Difference between revisions of "Tongue Trauma"

Revision as of 16:52, 1 March 2011

Causes

Lacerations e.g. tin cans, cat fights
Penetrating foregin bodies e.g. sticks or bones
Linear foregin bodies e.g. string
Electrical burns e.g. from chewing electrical cable
Chemical burns e.g. from caustic agents
Damage due to infection e.g. feline herpes, panleukopanenia, calicivirus, fungal or necrotising stomatitis
Damage due to glossitis caused by azotaemia
Macroglossia- if too large may become traumatised by teeth etc (common in brachycephalics)

Diagnosis

History

Cat fight
Seen playing with or eating a foreign body
Chewing electric cables
ingestion of caustics ETC

Clinical Signs

drooling saliva
reluctance to eat
bleeding
pawing at mouth
secondary infections

Definitive Diagnosis

Inspection under a general anaesthetic making sure to check under the tongue for foreign bodies.

Treatment

Caustic chemicals: exagerated flushing of the mouth with water
Lacerations: Primary surgical repair or second intention healing with sloughing +/- debridement
Amputation: if severe injury. Animals can function very well with 40-60% of the rostral tongue amputated
General: Antibiotics, palliative treatment aimed at reducing oral discomfort including anti-inflammatory drugs, mainly corticosteroids. Assisted feeding (Naso-oesophageal, oesophageal, ventricular or enteral) should be used if normal feeding cannot be maintained

Prognosis

Dependent on cause and severity.

References

Ettinger, S.J., Feldman E.C. (2000) Textbook of Veterinary Internal Medicine 5th Ed

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

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

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-{{OpenPagesTop}}
+== Causes ==
-== 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|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.
+*Lacerations e.g. tin cans, cat fights
+*Penetrating foregin bodies e.g. sticks or bones
+*Linear foregin bodies e.g. string
+*Electrical burns e.g. from chewing electrical cable
+*Chemical burns e.g. from caustic agents
+*Damage due to infection e.g. feline herpes, panleukopanenia, calicivirus, fungal or&nbsp;necrotising stomatitis
+*Damage due to glossitis caused by azotaemia
+*Macroglossia- if too large may become traumatised by teeth etc (common in brachycephalics)<br>
-This article will focus on Dogs and Cats.
+== Diagnosis ==
-== Causes of tongue trauma  ==
+=== History ===
-The most common causes of trauma in small animals are:
+*Cat fight
+*Seen playing with or eating a foreign body
-*'''Lacerations''' e.g. tin cans, cat fights
+*Chewing electric cables
-*'''Penetrating foreign bodies e.g. sticks or bones'''
+*ingestion of caustics ETC
-*'''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 Herpesvirus 1|feline herpes]], [[Feline Panleucopenia|panleukopanenia]], [[Feline Calicivirus|calicivirus]], fungal or necrotising [[Stomatitis|stomatitis]] or damage due to [[Glossitis|glossitis]] caused by [[Azotaemia|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.<br>
-== 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'''
+*drooling saliva
-*'''Reluctance to eat'''
+*reluctance to eat
-*'''Bleeding'''
+*bleeding
-*'''Pawing at mouth'''
+*pawing at mouth
+*secondary infections
-Secondary infections, general distress of the animal and vocalisation are other less specific signs of tongue trauma.
-===Definitive Diagnosis ===
+=== Definitive Diagnosis ===
-Inspection under a general anaesthetic is required. Be sure to lift the tongue and check underneath it for linear foreign bodies.
+Inspection under a general anaesthetic making sure to check under the tongue for foreign bodies.
-<br>
-== Treatment  ==
-'''Always treat the underlying cause'''!
+== Treatment ==
-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).
+*'''Caustic chemicals''': exagerated flushing of the mouth with water&nbsp;
+*'''Lacerations''': Primary surgical repair&nbsp;or second intention healing with sloughing +/- debridement
+*'''Amputation''': if severe injury. Animals can function very well with 40-60% of the rostral tongue amputated
+*'''General''': Antibiotics, palliative treatment aimed at reducing oral discomfort including anti-inflammatory drugs, mainly corticosteroids. Assisted feeding (Naso-oesophageal, oesophageal, ventricular or enteral) should be used if normal feeding cannot be maintained<br>&nbsp;
-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.
+== Prognosis ==
-[[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 [[Steroids|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. <br>
-== References  ==
+== 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''
+Ettinger, S.J., Feldman E.C. (2000) Textbook of Veterinary Internal Medicine 5th Ed
-Tutt, C., Deeprose, J. and Crossley, D., (2007) '''BSAVA Manual of Canine and Feline Dentistry''' (3rd Edition) ''BSAVA''
+Fossum, T.W. (2002) Small Animal Surgery
+Tutt, C., Deeprose, J. and Crossley, D., (2007) BSAVA Manual of Canine and Feline Dentistry (3rd Edition) ''BSAVA''
-{{review}}
-{{OpenPages}}
-[[Category:Expert_Review - Small Animal]] [[Category:Tongue_-_Pathology]] [[Category:Oral_Diseases_-_Dog]] [[Category:Oral_Diseases_-_Cat]]
+[[Category:To_Do_- Kate]] [[Category:Tongue_-_Pathology]] [[Category:Oral_Diseases_-_Dog]] [[Category:Oral_Diseases_-_Cat]]
-[[Category:LisaM reviewing]]