Oral Cavity Disorders

Question 1

List differentials for hypersalivation

Answer 1

1. Oral cavity disease
2. Salivary gland issue
3. Systemic or neuro conditions
4. Esophagus issue
5. GI issue

Question 1

What is pseduoptyalism?

Answer 1

• Drooling caused by inability to swallow a normal amount of saliva

Question 2

What is xerostomia?

Answer 2

lack of saliva production (rare)

seen with feline dysautonomia

Question 3

List oral cavity issues causing disorders in salivation?

Answer 3

• Inability to open or close mouth
• Oral mass
• Oral ulcers
• Dental disease
• Trauma
• Macroglossia
• Cleft palate

Question 4

List differentials for excessive salivation due to inability to open the mouth

Answer 4

• Crandiomandibular osteopathy in WHT
• Masticatory muscle myositis in young, large breed dogs

Question 5

CS of craniomandibular osteopathy?

Answer 5

• Inability to open the mouth
• Ptyalism
• Intermittent fever
• Dogs < 1 year old
• Pain on palpation

Question 6

How to treat craniomandibular osteopathy?

Answer 6

• Medically manage with analgesics, progression slows by 1 year of age
• Poor px if ankylosis of TMJ joints

Question 7

CS of masticatory muscle myositis?

Answer 7

• Inability to open the mouth
• Ptyalism
• Young, large breed dogs
• Acute phase shows masticatory muscle SWELLING
• Chronic phase shows muscle atrophy and fibrosis

Question 8

How to diagnose masticatory muscle myositis?

Answer 8

Blood test for Type 2M muscle fiber antibodies +/- muscle biopsy if already on prednisone

Question 9

Tx of masticatory muscle myositis?

Answer 9

Prednisolone and physical therapy

Question 10

List causes of ptyalism due to salivary gland problem

Answer 10

• Neoplasia
• Salivary mucocele
• Phenobarb responsive sialadenosis
• Sialolith

Question 11

Tx for salivary mucocele?

Answer 11

• Surgical removal of affected gland
• Exception: sublingual salivary gland can be marsupilized

Question 12

CS of Phenobarb responsive sialadenosis?

Answer 12

• Gagging
• Lip smacking
• Ptyalism
• Vomiting
• Bilateral painless, non inflammatory enlargement of salivary glands
• Rapid improvement with phenobarb

Question 13

List systemic causes of ptyalism

Answer 13

• Rabies
• Tetanus
• PSS
• Intoxication
• CN damage

Question 14

List physiological causes of ptyalism

Answer 14

• Pain
• Fear
• Stress
• Pavlovian response

Question 15

List esophageal causes of pseudoptyalism

Answer 15

• Megaesophagus
• Stricture
• Foreign body
• Mass

(Considered as PSEUDOptyalism due to inability to swallow)

Question 16

List extra oral causes of halitosis

Answer 16

• Megaesophagus / reflux disease
• Ketosis
• Uremia
• Liver disease (ammonia / bleach smell)

Question 17

What is oral dysphagia?

Answer 17

Inability to prehend, masticate and form food bolus

Question 18

What is pharyngeal dysphagia?

Answer 18

Inability to move bolus of food from mouth to esophagus

Question 19

List causes of oral dysphagia

Answer 19

• Salivary mucocele
• TMJ disorders
• Mandibular fx
• Cleft palate
• Dental dz
• Glossitis
• Neuro disease

Question 20

List causes of pharyngeal dysphagia

Answer 20

• Inflammation
• Foreign body
• Cricopharyngeal achalasia
• Rabies
• Neuro or brainstem disease

(inability to swallow, results in gagging)

Question 21

CS of Cricopharyngeal achalasia?

Answer 21

• Young animals
• Recurrent attempts to swallow
• Gagging

(Due to inability of the upper esophageal sphincter to relax)

Question 22

How to diagnose Cricopharyngeal achalasia?

Answer 22

Fluoroscopic swallow study

(Must do rads first to R/O megaesophagus prior to swallow study)

Question 23

How to treat Cricopharyngeal achalasia?

Answer 23

• Surgical resection of affected cricopharyngeal muscle and dietary management