Page 475 - Small Animal Internal Medicine, 6th Edition

CHAPTER 29
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Disorders of the Oral

Cavity, Pharynx,

and Esophagus

MASSES, PROLIFERATIONS, AND Clinical Features
INFLAMMATION OF THE OROPHARYNX The condition may cause a painless enlargement of one or
more salivary glands (usually the submandibular). If there
SIALOCELE is substantial inflammation, animals may be dysphagic. A
syndrome has been reported in which noninflammatory
Etiology swelling (sialoadenosis) is associated with vomiting only
Sialoceles are accumulations of saliva in subcutaneous tissues responsive to phenobarbital therapy. Cause and effect are
caused by salivary duct obstruction and/or rupture, and unclear, but it is clear that chronic vomiting will cause sialo-
subsequent leakage of secretions into subcutaneous tissues. adenitis and even necrosis in some dogs.
Most cases are probably traumatic, but some are idiopathic.
Diagnosis
Clinical Features Cytology or histopathology confirms that the mass is sali-
A large swelling is found under the jaw or tongue or occa- vary tissue and determines whether inflammation or necro-
sionally in the pharynx. Acutely the swelling may be painful, sis is present.
but most are nonpainful. Oral cavity sialoceles may cause
dysphagia, whereas those located in the pharynx often Treatment
produce gagging or dyspnea. If traumatized, sialoceles may If there is substantial inflammation and pain, surgical
bleed or cause anorexia due to discomfort. Classically found removal seems most efficacious. If the patient is vomiting, a
in 2- to 4-year-old dogs; German Shepherds and Miniature search should be made for an underlying cause. If a cause is
Poodles seem to be predisposed. found, it should be treated and the size of the salivary glands
monitored. If no other cause for vomiting can be found,
Diagnosis phenobarbital may be administered at anticonvulsant doses
Aspiration with a large-bore needle reveals thick fluid with (see Chapter 62).
some neutrophils. The fluid usually resembles mucus,
strongly suggesting its salivary gland origin. Contrast sialo- Prognosis
grams and/or contrast computed tomography (CT) some- The prognosis is usually excellent.
times define which gland is involved.
NEOPLASMS OF THE ORAL CAVITY
Treatment IN DOGS
The mass is opened and drained. The salivary gland respon-
sible for the secretions must be excised. Etiology
Most soft tissue masses of the oral cavity are neoplasms, and
Prognosis most of these are malignant (i.e., melanoma, squamous cell
The prognosis is excellent if the correct gland is removed. carcinoma, fibrosarcoma). However, acanthomatous amelo-
blastomas (previously called epulides), fibromatous epulides
SIALOADENITIS/SIALOADENOSIS/ (classically in Boxers), oral papillomatosis, and eosinophilic
SALIVARY GLAND NECROSIS granulomas (e.g., in Siberian Huskies and Cavalier King
Charles Spaniels) also occur.
Etiology
The etiology is unknown, but the condition apparently has Clinical Features
occurred as an idiopathic event as well as secondary to The most common signs of tumors of the oral cavity
chronic vomiting/regurgitation. are halitosis, dysphagia, bleeding, salivation, or a growth

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