Gum Color and Appearance: Assessing Your Dog's Health
What makes a dog's gums pale?
We look at the color of humans' faces to determine their health; indeed, facial pallor has been associated with sickness for centuries. In dogs, on the other hand, we can get an idea of the dog's overall health by simply looking at the color of the gums.
Yes, the gums... you heard right. Contrary to how the saying goes, a wet nose isn't an indicator of a dog's health, but the gums are fairly reliable if you know what to look for. This is why if your dog has been acting sickly, your vet will skip the nose and go straight to the mouth.
It's a good habit to get accustomed to the look of your dog's gums so you can recognize changes. A baseline assessment will help you quickly recognize any signs of problems, especially life-threatening ones.
If your dog is mellow and accustomed to having its mouth checked (a big plus!), what should you be looking for? There are three important criteria to consider:
- gum color
- capillary refill time
Let's take a look at each of these. Then, if your dog ever shows any abnormalities, you should be on your way to the vet without wasting time.
Be extra careful if you have a fractious dog or are unsure about how it may react!
Some dogs don't like having their mouths handled or may be in pain, which may trigger defensive biting.
If you're not sure, please stay safe and out of harm's way!
Assessing the Color of Your Dog's Gums
Take a look at your dog's gums now, at this very moment. If your dog is healthy, you can use this as a baseline assessment of normal gum color. Lift the upper lip to observe the color of the gums just above the upper canine teeth. Most dogs have gums that are of a healthy, bubble gum sort of salmon-pink color; however, consider that what is "normal" varies from dog to dog.
What should you do if your dog has naturally dark, black patches or black-pigmented gums (as often seen as in the Chow Chow or Shar Pei)? In that case, things can get a bit tricky. Veterinarian Christine Zink suggests examining the eyes instead by gently pulling the eyelid down and looking at the color of the tissue. Walker Valley Vet suggests as an alternate to assess the color of the tongue.
Now, take a mental picture of your dog's gums, tongue, and eye tissue color so you can remember what they look like. This way, if these tissues ever change, you can recognize problems quickly.
Note: It may be tempting to take actual photos of your dog's healthy tissues, but different lighting situations may make things complicated to interpret, so keep that in mind.
Assessing Your Dog's Gums' Capillary Refill Time
Capillary refill time may sound like a complicated term, but it's nothing more than the time it takes for the color of your dog's gums to return to normal after enough pressure is applied to cause blanching.
Gums have many small blood vessels called capillaries. In pressing and then releasing pressure on the gums, blood is forced out of these capillaries and then let back in, so you can measure the level of blood perfusion. All you will need to do is to simply press firmly on your dog's gums with your finger. Upon removing your finger, you'll notice how the tissue will appear briefly white until the normal pink color returns, preferably within 1.5 seconds. It should take no more than 2 seconds, explains veterinarian Ron Hines. In dogs with dark or black gums, you really cannot perform this test, but you can still rely on the color of the eye tissue as described above.
Assessing Hydration of Your Dog's Gums
While you're looking at your dog's gums and touching them, also check their level of hydration. In a normally hydrated dog, the gums will be slick and wet. In other words, slimy is the norm. You should feel the moisture upon touching them.
How to Check the Gums of Your Dog or Cat
What if My Dog's Gums Are Dry, Pale, and Bloodless?
Does your dog have any of these abnormalities as you are reading this article? If so, please stop reading and take your dog to vet!
This article was not necessarily meant to be read when your dog has pale gums and you're trying to figure out what is wrong with him. There are too many posts on forums and websites by dog owners concerned about their dogs' pale gums, asking what they should do. Instead of surfing for a solution, they should be on their way to the vet! Sadly, waiting it out often leads to a dire outcome.
This article is intended to help the reader recognize signs of trouble. Below, you'll find a list of possible causes for pale gums, but this is not meant to tell you what is wrong (that's your vet's job!). Use this list not for diagnosis but as impetus for taking your dog to the vet right away.
If your dog has pale gums at this very moment, stop reading and go see your vet!
This article was meant to be read when your dog is healthy.
If your dog is unwell, go to the vet.
