Differential Diagnosis for Ptyalism

(or hypersecretion of saliva)

Symptoms

Differential diagnosis

Ptyalism is often classified as acute drooling or chronic drooling.

In each case, causes are different.

Acute ptyalism:	Epiglottitis
	Neoplasia or presence of a tumor
	Presence of an abscess
	Pain

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
	Stress

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 feel 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.

Food:

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 gumline)
	Broken tooth
	Broken maxillar bone
	Wounded or lacerated tongue and/or gums

Nervous causes:	Stress
	Pain

Toxicity:	Medication
	Toxins
	Poisoning

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