“Case of the Month” – September 2018
 

Arai, a 5-year-old female pit bull terrier, loves to chew on balls. Her owners describe her as a “100 percent ball dog.” So when she had a ball in her mouth for a few hours, they didn’t think much was out of the ordinary. When Arai wouldn’t drop the ball when it was time to eat, however, they knew something was wrong. 

The ball was constructed with one small circular opening, and her tongue was stuck so severely in the hole that her owners could not get it loose. The hole in the ball was only about one half inch in diameter, yet Arai’s tongue—average size for a 42-pound dog—managed to get sucked into the opening. 

They took her to their local veterinary emergency room where Arai was sedated and the ball was cut off her tongue. After the ball was removed, her tongue was swollen due to a decrease in venous return from the region. She was treated with anti-inflammatory and antibiotic medications and was able to go home.

The next day, Arai was not eating or drinking, and her owners were only able to give her half of the prescribed dose of the anti-inflammatory drug and none of the antibiotic. They took her back to the veterinarian, who administered the drugs via injection. 

When Arai’s tongue remained enlarged and turned dark purple the next day, her owners took her to the UC Davis veterinary hospital’s emergency room. There, emergency/critical care specialists consulted with Drs. Frank Verstraete and Boaz Arzi of the Dentistry and Oral Surgery Service, who advised that the front part of the tongue be amputated due to necrosis. 

Arai was placed under general anesthesia and prepared for surgery by the Anesthesia/Critical Patient Care Service. Assisting Drs. Verstraete and Arzi was resident Dr. Colleen Geisbush, who removed the devitalized portion of Arai’s tongue—about three to four inches—using a surgical laser. After removal, the ends of the remaining healthy tongue were sutured together with absorbable sutures that dissolve on their own over the course of a few weeks. Arai recovered well from anesthesia and was able to go home that day.

Arai was fed a soft food diet while her tongue healed and may need to continue afterwards until she adapts to using her now shortened tongue. She continued on anti-inflammatory medication, as well as antibiotics to help treat and prevent bacterial infection and a pain reliever.

Arai was kept away from any toys, bones, or anything hard to chew on during the next two weeks. Beyond warnings about toys with holes, her owners were also advised to only allow Arai to chew on soft toys – ones soft enough to indent with a fingernail. If a toy is harder than this (such as bones, antlers and sticks), they can cause tooth wear/damage, and potentially broken teeth. Frisbees and tennis balls can also cause tooth damage. (Visit the Veterinary Oral Health Council’s website for suggestions on different treats and chews that can be offered to help prevent the progression of periodontal disease.)

Arai recovered quickly following surgery and has adapted well to new ways of eating, drinking and cleaning. Her owners report that she now “chomps” at the water instead of lapping it with her tongue. While it takes a bit longer to get enough water, she does well on her own. As for cleaning herself, she found a unique way to utilize the inside of her bottom lip. 

At Arai’s 2-week, post-surgery recheck, Dr. Geisbush noted near complete healing of the surgical site and expected Arai to make a full recovery.