Vet360 Vet360 Vol 05 Issue 04 - Page 25

GASTRO-ENTEROLOGY 7. 8. 9. 438–443. Schroeder, H. & Berry, W.L., 1998, ‘Salivary gland necrosis in dogs: A retrospective study of 19 cases’, Journal of Small Animal Practice 39, 121–125. Spangler, W.L. & Culbertson, M.R., 1991, ‘Salivary gland disease in dogs and cats: 245 cases (1985–1988)’, Journal of the American Veterinary Medical Association 198, 465–469. Stonehewer, J., Mackin, A.J., Tasker, S. & Simpson, J.W., 2000, ‘Idiopathic phenobarbitone responsive hypersialosis in the dog: An unusual form of limbic epilepsy?’, Journal of Small Animal Practice 41, 416–421. Sialoadenosis and Sialorrhoea in Canine Spirocecosis Liesel van der Merwe BVSc MMed Vet (Med) Small Animals Senior Lecturer, Outpatients OVAH lieselvdmvet@gmail.com The typical clinical signs of canine spirocercosis include regurgitation and/or vomiting and weight loss. Other frequently encountered clinical signs include coughing, dysphagia, pyrexia, melaena and sialorrhoea. An article evaluating sialorrhoea in dogs with spirocercosis calculated the incidence at a conservative (some data was retrospective) 11%, 33 of 298 patients. The fox terrier and Jack Russell terrier breeds accounted for 36.4% (12/33) of the population of dogs with spirocercosis with sialorrhoea, compared with only 4/265 (1.5%) of the dogs with spirocercosis without sialorrhoea, a significant finding. Sialorrhoea was also more prevalent in smaller dogs with 69% of affected animals having ≤ 12 kg body weight. It is hypothesised that this may be caused by a relatively greater degree of oesophageal distension in these smaller animals caused by the parasitic nodule, as it has been demonstrated that the vago-oesophageal reflex can be stimulated by distension The number of nodules was statistically different between the groups, with the sialorrhoea group having fewer nodules than the non-sialorrhoea group. This phenomenon cannot be explained but it is theorised that these patients show clinical signs earlier in the disease process because of the hyperresponsiveness of the oesophago-salivary reflex. The mandibular salivary glands were enlarged in 86.6% of cases and the parotid glands were involved in 13.3%. An analysis of the clinical history of the sialorrhoea group revealed that the duration of clinical signs ranged from 4 days to 3 months and included regurgitation, intermittent to persistent retching, gulping with repeated swallowing movements, coughing, making efforts to ‘clear the throat’, apparent choking, excessive salivation and anorexia. Clinical signs worsened with excitement or palpation of the pharyngeal area and glands. The choking episodes could be quite severe with the dogs vocalising, scratching at their faces with their forepaws, contorting the forequarters, head and neck, and these symptoms were even on occasion misinterpreted by owners and referring veterinarians as seizures. Retching often terminated in vomition or regurgitation. Where mentioned, the vomitus was generally described as frothy saliva All patients had weight loss and many showed a very "tucked up" abdomen. In the longstanding cases clinical signs generally progressed to severe dysphagia and a disinclination or a reluctance to eat. Food aversion was specifically noted in three cases. Laboured respiration was noted by owners in two cases and was detected on clinical examination as abdominal respiration in 25% of the dogs. A variety of anti-emetics including metoclopramide, betaperamide and chlorpromazine had been used to no avail in the majority of the cases referred. All patients with hypersialosis were treated with doramectin (Dectomax, Pfizer), phenobarbitone (Lethyl, Pharmacare Ltd. SA) and other symptomatic therapies as required. The treatment regimen of doramectin varied amongst clinicians but generally complied with the following: 400 mg/kg per os or by subcutaneous injection every week or every second week for a minimum of six treatments or until regression of the nodules occurred. The initiating dosage of phenobarbitone was generally around 2 mg/kg bid with a duration of 2–6 weeks as required. A marked decrease in clinical signs was generally noted within 48 hours of initiating phenobarbitone treatment at approximately 2mg/kg bid. Three cases took up to 2 weeks to respond and in these cases either an oesophagostomy tube or percutaneous endoscopically placed gastrostomy (PEG) tube was inserted Patients with spirocercosis-induced dysphagia will, and do, show reduction of clinical signs with treatment of the underlying cause, but in some patients the degree of dysphagia precludes proper food intake and nutrition and the phenobarbitone therapy provides symptomatic relief whilst the nodule regresses. References 1. Van der Merwe, L.L., Kirberger, R.M., Clift, S., Wiliams, M., Keller, N. & Naidoo, V., 2008, ‘Spirocerca lupi infection in the dog: A review’, Veterinary Journal 2. Van der Merwe, L.L., Christie, J., Clift, S.J. & Dvir, E., 2012, ‘Salivary gland enlargement and sialorrhoea in dogs with spirocercosis: A retrospective and prospective study of 298 cases’, Journal of the South African Veterinary Association 83(1), Issue 04 | SEPTEMBER 2018 | 25