Tongue sticking out in cats and dogs

Important note for owners

The key question is whether this is your pet's usual state or something new. If the tongue has been sticking out since teeth were extracted, or it has always been like this, and your pet eats, drinks and grooms as usual, it is most likely a cosmetic feature that only needs monitoring. If it appeared suddenly, your pet cannot close its mouth, struggles to swallow or paws at the face, an examination is needed — sometimes urgently.

Most common possible causes

• —After extraction of the lower canines or many teeth. The lower canines keep the tongue in the mouth like side rails. Without them, and especially after all the teeth have been extracted, the tip of the tongue may fall out of the mouth — often on the side where a canine is missing. This usually does not interfere with eating or drinking.
• —Jaw shape in small and short-nosed breeds. In brachycephalic breeds — Pugs, French Bulldogs, Shih Tzus, Persians — the tongue is relatively large for the short jaw. Small dogs have a short, narrow lower jaw, and with age they often lose teeth to periodontal disease, so the tongue lacks both room and support.
• —Normal behaviour. Cats sometimes “forget” to put the tip of the tongue away after grooming, while asleep or when relaxed; in dogs the tip of the tongue may also show during sleep. If it passes, there is no need to worry.
• —Pain in the mouth. A fractured tooth, tooth resorption (TR), stomatitis or ulcers on the tongue make an animal keep its mouth slightly open. The protruding tongue then comes with drooling, bad breath and careful biting of food.
• —A foreign object. A thread or fishing line wrapped around the base of the tongue (especially in cats), a stick or bone wedged between the teeth or across the palate, or an elastic band constricting the tongue. Such animals drool, swallow repeatedly, shake their head or paw at the face.
• —A jaw or joint injury. A jaw fracture, a dislocated temporomandibular joint or nerve damage that makes the jaw “drop” stop the mouth from closing, so the tongue stays out. This is an urgent situation — see the page “Cannot close or open the mouth”.
• —Swelling, a burn or a growth. Allergic swelling after an insect sting, a burn (including from chewing an electric cable), a salivary cyst under the tongue (ranula) or a tumour on or under the tongue enlarge the tongue or push it out of the mouth.
• —Neurological causes. Damage to the nerves that control the tongue, or other neurological diseases: the tongue may be limp or deviate to one side. This needs your regular vet and sometimes a neurologist.
• —Mouth breathing: overheating, stress, heart or lung disease. A dog panting with its tongue out after running or in the heat is cooling down — this is normal. A cat breathing with its mouth open needs emergency care; more on this in the section below.

Tongue sticking out after tooth extraction: what is normal

Extracting the lower canines or all the teeth is sometimes necessary — for example, with severe gingivostomatitis, tooth resorption (TR) or a fracture when the tooth cannot be saved. Afterwards the tip of the tongue may show at the side or front of the mouth. This is not a sign that the surgery went wrong, and it usually does not stop your pet from eating, drinking and grooming.

In some animals the tongue sticks out less over time; in others the tip stays visible permanently. In itself this is a cosmetic feature, but the exposed tip can dry out — in hot weather, in frost or near heaters. So I recommend checking it from time to time:

• ✓the tip is moist and pink, and your pet eats and grooms as usual — all is well
• ✓dryness, cracks, crusts or sores on the tip — have your pet seen by a vet
• ✓the tongue is swollen, pale, bluish or dark — urgent help is needed
• ✓your pet has started eating, drinking or grooming less — this is a reason for an examination, not a habit

Tongue out because your pet is breathing through the mouth: when it is an emergency

Dogs cool down by panting, so a tongue hanging out after running or in the heat is normal for them. Warning signs are panting that does not settle in a cool, quiet place, a very red or bluish tongue, weakness or vomiting — this may be heatstroke, especially in short-nosed dogs.

Cats don't usually cool down this way. Brief open-mouth breathing after very intense play or severe stress, for example in a carrier, should stop within a few minutes of rest. If your cat breathes with its mouth open at rest, if it keeps happening or comes with weakness or a pale or bluish tongue, go to a clinic that provides emergency care. The cause may be heart or lung disease, fluid in the chest, asthma or overheating — this is not a dental problem, and it cannot wait for a routine appointment.

