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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 32803
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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my 3 year old shih Tzu dog has a bad smell around his mouth,

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my 3 year old shih Tzu dog has a bad smell around his mouth, he has lovely white teeth and his breath does not smell, I have had him at the groomers today and she said he could have picked up a bacterial germ when sniffing on his walks, we live in the country. He does sniff a lot when off the lead.

Aloha! You're speaking to Dr. Michael Salkin
I'm sorry to hear of this with Theo. Please carefully examine his lips - particularly near the commissures (where the upper lips meet the lower lips) - for swelling, erythema (reddening), and crusting which is often bilateral and sometimes symmetrical. These changes would be consistent with a lip fold pyoderma or mucocutaneous pyoderma - both of which describe bacterial infection but have different etiologies.

A lip fold pyoderma is more likely. This is caused by infection within skin folds and in this case would cause a fetid breath which is caused by saliva accumulating in macerated (softened/broken), erythematous (reddened) lower lip skin folds. If this is the case, cleansing wipes as you've used work very well when used every 12-72 hours. You can also use an antibacterial shampoo containing chlorhexidine, benzoyl peroxide, or ethyl lactate which can be found either over the counter or at Theo's vet hospital. Topical application of an antibiotic ointment, solution, or spray every 24 hours for the first 5-7 days of therapy may be helpful.

Please let me know what you find and we can continue our discussion if need be.
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Customer: replied 3 years ago.

Dear Dr Michael,


Thank you for replying to my question regarding Theo, I am sure you are right about his corner lip folds and I have ordered some medication to put into his drinking water which contains chlorhexedine and a mouth spray.


I will keep wiping Theo's lips with the non perfumed baby wipes until my order arrives.


Also I hope this will stop Theo from regurgitating his spittle which sometimes makes him sick up a small bit of yellow bile.


Fondest regards XXXXX XXXXX you a very happy day


Linda Ellershaw

You're quite welcome, Linda. Thank you for your kind accept. I appreciate it.

Theo's regurgitating, however, shouldn't be related to his lips. I would need more history about this behavior to talk about it intelligently.

I'm going to check back with you in a few weeks for an update. Feel free to return to our conversation - even after rating - prior to my contacting you if you wish.
Customer: replied 3 years ago.

Hello Again Dr Michael,


Thank you for your reply and asking for more information.

Theo, has been castrated (2 years ago) he is a very laid back little boy and nothing seems to upset him, he is hardly ever told off as he is so good and obedient, everyone loves him young and old as he is so friendly and he loves playing with his doggie friends up the lane. (2 cocker spaniels),loves his walks every day with my husband who is in his 70's, they look like 2 old men walking down the lane. Theo lives in a large house with plenty of land for him to play in and we make sure he has plenty of fresh water, however he will go to puddles on the patio and drink the rain water from there too. We feed him James Wellbeloved kibble, we do not give him any dairy produce as our vet said the kibble was quite enough and the egg, milk, piece of cheddar cheese could be making him regurgitate his spittle and in the end make him sick, Theo could be lactose intolerant. We stopped giving him dairy produce when he was 6 months old and now at 3yrs he is still now and again regurgitating etc. I do not know what more I can tell you Dr, he does not chew anything up to eat. He only chews his hide chews which I have given to all my dogs to keep their teeth clean etc.

My best Regards Linda Ellershaw.

Thank you for the additional information, Linda. It doesn't sound pressing that we need to investigate his regurgitation at this time. Theo appears to be happy in himself and his quality of life isn't altered by his occasional regurgitation. If this exacerbated, his vet is likely to perform a basic biochemical profile of blood and urine tests plus imaging (X-ray + barium swallow) of Theo's esophagus. If nothing untoward is found, a presumptive hypoallergenic food might be prescribed. When we're still at a loss to understand why our patient regurgitates, we'll scope and biopsy these dogs looking for an inflammatory bowel disorder (IBD) or functional disorder such as pyloric stenosis- an anatomical defect of one of the sphincters of the stomach.

My best to Theo!
Customer: replied 3 years ago.

Dear Dr Michael,


Thank you so much for your time and your response, I have looked on Theo's Food Packet and it has on James Wellbeloved hypoallergenic Kibble, so we seem to be doing the correct thing for Theo.

Best Regards and have a good day


Linda Ellershaw & Theo.

It's my pleasure.

Please disregard the info request.

You may receive an inappropriate follow up from the site ostensibly from me. It wasn't and I apologize in advance should you receive it.
Customer: replied 3 years ago.

ok. Thank you.

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