Page 784 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Gastrointestinal system: 4.1 The upper gastrointestinal tr act 759

VetBooks.ir 4.79 4.80

Figs. 4.79, 4.80 A severe laceration of the dorsal middle part of tongue preop (4.79) and after repair
consisting of a multiple layer muscle closure and initial coaptation of the mucosa with vertical mattress non-
absorbable sutures (4.80). The mucosa was subsequently closed with a fine simple continuous non-absorbable
suture to seal it from excess contamination. (Photos courtesy Graham Munroe)

Differential diagnosis many of which granulate eventually. The provision of
Painful swellings in the vicinity of the oral cavity semi-liquidised diet can enable animals with severe
must be distinguished from abscesses caused by oral pain to eat. Severe lacerations can be repaired in
systemic diseases such as Streptococcus equi var. equi. multiple layers, with absorbable sutures to accelerate
Discharging tracts from the gingiva can also be healing. Some tongue lacerations involving almost
associated with mandibular fractures and occasion- full-thickness transection may require surgical
ally sequestra in the interdental spaces as a result of debridement and repair under general anaesthesia,
bit trauma. Tongue lacerations are often obscure due with a reasonable prognosis. Any potentially viable
to the high mobility of the tongue and the difficulty tissue should be salvaged wherever possible, and even
of examination when it is injured. apparently severe wounds can heal surprisingly well
with surgical repair using multiple layers of absorb-
Diagnosis able sutures and despite the contaminated operating
Most lacerations are clearly visible on a thorough oral field (Figs. 4.79, 4.80). Loss of the rostral portion
examination and only minimal further investigation of the tongue can adversely affect the ability of the
is necessary. Injuries associated with chronically dis- horse to accommodate a normal bitted bridle.
charging tracts should be assessed radiographically
to rule out the presence of sequestra or fractures. STOMATITIS
Intermandibular ultrasonography can be useful to
image the intermandibular soft tissues and mandib- Definition
ular cortices, and CT is useful to reveal deeper lying Stomatitis is defined as inflammation of the soft
structures, especially osseous ones. tissues of the oral cavity.

Management Aetiology/pathogenesis
Most oral lacerations heal spontaneously with mini- Stomatitis is an uncommon condition in horses and
mal intervention other than tetanus prophylaxis is usually associated with inflammation secondary to
and broad-spectrum antibiotics. Damage to salivary other disease processes. Viral stomatitis may affect
ducts can be associated with a chronic salivary fistula, the dorsum of the tongue and the lips and is usually