Document Type : Clinical Report
Authors
1 resident of veterinary surgery, faculty of veterinary medicine, shahid bahonar university of kerman, kerman, iran
2 Postgraduate Student of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
3 Department of Surgery, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, IRAN.
Abstract
Case Description- A six-month-old Doberman Pinscher male with sever laceration in the mucosa of the lip, nose and nostrils as well as the shoulder area was referred to Veterinary Hospital of Shahid Bahonar University of Kerman.
Clinical Findings- The animal showed anorexia, depression, and sialorrhea. There was also a deep laceration over the right shoulder.
Treatment and Outcome- Surgery was performed under general anesthesia. Submocusa and mocusa were sutured in separate layer using simple interrupted pattern of absorbable suture material, and the skin of the nostril was reconstructed with the same pattern and non-absorbable suture material.
Clinical Relevance- Injuries of the oral cavity in dogs happen in a variety of conditions. This report describes surgical reconstruction of lip and muzzle laceration in a Doberman pinscher
Keywords
Case Description
A six-month-old Doberman Pinscher with sever laceration in the mucosa of the lip and nose, and a part of nostrils, as well as the shoulder area was referred to the Veterinary Hospital of Shahid Bahonar University of Kerman. According to the owner’s statement, the animal was injured due to a clash with barbed wire, 24 hours before admission.
Clinical Findings
On physical examination of oral cavity, there was a sharp tear began in the mucosa and submucosa of the right side of the upper lip, adjacent to the upper canine teeth, and continued craniorostrally and involved the right nostril in full thickness (Fig.1).
The animal showed anorexia, depression, and sialorrhea. There was also a deep laceration over the right shoulder, involving skin and subcutaneous tissue, and part of the musculature.
Treatment and Outcome
The dog initially sedated by 0.05 mg/kg of Acepromazine 1%, IM. Anesthesia was induced using 15 mg/kg of Ketamine 10% (Alfasan co, Neatherland) plus 0.2 mg/kg of diazepam (Chemidarou, Iran) through angiocatheter.4 Since endotracheal intubation interfered with surgical site, the surgery continued via total intravenous anesthesia (TIVA). The wound was lavaged with copious amount of normal saline and remnants of necrotic tissues and foreign bodies removed. Muzzle and nostrils were also surgically prepared. Wound repair was begun from the oral side by suturing the submucosa and mucosa in separate layers with simple interrupted pattern of absorbable suture material (Vicryl 3/0). In order to have uniform tension to the wound edges, all the sutures in the submucosal layer were preplaced and tied at the end (Fig.2). Finally the muzzle and nostril was repaired using simple interrupted pattern of non-absorbable suture material (nylon 3/0) (Fig.3). Shoulder laceration was managed as second intention wound healing.1 Finally, two weeks after the surgery and healing time is right for the stitches removed (Fig.4).
Following the surgery, dexamethasone (0.5 mg/kg IM), tramadol (3 mg/kg IV) and ceftriaxone (40 mg/kg IV for 4 day) were administered. The owner was advised to feed the soft food to the animal for seven days and wash the oral cavity with normal saline following each meal.3
Clinical Relevance
Lacerations of the mouth, lips and muzzle in the dogs happen in a variety of conditions such as fight, clash to obstacles and chewing the sharp foreign bodies. Although the lacerations of oral cavity heal fast, good alignment of the wound edges is mandatory to avoid undue scar formation which induce a foreign body sensation in the mouth.2 Preplacing the sutures deep in the submucosa avoids undue tension on the wound edges during chewing and obliterates the dead space, which results in favorable wound healing with minimal scar formation.
2. Javaid M, Feldberg L, Gipson M. Primary Repair of Dog Bites to the Face: 40 Cases. Journal of the Royal Society of Medicine, 1998; 91:414- 416.
3. Butterwick RF and Hawthorne AJ. Advances in Dietary Management of Obesity in Dogs and Cats. Journal of Nutrition, 1998; 128:2771- 2775.
4. Farver TB, Haskins SC, Patz JD. Cardiopulmonary effects of acepromazine and of the subsequent administration of ketamine in the dog. American Journal of Veterinary Research, 1986; 47:631- 635.
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