Difference between revisions of "Tongue Trauma"
| Line 1: | Line 1: | ||
| + | {{review}} | ||
== Introduction == | == 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 | + | 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. |
This article will focus on Dogs and Cats. | This article will focus on Dogs and Cats. | ||
| Line 10: | Line 11: | ||
*'''Lacerations''' e.g. tin cans, cat fights | *'''Lacerations''' e.g. tin cans, cat fights | ||
| − | *'''Penetrating | + | *'''Penetrating foreign bodies e.g. sticks or bones''' |
| − | *'''Linear | + | *'''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, | + | 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 == | == 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. | + | 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''' | ||
| Line 28: | Line 29: | ||
*'''Pawing at mouth''' | *'''Pawing at mouth''' | ||
| − | Secondary infections, general distress of the animal and | + | 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. | Inspection under a general anaesthetic is required. Be sure to lift the tongue and check underneath it for linear foreign bodies. | ||
| Line 38: | Line 39: | ||
== 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 | + | 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. | + | 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 | + | 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 == | == Prognosis == | ||
| Line 62: | Line 62: | ||
Tutt, C., Deeprose, J. and Crossley, D., (2007) BSAVA Manual of Canine and Feline Dentistry (3rd Edition) ''BSAVA'' | Tutt, C., Deeprose, J. and Crossley, D., (2007) BSAVA Manual of Canine and Feline Dentistry (3rd Edition) ''BSAVA'' | ||
| − | [[Category: | + | [[Category:Expert_Review]] [[Category:Tongue_-_Pathology]] [[Category:Oral_Diseases_-_Dog]] [[Category:Oral_Diseases_-_Cat]] |
Revision as of 18:45, 4 March 2011
 |
This article has been peer reviewed but is awaiting expert review. If you would like to help with this, please see more information about expert reviewing. |
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., 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