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sam dr green > disorders of the oral cavity > Flashcards

disorders of the oral cavity Flashcards

1
Q

causes for cealocele

A
  • Accumulation of saliva in SQ tissue
  • •Salivary duct obstruction / rupture
  • •Most are traumatic
  • •May be idiopathic
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2
Q

clinical featres of cealocele

A
  • Large, painless swelling
  • •Ventral cervical region
  • May cause gagging, dyspnea
  • •Under tongue (ranula)
  • May cause dysphagia
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3
Q

dx for cealocele

A

Aspiration
•Thick fluid (mucus, saliva)

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4
Q

tx and px for cealocele

A
  • Mass opened and drained
  • •Salivary gland removed
  • Prognosis
  • •Excellent
    • If correct gland removed
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5
Q

etiology of sialodenosis

A

unknown

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6
Q

clinical features of sialodenosis

A
  • Painless enlargement of salivary glands
  • •Submandibular gland most common
  • •Episodic ptyalism, dysphagia, regurgitation/vomiting
  • •Palpation of glands sometimes triggers signs
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7
Q

dx for sialodenosis

A
  • Diagnosis of exclusion
  • •MDB
  • •Normal pharyngeal & esophageal function
  • •Normal salivary histopathology
    • Non inflammatory
    • Non infectious
    • Non neoplastic
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8
Q

tx and px for sialodenosis

A

Phenobarbital

px?

uncommon dz

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9
Q

neoplasia of the oral cavity

A
  • Soft tissue masses in oral cavity (most are malignant)
    • Melanoma, SCC, fibrosarcoma, MCT, lymphoma
  • •Some are benign
    • Epulis (“on the gums”) –arise from periodontal ligament
    • Fibromatous (peripheral odontogenic fibromas) –BOXERS!!!
    • Ossifying (peripheral odontogenic fibromas)
    • Acanthomatous (canine acanthomatous ameloblastoma)
    • Oral papillomatosis
    • Eosinophilic granulomas (Siberian Husky, CKCS)
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10
Q

clinical features of oral neoplasia

A
  • Halitosis, dysphagia
  • •Bleeding
  • •Visible growth
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11
Q

dx for oral neoplasia

A
  • Thorough oral exam (+/-anesthesia)
  • •MDB
  • •Cytology / histopathology
  • •Regional lymph nodes
  • •Thoracic radiographs
  • •Skull radiographs / CT
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12
Q

tx for oral tumors

A
  • Surgical removal
  • •Radiation therapy
  • •Chemotherapy
  • •Melanoma vaccine
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13
Q

px for oral tumors

A

Variable, dependent on:
Tumor type
Tumor location
Complete / incomplete excision
Metastatic disease present

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14
Q

most common neoplasia in cats

A

Oral tumors less common in cats
•Squamous cell carcinoma most common
•May mimic eosinophilic granuloma

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15
Q

clinical features of neoplasia in cats

A

Dysphagia
•Halitosis
•Anorexia
•Bleeding

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16
Q

dx of neoplasia in cats

A
  • MDB
  • •Large, deep biopsy needed
  • •Superficial portions often ulcerated, necrotic
  • •Differentiate neoplasia from eosinophilic granuloma
  • •Radiographs / CT
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17
Q

tx n px of neoplasia in cats

A

Surgical excision
•Radiation therapy
•Chemotherapy

px

SCC on tongue or tonsil –Guarded to Poor

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18
Q

causes of feline eosinophilic granuloma

A

unkwown

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19
Q

clinical features of feline eosinophilic granuloma

A
  • Cutaneous Eosinophilic Granuloma
  • •Oral Eosinophilic Granuloma
  • •Eosinophilic Ulcer (Indolent Ulcer, Rodent Ulcer)
  • •Eosinophilic Plaque
  • •Mosquito-Bite Hypersensitivity
  • If severe oral involvement
    • Dysphagia
    • Halitosis
    • Anorexia
  • •May have concurrent cutaneous lesions
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20
Q

dx for feline eosinophilic granuloma

A
  • Presence of ulcerated mass
    • Base of tongue
    • Hard palate
    • Glossopalatine arches
    • Anywhere in mouth
  • •Deep biopsy
  • •MDB, FeLV/FIV
    • +/-peripheral eosinophilia
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21
Q

tx for feline eosinophilic granuloma

A
  • Rule out / treat underlying cause
  • •Corticosteroids
    • Prednisolone (2-4 mg/kg/day PO)
    • Taper once in remission (2 mg/kg/q 48 hrs PO)
  • •Cyclosporin(5-10 mg/kg/day PO x 4 weeks)
    • Intractable, corticosteroid-resistant forms of disease
    • Dose reduced to alternate daily for 4 weeks, then twice weekly
  • •Chlorambucil (0.1-2 mg/kg q 24-48 hrs PO)
    • Refractory cases
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22
Q

px for feline eosinophilic granuloma

A
  • Variable
  • •Young cats often have better prognosis
    • Cats < 1 yr, lesions may regress over 3 to 5 months
  • •Cats with recurring lesions with no underlying cause
    • Long-term therapy typically required
    • May become refractory to medications
    • May develop side effects from medications
    • Poorer prognosis
23
Q

etiology for stomatitis

A
  • Inflammation of the mucous lining of any of the structures in the mouth
  • •Causes
    • Renal failure
    • Trauma
    • Immune mediated disease
    • Viral (Calicivirus, FVR)
    • Immunosuppression (FeLV, FIV)
    • Tooth root abscess
    • Severe periodontitis
    • Osteomyelitis
24
Q

