Phenobarbital-Responsive Sialadenosis in Dogs: Case Series

Imaging diagnosis: CT findings in bilateral necrotising sialometaplasia of the mandibular salivary glands in a Tibetan Terrier

“…Imaging features of canine sialadenosis have not been reported, but these cases generally present with a non-painful swelling in the region of the affected gland, without evidence of inflammation, necrosis or cavitary lesions on histopathological analysis. 11 Enlargement and cavitary lesions have been described in the few imaging reports of canine salivary gland neoplasia. 25,26 However, parenchymal mineralisation, capsular distortion and less frequently associated osseous lysis are described in CT reports of mandibular salivary adenocarcinoma, unlike the imaging features reported in this case.…”

“…8,27 Although this has not been formally demonstrated, the response to phenobarbitone may support an aetiology of vagal stimulation of glandular tissue, secondary to limbic epilepsy as is reported in phenobarbitone responsive sialadenosis. 6,10,11,18 Spontaneous resolution of necrotising sialometaplasia is often reported in human patients; however, discrepancies exist between the disease in human patients compared to that described in dogs. 6,28 In dogs, the mandibular salivary glands are more commonly affected causing pain, gagging and retching.…”

“…2,8,9 Both spontaneous resolution and response to phenobarbitone treatment have been reported in veterinary patients. 10,11 This case describes the imaging features of a condition that should be a differential diagnosis for aggressive salivary disease.…”

Successful treatment of a dog with phenobarbital‐responsive sialadenosis and an oesophageal stricture

“…Initial anticonvulsant therapy reduces clinical signs within 48 hr. However, after tapering the dose of the drugs, a few cases of relapse have been reported (Alcoverro et al., 2014). In such cases, the clinical signs only partially improve, leading to the patient requiring long‐term management of symptoms.…”

“…The pathogenesis of PRS in dogs and cats is unclear, but it has been suggested that PRS may be an unusual form of limbic epilepsy (Stonehewer et al., 2000). Diagnosis of PRS should be based on the distinct response to phenobarbital therapy after excluding other potential extraintestinal and primary gastrointestinal causes (Alcoverro et al., 2014). Initial anticonvulsant therapy reduces clinical signs within 48 hr.…”