Chewing Lesions in Small Animals
A proliferative, verrucous mucosal chewing lesion can result from self-induced bite trauma on the cheek, lip, palate, tongue, or sublingual region (see tongue chewer images) when tissue becomes trapped between or punctured by teeth during chewing or panting or in occlusion.
Courtesy of Dr. Brenda Mulherin.
Biopsy and histological examination should be performed if a unilateral lesion appears suspicious for neoplasia. Small lesions can be monitored. Large lesions are surgically removed to prevent exacerbation (inflammation and infection) from further trauma. The cause of trauma may also be addressed (eg, smoothing and sealing sharp edges of a fractured tooth; orthodontic movement, crown reduction, or endodontic therapy; or extraction of a misaligned tooth).
These types of lesions are frequently found in brachycephalic animals with generally larger tongues and cheeks. In addition, affected dogs and cats have a class 3 malocclusion, an occlusion where the mandible protrudes farther than the maxilla, which predisposes the tongue, lip, and cheeks to more traumatic contact with teeth.
Mouth Burns in Small Animals
Thermal, chemical, and electrical burns involving the mouth are not uncommon. Pet owners may have observed the injury, but more commonly, it occurs in their absence. The patient hesitates to eat or drink, hypersalivates, and resents handling of its mouth or face.
Pearls & Pitfalls
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Animals suspected of a burn should be evaluated and treated for systemic involvement, which may be life-threatening (eg, neurogenic pulmonary edema).
The tongue, lips, cheeks, palate, labial and buccal mucosa, alveolar mucosa, gingiva, and underlying bone are frequently involved with electrical burns (see electrical burn maxilla image).
Caustic lesions from chemical agents typically affect the tongue and palate.
The nasal planum, lips, and tip of the tongue are most commonly involved with exposure to overheated liquids or soft food.
Injuries may be mild, with only temporary discomfort (more commonly with thermal and chemical burns), or they may be destructive, with substantial loss of necrotic tissue, scar formation, and subsequent deformity or tissue deficits (usually with electrical burns; see healed electrical burn image).
Courtesy of Dr. Brenda Mulherin.
Courtesy of Dr. Brenda Mulherin
Burns from chewing on electrical cords occur most frequently in kittens, puppies, and pet rabbits. These animals often develop a linear scar across the dorsal lingual surface, outlining the electrical cord's path. One or both lip commissures may have a scar or wound, and the crowns of affected teeth may be discolored, eventually requiring endodontic treatment or extraction due to irreversible pulpitis and necrosis.
If recent contact with a corrosive alkaline chemical has occurred, the mouth should be rinsed with a dilute solution of vinegar or citrus juice; if the chemical was acidic, a dilute solution of sodium bicarbonate should be used. Copious oral lavage with water can help remove chemical residue. More commonly, the patient is seen well after the exposure, which renders attempts at chemical neutralization ineffective.
Hair should be clipped or washed if it is suspected to contain residue of the caustic chemical.
Animals that have oral mucosal inflammation without tissue defects require no specific supportive treatment other than a soft or liquid diet until the lesions have healed. Pain medication may be considered to relieve discomfort.
If tissue damage is extensive, surgical debridement and repair should be delayed until there is a clear demarcation between healthy and damaged tissue.
Defects resulting in functional impairment (eg, palate defects causing oronasal communication) should be repaired once surrounding lesions have granulated and evidence of re-epithelialization has appeared.
For More Information
Also see pet owner content regarding disorders of the mouth in dogs.