Dog Gum Color Chart
Blue or purple
Lack of oxygen, trouble breathing, pneumonia, asthma, choking, heart disease, low blood pressure, and/or hypothermia
Bright, cherry red
Exposure to toxins, heat stroke, high blood pressure, and/or carbon monoxide poisoning
Topical irritation (such as from chewing a new toy), gingivitis, and/or infection
Liver problem, anemia, and/or massive destruction of red blood cells
Pale pink or white
Anemia, heart problems, blood clotting disorder, internal bleeding, kidney disease, shock, bloat, rat poison, heavy metal poison, cancer, and/or hypothermia
Recognizing Signs of Trouble
Now that you know how your dog's gums should feel and look like, it's time to learn what abnormal gums may mean. As mentioned, this is simply a guide to emphasize the seriousness of these gum abnormalities, it's not meant to give a diagnosis. Of course, it's also an interesting read for those who, like me, are intrigued about learning more about how the dog's body works!
Abnormal Gum Color
We talked earlier about how a dog's normal gums are generally a healthy, bubble gum pink. We also mentioned that the shade may vary from dog to dog. Owners who brush their dog's teeth on a daily basis are advantaged because they often inspect their dog's teeth and gums. This helps them keep track of any abnormalities. Anything that appears abnormal should raise a red flag. Pale gums will appear pale pink or whitish. If you notice pale gums in your dog, you are dealing with a serious condition, as this means poor blood supply to the area and often indicates a problem with the dog's circulation. See your vet immediately.
Medical Issues That Can Cause Pale Gums
The following are some causes of pale gums in dogs. Notice how most of these conditions are an emergency!
- Shock. in the case of shock, the blood may be concentrated in certain body parts (the most important organs) causing less blood flow to the gums. The causes for shock are many and may encompass several of the conditions below. See also the capillary refill time section.
- Chronic renal failure (kidney disease). The kidneys normally make a hormone called erythropoietin which is responsible for telling the bone marrow to make red blood cells. When kidney function is impaired, less of this hormone is made, therefore the dog becomes anemic and develops pale gums.
- Internal bleeding. This may be caused by several factors. Dogs who have been injured such as being hit by a car may bleed internally. Or the liver and/or spleen and sometimes kidneys have been damaged. A stomach ulcer may trigger internal bleeding, and often dog owners will notice their dogs will produce produce black, tarry stools. Another cause of internal bleeding is a splenic mass which may rupture and bleed causing lethargy, pale gums, collapse, and fluid in the belly (ascites).
- Auto-immune disease. This is a condition where the dog's immune system attacks itself. In the case of hemolytic anemia, the immune system starts destroying red blood cells which leads to anemia and pale gums. Hemolytic anemia is a condition that can be triggered by an immune-mediated cause.
- A blood clotting disorder. In this case, the blood doesn't coagulate normally, causing a predisposition to bleed abnormally or excessively. Examples are conditions like thrombocytopenia and thrombocytopathy. Affected dogs may develop pale gums, bleeding, blood in urine or stool, petechiae, and bruises on the skin.
- Heart disease. A heart problem may cause a drop in blood pressure and coughing, tiredness, rapid breathing, poor appetite, pale or bluish gums, weak pulse, and an enlarged abdomen (ascites).
- Bloat. In this case, the dog will have a distended abdomen, may try to vomit, may appear in distress, and will have ghost-white gums. The pale gums in this case appear because the stomach torsion stops blood from returning from the lower body back to the heart, explains veterinarian Patrick Mahaney.
- Severe parasite infestation. This can be seen when dogs have a heavy load of intestinal worms (such as hookworms) or a severe flea infestation. Yes, fleas can consume 15 times their own body weight in blood and trigger parasitic anemia, according to theASPCA. Also, tick-borne diseases like babesiosis may cause anemia.
- Exposure to rat poison. Rat poison often contains warfarin, an anticoagulant, causing affected dogs to bleed profusely.
