Buffalo Bulletin Vol. 22 No.1 (March 2003 ) p.3-5
Obstructive Sialolithiasis in buffalo and its management
V.B. Joshi, S.P. Tyagi and Avinash Sharma
A nine years old female buffalo was presented in the clinics with a history of the development of two hard swellings on right cheek followed by another larger diffuse soft swelling caudal to that since last 9 months. The softer swelling gradually increased in size and eventually ruptured one-month back leading to continuous leakage of transparent viscous fluid since then. On clinical examination, the condition was diagnosed as salivary fistula resulting due to the complete obstruction in the flow of saliva through the Stensonís duct by sialoliths. Sialolithiasis has been reported in a number of animal species but not in buffaloes so far. Therefore, this condition and its successful surgical treatment are described in the present communication.
Sialoliths or salivary calculi may form in the salivary glands or salivary ducts of
The animals. The sialoliths developing in the salivary ducts of the animal may eventually obliterate the passage of saliva. This may either lead to formation of a salivary cyst and then a fistula or may cause salivary gland atrophy. A case of a buffalo having salivary fistula due to sialoliths is presented in the present communication. Sialolithiasis has been reported in a number of animal species but not in buffaloes so far. Therefore, this condition and its successful surgical treatment are described.
Case history and clinical examination:
A nine years old female buffalo was reported with the history of developing two hard swellings on right cheek which were gradually increasing in size since last 9 months. After a few months, another larger diffuse soft swelling started developing distal to them and gradually increased in size leading to its eventual rupture one month back releasing a clear transparent viscous fluid. Continuous leakage of this fluid from the opening was being observed since then. The clinical examination of the animal revealed the presence of two well-defined hard nodular swellings at the course of Stensonís duct over massatter muscle on right cheek. The saliva (pH 8.5) was observed leaking continuously through a small fistula caudo-ventral to these swellings (Fig. 1). Exploration of fistula revealed marked enlargement and complete obliteration of the lumen of Stensonís duct by two hard intra-luminal mass rostral to fistulous opening. The case was diagnosed as salivary fistula resulting due to complete obliteration of Stensonís duct by sialoliths. The surgical intervention for removal of calculi and repair of fistula was contemplated.
Fig. 1. Nodular swelling at the course of dilated Stensonís duct with caudoventral fistula
Anaesthetic and surgical management:
The animal was routinely prepared for aseptic surgery. The animal was sedated with 5 ml Triflupromazine (Siquil, Sarabhai. India Ltd.) administered intramuscularly 30 minutes prior to surgery. Local analgesia of surgical site was achieved by subcutaneous infiltration of 10 ml of 2% Lignocaine HCL (Xylocaine, Astra-IDL). A 5-cm long linear incision was given on skin directly over the hard swellings. The Stensonís duct was dissected carefully taking care to avoid accompanying veins and arteries (Fig. 2) The culculi were exposed by an incision on the duct and these were removed with the help of an Allis tissue forceps. The duct was lavaged with Ringerís solution and its patency was confirmed by catheterization rostrally, Careful dissection, debridement and excision of superfluous part of the wall of fistula and duct were then done followed by lavaging with Ringerís solution. The fistulous opening of the duct was then closed with chromic catgut sutures applied in a simple continuous manner. The first suture line was buried under the overlying fascia again by catgut sutures. The skin was closed routinely with silk sutures in an interrupted mattress pattern. The animal was given Inj. Streptopenicillin (Dicrysticin, Sarabhai India Ltd.) 2.5 gm I/M and Inj. Diclofenec sod. (Zobid, Sarabhai India Ltd.) 15 ml I/M daily for 7 days besides regular antiseptic dressing of wound post operatively. The surgical wound eventually healed normally and no leakage of saliva was seen thereafter. No recurrence of the condition was reported till six months after the surgery.
The occurrence of sialoliths or salivary calculi has been reported in different kinds of animals such as dog (Bartels, 1978), cattle (Ali et al, 1978), monkey (Ensley et al, 1981), donkey (Misk et al, 1984), horse (Bouayad et al, 1991) camel (Barvalia et al, 1992), chimpanzee (Orkin et al, 1990) etc. These are seen more often in horses than in other species (Hofmeyr, 1988). Sialoliths form in a duct or in the salivary gland itself, generally as a result of chronic inflammation, which provides desquamated cells or consolidated exudates as a minute nidus upon which calcium salts precipitate (Orkin et al, 1990). Small foreign bodies entering the ostium of salivary duct may also initiate the precipitation of salts (Hofmeyr 1988; Baskett et al, 1995). The cross sectioning of the sialoliths in the present case revealed the presence of hay straw in the centre (Fig. 4). This suggests that the hay straw might have accidentally entered the salivary duct probably during rumination and acted as nidus for the deposition of salivary salts. The continuous
Deposition of salts may result in formation of very large sized calculi of various shapes sometimes up to several centimeters in length and diameter (Jones et al, 1997). In the present case also, one calculus was almost cylindrical (approximately 2.5 cm x 2.0 cm x 2.0 cm) and weighing 10.14 gm whereas, another calculus occupying rostral position in the duct was almost rounded (diameter 2.0 cm) and weighed 6.77 gm (Fig. 3). The main component of sialoliths in the present case was identified to be calcium carbonate along with traces of magnesium and phosphate. Calcium carbonate is routinely identified in cases of sialoliths in other species of animals also (Hofmeyr, 1988). Larger calculi obliterate the salivary ducts that may result in to atrophy of associated salivary gland. However, generally before this process is complete, a cyst may form in the obstructed duct due to the dilating effect of the entrapped secretions. A salivary fistula occasionally forms when an injury creates an opening from the duct to the outside of the body (Orkin et al, 1990). The early surgical intervention is must for the treatment of this condition to save the affected salivary gland from atrophy.
perusal of the literature failed to reveal any report about the occurrence of
sialoliths in buffaloes so far. Therefore this case is reported to record the
occurrence of sialoliths in buffaloes in
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