Clinical and CT sialography findings in 22 dogs with surgically confirmed sialoceles.

Sialoceles are an uncommon canine salivary gland disease, and complete surgical resection is important for a positive outcome. Radiographic sialography has been described as a diagnostic test for presurgical planning; however, superimposition artifacts may limit the diagnosis and detection of all affected glands. Computed tomographic (CT) sialography is a promising technique for delineating the salivary gland apparatus. The aims of this retrospective, observational study were to describe clinical and CT sialographic findings in a group of dogs with confirmed sialoceles, to determine the sensitivity of CT sialography for detecting affected salivary glands using surgery as the reference standard and to determine interobserver agreement for CT sialographic assessments. Dogs were included if they underwent a CT sialography study followed by surgical resection of the diseased gland(s) and histopathological analysis. Computed tomography sialography studies of dogs with surgically confirmed sialoceles (n = 22) were reviewed by a European College of Veterinary Diagnostic Imaging (ECVDI)-certified radiologist and an ECVDI resident. Interobserver agreement was calculated using Cohen's kappa statistics. CT sialography results were compared to surgical findings to determine sensitivity. Contrast leakage was detected in 12 of 22 dogs (54.5%), with intrasialocele leakage being most frequently observed (7/12, 58.3%). There was substantial agreement (κ = 0.70) between reviewers identifying diseased glands, substantial agreement (κ = 0.62) on the diagnostic quality, and no to slight agreement (к = 0.13) in the detection of contrast leakage. The overall sensitivity of CT sialography to detect surgically confirmed diseased glands was 66.7% (95% confidence interval: 48.8-80.8). In conclusion, these findings support the use of CT sialography as an adjunct diagnostic test for treatment planning in dogs with sialoceles.

Multi-institutional study of long-term outcomes of a ventral versus lateral approach for mandibular and sublingual sialoadenectomy in dogs with a unilateral sialocele: 46 cases (1999-2019).

OBJECTIVE: To compare the long-term outcomes of a ventral versus lateral surgical approach for mandibular and sublingual sialoadenectomy in dogs with a unilateral sialocele. ANIMALS: 46 client-owned dogs. PROCEDURES: Medical records of dogs that underwent unilateral sialoadenectomy between 1999 and 2019 were retrospectively reviewed, and information was collected regarding signalment, clinical signs, historical treatment, swelling location, diagnostic imaging findings, sialoadenectomy approach, adjunctive treatments, intraoperative complications, hospitalization time, postoperative complications, recurrence, and contralateral sialocele development. RESULTS: There were no significant differences in incidences of intraoperative complications, recurrence, or postoperative complications between dogs in which a lateral versus ventral approach was used. Clinically important intraoperative complications included iatrogenic tears in the oral mucosa, ligature slippage from the duct end, hemorrhage, and possible lingual nerve transection. Surgical experience was associated with the likelihood that intraoperative complications would develop. Suspected recurrence was reported in 2 of 26 (8%) dogs that underwent a lateral approach and 2 of 12 (17%) dogs that underwent a ventral approach. Hospitalization time was significantly shorter with the lateral approach than with the ventral approach. Postoperative complications had a short-term onset and occurred in 4 of 25 (16%) dogs that underwent a lateral approach and 3 of 12 (25%) dogs that underwent a ventral approach. Age and presence of a pharyngeal sialocele were associated with development of postoperative complications. CLINICAL RELEVANCE: Long-term outcomes for ventral and lateral approaches to sialoadenectomy were favorable and appeared to be comparable. Further prospective study into potential associations of sialoadenectomy approach, age, and pharyngeal sialoceles on outcome is needed.

Zygomatic sialocele secondary to infarction treated with sialoadenectomy in a dog.

Zygomatic salivary gland disease is not commonly reported in dogs and there is a paucity of literature reporting salivary gland disease secondary to infarction in dogs. A 9-year-old German wirehaired pointer presented with left eye exophthalmos, 3rd eyelid elevation, negative retropulsion, and pain upon opening of the mouth. Computed tomography revealed a mass extending from the left zygomatic salivary gland, consistent with a sialocele. A left-sided zygomatic sialoadenectomy was performed successfully. Histopathologic diagnosis concluded zygomatic salivary gland infarction. The dog had no signs of recurrence 20 mo after surgery. Key clinical message: To the authors' knowledge, this is the first case report with long-term outcome of a zygomatic sialocele secondary to salivary gland infarction in a dog treated by zygomatic sialoadenectomy via zygomatic osteotomy.

