Cat owners are
surely familiar with the behavioral signs of kitty contentment. Happy
cats will purr, knead their paws, and offer up a few head butts for good
measure. Occasionally, cats really on cloud nine will drool on their
owners. As the owner of such a cat, I interpret the flow of saliva as
the utmost compliment. At the veterinary office, however, patients
rarely drool with glee. In a veterinary setting, drooling more likely
signifies that something is amiss.
continuously produced by the salivary glands. Excessive production and
secretion of saliva is called ptyalism. Oral problems and
central nervous system disorders are common reasons for ptyalism and
subsequent drooling. Ptyalism should not be confused with pseudoptyalism,
in which normal amounts of saliva is being produced, but it overflows
from the mouth due to anatomic abnormalities, such as malocclusion
(abnormal alignment of the teeth), or to an inability or reluctance to
swallow because of pain associated with swallowing.
The initial step
in determining the cause of a cat’s drooling is a thorough oral
examination. This may require sedation, tranquilization, or even
general anesthesia, as cats with painful mouths are often head-shy and
won’t allow a comprehensive exam.
Disorders of the
teeth and gums are a common reason for drooling. “Periodontal disease
and the accompanying gingivitis, if severe, can lead to halitosis (bad
breath), dysphagia (difficulty eating), and drooling”, says Dr. Theresa
Paoloni, owner of Veterinary Care Unlimited in Ozone Park, New York.
“Periodontal disease is easily diagnosed during an oral examination,
however, determination of the true extent of periodontal disease often
requires oral radiographs”. Some cats experience gingivitis or
stomatitis (inflammation of the entire mouth) of such severity that they
paw at their mouth, refuse to eat hard food, and may drool excessively.
Biopsy of the gums or other affected oral tissues may reveal a severe
infiltration of inflammatory cells. This condition, called “lymphocytic/plasmacytic
gingivitis or stomatitis” is usually quite painful. Treatment consists
of antibiotics, anti-inflammatory medications, and in extreme cases,
extraction of all of the teeth. (See Sidebar: Tips on Keeping Your
Cat’s Mouth Healthy)
During an oral
exam, the cat should be evaluated to see if it can close its mouth
properly. Some cats cannot, due to malocclusion. Although congenital
and developmental disorders are common causes of malocclusion, oral
tumors can cause misalignment of the teeth and/or jaw, leading to
improper closing of the mouth and subsequent drooling. In fact, oral
cancer is a very common cause of drooling in geriatric cats. Such was
the case with “Milo”, an 18 year-old American Shorthair belonging to Amy
Cousins. Last May, Milo presented to my hospital with a mouth that was
oozing foul-smelling drool. Initially, it appeared as if severe
periodontal disease alone might be the cause of his problem, however,
upon extracting one of his diseased upper canine teeth, a piece of bone
came loose, attached to the tooth root. Submission of the bone specimen
to the pathologist confirmed our fears: squamous cell carcinoma, an
aggressive oral cancer.
paralysis of the trigeminal nerve (cranial nerve V) can lead to drooling
secondary to an inability to close the mouth. Lesions involving other
cranial nerves (cranial nerve VII, IX, X, and XII) can also lead to
drooling. Fortunately, cranial nerve disorders are uncommon in cats.
Oral trauma and
associated pain and discomfort can lead to drooling. Broken teeth with
resultant nerve exposure, a fractured jaw, and temporomandibular joint (TMJ)
disorders are traumatic injuries that often lead to pain and drooling.
Kidney failure is
a very common condition, especially in geriatric cats. Cats with severe
kidney failure may have significant uremia (literally “urine in
the blood”). Uremic cats often develop ulcers on the gums, tongue, and
edges of the lips. These ulcers are painful, and many of these cats
drool foul-smelling saliva as a result. These ulcers are readily visible
on oral examination.
If the oral cavity
is determined to be normal, other causes for drooling that should be
considered include liver disease, nausea, seizure activity, and drug or
toxic stimulation of salivation.
The liver’s job is
to help remove toxins from the blood. If the liver isn’t working
properly, the toxins accumulate in the blood stream where they affect
the brain. This is called “hepatic encephalopathy”, which translates to
a mental condition due to liver dysfunction. One liver disorder, called
a “portosystemic shunt”, is a common cause of this, and is often seen in
young cats. This is a congenital abnormality in which blood coming from
the intestinal tract bypasses or “shunts” around the liver rather than
flowing through it. Because the blood bypasses the liver, the liver
never gets to detoxify it. Typical signs of this (and other) liver
disorders include behavioral changes, poor appetite, weight loss,
excessive thirst and urination, vomiting, diarrhea, nausea, and
drooling. Compared to dogs, cats are much more prone to drooling as a
result of liver disease.
Nausea is the
first stage in the process of vomiting. Although liver disease is a
well-documented cause of nausea in cats, any disorder that causes nausea
can lead to hypersalivation.
Various drugs and
toxins can cause hypersalivation in cats. Unpleasant tasting drugs can
cause cats to salivate profusely. The antiprotozoal drug metronidazole
(Flagyl), the antihistamine chlorpheniramne (Chlortrimeton), and the
sulfa antibiotics are particularly notorious for causing cats to
salivate copiously if the pill inadvertently lands on the tongue during
administration. These drugs require a client that is proficient in
pilling. Overdosing of flea and tick insecticides can lead to ptyalism,
as can the secretions of various toads and newts, and the venom of the
black widow spider. Various plants, including philodendron,
diffenbachia, poinsettia, and Christmas trees can cause increased
salivation. Household cleaning products can irritate the oral mucosa,
resulting in hypersalivation.
are not as common in cats as they are in dogs. During a seizure, cats
and dogs may drool secondary to reduced swallowing of saliva.
approach is necessary for diagnosing the underlying cause of drooling in
cats. Though it may seem obvious when a cat is drooling from happiness,
any signs of illness, including oral discomfort, unusual behavioral
changes, foul odor to the saliva, or saliva that is blood-tinged should
be investigated by a veterinarian.
Sidebar: Tips to
Keep Your Cat’s Mouth Healthy
In celebration of
Pet Dental Health Month, Rita Santiago, a certified veterinary dental
technician working at Manhattan Cat Specialists in New York City,
suggests the following tips for keeping your cat’s mouth in tip-top
veterinary exams – a thorough oral examination, every six months, is
essential. Periodontal disease can be prevented if caught early.
Gingivitis, the earliest stage of periodontal disease, is reversible
if detected early and treated promptly
cats teeth - brushing your cat’s teeth, ideally every other day,
can go a long way toward preventing dental disease. Dental homecare
should be introduced during kittenhood, so cats become used to
having their lips lifted, their mouth and gums touch and handled,
and their teeth brushed. Specially designed toothbrushes and
toothpastes for cats are available from veterinarians.
gels, and sprays – cats with especially tender mouths, or those with
established dental problems may benefit from these oral care
products. While brushing is best, rinsing helps protect and clean
teeth on days that you cannot brush.
special diets - dental diets are a somewhat recent veterinary
development. These diets are designed to prevent or dramatically
slow the accumulation of tartar on the teeth. Also available are
dental chews for cats. These offer an abrasive texture that help
remove debris and plaque from your cat’s teeth. They come in flavors
like fish or poultry.
maintenance, combined with frequent veterinary examinations will help
your cat maintain a sound, healthy mouth for life.