Dear Colleagues,

I would be grateful for your input into this case that involves a 6-year-old neutered JRT dog, Sprocket.

He came in to see me on Wednesday because he was showing oral discomfort manifested by drooling, smacking of his lips, halitosis and pawing at his mouth of one week’s duration. He has been lethargic for some time, but he is otherwise all right.

Physical examination demonstrated the ulceration along the lips and particularly at the left commissure, and on the oral mucosa. There is a small vesicle evident on the photo of the left side.

CBC and a comprehensive chemistry panel results were unremarkable.

My differentials include mucocutaneous pyoderma, pemphigus folicaceus and erythematosus.

My plan is to take biopsies next. What do you think?

Best wishes, David