A dog or cat that keeps licking its lips or swallowing

Important note for owners

Licking the lips after eating, drinking or grooming is normal, and dogs also lick their lips when they are tense or anxious. It is worth paying attention when licking and swallowing become more frequent, happen in episodes for no obvious reason, at night or on an empty stomach, or come with other signs: drooling, bad breath, changes in eating, vomiting.

Most common possible causes

• —Gingivitis and periodontitis. Inflamed gums, tartar and periodontal pockets cause discomfort and an unpleasant taste, so your pet licks its lips more often. Usually there is also bad breath and a red line along the gum margin.
• —A fractured tooth. Exposed dentine or pulp hurts with pressure and cold. Your pet licks the sore spot, chews on one side and turns down hard treats and toys.
• —Tooth resorption (TR) in cats. Painful defects in the teeth at or below the gum line. The cat licks its lips, swallows, chatters its jaw while eating or drops food. Many lesions are visible only on dental X-rays.
• —Stomatitis, ulcers and growths in the mouth. In cats, chronic gingivostomatitis: bright red gums and lining at the back of the mouth, drooling, pain while eating. Mouth ulcers can also result from burns by household chemicals, calicivirus infection in cats or kidney disease. Growths on the gums, tongue or palate can also interfere with swallowing.
• —A foreign body. A stick across the palate, a bone fragment between the teeth, a thread under a cat's tongue, a grass awn in the gums. The signs appear suddenly: your pet paws at its face, holds its mouth open and swallows often.
• —Nausea. One of the common non-dental causes: lip licking, frequent swallowing, drooling and interest in grass before vomiting. Nausea can be caused by disease of the stomach and intestines, pancreas, liver or kidneys, poisoning, some medicines and motion sickness.
• —The oesophagus and throat. Reflux of stomach contents into the oesophagus, inflammation of the oesophagus or throat, and difficulty swallowing for neurological reasons. In dogs, bouts of licking the floor, walls or carpet with frequent swallowing are often linked to digestive problems.
• —Stress and tension (in dogs). Lip licking is one of the signals a dog uses to show tension or a wish to avoid conflict: when it is hugged, told off, examined or near another dog. These episodes are short and tied to the situation.
• —The skin around the lips. Lip fold inflammation in breeds with deep folds (spaniels, St Bernards, Shar Peis), allergies or irritation. Your pet licks because of itching, and the folds may be moist and smell unpleasant.

Mouth or not: reading the other signs

Licking alone does not tell you where the problem is. The signs that come with it, and the situations in which it happens, tell you far more. This list does not replace an examination, but it helps you decide where to start.

• ✓More likely a mouth problem: bad breath, drooling, blood on toys or in the bowl, red gums; your pet chews on one side, drops food, paws at its face, chatters its teeth, refuses hard food or toys.
• ✓More likely nausea or the digestive tract: licking and swallowing before vomiting or in the morning on an empty stomach, eating grass, licking floors and walls, gurgling tummy, appetite changes, vomiting, diarrhoea.
• ✓More likely the oesophagus or throat: frequent swallowing movements, coughing or regurgitation soon after eating, stretching the neck, swallowing as if with effort.
• ✓More likely stress: licking only in certain situations — at the vet, when hugged or told off — together with yawning, looking away or flattening the ears.
• ✓More likely the skin: redness, moisture or odour in the lip folds, an itchy face.
• ✓Separately: rhythmic chewing or licking with a vacant stare, when your pet does not respond to its name, can be a focal seizure. Film the episode and show it to a vet.

How to check the mouth at home and what to photograph

The signs often overlap: a cat with mouth pain may also vomit, and a dog with gastritis may also have tartar. That is why I recommend starting with an examination of the mouth: it either explains the licking or shows that the cause lies elsewhere.

If your pet is calm and allows it, lift the lip in daylight or with your phone torch. Don't force the mouth open: for a first assessment, a side photo with the lip lifted is enough.

