Halitosis is diagnosed simply by sensory evaluation – that is, by leaning towards the dog’s muzzle and smelling its breath. Care should be taken not to startle the dog or approach its head suddenly and rapidly with direct eye contact - especially if the person making the diagnosis is unfamiliar with the dog – because that approach may be interpreted by the dog as an act of aggression.
While almost anyone can identify bad breath, the hunt for the cause of the stinky breath is usually much more challenging. Presented with a dog with halitosis, the attending veterinarian will perform a physical examination, including a thorough examination of the oral cavity (mouth; gums; hard and soft palate; tongue). This may reveal retained food debris, lodged foreign objects (needles, sticks, bones, porcupine quills, others), tumors, ulcers, inflamed tissue, bleeding tissue, weeping sores and/or other non-healing wounds. The veterinarian will also probably recommend drawing blood samples and submitting them for a complete blood count and a serum biochemistry profile. She will also likely submit urine for a routine urinalysis. The results of these tests may identify or suggest many of the underlying conditions that can contribute to halitosis, such as liver disease, kidney disease or diabetes. If these diagnostic techniques are inconclusive, the veterinarian may suggest more advanced assessment of the mouth and throat, which will require use of general anesthesia. With the dog safely anesthetized, the veterinarian will be able to safely take tissue biopsy samples for microscopic evaluation and for culture. She also will be able to take survey oral radiographs (X-rays), without causing undue discomfort to the patient.
Halitosis can drastically change the relationship between a dog owner and his beloved pet, and the change is almost always negative. Foul-smelling dog breath can gradually and unintentionally diminish the physical and emotional closeness between the pet and its owner. For example, bad breath might reduce the amount of close snuggling time, because the owner may be unknowingly less comfortable being licked by and physically close to a dog whose breath is highly unpleasant. Other members of the dog’s close and extended human family - especially children or people who are not unconditional dog lovers – may resent a smelly dog’s presence during mealtimes or family room movies or game nights, much as they may want to avoid a dog that sheds excessively. As a result, the dog with bad breath may be banished to a crate, the garage or the back yard and be deprived of the human companionship that is so important to a human-canine bond.