Image source nadja robot, Flickr.
Also referred to as "dribbling, hypersalivation, sialorrhea or ptyalism", drooling is the flow of saliva from the mouth. Saliva is constantly being secreted by the salivary glands, its function is to keep the mouth moist and aid digestion. Cats have five salivary glands, parotid, mandibular, zygomatic, molar and sublingual. Saliva production is controlled by the autonomic nervous system. Drooling can either be caused by over production of saliva, spillage of saliva from the mouth or difficulty swallowing. Cats generally aren't as prone to drooling as dogs.
There are some harmless causes that may result in drooling such as when they are being petted or about to be fed. This is a sign of excitement and/or pleasure. Cats will often drool when they have consumed catnip. Certain prescription medications can also cause drooling or foaming of the mouth due to the bitter or unpleasant taste.
If drooling is not normal for you cat, and suddenly occurs for reasons other than those listed above, it can be a sign that there is something wrong.
Medical causes of drooling in cats includes:
- Dental problems - Disorders of the mouth are one of the most common causes of drooling in cats. Common oral problems include gum disease, tooth abscess, stomatitis, gingivitis.
- Poisoning - Another common cause of drooling is due to poisoning. Antifreeze, snail bait, toxic plants, laundry detergent, household cleaning products, bleach, liquid potpourri, mercury, copper, arsenic, poisonous toads, chocolate, glow sticks, mercury. Many of these products are not only toxic but also corrosive, causing ulceration in the mouth and esophagus.
- Pancreatitis - Inflammation of the pancreas due to activation of digestive enzymes which begin to break down and digest the pancreas.
- Certain medications - Certain antihistamines, metronidazole (Flagyl), sulfa antibiotics.
- Topical flea products which have been accidentally licked off the coat.
- Foreign object in mouth such as a stick or bone fragment.
- Choking on food or other object such as a thread or a bone fragment.
- Mouth ulcers. Small, painful lesions which may be due to kidney disease, cat flu, pemphigus, ingestion of toxins and thermal burns.
- Upper respiratory infection (cat flu) - Similar to colds and flu in humans, cat flu is an upper respiratory infection which is caused by a number of viruses or bacteria.
- Liver disease - There are several causes of liver disease all of which affect the liver's ability to function as it should including removing toxins from the blood. These toxins begin to build up in the brain, leading to neurological disturbances, this is known as hepatic encephalopathy. Some causes of liver disease include hepatic lipidosis, cholangitis, damage by toxins, toxoplasmosis and tumours.
- Heat stroke.
- Oral cancer - There are more than twenty types of cancer which can develop in the oral cavity of cats with squamous cell carcinoma being by far the most common (approximately 70%), followed by fibrosarcoma (20-10%), other less common tumours include melanoma, lymphoma, osteosarcoma, granular cell tumours, fibropapillomas, hemangiosarcoma and ameloblastomas.
- Portosystemic (liver) shunt - Caused by an abnormal connection between the portal vein (a blood vessel which carries blood from the gastrointestinal tract to the liver) and the systemic circulation. As with liver disease, toxins begin to build up, leading to neurological disturbances (hepatic encephalopathy).
- Chronic renal failure - Drooling in cats with kidney failure may be due to nausea, reflux or uremia (a build up of toxins which would ordinarily be flushed out via tha urine) which can cause mouth ulcers.
- Nausea - Not all nauseous cats will actually vomit, just feeling sick can be enough to cause drooling in some cats. Many cats can suffer from motion sickness making them feel extremely nauseous.
- Reflux or esophageal disease.
- Kitten teething.
- Tetanus (lock jaw). A bacterial infection which releases a neurotoxin causing painful muscle contractions and spasms.
- Epilepsy - A neurological disorder which causes a disturbance of the electrical activity in the brain.
- Fractured jaw - Due to not being able to close the jaw.
- Tick paralysis - Neurotoxins injected into the cat's bloodstream cause paralysis, once the poison reaches the head, drooling can develop.