Sialocèle zygomatique secondaire à un infarctus traité par sialoadénectomie chez un chien. Une atteinte des glandes salivaires zygomatiques n'est pas fréquemment rapportée chez le chien et il existe peu de littérature rapportant une maladie des glandes salivaires secondaire à un infarctus chez le chien. Un pointeur allemand à poil dur de 9 ans présentait une exophtalmie de l'oeil gauche, une élévation de la troisième paupière, une rétropulsion négative et une douleur à l'ouverture de la bouche. La tomodensitométrie a révélé une masse s'étendant à partir de la glande salivaire zygomatique gauche, compatible avec une sialocèle. Une sialoadénectomie zygomatique gauche a été réalisée avec succès. Le diagnostic histopathologique a permis de conclure à un infarctus des glandes salivaires zygomatiques. Le chien n'avait aucun signe de récidive 20 mois après la chirurgie.Message clinique clé :À la connaissance des auteurs, il s'agit du premier rapport de cas avec évolution à long terme d'une sialocèle zygomatique secondaire à un infarctus des glandes salivaires chez un chien traité par sialoadénectomie zygomatique via une ostéotomie zygomatique.(Traduit par Dr Serge Messier).

Transoral approach for mandibular and sublingual sialoadenectomy in a cat.

Sialocele is an uncommon condition in cats. The treatment of choice for sublingual sialocele is excision of the ipsilateral mandibular and sublingual salivary gland/duct complex. Lateral and ventral cervical approaches have been described for mandibular-sublingual sialoadenectomy; however, the transoral approach, described here, has never been reported in cats. Ranula in the present case was likely caused by an inadvertent trauma of the sublingual duct during resection of a sublingual lesion performed by the referring veterinarian. The definitive surgery consisted of mass removal and sialoadenectomy through a unique oral approach. The surgery was effective without complications encountered after 6 months of follow-up. Key clinical message: This article reports a novel, transoral approach, for mandibular and sublingual sialoadenectomy in the cat. This approach decreases the surgical time and prevents recurrence of the mucocele.

Approche trans-orale pour la sialo-adénectomie mandibulaire et sublinguale chez un chat. La sialocèle est une maladie rare chez les chats. Le traitement de choix pour la sialocèle sublinguale est l'excision du complexe glandes salivaires/canal salivaire ipsilatéral mandibulaire et sublingual. Des approches cervicales latérales et ventrales ont été décrites pour la sialo-adénectomie mandibulaire-sublinguale; cependant, l'approche trans-orale, décrite ici, n'a jamais été rapportée chez les chats. Dans le cas présent, la ranula a probablement été causée par un traumatisme involontaire du canal sublingual lors de la résection d'une lésion sublinguale réalisée par le vétérinaire référent. La chirurgie définitive consistait en un enlèvement de masse et une sialo-adénectomie par une approche orale unique. La chirurgie a été efficace sans complications rencontrées après 6 mois de suivi.Message clinique clé :Cet article rapporte une nouvelle approche trans-orale pour la sialo-adénectomie mandibulaire et sublinguale chez le chat. Cette approche diminue le temps chirurgical et empêche la récidive de la mucocèle.(Traduit par Dr Serge Messier).

Successful treatment of a dog with phenobarbital-responsive sialadenosis and an oesophageal stricture.

BACKGROUND: Phenobarbital-responsive sialadenosis (PRS) can cause nausea and vomiting, and is rarely reported in dogs. OBJECTIVES: An 8-year-old neutered, male Pomeranian dog was presented to our teaching hospital with vomiting that began 2 years ago. The clinical signs repeatedly improved and deteriorated despite treatment. METHODS: The only abnormality found on physical examination was salivary gland enlargement, and no specific findings were observed on blood analysis and imaging tests. The results of the fine needle aspirate cytology from the salivary glands revealed possible sialadenosis. Phenobarbital was prescribed, and the patient's symptoms resolved. However, upon discontinuing drug, the patient's clinical signs recurred and did not improve even after re-introduction of phenobarbital and the addition of other anticonvulsant drugs. An oesophageal stricture was observed on an oesophagram, and fibrosis was confirmed endoscopically. A balloon dilation was performed to expand the stenosis. RESULTS: After the first procedure, the patient's clinical signs initially improved, but relapsed 2 weeks later. A total of three oesophageal dilation procedures were performed using a sequentially larger diameter balloon. After the third procedure, the patient's clinical signs were managed without recurrence. The cause of recurrent gastrointestinal signs following the initial successful treatment of phenobarbital-responsive sialadenosis was due to oesophageal stricture formation. CONCLUSIONS: This case report demonstrates the successful management of PRS with subsequent oesophageal stricture formation in a dog.

