, Addie D D, Lutz H, Thiry E, Radford AD, Möstl K. Calicivirus Infection in Cats. Viruses.2022; 14(5), 937. doi: 10.3390/ v14050937
Love DN, Malik R, Norris JM. Bacteriological warfare amongst cats: what have we learned about cat bite infections? Vet. Microbiol. 2000 1;74 (3): 179–193. doi: 10.1016/s0378-1135(00)00186-3
Love DN, Vekselstein R, Collings S. The obligate and facultatively anaerobic bacterial flora of the normal feline gingival margin. Vet. Microbiol. 1990;22(2-3): 267–275. doi: 10.1016/0378- 1135(90)90114-b.
Mallonee DH, Harvey CE, Venner M, Hammond BF. Bacteriology of periodontal disease in the cat. Arch. Oral Biol. 1988;33(9): 677–683. doi: 10.1016/0003-9969(88)90123-9.
Sims T J, Moncla BJ, Page RC. Serum antibody response to antigens of oral gram-negative bacteria by cats with plasma cell gingivitis-pharyngitis. Journal of dental research.1990; 69(3), 877-882. doi: 10.1177/00220345900690031001.
Dolieslager SMJ, Riggio MP, Lennon A, Lappin DF, Johnston N, Taylor D, Bennett D. Identi- fication of bacteria associated with feline chronic gingivostomatitis using culture-dependen
and culture-independent methods. Veterinary Microbiology.2011; 148(1), 93–98. doi: 10.1016/j. vetmic.2010.08.002
Gerds-Grogan S, Dayrell-Hart B. Feline cryptococcosis: a retrospective evaluation. J Am Anim Hosp Assoc 1997; 33(2): 118-122. doi: 10.5326/15473317-33-2-118.
Odom T, Anderson J G. Proliferative gingival lesion in a cat with disseminated cryptococcosis.
Journal of Veterinary Dentistry. 2000; 17(4), 177-181. doi: 10.1177/089875640001700403.
Legendre AM, Toal RL. Diagnosis and treatment of fungal diseases of the respiratory system. ln: Bonagura JD (ed.) Kirk’s current veterinary therapy Xlll: small animal practice. Philadelphi- a:WB Saunders; 2000; p.815-819;
Malik R, Wigney Dl, Muir DB, et al. Cryptococcosis in cats: clinical and mycological assess- ment of 29 cases and evaluation of treatment using orally administered fluconazole. J Med VetMycol. 1992;30(2):133-144. 10.1080/02681219280000181.
Anderson J G. Canine oral lesions: a decision-tree approach to ulcers, leukoplakia, and pig- mented lesions. Journal of the American Veterinary Medical Association, 2023;261(S2):62-69. doi:10.2460/javma.23.05.0294
Bizikova P, Linder KE, Anderson JG. Erosive and ulcerative stomatitis in dogs and cats: which immune-mediated diseases to consider?. Journal of the American Veterinary Medical Associati- on, 2023;261(S1): 48-57 doi:10.2460/javma.22.12.0573)
Tham HL, Linder KE, Olivry T. Deep pemphigus (pemphigus vulgaris, pemphigus vegetans and paraneoplastic pemphigus) in dogs, cats and horses: a comprehensive review. BMC Vet Res. 2020;16(1):457. doi:10.1186/s12917-020-02677-w
Yager JA. Erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis: a comparative review. Vet Dermatol. 2014;25(5):406-e64. doi:10.1111/vde.12142
Banovic F, Olivry T, Bazzle L, et al. Clinical and microscopic characteristics of canine toxic epidermal necrolysis. Vet Pathol. 2015;52(2):321–330. doi:10.1177/0300985814537530
