Tongue Trauma

Introduction

Tongue injury in small animals is a relatively common presentation. More commonly so in dogs due to their curious nature, especially regarding food. In large animals, tongue trauma by foreign objects is less common but there are certain diseases such as Foot and Mouth disease virus and Calf Diptheria (Fusobacterium necrophorum), which cause a sloughing and swelling of the tongue by infection and are incredibly painful.

This article will focus on Dogs and Cats.

Causes of tongue trauma

The most common causes of trauma in small animals are:

• Lacerations e.g. tin cans, cat fights
• Penetrating foreign bodies e.g. sticks or bones
• Linear foreign bodies e.g. string- this becomes wrapped around the base of the tongue and as peristalsis carries the rest of the string through the alimentary tract, the caught part cuts deeper into the tongue as this happens.

Other causes of tongue trauma include electrical burns e.g. from chewing electrical cable, chemical burns e.g. from caustic agents accidentally consumed, damage due to infection e.g. feline herpes, panleukopanenia, calicivirus, fungal or necrotising stomatitis or damage due to glossitis caused by azotaemia. In brachycephalic breeds, macroglossia occurs due to the size of the dogs skull and this can occasionally lead to trauma if the tongue is protruding excessively.

Diagnosis

History

A full history finding out relative information to the case, such as 'were they in a fight?' or 'have you seen them playing with string or chewing electrical cables?' etc. is vital.

Clinical Signs

• Drooling saliva
• Reluctance to eat
• Bleeding
• Pawing at mouth

Secondary infections, general distress of the animal and vocalisation are other less specific signs of tongue trauma.

Definitive Diagnosis

Inspection under a general anaesthetic is required. Be sure to lift the tongue and check underneath it for linear foreign bodies.

Treatment

Always treat the underlying cause!

For caustics, you will need to flush the mouth out with water and administer and specific antidotes or treatments for the particular chemical involved. If an infection is the cause of the damaged tongue then of course, treatment of the disease, with palliative care, is required. Electrical burns will also require palliative care (see below).  

A laceration will require either primary surgical repair or second intention healing with sloughing +/- debridement. Amputation can be performed for animals with severe injury or for those with neoplasia of the tongue. Research has shown that animals can function very well with 40-60% of the rostral tongue amputated.

Antibiotics should always be given following tongue trauma due to the contaminated area of the wound.

Palliative treatment should commence immediately to make the animal more comfortable. Depending on severity of the trauma, animals should either be fed soft food, liquidised food or have a feeding tube (naso-oesophageal, oesophageal, ventricular or enteral) placed if normal feeding cannot be maintained. Anti-inflammatories, usually corticosteriods (unless contraindicated due to surgery) should be immediately prescribed. Cats should be groomed daily as their quality of life will decrease if they are not able to keep themselves clean

Prognosis

Dependent on cause and severity.

References

Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition) W.B. Saunders Company

Fossum, T.W. (2002) Small Animal Surgery Mosby Elsevier

Tutt, C., Deeprose, J. and Crossley, D., (2007) BSAVA Manual of Canine and Feline Dentistry (3rd Edition) BSAVA

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