Feline sublingual lesions: SCC is likely, but not the only possibility

Eosinophilic granulomas under the tongue can look like either SCC or a ranula. They often appear alongside other eosinophilic signs, such as a swollen lower lip. In one cat Lewis describes, the sublingual swelling was firm and not fluctuant, unlike a true ranula.

In the case that prompted the article, a 1-year-old ragdoll had a firm, ulcerated, verrucous swelling under the tongue that resembled SCC. The cat also had a history of lower lip swelling. Biopsy showed eosinophilic granulomatous glossitis with ulceration. Because the team was worried the teeth would injure the swollen tissue, they started dexamethasone sodium phosphate while waiting for results. The next day they began oral prednisolone at 1 mg/kg/day. The swelling had dropped a lot within a week and was nearly gone by two weeks. The team recommended a dermatology consult to look for allergic triggers.

Linear foreign bodies caught around the lingual frenulum can cause marked sublingual swelling, redness, and swelling of the tongue. They are most common in young cats but also happen in dogs. Lewis recalls a 10-year-old dog that got golf ball twine wrapped around the base of its tongue. Chronic irritation can also cause granulation tissue under the tongue, for example from a rough tooth surface left by tooth resorption.