clinical features of stomatitis

A
  • Thick saliva
  • •Severe halitosis
  • •Anorexia (pain)
  • •Pyrexia
  • •Weight loss
25
dx of stomatitis
* Thorough oral exam (anesthesia) * •Gross observation * •MDB, FeLV / FIV * •Biopsy / histopathology * •Radiographs
26
tx for stomatitis
* Symptomatic (to control signs) * Teeth cleaning * Antibiotics (metronidazole, clindamycin) * Cleansing oral rinses (chlorhexidine) * Analgesics * Teeth extraction * •Specific (treat underlying disease)
27
px for stomatitis
Variable, dependent on underlying disease
28
etiology for feline lymphocytic plasmacytic stomatitis
unknown
29
clinical features of feline lymphocytic plasmacytic stomatitis
* Anorexia, halitosis (most common signs) * •Reddened gingiva (around teeth, pharynx) * •Gingiva bleeds easily * •Dental neck lesions (FORLs) * •Teeth chattering
30
dx for feline lymphocytic plasmacytic stomatitis
Biopsy / histopathology •MDB, FeLV / FIV •+/-Hyperglobulinemia
31
tx for feline lymphocytic plasmacytic stomatitis
* Teeth cleaning * •Antibiotics * •Teeth extraction * •(Prednisolone 2-4 mg/kg/day PO) * •No reliable / consistent therapy
32
px for feline lymphocytic plasmacytic stomatis
Variable •May be guarded •Some severely affected animals do not respond to therapy
33
primary cleft palate
Cleft lip or harelip
34
secondary cleft palate
* Roof of the mouth * Hard palate, soft palate, both
35
clinical features of claeft palate
* Hard palate clefts * Unable to nurse * Milk comes out of the nose * Aspiration pneumonia * •Unable to maintain weight * •Sneezing, coughing, gagging * •Nasal discharge when eating * •Fatal pneumonia * 30% of animals
36
dx for cleft palate
* Primary –obvious on exam * •Secondary –thorough oral exam (anesthesia) * •Thoracic radiographs * •MDB
37
tx for cleft palte
* Surgery * •Often delayed until 3-4 months of age * •Stomach tube feeding * •Esophagostomy tube
38
masticatory muscle myositis
* Idiopathic * •Immune mediated * •Inflammatory disorder –muscles of mastication * •Circulating antibodies (IgG) to Type 2M myofibers * •Dogs (not reported in cats)
39
signalment for masticatory mm. myositis
Young, middle aged dogs •Any breed acute or chronic
40
cs of acute mm myositis
* Recurrent painful swelling * •Temporalis, masseter muscles * •Exophthalmus * •Pyrexia * •Anorexia, depression * •Pain on palpation of muscles of head * •Pain when trying to open mouth
41
clinical presentation of chronic mm. myositis
* **_Most common presentation_** * •Progressive, severe atrophy of temporal, masseter muscles * •Difficulty opening mouth * •Otherwise BAR
42
dx for mm myositis
* History, clinical findings * •MDB * Elevated CK, AST, globulin (+/-) * •Serum antibodies to Type 2M fibers * \> 80% of cases * •Histopathology is definitive (immunohistochemistry)
43
tx for mm myositis
* Prednisone (1-2 mg/kg PO q 12 hours) * •Rapid response * •Start to wean at 3-4 wks, gradual taper (4-6 months) * •Inadequate dosing, early weaning -HIGH RATE of relapse!! * •Other immunosuppressives (azathioprine) * •Opening jaw under anesthesia –not recommended
44
px for masticatory mm myositis
* Usually good with treatment * •Long term medication may be needed * •Fibrosis in jaw muscles –poor prognostic indicator
45
cause of cricopharyngeal achalacia/dysfunction
* Incoordination between cricopharyngeus muscle (UES) and swallowing reflex * •Sphincter does not open at proper time * •Causes obstruction at UES (cricopharyngeal sphincter) * •UNCOMMON disease!!
46
clinical features of cricopharyngeal achalasia
* Primarily seen in young dogs * •RARELY an acquired disorder * •Regurgitation immediately after/during swallowing * •Anorexia, weight loss * •Clinically similar to pharyngeal dysfunction
47
dx for cricopharyngeal achalasia
* History, clinical signs * •MDB * •Fluoroscopy / Barium swallowing study * •Must distinguish from pharyngeal dysphagia * Experienced radiologist needed !!
48
tx and px for crichopharyngeal achalasia
* Cricopharyngeal myotomy * •Esophageal function MUST be evaluated prior to sx * *Prognosis* * •Good (if no stricture formation)
49
etiology for pharyngeal dysfnction
* Acquired disorder * •Neuropathies, myopathies, junctionopathies * Myasthenia gravis * •Inability to form food bolus at base of tongue * •Inability to propel food bolus into esophagus * •CN IX (Glossopharyngeal) & CN X (Vagus) * •Food retention in cranial esophagus due to concurrent esophageal dysfunction
50
clinical features of pharyngeal dysfunction
* Usually seen in older animals * •May mimic cricopharyngeal achalasia * •Regurgitation during swallowing * •More difficulty with fluids than solids * •Aspiration is common (liquids)
51
dx for pharyngeal dysfunction
* History, clinical signs * •MDB * •Fluoroscopy / Barium swallowing study * •Must distinguish from cricopharyngeal dysphagia * Experienced radiologist needed !!
52
tx for pharyngeal dysfunction
* Bypass pharynx (gastrostomy tube) * •Treat underlying disease (myasthenia gravis) * •Cricopharyngeal myotomy CONTRAINDICATED!!
53
px for pharyngeal dysfunction
Guarded (difficult to find / treat underlying disease) •Prone to weight loss / recurrent aspiration pneumonia

sam dr green (10 decks)

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