Page 754 - Cote clinical veterinary advisor dogs and cats 4th

Foreign Body, Oral 354.e3

○ Retrobulbar area explored through inci- Recommended Monitoring ○ Changing bandages as directed
sion in oral mucosa just caudal to last • Repeat visits to veterinarian as necessary ○ Administration of antibiotics as directed
VetBooks.ir • Provide postoperative drainage until ○ To ensure abscess has resolved (allowing ○ Ensuring that patient is receiving adequate Diseases and Disorders
upper molar tooth or through existing
○ To ensure oral lesions or wounds heal
○ Ensuring adequate analgesia is provided
penetrating wound
drain removal)
nutritional support
abscess has resolved (submandibular/
intermandibular). ○ To remove feeding tube after oral problems Client Education
have healed
• Antibiotic therapy for bacterial infection • Observe for recurrence of abscess and • Do not let animals play with or chew
○ Long-term therapy based on results of development of draining tract. on objects such as sticks that could cause
microbiologic culture and sensitivity penetrating oral injuries or linear objects
tests PROGNOSIS & OUTCOME (e.g., fishing line, yarn) that could act as
• Empirical therapy until results available linear foreign bodies.
○ Cefazolin 22 mg/kg IV q 6h if animal • Usually good, provided all foreign material • Do not let dogs interact with porcupines.
receiving IV fluids and unable to take has been removed and abscess pockets are
oral medications, or adequately drained SUGGESTED READING
○ Amoxicillin 10-20 mg/kg PO q 12h • Recurrent problems likely to occur or chronic Pratt CL, et al: Sewing needle foreign body ingestion
draining tract may develop if in dogs and cats: 65 cases (2000-2012). J Am Vet
Chronic Treatment ○ Failure to remove all foreign material, Med Assoc 245:302-308, 2014.
• Antibiotic therapy (see Acute General Treat- especially porcupine quills, migrating
ment, above) until resolution of infection grass awns, or wood splinter/tree bark ADDITIONAL SUGGESTED
• Reconstructive surgery of damage caused to ○ Late-onset tissue necrosis develops (oro- READINGS
oral cavity by foreign body nasal fistula, osteomyelitis) Doran IP, et al: Acute oropharyngeal and esophageal
○ Oronasal fistula stick injury in forty-one dogs. Vet Surg 37:781-785,
PEARLS & CONSIDERATIONS 2008.
Nutrition/Diet Johnson MD, et al: Porcupine quill injuries in dogs:
• For lesions or wounds in the oral cavity that Comments a retrospective of 296 cases (1998-2002). Can Vet
may hinder oral feeding, it is necessary to In situations where multiple foreign bodies are J 47:677-682, 2006.
provide alternative route for nutrition and in the oral cavity (e.g., porcupine quills, burrs, Potanas CP, et al: Ultrasonographic and magnetic
antibiotic administration. wood splinters, tree bark), perform a thorough resonance imaging diagnosis of an oropharyngeal
○ Esophagostomy tube (p. 1106) or PEG examination of the oral cavity, tonsillar crypts, wood penetrating injury in a dog. J Am Anim
Hosp Assoc 47:e1-e6, 2011.
tube (p. 1109) and the entire pharynx to ensure all foreign
○ Re-examine oral cavity in 10-14 days. If material is removed. Foreign body is not always
healed, patient can return to oral feeding, found when draining/exploring an abscess. RELATED CLIENT EDUCATION
and the tube can be removed. SHEETS
Prevention
Possible Complications Avoid situations that could lead to foreign Consent to Perform General Anesthesia
• Failure to remove entire foreign body bodies injuring or becoming lodged in the How to Use and Care for an Indwelling Feeding
○ Persistent/recurrent abscess of adjacent oral cavity. Tube
tissue (e.g., retropharyngeal) AUTHOR: Don R. Waldron, DVM, DACVS
○ Development of draining tract Technician Tips EDITOR: Elizabeth A. Swanson, DVM, MS, DACVS
• Development of late-onset tissue necrosis • In-hospital care may include
○ Osteomyelitis ○ Keeping drain/drainage site clean and free
○ Oronasal fistula of discharge

www.ExpertConsult.com