An Atypical Presentation of a Zygomatic Sialocele in a dog.

A sialocele is an accumulation of salivary fluid due to leakage into the interstitial space surrounding the affected salivary gland and/or its corresponding duct. Reported causes of salivary leakage include trauma, foreign bodies, sialoliths, and neoplasia, but in many cases the etiology is not identified. Clinical signs of sialoceles associated with the zygomatic salivary gland or corresponding duct usually include exophthalmos due to periorbital salivary accumulation, whereas sialoceles associated with the mandibular or sublingual glands or ducts usually manifest as cervical, pharyngeal and/or sublingual salivary accumulation. This case report describes an atypical cervical presentation of a zygomatic sialocele in a dog that resolved after zygomatic sialoadenectomy.

Intracanalicular injection of N-acetylcysteine as adjunctive treatment for sialoceles in dogs: 25 cases (2000-2017).

OBJECTIVE: To describe intracanalicular injection of 10% N-acetylcysteine (IINAC) as adjunctive treatment for sialoceles in dogs. ANIMALS: 25 client-owned dogs. PROCEDURES: Hard copy medical records at 2 veterinary ophthalmology practices were searched to identify dogs that underwent IINAC for treatment of sialoceles from January 2000 to December 2017. Signalment, affected salivary gland, clinical signs, duration of signs, other treatments administered, diagnostic tests performed, anesthetic approach, N-acetylcysteine volume administered, complications, follow-up time, and recurrence of sialoceles were recorded. Descriptive statistics were reported. RESULTS: Boxers and mixed-breed dogs were most commonly represented. Subjectively decreased globe retropulsion and conjunctival or periorbital swelling (23/25 [92%] dogs each) were the most common clinical signs, with no vision deficits in any patient. The zygomatic gland was mainly affected (23/25 [92%] dogs), followed by parotid and mandibular glands (1 [4%] dog each). The condition was unilateral in 22 (88%) dogs. Ultrasonography (19/25 [76%] dogs), MRI (14 [56%]), fine-needle aspiration (20 [80%]), and biopsy (4 [16%]) were performed; however, the condition was deemed idiopathic in 22 (88%) dogs. Most IINACs were performed with local anesthesia (median volume, 5 mL/gland; range, 1.5 to 9 mL). No complications were identified. Other treatments included antimicrobials and anti-inflammatories. Mean follow-up time was 18.8 months. All recurrences (5/23 [22%] dogs) were controlled with medical management. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested noninvasive IINAC may be a useful adjunctive treatment for sialoceles in dogs. The procedure was easily and safely performed with local anesthesia (or general anesthesia with concurrent diagnostic imaging) in these dogs.

A retrospective study of salivary gland diseases in 179 dogs (2010-2018).

Salivary gland diseases are well characterized in human medicine but are uncommonly reported in dogs. Herein we describe the clinical and pathologic features of 179 canine salivary gland biopsy submissions to the Athens Veterinary Diagnostic Laboratory from 2010 to 2018. The mean age of affected dogs was 8.5 y; no sex or breed predisposition was evident. The main reason for sample submission was regional swelling (107 cases; 59.7%). Extraoral (major) salivary glands were affected in 125 cases (69.8%), and oral (minor) salivary glands were affected in 43 cases (24% of cases). The location of the lesion (extraoral or oral) was not specified in 11 cases (6.1%). The diagnoses included nonspecific sialoadenitis (89 cases; 49.7%), normal salivary gland (42 cases; 23.4%), neoplasia (36 cases; 20.1%), salivary gland lipomatosis (7 cases; 3.9%), necrotizing sialometaplasia (4 cases; 2.2%), and traumatic hemorrhage (1 case; 0.5%). Most cases of sialoadenitis (63 cases), neoplasia (23 cases), and lipomatosis (5 cases), as well as all cases of necrotizing sialometaplasia and the only case of traumatic hemorrhage, affected extraoral glands. Most neoplasms (32 cases, 88.8% of the tumors) were epithelial and malignant, followed by round cell tumors (2 cases; 5.5%), a carcinosarcoma (1 case; 2.7%), and a tumor of undetermined histogenesis (1 case; 2.7%).

