RE: Dog with hypersalivation

Kirsten Frederiksen — Thu, 07 Jan 2021 21:13:22 GMT

Thank you for your reply. I must confess that I never once thought about simply removing the glands! I'll give it a try with antihistamins first before reaching for the scalpel.

RE: Dog with hypersalivation

Beats — Sun, 03 Jan 2021 21:02:31 GMT

Whast an interesting question!

Here are my non-expert thoughts:

It sounds like an increased saliva production (as opposed to decreased saliva clearance).

I think I would do 2 to 3 more attempts with drug trials, before considering removing some salivary glands (probably the easiest and best solution - assuming the large ones you can feel are the submandibular, then I would personally remove one side submandibular/sublingual, preferring a ventral approach personally as shown in Tobias Small Animal Surgery textbook - that is purely personal preference, and then the other side most likely on separate occasion few weeks later. I suspect surgical removal would be the simplest and most reliable solution.

The 50% reduction with phenobarbital would suggest you are on the correct lines in choosing a drug aimed at reducing saliva production (I'm not sure, but is this by an anticholinergic side effect?). The difficulty is likely to be in finding a drug that does this to a sufficient degree without other, more undesirable, side effects...

You could try a basic antihistamine first such as chlorpheniramine/piriton will do little harm as a brief trial.

Glycopyrollate might be more likely to work, and could try sialanar maybe? [I've never used this in a dog, so check another source, but can't see why not]

https://www.medicines.org.uk/emc/product/2301/smpc#gref

Other choices could include TCA's or any other drug that may cause dry mouth as a side effect through anticholinergic (or even sympathomimetic) effects - a rather lengthy list of possibilities, and I'm not sure there is much to suggest a reasoned ranking of the various options in likelihood of providing a useful long-term help.

Scopoderm patches might be fun to mess around with (and have at least been used on dogs, albeit to determine effectiveness against nerve agents...), but I suspect removing the salivary glands would prove wiser in the long-run.

Botulinm Toxin A injected into salivary glands may also work? (But again I'd be more confident just excising the gland(s).)

Denervation procedures are done in people sometimes - I wouldn't try that myself!

Apparently M1 and M3 antagonism might be needed in some patients (with M3 antagonism being the most important by far)

I can find nothing on the use of solifenacin (M3 in humans) in dogs so unless you turn something up would be rather experimental, but oral suspension and tablets are readily available in UK. Pirenzepine (M1 in humans) I seriously doubt has been tried in dogs, but may also be sourceable with effort, e.g. https://www.sps.nhs.uk/wp-content/uploads/2018/08/UKMi_QA_Hypersalivationdruginduced_update-May-2017.pdf

Other better options may exist and this information may be entirely inaccurate!