Ranula (mucocele) - anyone experienced?

[trishia42]

16-year old cat with CKD, mild HCM, and now OSCC. Because he is really the unluckiest cat ever, he also recently developped a ranula - a large fluid-filled (saliva) cyst under his tongue due to a damaged salivary gland.

The general treatment for this is marsupialization (making a permanent opening for draining) but of course would require general anaesthesia, which we are weary of due to the HCM. We have been wondering about incising and draining the ranula - we were told this generally led to re-occurrence but our vet did not know how quickly the re-occurence would be since she had never done a draining. I can't find any information (specifically about the ranula type of mucocele) online about speed of re-occurence.

The idea is that we would prefer to try that first if it had least had the chance of lasting a couple of weeks or so (we don't know how much time we have left and we don't want to put him through too much) - of course, if it only lasts a day or two, then it's pretty pointless.

So if anyone has had any experience with this, please let me know. We're not getting any guidance except either just leaving it or being pushed through surgery. It's clearly making him uncomfortable and we would like to help him.

 

[mrsgreenjeens]

I'm so sorry this is happening to your poor old guy . I don't have an answer for you as to how quickly it might fill up again, but am wondering if even just to drain it they might not need to sedate him? I would certainly think that would be necessary. So then the question is, is the difference just that it would take so much longer to do the surgery than to just drain it?

How long have they given him due to the OSCC? I read your other thread where it just came on very suddenly, so it appears it's a fast grower . Have they given you any sort of time frame? I know this is difficult to discuss, but would think your decision should be based on that, as well as his overall health. Meaning, I've had kidney cats who weren't doing well and would never consider taking any sort of action to prolong their lives, like any surgery for something else. But some cats with kidney disease act perfectly normal and you'd never know they had a chronic condition. Plus with the HCM, is it under control with meds? All these things need to be taken into consideration for his quality of life.

 

[trishia42]

Yes, but sedation does not carry the same risk; he was sedated for the FNA and that was perfectly fine. The problem with anaesthesia is the drugs used there can be hard on the kidneys, plus the IV fluids on the heart. His HCM was deemed 'mild' so there is no medication currently although we do treat hypertension in him (which is most likely from the kidney disease and has been treated for a few months now).

We spoke with an oral surgeon today who told us they could not be drained and that the definitive treatment was gland removal and marsupialization could lead to recurrence (although in our case, the recurrence time may not matter).

He was initially given 2-4 weeks by our vet but we saw an oncologist and started palliative treatment care (meloxicam and Palladia) - we certainly were not about to put him through the more aggressive and unlikely to work treatments - and she thought he might have a few months - but did warn us it could change in a single day due to the nature of OSCC.

Right now he is still very interactive and alert; meows for food, follows us around, sleeps in difference spots, loves his treats and his catnip, likes to go outside, loves to sleep with us so this is why we are completely torn. We feel this stupid ranula bothers him way more than the mass in his mouth. I promise though, we are very aware of what we are facing and our intention is not to make him go through unecessary procedures but we would like to make the rest of his time here as comfortable as we can while we can. I was pretty crushed today that we could not give him relief through simple drainage so I'm not sure what we will do at this point. My heart is absolutely broken.

 

[FeebysOwner]

I guess I am a bit confused. Is the draining possible but just not something the oral surgeon is willing to do, or that the oral surgeon says it is absolutely not possible? Over time, I have found that vet surgeons are not too different from human surgeons in that they are always going to go down the surgery path as their preferred mode. If draining it - just to see what happens - is possible, push for that. This is based solely on what I would do personally.

 

[trishia42]

His words were "These lesions can't be drained, as they are not cystic and the saliva is not contained in a simple pocket.", which is odd because I've seen many instances of them being drained by needle or incision online (including this article) and it really looks like one giant fluid-filled pocket when you look at it. I'm a bit confused, but I'm not the specialist either. I thought it was possible and might at least give him a couple of weeks of relief which might be all we need and now I just don't know.