- Heavy metal toxicity. Zinc toxicity results from the ingestion of objects made of zinc (think pennies minted after 1982). Zinc interferes with the absorption of iron meant for the production of red blood cells and triggers anemia, explains veterinarian Douglas Brum. Affected dogs develop pale yellow-colored gums and skin along with a brown, orange tint to the urine. Some may even develop acute kidney failure.
- Cancer. There are some forms of cancer, such as bone marrow cancer, that cause a decreased production of blood cells. Cancers affecting the liver and the spleen (hemangiosarcoma) can also cause significant internal bleeding into the abdomen.
*Note: In humans, pallor is often associated with anemia which is often due to reduced iron intake. Anemia can affect dogs, too, but for different reasons. Lack of iron is mostly unheard of in dogs because their diets are rich in iron.
Do you check your dog's gums?
Abnormal Capillary Refill Time
We talked about conditions associated with pale gums, but what about gums that take a longer than normal to resume their color? According to Pet Education, a prolonged capillary refill time (more than 2 seconds) signifies that the blood is not flowing adequately. Affected pets are not getting enough oxygen to their tissues. The following are just some possible causes of prolonged capillary refill times in dogs:
- Shock. In this case, the dog is experiencing decreased blood volume. Affected dogs may be lethargic and exhibit low blood pressure, low pulse, cold feet, rapid breathing, and prolonged capillary refill times. The causes of shock are many and include exposure to rat poison or toxins and internal bleeding.
- Dehydration. In this case, the volume of water within the dog's bloodstream falls, making blood thicker and more concentrated. This makes it more difficult to circulate, and as a consequence, those capillaries become slow to fill. Causes for dehydration include fever, heat stroke, or excess fluid loss from vomiting or diarrhea. Along with prolonged capillary refill times, dehydrated dogs may exhibit sunken eyes, dry mouth and gums, or poor skin elasticity which can be tested by gently pulling up the skin at the scruff area. If the skin fails to immediately spring back to its normal position, your dog is dehydrated and most likely needs vet attention.
- Heart problems. Affected dogs may have a fast heart rate but a weak pulse. How does this happen? Basically, there's a problem with circulation. The blood has a hard time flowing to certain areas. Heart conditions such as congestive heart failure or cardiomyopathy may cause decreased blood flow, which makes capillaries slow to fill.
- Medication overdoses. Some drugs such as Atenolol (Tenormin), propranolol (Inderal), and calcium channel blockers such as diltiazem (Cardizem) or digoxin (Lanoxin, Cardoxin) may trigger bradycardia, e.g. a slow heart rate, explains veterinarian Ron Hines. Because circulation is slower, it causes prolonged capillary refill times.
What if the Capillary Refill Time Is Fast—Less Than 1 Second?
This can also be a sign of trouble. According to the Merck Veterinary Manual, this may be an indication of "fever, heat stroke, distributive shock, or an early compensatory stage of hypovolemic shock."
Abnormal Gum Hydration
Last but not least, we have abnormal gum hydration. Normally, a dog's gums should be glistening, smooth, firm, and pink. In the case of dry, sticky, tacky gums, dehydration is the usual cause. This is often accompanied by sunken eyes and skin tenting. When dogs are dehydrated, they usually need to see the vet for IV fluid therapy and the cause of the dehydration needs to be addressed.
A Tip to Help Puppies Love Having Their Gums Checked
I like to train young puppies to get accustomed to having their mouth inspected from an early age. This way, their owners can start brushing their teeth and the pups don't mind when the vet needs to inspect their mouths. I use counterconditioning to accomplish this. I start by touching their mouth briefly and following with a tasty treat. Then I increase the length of the touch until I can open their mouth slightly. Then I stick a high-value treat in their mouth, yum! After several repetitions, the dog is eager to let me open its mouth because he knows a treat will follow. How about that!
Disclaimer: this article is the fruit of my research and not meant to be used as a substitute for professional veterinary advice. If your dog has pale gums or any other abnormality, please don't waste time online and see your vet immediately. It never hurts to play it safe! Also, if you're not sure how your dog may react to a gum check, stay out of harm's way. Some don't like their mouths checked or may be in pain which may lead to defensive biting. By reading this article, you accept this disclaimer.
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