Dogs are known for having breath that ranges from less-than-fresh to downright nasty. Bad breath can be a sign of dental or periodontal disease. Sometimes, however, bad breath can be a sign of something more serious than a snack from the cat box or poor dental hygiene.

Diabetes
Sweet, fruity breath might sound like an improvement, but sweet-smelling breath is a common symptom of diabetes. Some can easily smell this symptom, while others cannot. Diabetes is a serious condition that requires careful monitoring and regular treatment. The sweet smell is a result of ketoacidosis, which is a serious, potentially life-threatening complication of diabetes.

Kidney Disease
If your dog’s breath smells like urine, it is probably not because she has been drinking pee. Kidney disease can cause your dog’s breath to smell like urine, and this serious condition requires a speedy diagnosis for the best prognosis. Keep an eye out for other symptoms of kidney disease in dogs, like lethargy, loss of appetite, and increases in drinking or urination.

Liver Disease
Liver disease can lead to an unusually foul odor, which is distinctly different from the bad breath associated with periodontal disease. Dogs with liver disease usually present with other symptoms, such as vomiting, yellowing of the corneas and gum (jaundice), and a lack of appetite. Liver disease is a serious condition and requires immediate veterinary intervention.

Gastrointestinal Disease
Some gastrointestinal diseases, such as inflammation of the throat, enlargement of the esophageal tube (megaesophagus), infections, or even cancer can cause bad breath. Observe your dog for other signs of gastrointestinal discomfort, like vomiting, diarrhea, or changes in appetite, and contact your veterinarian.
Eating Habits
Consuming garbage, feces, or carrion is not only disgusting, it also puts your dog at risk of intestinal blockages and diseases. If your dog’s breath smells like he has found his way into the trash, is consuming feces from wildlife, or has come across a dead animal, do your best to limit his access to the substance to avoid putting him at further risk.

Rhinitis and Sinusitis
Inflammation of the upper respiratory tract can also cause bad breath. There are a wide range of causes of rhinitis and sinusitis, including infection, parasites, tumors, and foreign bodies. Other symptoms may include nasal discharge, labored breathing, sneezing, and inflammation of the conjunctiva (the membrane surrounding the eyes).

Bad breath may seem like one of those things that dog owners just have to deal with, but in some cases, your dog’s bad breath could be a sign of a much more serious problem. Contact your veterinarian if your dog develops acute or chronic bad breath, and observe him closely for signs of other symptoms.

From akc.org      Anna Burke March, 2018

More Than Bad Breath

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