This 11 year-old Cocker Spaniel has a history of hyperadrenocorticism, hypertension, and mitral valve degeneration. What medications might be responsible for the condition presented in the image above?
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Drugs that inhibit calcium influx across cell membranes have been associated with gingival hyperplasia in some canine and feline patients. The patient in the image has been receiving amlodipine for high blood pressure for the previous 12 months.
Diagnostics must include full mouth intraoral radiography and periodontal probing to assess for current periodontal disease. Drug induced gingival enlargements create pseudopockets that may progress into periodontal pockets. Treatment for this case involved several extractions for severe periodontal bone loss and a combination of surgical excision and gingivoplasty with a #12 fluted bur on a water-cooled high-speed handpiece.
Assessment 10 days postoperatively demonstrated mild gingival inflammation consistent with progressive healing. Amlodipine was replaced by hydralazine by the referring veterinarian to avoid recurrence. However, not all patients receiving amlodipine develop gingival enlargement and changing classes of antihypertensive medications must be weighed against the overall systemic benefit to the patient as various classes of antihypertensive drugs work via different mechanisms.
For a detailed discussion of gingival hyperplasia and more on drugs that can induce this condition download this .pdf