- Neurological disturbances which may include cancer, rabies, seizures, poisoning, congenital disorders such as hydrocephalus (water on the brain), infectious diseases such as feline infectious peritonitis and bacterial infection which originate in the middle ear before progressing to the brain, neurotoxins from spider or snake bites, trauma, liver disease (see above).
Any changes in behaviour and/or new symptoms should be immediately investigated by your veterinarian. He will perform a complete physical examination of your cat, including a thorough examination of the mouth and observing other symptoms which may accompany the drooling.
Aside from drooling, other symptoms will depend on the underlying cause.
Oral problems - Reluctance to eat, oral swelling, facial swelling, red gums, bad breath.
Poisoning - Symptoms of poisoning can vary depending on the type of poison consumed, but may include loss of appetite, lack of coordination (ataxia), vomiting, diarrhea, muscle twitching, painful abdomen, mouth ulcers, neurological signs and seizures.
Heat stroke - Excessive panting, bright red gums, weakness, anxiety.
Cat flu - Sneezing, nasal and/or eye discharge, fever, loss of appetite.
Portosystemic shunt - Stunted growth, lack of appetite, diarrhea, seizures, tremors, intermittent blindness, neurological disorders, behavioural changes, copper coloured irises.
Liver disorders - Jaundice (yellow gums), lethargy, diarrhea, vomiting, dark coloured urine, dark tarry stools (melena), neurological disorders such as behavioural changes and seizures.
Fractured jaw - Unable to close mouth, reluctance to eat, facial deformity, bleeding from the mouth, broken or missing teeth, pain.
Kidney disease - Excessive thirst and urination, vomiting, weight loss, mouth ulcers, bad breath and lethargy.
Choking - Pawing at the mouth, coughing, difficulty breathing, anxiety, fainting.
Licked topical flea/worming medication or bitter pills - Smacking of the lips, possibly shaking the head. If your cat has ingested a large amount of flea product designed for the skin, poisoning may occur. Symptoms can include twitching, vomiting, diarrhea and seizures.
Mouth ulcers - Lesions in the mouth, reluctance to eat.
Teething - Kittens begin teething around 2 weeks of age. Symptoms of teething may include pain, chewing on objects and of course drooling.
Foreign object - Pawing at the mouth, bad breath (if the object has been there a while), anxiety.
Reflux - Frequent vomiting, reduced appetite, weight loss.
Nausea - Loss of appetite, lip smacking, grinding teeth, listlessness.
Tetanus - Localised symptoms around the wound such as stiffness, this may progress to generalised stiffness of the entire body including the jaw which may become locked making eating and drinking difficult. Seizures may develop in advanced cases.
Pseudorabies - Behavioural changes, shortness of breath, unsteady gait, muscle stiffness, head pressing, circling, fever, collapse and coma.
Rabies - Fever, increased vocalisation, restlessness, aggression, irritability, muscle tremors, incoordination, paralysis of the throat, respiratory failure, coma.
Pancreatitis - This condition is extremely painful with symptoms including anorexia, loss of interest in surroundings, dehydration, fever, abdominal pain, vomiting, diarrhea, wobbly gait, jaundice and weight loss.
Oral tumours - Lumps in the mouth, inability to close the mouth, pain, swelling, reluctance to eat, weight loss.
Epilepsy - Muscle twitching, rigid extension of the legs, involuntary crying, champing or chewing, urinating and/or defecating.
Neurological disturbances - Symptoms may vary depending on the underlying cause but may include seizures, changes in behaviour such as aggression or confusion, ataxia (wobbly gait), vocalisation, change in gait, limb weakness.
If your cat appears to be otherwise happy and well with no additional symptoms a wait and see approach may be all that is necessary. If however your cat is still drooling after a day, or if you notice any other symptoms accompanying the drooling, you should see a veterinarian immediately.
Your veterinarian will perform a complete physical examination of your cat. A complete medical history will be required, questions such as other symptoms you may have noticed if the cat has had access to any poisons or medications and how long the cat has been drooling for.