Efficacy of Radiation Therapy for the Treatment of Sialocele in Dogs.

BACKGROUND: Sialocele is a collection of saliva that has leaked from a damaged salivary gland or duct and is surrounded by granulation tissue. Surgery is the recognized first-line treatment. Recurrence rate after surgery is 5-14%. Salivary gland tissue is very sensitive to radiation therapy (RT). HYPOTHESIS/OBJECTIVES: Radiation therapy will be useful for the treatment of sialocele. The aims were to characterize response rate and clinical course of dogs with sialocele treated with RT and to determine a starting dose for clinical use. ANIMALS: Eleven dogs with sialocele. METHODS: Retrospective study of response and outcome after RT. RESULTS: All dogs had cervical sialocele. Seven dogs (63.6%) were treated with 3 weekly fractions of 4 Gray (Gy); (total dose, 12 Gy). Three dogs (27.3%) received 4 fractions of 4 Gy (16 Gy) and 1 dog received 5 fractions of 4 Gy (20 Gy) on a Monday-Wednesday-Friday schedule. Six dogs (54%) achieved a complete response (CR), and 5 dogs (45%) achieved a partial response (PR). Three dogs had progression of their sialocele 2, 3, and 9 months after RT; all three had received 12 Gy initially and 2 received 2 additional fractions of 4 Gy (cumulative total dose, 20 Gy) and subsequently achieved remission for >2 years. CONCLUSIONS AND CLINICAL IMPORTANCE: Radiation therapy is useful for the treatment of recurrent sialocele refractory to surgical management and a minimum total dose of 16 or 20 Gy in 4 Gy fractions appears effective.

Sialoendoscopy as a treatment for an obstructed mandibular salivary duct in a horse.

A 14-year-old Quarter Horse was examined for a draining tract of 8 months' duration on the right mandible that was non-responsive to antibiotic therapy and surgical therapy. Further investigation and subsequent treatment with sialoendoscopy and ultrasonography were performed to relieve an obstruction of plant awns in the mandibular salivary duct.

Sialo-endoscopie comme traitement pour un canal salivaire mandibulaire bloqué chez un cheval. Un cheval Quarter Horse âgé de 14 ans a été examiné pour une fistule purulente d'une durée de 8 mois à la mandibule droite qui ne répondait pas à la thérapie antibiotique et à la thérapie chirurgicale. De nouvelles investigations et le traitement subséquent à l'aide de la sialo-endoscopie et de l'échographie ont été réalisés pour éliminer un blocage du canal salivaire mandibulaire par des barbes de plantes.(Traduit par Isabelle Vallières).

Management of Orbital Diseases.

Orbital diseases are common in dogs and cats and can present on emergency due to the acute onset of many of these issues. The difficulty with diagnosis and therapy of orbital disease is that the location of the problem is not readily visible. The focus of this article is on recognizing classical clinical presentations of orbital disease, which are typically exophthalmos, strabismus, enophthalmos, proptosis, or intraconal swelling. After the orbital disease is confirmed, certain characteristics such as pain on opening the mouth, acute vs. chronic swelling, and involvement of nearby structures can be helpful in determining the underlying cause. Abscesses, cellulitis, sialoceles, neoplasia (primary or secondary), foreign bodies, and immune-mediated diseases can all lead to exophthalmos, but it can be difficult to determine the cause of disease without advanced diagnostic imaging, such as ultrasound, magnetic resonance imaging, or computed tomography scan. Fine-needle aspirates and biopsies of the retrobulbar space can also be performed.

Surgical excision of the parotid salivary gland for treatment of a traumatic mucocele in a dog.

