Pet 411: What do I do about my pet’s stinky breath?

Even under the best of circumstances, few of our pets have minty fresh breath. But if the smell coming from your dog’s or cat’s mouth suddenly takes a turn for the worse, that’s a major clue that ST Meeks Blog Logo Image 2016 01 28something may not be quite right.

That’s why I was concerned when I received an email from a reader who said his 11-year-old dog had developed a case of horrible breath. He took the pup to the veterinarian, who said her teeth and gums looked good. The only other unusual behavior the dog was displaying was an increase in the amount of water she was drinking. What, the reader wanted to know, should he do next?

It’s impossible to make a diagnosis without seeing the dog myself. But the reader is correct to be concerned. While most of the time bad breath is due to problems with the teeth or gums, it can also be an indicator of larger medical problems, including issues with the respiratory system, gastrointestinal tract or internal organs. It’s also a timely subject, since February is National Pet Dental Health Month.

As an internal medicine specialist, I would recommend the pup undergo a full test of her blood and urine to see if there are any underlying medical conditions causing the stinky breath. Diabetes and kidney disease can cause increased drinking and bad breath and can be easily detected with bloodwork.

I also reached out to my colleague, Dr. Donnell Hansen, a board-certified veterinary dentist who works in our Minnesota BluePearl hospitals, to see if she had any suggestions.  While the reader’s primary care vet said the dog’s teeth and gums look good, a more thorough investigation may be necessary. The majority of dental disease occurs beneath the gum line, Dr. Hansen said. That’s why it’s so important to schedule an annual oral examination for your pet that includes X-rays.

The exam should be conducted while the pet is under anesthesia, Dr. Hansen added. Why? Unlike people, dogs and cats don’t understand the concept of “open wide” or how to rinse out their mouths on command.  Also, sedating a pet gives the veterinary dentist a better opportunity to probe for hidden problems and avoid causing pain, she said.

These exams can help identify problems with a pet’s mouth that aren’t immediately apparent. For example, Dr. Hansen said she recently examined a Brittany spaniel with smelly breath. While the dog’s teeth and gums looked beautiful, X-rays showed extensive periodontal disease beneath the gum line. In fact, Dr. Hansen had to extract 22 of the dog’s teeth! The owner was so grateful, she baked Dr. Hansen 22 tooth-shaped cookies.

Dr. Hansen also encouraged the reader to talk to his veterinarian about ruling out the possibility of a tumor either in the mouth or the gastrointestinal tract. The vet might order an abdominal ultrasound in order to make a diagnosis.

So if your pet’s breath turns foul, definitely do some investigation. Your family veterinarian is the best first step. He or she can also refer you to a board certified veterinary dentist if your pet requires additional help.

Thanks for writing! And don’t forget those oral exams.

Have a question about your pet that you’d like answered? Write to Dr. Cathy Meeks at She’d love to hear from you, and your letter may be picked for an upcoming Pet 411 column.