Pale and White Gums in Dogs

A dog’s gums are often overlooked. We usually only see them if a dog is yawning or barking, or we’re looking into their mouth.

However, the color of your dog’s gums can give you important clues about their health. It’s important to know your dog’s normal gum color so you can know when the color changes and something might be wrong.

Having pale or white gums is not normal for dogs. This is also called pallor, which means loss of color. There are many conditions that can cause pale gums, and some can be quite serious or even fatal if left untreated.

If your dog has pale pink or white gums, get them to a veterinarian as soon as possible for assessment, especially if they collapse, seem weak or lethargic, have a swollen belly, or are breathing weird or vomiting.

How to Check Your Dog for Pale Gums

Normal dog gums should be a powder pink color, similar to the color of cooked shrimp. Some dogs naturally have dark or black gums, but they are usually speckled with pink areas that you can check for changes in color.

Gently lift your dog’s upper lip or pull down on the lower lip to see your dog’s gums. Do this once or twice a month to check the color. It is best to do this when your dog is calm, quiet, and resting. If you notice any change in the color of the gums, such as white, gray, blue, or yellow, this can be a signal of underlying health issues.  

What Causes Pale Gums in Dogs?

There are many possible causes of pale to white gums in dogs.

Anemia (low red blood cell count) can be caused by many things, and this can lead to pale or white gums. With anemia, the body has fewer circulating red blood cells. These cells deliver oxygen to the organs. Without them, the body suffers a lack of oxygenation, which can lead to pale gums.

Poor circulation from underlying health issues or shock can also lead to pallor. Your vet will need to investigate the cause of the pallor (or anemia) to diagnose and treat it appropriately.

Listed below are the most common causes of pale gums in dogs:

1. Immune-mediated hemolytic anemia (IMHA): This is a condition where the immune system starts to target and destroy red blood cells circulating in the body. Drug reactions, snake bites, abnormal vaccination response, certain viruses, or primary immune system dysfunction can cause this condition.
2. Internal bleeding: This can occur from trauma, bleeding ulcers or tumors, clotting disorders, severe parasite infestations (external or intestinal), or rodenticide (rat poison) ingestion. The blood loss leads to anemia, causing pale to white gums.
3. Shock: This is a life-threatening medical issue where the body has inadequate blood flow, leading to organ damage. This can occur rapidly and is usually fatal if left untreated.
4. Toxins: Certain toxins, such as rat poison, can lead to bleeding. Most rat poisons cause clotting deficiencies and lead to internal bleeding. If diagnosed appropriately and early, these are often treatable toxicities. If left untreated, they are often fatal.
5. Heart disease: Many heart conditions can lead to congestive heart failure, such as valvular disease, dilated cardiomyopathy, hypertrophic cardiomyopathy, and congenital malformations. The gums become pale from decreased oxygenation to the tissues or from bleeding, in the case of heart-based tumors.
6. Cancer: Some forms of cancer lead to bleeding tumors, which are most commonly found on the spleen, liver, gastrointestinal tract, and kidneys. Often, these tumors grow so large and so quickly that they rupture. An acute bleed occurs, which can lead to weakness, collapse, or even death if left untreated.
7. Clotting disorders: Some dogs are born with abnormal clotting factors in the body, such as with Von Willebrand disease and Hemophilia A. Other causes of clotting issues include rat poison ingestion, cancers in the body (paraneoplastic syndrome), and immune-mediated thrombocytopenia (low platelets due to immune destruction). Some of these causes can be treated easily once diagnosed, while others require long-term or even lifelong therapy.
8. Bloat: This condition is also called gastric dilatation and volvulus (GDV) and occurs when a dog’s stomach fills with food, fluid, and gas and twists on itself. This blocks the blood flow to and from the stomach and eventually leads to shock as the stomach enlarges and starts to die. This enlarged stomach also cuts off blood supply to the lower half of the body, causing further circulation issues.
9. Parasites: Certain internal parasites, specifically severe hookworm infestations, can latch onto the lining of the gastrointestinal tract, causing blood loss that leads to anemia. Severe external parasite infestation with fleas can also lead to anemia. Your pet will need to be on appropriate deworming and flea treatment/prevention to clear the body, and you will also need to rid your home of any parasites.
10. Kidney disease: Severe kidney disease can lead to dehydration, which can affect circulation and stimulate inflammatory factors in the body. The kidneys also produce a hormone that tells the bone marrow to make more red blood cells. If the kidneys are diseased significantly, this can lead to anemia and pale gums.
11. Severe stress/pain/anxiety: Panting and activation of the nervous system can cause the gums to become pale. If the cause is short-lived, such as fireworks, the stress and symptoms might go away after the incident, but longstanding pain and/or severe stress should be treated to alleviate changes to blood circulation.

