Drooling & Gulping... Is that a physio problem?
31 Aug 2020
Laurie Edge-Hughes, BScPT, MAnimSt (Animal Physio), CAFCI, CCRT
So, what do you think when you see your dog drooling more or hear him (or her) gulping and clearing his throat more often, or perhaps even sneezing? Well, this blog will give you one more idea regarding where to seek treatment for these issues.
I had an interesting case a while back. It was an older dog who had recently seemed to develop allergies. He would sneeze near the hay, sneeze in the barn, and generally was having issues that would necessitate him swallowing more often, gulping, and clearing his throat. His throat had been scoped and he had been put on Prednisone, but that just gave him diarrhea. So, he was then also put on Metronidazole to control the diarrhea. All in all, here it was 5 days later, in the clinic for his regular physio session, and he was still gulping and hacking.
I decided to treat him as if he had laryngeal paralysis, a condition that can affect breathing especially when doing strenuous activity. His scope to look at his larynx had revealed nothing, however I wanted to try something for this poor dog. I did acupuncture for the upper cervical spine and laser to the same region. But midway through the treatment, as nothing was settling down the gulping, I thought about checking his first cervical (neck) vertebra (C1). His C1 was rotated to the right. I mobilized it, which was a bit uncomfortable for him. It was quite stiff! However, when I finished, so had the gulping!! I admit to having been amazed, and so was the owner!
At lunch, I was telling the story to some of my coworkers about the case. One staff member had remarked that a few years ago she had noted her dog was drooling more than usual. She had asked one of the therapists to check the dog. A C1 dysfunction was found as well. It was mobilized and miraculously, the drooling stopped!
Now, if you do a bit of a search (I’m a nerd like this) about what C1 supplies, Wikipedia can remind us!
The cervical spinal nerve 1 (C1) is a spinal nerve of the cervical segment. C1 is unique in that all other spinal nerves have both sensory and motor fibres, whereas C1 carries only motor fibres and also a small meningeal branch that supplies some parts of the floor of foramen magnum (via hypoglossal nerve). It originates from the spinal column from above the cervical vertebra 1 (C1).
Muscles innervated by this nerve are: geniohyoid, rectus capitis anterior & posterior, longus capitus, rectus capitis lateralis, splenius cervicis, levator scapulae, thyrohyoid, omohyoid, and sternohyoid muscles.
Let me put that into words for everyone to understand. The C1 nerve primarily supplies muscles. Some of the muscles it supplies are those that would be involved in swallowing and tongue control.
Then when you look up about C2, here’s an interesting little tidbit from Steven D. Waldman MD, JD, in Atlas of Uncommon Pain Syndromes (Third Edition), 2014.
The pain of neck-tongue syndrome is in the distribution of the C2 nerve root. It is intermittent, but is reproducible with certain neck movements. The physical findings associated with this pain are ill defined, with some patients with neck-tongue syndrome exhibiting a decreased range of motion of the cervical spine or tenderness of the upper paraspinous musculature. The main objective finding in neck-tongue syndrome is decreased sensation of the ipsilateral half of the tongue. Often associated with this finding are pseudoathetoid movements of the tongue resulting from an impairment of the proprioceptive fibers.
And to translate all of that, the author is saying that sometimes issues with C2 (the second neck vertebra) can cause pain in the tongue that comes on with certain neck movements. The neck muscles are tender and the joints are stiff. People will also note that there is decreased sensation on half of the tongue.
So, with both pieces of information, drooling and gulping can make sense to be coming from the C1 and C2 region. Fascinating! As a caveat, this is not to say that all drooling and gulping is a C1-2 issue. But from now on, maybe it something that you should have checked out by your dog’s therapist! You just never know!