Accompanying symptoms (if any) may help to narrow down the cause of drooling. During the examination, your veterinarian will check the mouth for signs of dental problems, cancer or a foreign object in the mouth and assess the overall condition of your cat. Oral examinations may need to be performed under sedation.
He may need to perform some medical tests, including:
Complete blood count, urinalysis and biochemical profile. These can provide your veterinarian with a picture of the cat's overall health. If there is a sign of infection, dehydration, and how the organs including the liver and kidneys are functioning.
Other tests he may wish to perform include:
- Ultrasound or x-ray to evaluate the organs (liver, kidneys, pancreas) and look for tumours or a dental abscess.
- Biopsy and histopathology of oral tumours.
- If reflux is suspected, your veterinarian may perform an endoscopy. This is a thin tube with a camera at the end which is inserted into the esophagus and digestive tract.
Specific blood tests may also be required to diagnose pancreatitis, kidney, liver disease or infection.
Treatment will depend on the cause of drooling and may include:
Poisoning: Inducing vomiting, administration of activated charcoal or pumping the stomach may be necessary as well as supportive care while your cat recovers.
Dental: Treatment of dental problems such as tooth extraction, dental cleaning or antibiotics for infections.
Foreign object: Removal of a foreign object.
Oral tumours: Surgical removal (if possible) followed by chemotherapy or radiotherapy.
Cat flu: Most upper respiratory infections can't be treated with medications but supportive care will be given to help your cat while he recovers. This may include administration of IV fluids, encouraging him to eat, keeping the eyes and nose clear of discharge.
Rabies can not be treated and euthanasia is necessary.
Portosystemic shunt: Surgery. Your cat may also be put on a prescription diet to restrict protein if surgery isn't an option.
Chronic renal failure treatment is complicated and too long to cover in detail but may include prescription diet, medications, and supportive care.
Heat stroke: Slowly bringing your cat's body temperature down and giving supportive care.
Topical flea product ingestion - If only a small amount has been ingested, offer him a drink or some food and watch him carefully. If other symptoms develop, your veterinarian will need to treat the symptoms, such as anti-seizure medication as well as supportive care such as IV fluids and nutritional support.
Tablet ingestion - This depends on the kind of medicine ingested. If it is prescribed medication which has a bitter taste, your cat may salivate with no other symptoms.
Fractured jaw - Surgery will be required to repair and realign the jaw.
Pancreatitis: Painkillers, supportive care such as IV fluids and anti-nausea medication, nutritional care may include a feeding tube, antibiotics, plasma transfusion may be necessary in some cases.
Reflux: Addressing the underlying cause if one is found, antacids to protect the esophagus, medication to coat the lining of the esophagus if ulceration has developed, low protein low fat diets may be prescribed.
Liver disease: Treatment depends on what has caused the liver disease but may include surgery to remove tumours, medications to control nausea, nutritional support, fluid therapy, vitamin K to assist with clotting, and in some cases a plasma transfusion may be necessary.
Dental abscess: Surgery to lance the abscess and clean it out, in most cases the tooth will also need to be extracted. Antibiotics will be prescribed to treat the infection.
Tetanus: Cleaning and debriding the wound, antibiotics to kill the bacteria, sedatives to control spasms and seizures, tube feeding and cage rest while your cat recovers.
Pseudorabies - There is no treatment for pseudorabies, it is almost always fatal.
Topical flea product ingestion - There is no specific antidote for ingestion of topical flea products, treatment is aimed at managing symptoms such as controlling muscle tremors and activated charcoal to prevent further absorption.
Bitter tasting tablets - There is no treatment for this, offer him some food or water after administration (unless stated otherwise on the packet) to help get rid of the taste.
Epilepsy - Treating the underlying cause if possible. In some cases, your cat may need to be put on anticonvulsant medication.
Neurological disorders - Treatment depends on the underlying cause. Rabies and pseudorabies are almost always fatal. Infections may be treated with antibiotics to kill bacteria as well as supportive care. Seizures may be managed with anti-seizure medications.