A 3 yr old spayed female mixed-breed German shepherd dog was presented with a right facial swelling that developed after fighting with another dog. A parotid salivary mucocele was diagnosed via physical examination, fine-needle aspirate, and sialography of the parotid and mandibular salivary glands. Surgical excision of the right parotid salivary gland and duct was performed along with drainage of the mucocele. Neither intraoperative nor postoperative complications occurred, and follow-up examination 4 mo later revealed no evidence of recurrence. Case outcome was considered excellent. Sialography was useful for confirming the parotid gland as the source of the mucocele. Surgical excision of the parotid salivary gland is technically challenging, but an effective treatment option for traumatic mucoceles in the dog.

Zygomatic salivary gland diseases in the dog: three cases diagnosed by MRI.

This article describes three original cases of zygomatic gland disease in the dog diagnosed by low-field MRI and treated by a modified lateral orbitotomy with zygomatic osteotomy. Presenting complaints included exophthalmia, protrusion of the third eyelid, and periorbital swelling without any history of trauma. Low-field MRI allowed for adequate diagnosis of zygomatic gland disease in all cases and provided detailed information about both the specific tissue characteristics of each lesion and extension into surrounding structures. MRI findings were also helpful for surgical planning and dictated the choice of a modified lateral orbitotomy without removal of the orbital ligament. Histopathologic diagnosis for each of the three dogs was a mucocele, a malignant mixed salivary tumor, and sialadenitis.

Ectopic ossification presenting as osteoid metaplasia in a salivary mucocele in a Shih Tzu dog.

BACKGROUND: Salivary mucocele is an accumulation of saliva in a single or multiloculated cavity lined by connective tissue that is contiguous to a salivary gland-duct complex and is the most common condition affecting the salivary glands in dogs. Occasionally, different types of metaplastic lesions, such as squamous and osseous metaplasia - which are rare lesions in animals - can be observed in association with salivary mucocele. CASE PRESENTATION: A right facial enlargement was suddenly observed in a 4-year-old non-spayed female Shih-Tzu dog. The lesion presented itself as a soft and fluctuant mass located in the right side of the face near to the neck. Histologically, the mass consisted of a cavitary formation without an epithelial lining. Additionally, microscopic examination revealed the presence of osteoid-producing cells which gave rise to areas of bone formation, probably induced by irritation due to the presence sialoliths. Such cells and bone formations were also present in the cavity wall, consequently leading us to classify the condition as a salivary mucocele with osseous metaplasia. CONCLUSIONS: In the present case, the pathogenesis was probably associated with the presence of sialoliths, which can behave as etiological agents for the metaplastic lesion. The occurrence of osteoid metaplasia is a rare peculiar condition in the canine salivar y gland, and due to the rarity and lack of information about this specific disease, no clinical data can yet be associated with the development of salivary mucocele with osseous metaplasia in dogs.

Pathological features of salivary gland cysts in a Shiba dog with GM1 gangliosidosis: a possible misdiagnosis as malignancy.

Salivary gland cysts are often concurrent with GM1 gangliosidosis in Shiba dogs. Although the etiology is unknown, these cysts may be misdiagnosed as malignant due to the accumulation of foamy cells. The present study investigated the cytological, histopathological, immunohistochemical and electron microscopic characteristics of salivary gland cysts in a Shiba dog affected with GM1 gangliosidosis. The salivary gland masses were surgically enucleated and examined clinicopathologically and pathologically in a 7-month-old Shiba dog with GM1 gangliosidosis. Many large cells with rich cytoplasm including vacuoles of various sizes, i.e., foamy cells, were observed in stamp smears from the cut-surface of the masses and histopathologically in major parts of the cyst wall. Some of these foamy cells presented features similar to a spider-web appearance. The foamy cells were confirmed to have originated from macrophages based on marked immunohistochemical expression of vimentin, HLA-DR, lysozyme and Iba1. An ultrastructural study demonstrated electron-dense vesicular structures in the vacuolated cells. Therefore, the masses were diagnosed pathologically as benign salivary gland cysts with accumulation of foamy cells. In conclusion, the histopathological features of the salivary gland cysts in this Shiba dog were similar to those of lipoma and/or liposarcoma. In such cases, immunohistochemical and ultrastructural examinations were useful in the differential diagnosis. Practitioners, clinical pathologists and pathologists should take GM1 gangliosidosis into consideration when they encounter salivary gland cysts in Shiba dogs.