Ailment of the oral cavity (Continued)

Problems with the salivary glands

Cysts

Salivary cysts are characterized by an accumulation of thick, sticky saliva because of a blocked-up duct (canal) through which the saliva travels to the mouth). The duct can become obstructed by food particles, or even by the thickening of saliva at the onset of the problem. If the saliva can’t flow, it backs up and collects as a fluid-filled cyst in the gland itself. Usually, the actual cause cannot be immediately determined. We see only the effect. 20130407pet cornerNevertheless, we do know that salivary cysts can be caused by traumatic or an inflammatory occlusion or rupture of the duct of the salivary glands (situated below the tongue, in the area of the jaw or the parotid gland). Because the channel of the mandibular (lower jaw) salivary gland and the major duct of the sublingual (below the tongue) salivary gland frequently empty through a common opening, these glands often are involved in the ailment simultaneously.

We have encountered quite a few salivary cysts over the years, usually in the salivary gland under the tongue (sublingual), on the floor of the oral cavity. This type is called a ranula or ‘honey cyst’. The ranula presents itself as a relatively large, smooth-surfaced swelling under the tongue. One does not notice the development of the fluctuating mass until it is so big that it is pushing the tongue to one side. Salivary cysts develop slowly and are not painful. By the time a cyst reaches a size that you can actually see it, great discomfort would have been created. The animal might even go off its food or, when eating, food clumps tend to drop out of the mouth.

Often, the first sign is a fluctuant mass (not accompanied with redness) under the tongue. Sometimes when pressure is applied to the cyst, a viscid, odorless, gray or brownish fluid may exude from the ducts at one or both sides below of the tongue, or opposite the upper fourth premolar, depending upon which gland is involved.

On some occasions, the ranula can burst and we may see some bleeding; then, for the first time, we know that something is wrong. The ranula must not be confused with an abscess or a cancerous tumour. Sometimes the cyst can become infected, then pain and usually a fever will accompany the infection.

Let me make a special note: Cysts usually are not accompanied by redness (inflammation) and /or fever. Consequently, any swelling must be differentiated from abscesses, tumours and other types of cysts. Tumours are usually firmer and slower growing than a cyst.

 

Treatment

One can prick the cyst and withdraw the thick honey coloured fluid (that’s why it’s also called ‘honey cyst’). On some occasions, this intervention suffices. If it recurs, then we have no other option than to go the surgical route.

My own experience is that when dealing with the salivary cyst, medical therapy alone is rarely successful. There are isolated instances in which a local infection or inflammation can be eliminated with medication. If only the salivary duct flow has been restricted, all may return to normal. Once the salivary duct has ruptured, however, the leakage will continue. We do not know of any case in which a duct closed or healed on its own after injury. The problem does not just go away.

Surgery is required in cases where saliva is leaking into the surrounding tissues. In those animals with a large, fluid-filled cyst below the jaw, the salivary glands on the affected side are completely removed.  Usually this means all of the mandibular and sublingual glands on one side.  Although this may seem extreme, the remaining glands respond to the increased need and adjust their production to compensate for the removal.

The important point for owners to recognise is that salivary cysts should be seen by a veterinarian as soon as possible. If the owner waits too long in a case of the cyst below the jaw, it is difficult for the clinician to determine on which side it originated. No one wants to surgically remove all the mandibular and sublingual glands from one side and then discover it was the wrong side. Help your veterinarian and your dog with an early trip to the clinic.

Enjoy the week.

Please implement disease preventative measures (vaccinations, routine dewormings, monthly anti-Heartworm medication, etc) and adopt-a-pet from the GSPCA’s Animal Clinic and Shelter at Robb Street and Orange Walk, if you have the wherewithal to care well for the animals.  Do not stray your unwanted pets, take them to the GSPCA’s Clinic and Shelter instead. If you do not wish your pet to have puppies or kittens, you may exploit the GSPCA’s free spay and neutering programme. If you see anyone being cruel to an animal, or if you need any technical information, please get in touch with the Clinic and Shelter by calling 226-4237.

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