Page 599 - Problem-Based Feline Medicine

27 – THE CAT WITH SALIVATION 591

Check under tongue for linear foreign body (e.g. cotton Pathogenesis
or string).
Most commonly due to gastric reflux during and after
anesthesia.
Differential diagnosis
Pre-anesthetic and anesthetic agents suppress normal
Pharyngeal foreign body or acute pharyngitis. esophageal motility and can cause the lower esophageal
Examine pharynx under general anesthetic. sphincter to relax allowing gastric reflux.
Acute viral esophagitis/pharyngitis/laryngitis. Usually Refluxed in hydrochloric acid can reduce esophageal
other viral signs predominate (i.e. sneezing, running pH to 2.0 and cause protein denaturation of the
eyes, etc.). Both calici and herpes virus possible. esophageal mucosa.

Acute gastroesophageal intussusception or hiatal Once esophagitis exists, the lower esophageal sphinc-
hernia – usually intermittent signs. ter becomes incompetent, perpetuating reflux.
Caustic chemical pharyngitis/esophagitis (rare) is Tilting of the surgery table and poor patient prepa-
always associated with chemical burning of the dor- ration (food-filled stomach) before surgery predis-
sum of the tongue. poses cats to reflux esophagitis.

Esophagitis can occur secondary to esophageal for-
Treatment eign bodies or persistent vomiting.
Retrieval of the foreign body by endoscopy. Rarely, esophagitis can result from ingestion of caustic
agents.
Perforating foreign bodies require thoracotomy and
esophagotomy. Pooling of gastric fluids and resultant esophagitis char-
acteristically occurs in the region of the base of the
Sewing needles and fish hooks on string can often by
heart.
retrieved by passing a plastic tube down the string to
dislodge and guard the foreign body during retrieval. Young animals with congenital esophageal hernia are
likely to have a higher risk for reflux esophagitis.
Broad-spectrum antibiotics (amoxicillin 20 mg/kg SC
or IM q 12 h). Occasionally, esophagitis associated with severe feline
herpes virus or calicivirus infection occurs.
Withhold food and water for 24–48 hours.
Pain and inability to swallow probably plays a major
Intravenous or subcutaneous fluid support will be
role in pathogenesis of ptyalism.
required first 24–48 hours.
If untreated, esophagitis often leads to secondary
Some foreign bodies can be pushed into the stomach
esophageal stricture.
and retrieved by gastrotomy.
Prognosis
Clinical signs
Good unless esophageal perforation has occurred.
Dysphagia, excessive salivation, repeated swallow-
ing attempts with out-stretched neck occurs in the
ESOPHAGITIS* early, acute phase of the disease syndrome.

Regurgitation of white froth, often blood stained
Classical signs
occurs in the early stages of acute, severe esophagitis.
● Excessive salivation.
Signs generally occur within 24–48 hours of anesthetic
● Repeated attempts at swallowing.
if post-anesthetic esophagitis.
● Anorexia, dysphagia.
● Regurgitation. Intense pain associated with swallowing attempts may
cause the cat to cry out.