Efficacy of Radiation Therapy for the Treatment of Sialocele in Dogs

Sialocele and Its Association with Hypercortisolism and Long-Term Glucocorticoid Treatment in Dogs: Retrospective Case-Control Study

Dogs with sialocele often have concurrent hypercortisolism or are receiving long-term glucocorticoid treatment. However, their association has not been investigated. This retrospective matched case-control study investigated the association between hypercortisolism, long-term glucocorticoid treatment, and sialocele in dogs. We retrospectively reviewed the records from 1 January 2018 to 31 December 2022. Records of 19 dogs diagnosed with sialocele were investigated for hypercortisolism and long-term glucocorticoid treatment. Two age- and breed-matched controls for each sialocele dog (38 dogs) were investigated for the same concurrent diseases. Logistic regression analysis was used. The odds of sialocele in dogs with hypercortisolism were 15.56 times those of dogs without hypercortisolism (p = 0.02; 95% CI: 1.54-156.79). The odds of sialocele in dogs with long-term glucocorticoid treatment (median, 8 months; range, 5-13) were 7.78 times those of dogs without long-term glucocorticoid treatment (p = 0.03; 95% CI: 1.23-49.40). No associations were found between age, sex, body weight, and the presence of sialocele. The results indicate that sialocele was significantly associated with hypercortisolism and long-term glucocorticoid treatment in dogs. Therefore, dogs with hypercortisolism or receiving long-term glucocorticoid therapy should be screened for possible sialocele. Additionally, dogs with sialocele should be identified for concurrent hypercortisolism and prolonged glucocorticoid exposure.

Diagnostic Findings and Surgical Management of Three Dogs Affected by Osseous Metaplasia Secondary to a Salivary Mucocele

Saliva is an irritant of the subcutaneous tissue, thus causing the development of a non-epithelial reactive pseudocapsule. Metaplastic ossification of the pseudocapsule is a condition rarely described in the veterinary literature. The main causes of calcification are trauma, tumours, various chronic inflammatory conditions and fibrodysplasia ossificans progressiva. The aim of the present case series was to describe three dogs affected by a calcified salivary mucocele. The medical records of dogs affected by a cervical sialocele were retrospectively evaluated, and three cases met the inclusion criteria. All the dogs in this study were referred to the Veterinary Teaching Hospital (VTH) of the Department of Veterinary Sciences of the University of Turin (Turin, Italy) for a large solid mass in the intermandibular region. The diagnosis of a mucocele was confirmed clinically by centesis and by radiography or CT. Complete excision of both the pseudocyst and the ipsilateral mandibular/monostomatic sublingual salivary gland was performed in all cases. The histological report showed large areas of bone metaplasia within the pseudocapsule and chronic sialadenitis. Based on this limited case series, complete excision of the pseudocyst and a concurrent sialoadenectomy provided an effective treatment for this rare salivary mucocele disorder.

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.

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.

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.

Complications between ventral and lateral approach for mandibular and sublingual sialoadenectomy in dogs with sialocele

OBJECTIVE

To compare complications of dogs treated with mandibular and sublingual sialoadenectomy for sialocele using a lateral (LAT) or ventral paramedian (VPM) approach.

STUDY DESIGN

Retrospective multicenter study.

ANIMALS

Dogs (140) with mandibular and sublingual sialocele.

METHODS

Medical records of dogs that underwent mandibular and sublingual sialoadenectomy through a LAT or VPM approach from 2004 to 2020 were reviewed. Clinical and histopathological findings were analyzed to compare the groups.

RESULTS

Seventy dogs were included in each group. The most represented breed was crossbreed (26%), and males (99/140 [71%], intact/neutered) were overrepresented. Dogs in the VPM approach group were more likely to undergo digastricus tunnelization and placement of a drain or a bandage. Dogs in the LAT approach group were heavier and more likely to undergo excision of an inflammatory pseudocapsule. No difference was detected in complication rates between groups (LAT [20%], VPM [31%], P = .116). Recurrences were more likely after LAT approach (5/70 vs 0/70, respectively; P = .029), whereas wound-related complications were more likely after VPM approach (20/70 vs 9/70, respectively; P = .018). Prolonged duration of surgery was associated with an increased risk of recurrence, and none of the other variables affected the complication rate.

CONCLUSION

Ventral paramedian approach for mandibular and sublingual sialoadenectomy was associated with a lower risk of recurrence but a higher risk of wound-related complications compared with LAT approach.

CLINICAL SIGNIFICANCE

Ventral paramedian approach for mandibular and sublingual sialoadenectomy may be preferred to reduce recurrence in dogs with sialoceles, but wound-related complications are common.

Treatment of Exuberant Granulation Tissue in an Umbrella Cockatoo (Cacatua alba) with Strontium Radiation

A 26-year-old female umbrella cockatoo (Cacatua alba) was presented for reoccurrence of a soft tissue mass extending from a fractured area of the rhinotheca. The mass was originally observed 12 years before, after unknown trauma. Histopathology after initial removal was consistent with inflammatory granulation tissue. The mass reoccurred 3 additional times in the same location despite surgical removal and cryogenic therapy. On the fourth surgical resection, strontium-90 radiotherapy was applied to the site immediately after the surgical procedure. No recurrence of the tissue mass from this location has been observed for almost 2 years. This case demonstrates the novel use of strontium radiotherapy to treat exuberant granulation tissue in a bird.