Difference between revisions of "Tongue Trauma"
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| − | 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. | + | == 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. | This article will focus on Dogs and Cats. | ||
| − | == Causes of tongue trauma == | + | == Causes of tongue trauma == |
| − | The most common causes of trauma in small animals are: | + | The most common causes of trauma in small animals are: |
*'''Lacerations''' e.g. tin cans, cat fights | *'''Lacerations''' e.g. tin cans, cat fights | ||
| − | *'''Penetrating foregin bodies e.g. sticks or bones''' | + | *'''Penetrating foregin bodies e.g. sticks or bones''' |
*'''Linear foregin bodies e.g. string'''- this becomes wrapped around the base of the tongue and as perstalisis carries the rest of the string through the alimentary tract, the caught part cuts deeper into the tongue as this happens. | *'''Linear foregin bodies e.g. string'''- this becomes wrapped around the base of the tongue and as perstalisis carries the rest of the string through the alimentary tract, the caught part cuts deeper into the tongue as this happens. | ||
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== Diagnosis == | == Diagnosis == | ||
| − | === '''History''' === | + | === '''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. | + | 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''' === | + | === '''Clinical Signs''' === |
*'''Drooling saliva''' | *'''Drooling saliva''' | ||
| − | *'''Reluctance to eat''' | + | *'''Reluctance to eat''' |
| − | *'''Bleeding''' | + | *'''Bleeding''' |
*'''Pawing at mouth''' | *'''Pawing at mouth''' | ||
| − | Secondary infections, general distress of the animal and vocalisation are other less specific signs of tongue trauma. | + | 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. | ||
| + | <br> | ||
== Treatment == | == Treatment == | ||
| − | '''Always treat the underlying cause''' | + | '''Always treat the underlying cause''' |
| − | For caustics, you will need to flush the mouth out with water and administer and specific anitidotes 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). | + | For caustics, you will need to flush the mouth out with water and administer and specific anitidotes 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. | + | 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. |
| − | 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. | ||
Anitbiotics should always be given following tongue trauma due to the contaminated area of the wound. | Anitbiotics 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 | + | 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 |
| | ||
Revision as of 10:15, 2 March 2011
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 foregin bodies e.g. sticks or bones
- Linear foregin bodies e.g. string- this becomes wrapped around the base of the tongue and as perstalisis 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 occassionally 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 anitidotes 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).
Alaceration 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.
Anitbiotics 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., 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