Introduction

• Cause:  clinical sign which can be seen with heat stress, dental disease, nausea, oral inflammation, oral foreign body, trauma, nausea, neoplasia or accompanying tasting something bitter such as a bitter medication.
• Signs: wet fur at corners of the mouth and chin (the fur may be stained). More acute ptyalism with tasting something bitter may look more like foaming at the mouth. Accompanied with a lot of tongue movements and mastication. May be weight loss and weakness if this is associated with dental disease. May be stupor or coma if due to hypoglycemia.
• Diagnosis: history, oral/dental examination, hematology, biochemistry, blood glucose, cytology and culture of any lesions, radiography, CT.
• Treatment: depends on cause.
• Prognosis: poor to good, depending on cause.

Pathogenesis

Etiology

• Noxious stimulation (such as irritation, toxin, or oral discomfort) in mouth causing excessive salivation Toxicosis overview.
• Heat stress response as body temperature rises Heat stress.
• Insulinoma Insulinoma leading to hypoglycemia Hypoglycemia.
• Stress or Helicobacter infection causing gastric ulceration Helicobacter mustelae gastritis and nausea.
• Ferrets have a strong vagal reflex.
• Stomatitis causing oral pain and hypersalivation.

Predisposing factors

General

• If heat stress Heat stress: elevated ambient temperature and humidity.
• If dental disease Periodontal disease usually inappropriate diet or lack of tooth brushing by owner.
• If allowed free roam of the house/environment, may chew on foreign body or noxious or toxic substance Toxicosis overview.
• Stress from bullying, inappropriate husbandry, diet or overcrowding.
• Helicobacter infection Helicobacter mustelae gastritis.
• Raw meat diet increases chance of infection with Salmonella or Campylobacter, also increases the risk of trauma from bone ingestion Bacterial gastroenteritis.

Pathophysiology

• Hypersalivation may occur with heat stress Heat stress as excess saliva can be produced to encourage heat loss through deposition on the coat since sweat is not produced.
• Irritation in the mouth from dental disease Periodontal disease or noxious Toxicosis overview/bitter substance causes hypersalivation.
• Irritation to the mouth from ingestion of a toxin may be due to direct action of the toxic chemical in the mucosa Toxicosis overview.
• Distress or oral pain Oral ulceration or dyspnea from foreign body present in the oral cavity.
• Irritation to the mouth from bacterial, viral, or fungal infections Oral ulceration.
• Insulinoma Insulinoma causes hypoglycemia Hypoglycemia, which in the early stages is thought to cause an increase in adrenaline, leading to nausea Vomiting.
• Helicobacter Helicobacter mustelae gastritis, Salmonella Bacterial gastroenteritis, and other gastrointestinal infections may cause nausea.
• Neoplasia either affecting the functions of the oral cavity or causing an esophageal or oral space occupying lesion Oral neoplasia.

Timecourse

• Heat stress, toxin, bitter substance, foreign body: rapid, usually within minutes.
• Dental disease: may be chronic.
• Insulinoma: may be gradual.
• Neoplasia: may be gradual to a few weeks.

Diagnosis

Treatment

Prevention

Outcomes