Differential Diagnosis for Ptyalism

(excessive production of saliva, drooling, slobbering)

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When the causes are not found, or the treatment does not stop the excessive drooling, local alopecia can develop, showing a raw inflamed skin. This condition is painful.

Secondary bacterial or fungal skin infection may develop.

Photo: courtesy of Kim Chilson

Rabbit Anna, suffering from several health problems including a runny eye that was not linked to dental problems, extraction of incisors.




Differential diagnosis


Ptyalism is differentiated between acute drooling or chronic drooling.

In each case, the cause of excessive production of saliva is different.


Acute ptyalism


Neoplasia or presence of a tumor

Presence of an abscess



Chronic ptyalism

Neurologic trauma (e.g., stroke)

Medication (analgesics, anticonvulsants, anticholinesterase)

Obstruction in the nasal cavity (e.g., presence of polyps)

Size of the tongue

Position of the head

Sitting or lying position


Diseases, e.g., rabies or tetanus



Further causes for ptyalism relate to tooth problems.


Bacterial causes

Tooth root abscess

Inflammation of the tongue

Cheek abscess


Oral or gastro-intestinal causes

Oral ulcerations

Epulis, (tumor or growth on the gum)

Stomatitis (inflammatory condition of the mouth, resulting from infection by bacteria, viruses, or fungi, from exposure to certain chemicals or drugs, from vitamin deficiency).

Bloat, or an abnormal collection of gas in the stomach, or cecum. In this case the stomach feels swollen and the rabbit is in pain.

Gastroesophageal reflux

Gastric distension

Acute gastritis (inflammation of the lining of the stomach), caused by surgery, aspirin or other drugs, by food allergens or by the presence of viral, bacterial, or chemical poisons.

Pancreatitis (e.g., presence of gallstones, infection or medication)

Digestive organ failure (e.g., liver disease)



Respiratory causes

Inflammation of the pharynx, bronchia and lungs (e.g., alveolar abscess)

Pharyngitis (inflammation of the pharynx), where the compromise passage of air can lead to respiratory distress, and one symptom, among others is drooling.


Cardiovascular causes

Portosystemic shunts, a congenital or acquired vascular abnormalities that permit portal blood flow to bypass the liver and enter the systemic circulation directly. In small animal, this is characterized by drooling.



Nutrient deficiency, e.g., folate deficiency, chronic fluorosis, subacute scurvy


Mechanical causes

Presence of a trapped foreign body between molars (e.g., hay, fur)

Overgrowth of the crown of the tooth (e.g., presence of spikes)

Malocclusion of the front teeth

Odontoclastic lesions (small to large enamel defects right at the gum line)

Broken tooth

Broken maxillary bone

Wounded or lacerated tongue and/or gums


Nervous causes










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