When not to postpone an exam

• ✓The tongue has recently started sticking out, although no teeth were extracted
• ✓The tip of the tongue is drying out, cracking or changing colour, or has crusts or sores
• ✓Drooling, bad breath, blood in the saliva
• ✓Your pet paws at the face, eats carefully or drops food
• ✓The tongue is limp or deviates to one side
• ✓A swelling or growth is visible on or under the tongue

Urgent help needed

• ✓Your cat is breathing with its mouth open and tongue out at rest, or it does not stop after a few minutes of rest
• ✓A thread or fishing line is visible under the tongue, especially if your pet is vomiting or not eating
• ✓The tongue is rapidly swelling, darkening or turning blue — for example, constricted by an elastic band or after an insect sting
• ✓The tongue suddenly started sticking out after a fall, a blow or another injury, and the mouth will not close
• ✓Your pet may have chewed an electric cable
• ✓Difficulty breathing, a pale, grey or bluish tongue
• ✓Signs of heatstroke: heavy panting that does not settle in a cool place, weakness, vomiting

What you can do at home

• ✓Think back and note when the tongue started sticking out and whether tooth extraction, an injury or a walk in the heat came before it.
• ✓Watch how your pet eats, drinks and grooms: whether it drops food, drools or paws at the face.
• ✓If your pet is calm and allows it, look at the tongue and the area under it in good light. Don't force the mouth open.
• ✓After tooth extraction, keep fresh water available at all times, feed as advised for the healing period and check that the tip of the tongue is not drying out.
• ✓Take a photo or video of the tongue and send it for an online consultation on Telegram — I'll tell you how urgent an examination is, but a video does not replace one.

What not to do at home

• —Don't pull on a thread or fishing line under the tongue: there may be a needle attached, and the other end may be in the oesophagus or intestines
• —Don't put your fingers deep into the mouth or try to force the mouth shut or “put the jaw back”
• —Don't put human creams, balms or ointments on the tongue — your pet will lick them off
• —Don't give human painkillers — many are toxic to dogs and cats, and paracetamol is deadly for cats
• —Don't douse an overheated animal with ice-cold water — wet it with cool water and go to a clinic
• —Don't wait for a routine appointment if your cat is breathing with its mouth open

What diagnostics may be needed

• ✓Consultation: the tongue and the area under it, the oral cavity, the bite, and whether the mouth closes fully
• ✓A thorough examination under sedation or anaesthesia if your pet won't allow the mouth to be examined or a deeper look is needed
• ✓Dental radiography: fractured teeth, roots left behind after extraction, the condition of the jaws
• ✓If a jaw or joint injury is suspected, X-rays; CT may be needed
• ✓If there is a growth, a biopsy and histopathology
• ✓With open-mouth breathing, neurological signs or general symptoms, an assessment by your regular vet; a cardiology or neurology consultation may be needed

A tongue that hangs out because teeth are missing and a tongue that your pet cannot put away because of pain, a thread under it or a jaw injury look similar from the outside. A thread around the base of the tongue, roots left in the bone, fractures and growths deep in the mouth can only be seen during a thorough examination — often under anaesthesia — and on X-rays.

How treatment may proceed

• ✓If the tongue sticks out because teeth are missing or because of jaw shape, and the tissues are healthy, no treatment is needed — only monitoring and care
• ✓Removal of a foreign object under sedation or anaesthesia, and wound care
• ✓Treatment of painful teeth — endodontic treatment or extraction when clinically indicated
• ✓Stabilisation of a jaw fracture or reduction of a dislocated joint
• ✓Removal of a growth with biopsy and histopathology; the further plan depends on the result
• ✓Neurological, heart and general causes are treated by a vet in the relevant field
• ✓The cost depends on the cause and the extent of treatment; it is calculated after diagnostics

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