King Charles Spaniel diseases

Cavalier King Charles spaniels are predisposed to some eosinophilic syndromes, especially eosinophilic stomatitis, an autoimmune disorder.* Eosinophilic stomatitis may also be referred to as eosoniphilic granuloma.

Stomatitis is an inflammation of the mucous lining of any parts of the mouth, such as the tongue, palate, and gums. It usually appears as ulcers and lesions on the surfaces within the mouth.

Eosinophils, short for eosinophil granulocytes, are white blood cells which are a component of the immune system. These cells normally are found in parts of the brain, gastrointestinal tract, and some lower body organs and serve to combat certain allergens, parasites, and infections. When eosinophils are activated by an immune stimulus, they release cell-killing proteins capable of damaging tissues, ideally those of the parasites and infecting pathogen. When they infiltrate and accumulate in the lungs, esophagus, or respiratory tract, they often are associated with an immune dysfunction and may damage the dog’s own tissues.

Other forms of eosinophilic syndromes found in Cavaliers are eosinophilic bronchopneumonopathy (airway disease) and eosinophilic enteritis (intestinal).

The common symptoms are ulcers – which appear as appear as inflamed crater-like sores – on the surfaces of the mouth, such as the gums and soft palate (see photo at right by Dr. Gregg A. DuPont). Lesions – such as bumps or blisters – also may be present (see ).

The inflamed areas will be sensitive and painful, so the dog may exhibit difficulty in eating or a loss of appetite. Other clinical signs include halitosis, swallowing problems, coughing during meals, or clearing the throat. Often, the dog shows no visible symptoms, and the disorder is not discovered unless the dog's mouth is examined.

The appearance of the sores could be due to any of several causes. Thorough visual examination and a biopsy are standard procedure. A complete blood count, viral panel, and chemistry panel likely will be performed. Blood panel results usually are normal, except for elevated immunoglobulins reflecting chronic stimulation. Radiographs of the jaw may also be taken. The dog may be placed under anesthesia for some of these procedures.

Allopathic (conventional) veterinarians often assume that eosinophilic stomatitis is the result of an inappropriate, exceptionally active immune response. Therefore, their recommended treatment usually includes immunosuppressive doses of corticosteriods and/or other immune-suppressing drugs. They include prednisolone, azathioprine (Imuran, Azasan), cyclosporine (Sandimmune, Neoral, Cicloral, Gengraf), dexamethasone (Decadron, Dexasone, Diodex, Hexadrol, Maxidex), and glucocorticoid (cortisol).

However, since eosinophil granulocytes are blood cells which are activated by an immune stimulus to combat certain allergens, parasites, and infections, it would be advisable to test for the probable presence of an allergen, parasite, or infection, and these invaders should be treated accordingly, rather than to suppress the immune system which is trying to combat the invaders.

Antibiotics, especially clavamox and clindamycin, but also metronidazole* (Flagyl), doxycycline, and azithromycin, may be prescribed to offset any bacterial infection due to the side effects of the immune suppressing drugs.

Non-steroidal anti-inflammatory agents (NSAIDs) may provide both pain killing and anti-inflammatory relief.

Tooth removal may also be necessary. Laser therapy, such as CO2 laser treatment, has had inconsistent results in initiating a healing process of the ulcerated lesions, with any even limited success ususally only after full-mouth extractions.

In view of the limited treatment options offered by conventional veterinary practice, owners may want to consider contacting well-qualified licensed veterinarians who practice holistic care and treat auto-immune disorders. Search webpages for finding holistic veterinarians in the United States are located .

August 2015: US vet reports a case of eosinophilic stomatitis in a cavalier. In a , veterinary dental surgeon John R. Lewis (right) of NorthStar Vets in New Jersey reports discovering a cavalier King Charles spaniel with multiple areas of ulceration on her soft palate, including areas of yellow punctate raised plaques. He diagnosed eosinophilic stomatitis. He adds, "My personal experiences with use of amoxicillin-clavulanate or other antibiotics for eosinophilic diseases have not shown marked improvement."