• ✓A red line along the gums, swelling or bleeding.
• ✓Tartar, especially on the upper back teeth.
• ✓A fractured or darkened tooth; in cats, gum growing over a tooth or a defect at the gum line.
• ✓Ulcers, a coating or redness on the tongue, palate or at the back of the mouth.
• ✓Growths on the gums, lips or under the tongue.
• ✓Something stuck between the teeth or across the palate.
• ✓In a cat, a thread under the tongue: if you see one, don't pull it — go to a clinic straight away.

When not to postpone an exam

• ✓Licking and swallowing have become more frequent and haven't settled for several days
• ✓Licking comes with bad breath, drooling, blood or red gums
• ✓Your pet chews on one side, drops food or refuses hard food
• ✓Your cat licks its lips and swallows, eats less well or grooms less
• ✓Your cat is eating much less than usual or hasn't eaten for a day — don't wait any longer
• ✓Licking comes with occasional vomiting, eating grass or licking the floor — a reason to see a vet who specialises in internal medicine

Urgent help needed

• ✓Sudden intense licking, drooling, pawing at the face or holding the mouth open — a foreign body is possible
• ✓In a cat, a thread under the tongue, or thread or fishing line hanging from the mouth
• ✓Your dog is retching without bringing anything up, is restless and its belly is swollen — possible gastric dilatation-volvulus (bloat); go immediately
• ✓Difficulty breathing, or your pet cannot swallow
• ✓Suspected poisoning: your pet has chewed plants, household chemicals, medicines or an electric cable
• ✓Repeated vomiting, blood in the vomit, sudden weakness

What you can do at home

• ✓Keep a diary for a few days: when your pet licks its lips (after meals, on an empty stomach, at night, in certain situations), for how long and what else is going on — vomiting, grass eating, drooling, appetite changes.
• ✓Film the episodes — it makes it easier to tell mouth pain from nausea or stress.
• ✓Watch how your pet eats: whether it chews on one side, drops food, and is happy to take hard treats and toys.
• ✓If hard food clearly causes discomfort, offer soft food for the time being.
• ✓Send the videos, photos of the teeth and your notes for an online consultation on Telegram — I'll suggest where to start: a dental examination or an internal medicine vet. Photos and videos help you get your bearings but do not replace an examination.

What not to do at home

• —Don't give human medicines for nausea, pain or heartburn — some are toxic to dogs and cats, and paracetamol is deadly for cats
• —Don't rub gels or ointments “for teeth” on the gums — they don't treat the cause and can mask pain
• —Don't force the mouth open or pull a thread from under a cat's tongue
• —Don't withhold food to “rest the stomach” without a vet's advice — especially in cats: prolonged fasting is dangerous for cats
• —Don't tell your dog off for licking: if the cause is stress, the tension will only grow
• —Don't put frequent licking down to habit if it is new or getting worse

What diagnostics may be needed

• ✓Consultation: examination of the parts of the mouth that can be seen, review of videos and the diary, assessment of general condition
• ✓Examination and probing of every tooth under anaesthesia as part of COHAT
• ✓Full-mouth dental radiography — without it, resorption (TR), root fractures and lesions below the gum line often cannot be seen
• ✓If the mouth is healthy, investigation by an internal medicine vet: blood and urine tests, abdominal ultrasound and, if needed, X-rays or endoscopy

An awake pet won't let you examine every tooth and the area under the tongue, and resorption (TR), cracks, root lesions and periodontal pockets are often hidden under the gums. So to say with confidence that “the mouth is healthy”, an examination under anaesthesia and dental X-rays are needed. If they show nothing, I tell you so honestly and recommend seeing an internal medicine vet: the licking is then most likely not related to the teeth.

How treatment may proceed

• ✓Treatment depends on the cause and is chosen after diagnostics
• ✓Gingivitis and periodontitis: professional cleaning as part of COHAT, periodontal treatment and home care
• ✓A fractured tooth: endodontic treatment when saving it is clinically possible, or extraction
• ✓Tooth resorption (TR): extraction of affected teeth or — only for a specific type of resorption seen on X-rays — crown amputation
• ✓Stomatitis in a cat: extraction of teeth when clinically indicated and medication prescribed by a vet
• ✓A foreign body: removal under sedation or anaesthesia with the wounds checked
• ✓Nausea, reflux and other non-dental causes are treated by an internal medicine vet

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