In our opinion, removing the entire affected salivary gland would decrease the chance of recurrence. Since marsupialization
alone was effective in two cases, it may also be a useful therapy. However, if the surgery site were to heal completely closed,
the risk of local recurrence may be higher than is the risk with marsupialization along with salivary gland removal.
Surgically removing the sublingual-mandibular salivary complex is similar in cats and in dogs and has been described.18 In cats, the molar gland is located at the angle of the mouth between the orbicularis oris muscle and the mucosa of the
lower lip.9,10 It opens into the mouth through several small ducts. Surgical excision of the molar gland is best performed by making a
longitudinal intraoral incision caudal to the angle of the mouth (angulus oris) and immediately cranial to the masseter muscle.
It is important not to lacerate the deep facial vein, which courses along the cranial aspect of the masseter muscle. The molar
gland is visible immediately below the mucosal surface. The gland is dissected free by using sharp and blunt dissection, and
the associated vessels are ligated. The mucosa is closed routinely with absorbable sutures.
The pathogenesis of salivary mucoceles has not been firmly established. It is thought that trauma to the gland or duct system
may lead to their development, but experimental attempts to create mucoceles have not reliably re-created the syndrome.19,20 Although three cats in this series were indoor-outdoor, no history of trauma was present in any of the cases. It is likely
that a primary problem with a salivary gland or duct system may be a predisposing factor for salivary mucocele formation.
Although no case reports exist, theoretically, a salivary mucocele could be the result of a neoplastic process. So if any
excised tissue appears abnormal, it should be submitted for histologic examination.
In this case series, the most common presenting complaint was related to the presence of a ranula, which may cause respiratory
stridor or gastrointestinal signs. Although uncommon, a salivary mucocele should be a differential diagnosis in cats with
any intraoral swelling. If a mucocele is diagnosed, removal of the offending salivary tissue along with marsupialization of
the mucocele is recommended for the greatest chance of a rapid resolution and a permanent cure. The long-term prognosis after
appropriate surgical resection is excellent.
Kristina M. Kiefer, DVM*
Garrett J. Davis, DVM, DACVS
Red Bank Veterinary Hospital
197 Hance Ave.
Tinton Falls, NJ 07724
*Dr. Kiefer's current address is Gulf Coast Veterinary Surgery, 1111 West Loop South, Suite 160, Houston, TX 77027.
1. Parnell NK. Diseases of the throat. In: Ettinger SJ, Feldman EC, eds. Textbook of veterinary internal medicine. 6th ed. St. Louis, Mo: Elsevier Saunders, 2004;1196-1204.
2. Harrison JD, Garrett JR. An ultrastructural and histochemical study of a naturally occurring salivary mucocele in a cat.
J Comp Pathol 1975;85:411-416.
3. Rahal SC, Nunes AL, Teixeira CR, et al. Salivary mucocele in a wild cat. Can Vet J 2003; 44:933-934.
4. Speakman AJ, Baines SJ, Williams JM, et al. Zygomatic salivary cyst with mucocele formation in a cat. J Small Anim Pract 1997;38:468-470.
5. Feinman JM. Pharyngeal mucocele and respiratory distress in a cat. J Am Vet Med Assoc 1990;197:1179-1180.
6. Wallace LJ, Guffy MM, Gray AP, et al. Anterior cervical sialocele (salivary cyst) in a domestic cat. J Am Anim Hosp Assoc 1972;8:74-78.
7. Hawe RS. Parotid salivary sialocele in a cat. Feline Pract 1998;26:6-8.