 What to Do if Your Dog Has Pale Gums

If your dog has pale pink gums, call and schedule an appointment with your veterinarian. They may ask you to come in right away if they think it’s necessary.

If your dog has white gums or any of the following signs along with pale gums, take them to an emergency clinic, as these can be fatal if left undiagnosed and untreated.

• Vomiting or diarrhea
• Black tarry stool (melena)
• Severe lethargy
• Difficulty walking
• Weakness/ataxia (“drunken gait”)
• Collapse
• Trouble breathing
• Coughing
• Swollen stomach
• Bruising anywhere on the body
• Bleeding
• Trauma (they were hit by something)
• No appetite

How Do Vets Find the Cause of Pale Gums in Dogs?

Speedy diagnosis is needed to treat the underlying cause of the pallor. Here are some things your vet may do to investigate the underlying cause of pale to white gums:

• Thorough history: Often this alone gives vets plenty of information. Knowing if a dog got into rat poison or has previously been diagnosed with a heart condition can be helpful in directing diagnostic testing.
• Physical examination: A swollen stomach, trouble breathing, bruising on the body, and/or palpable abdominal tumors noted during a physical examination can also lead a veterinarian to the appropriate diagnosis quickly.
• Complete blood count (CBC): This is a blood test that gives information about the cells that the bone marrow makes. The most important of these is the red blood cell, which is the oxygen carrier for the body. The test also assesses platelets, which are cells that help clot bleeding. If either of these two cell lines are decreased, you may see pale gums. This lab test also assesses white blood cell counts, which can be elevated with inflammation, infections, and certain cancers.
• Serum chemistry panel: This is a blood test that assesses kidney enzymes, liver enzymes, glucose, proteins, fats, and electrolytes. Kidney disease and liver disease can lead to anemia, causing pallor. Bleeding into the gastrointestinal tract can sometimes first be noted by monitoring the values on this test.
• Urinalysis: This is a general urine profile that checks for inflammation, infection, and abnormal cells in the urinary tract. Some cancers of the urinary tract, as well as kidney disease, can lead to anemia and eventually pale gums.
• Chest radiographs: This is a non-invasive test where x-rays are taken to assess for heart disease, bleeding into or around the lungs, and any signs of metastatic cancers.
• Echocardiography: This non-invasive test uses an ultrasound to check for underlying heart disease and congestive heart failure.
• Abdominal ultrasound: This non-invasive test allows visualization of the abdominal organs to look for fluid or bleeding in the abdomen, tumors, or kidney changes.
• Coagulation testing: This involves blood testing to see how quickly a dog clots the blood once removed from the body. This is most helpful to diagnosis clotting disorders, rat poison ingestion, or some forms of cancer.
• Fecal testing: This tests for intestinal parasites that can cause bleeding as well as for blood in the feces itself, which can eventually lead to anemia and pale gums.
• Infectious disease testing: This includes a variety of testing on blood, urine, and serum to check for certain viruses, bacterial infections, or tick-borne diseases that can cause anemia.
• Bone marrow aspiration and biopsy: This is a more invasive test where a pet usually requires sedation or anesthesia as a bone marrow sample is extracted for testing. This helps investigate destruction or decreased production of blood cells or platelets, as well as checks for certain types of cancers or viral infections. 

How Do Vets Treat Pale Gums in Dogs?

Treatment of pale to white gums in dogs depends on the underlying cause and the severity of the condition.

In some cases, such as bleeding splenic tumors or bloat, the cause of bleeding must be corrected with surgery. Sometimes antibiotics, antivirals, immunosuppressive medications, or steroid medications are necessary to treat the reason for the anemia.

If you are concerned about your dog’s gums, especially if they are linked with other clinical signs of illness, have them assessed by a veterinarian as soon as possible.

Featured Image: Sandra Mitchell, DVM