Page 418 - Small Animal Internal Medicine, 6th Edition

390 PART III Digestive System Disorders

BOX 26.1
VetBooks.ir Causes of Dysphagia Oral Mass

Oral Pain
Fractured bones or teeth Tumor (malignant or benign)
Trauma Eosinophilic granuloma
Periodontitis or caries (especially cats) Foreign object (oral, pharyngeal, or laryngeal)
Mandibular or maxillary osteomyelitis Retropharyngeal lymphadenomegaly
Other causes Inflammatory polyp of middle ear (primarily cats)
Retrobulbar abscess/inflammation Sialocele
Various other abscesses or granulomas of the oral
cavity Oral Trauma
Temporal-masseter myositis Fractured bones (e.g., mandible, maxilla)
Stomatitis, glossitis, pharyngitis, gingivitis, tonsillitis, or Soft tissue laceration
sialoadenitis Hematoma
Immune-mediated disease
Feline viral rhinotracheitis, calicivirus, leukemia virus, or Neuromuscular Disease
immunodeficiency virus Localized myasthenia
Lingual foreign objects, other foreign objects, or Temporal-masseter myositis
granulomas Temporomandibular joint disease
Tooth root abscess Oral, pharyngeal, or cricopharyngeal dysfunction
Uremia Cricopharyngeal achalasia
Electrical cord burn Tick paralysis
Miscellaneous causes Rabies
• Thallium Tetanus
• Caustics Botulism
Pain associated with swallowing: esophageal stricture or Various cranial nerve dysfunctions/central nervous system
esophagitis disease

BOX 26.3
BOX 26.2
Major Causes of Drooling
Causes of Halitosis
Ptyalism
Bacterial Causes Nausea
Food retained in the mouth Hepatic encephalopathy (especially feline)
Anatomic defect allowing retention (exposed tooth Seizure activity
roots, tumor, large ulcer) Chemical or toxic stimulation of salivation
Neuromuscular defect allowing retention (pharyngeal (organophosphates, caustics, bitter drugs [e.g.,
dysphagia) atropine, metronidazole])
Food retained in the esophagus Behavior
Tartar or periodontitis Hyperthermia
Damaged oral tissue Salivary gland hypersecretion
Neoplasia/granuloma of mouth or esophagus
Severe stomatitis/glossitis Pseudoptyalism
Oral pain, especially stomatitis, glossitis, gingivitis,
Eating Noxious Substances pharyngitis, tonsillitis, or sialoadenitis (see Box 26.1)
Necrotic or odoriferous food Oral or pharyngeal dysphagia (see Box 26.1)
Feces Facial nerve paralysis

If oral examination findings are not helpful, plain oral and Halitosis often accompanies dysphagia, in which case it is
laryngeal radiographs are usually the best next steps. Oral usually more productive to determine the cause of the dys-
cultures are rarely helpful because normal oral flora makes phagia. If halitosis occurs without dysphagia, the clinician
interpretation of results difficult. Even animals with severe should first be sure that the odor is abnormal and then check
halitosis or stomatitis secondary to bacterial infection rarely for the ingestion of odoriferous substances (e.g., feces). A
benefit from bacterial culture, unless there is a draining tract thorough oral examination is still the most important test.
or abscess. Halitosis not attributable to an oropharyngeal lesion may be