Computed tomography findings and surgical management of acute oropharyngeal stick injuries in dogs

Authors: Evans AA, Hosgood G, Richardson J
Publication: Australian Veterinary Practitioner, Volume 51, Issue 4, pp 220-233, Dec 2021
Publisher: Australian Veterinary Association

Animal type: Dog
Subject Terms: Trauma/injuries
Article class: Scientific Article

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Abstract:

Objective: To characterise the computed tomography (CT) findings, and to describe the management and outcome, of acute oropharyngeal stick injuries (OSI) in dogs. Study Design: Retrospective case series. Medical records of dogs referred to a university teaching hospital that underwent CT imaging and surgery for OSI between 2009 and 2021 were reviewed.

Results: 25 dogs were included, presenting with oral haemorrhage and ptyalism. Oral examinations revealed oropharyngeal (n = 16) or palatal tears (n = 3), tonsillar avulsions (n = 6) and tongue lacerations (n = 4). CT typically showed displacement of cervical structures, and focal gas tracking. Evidence of foreign material was identified on CT in 11 dogs. A ventral cervical approach was used for surgical exploration in 19 dogs, a lateral cervical approach in one dog, and oral procedures in 4 dogs. One dog was euthanased prior to surgery based on CT findings. The extent of surgical exploration was directed by the CT and included debridement and lavage, with stick fragments identified in 8 dogs. Oesophageal tears were identified in two dogs. Closed suction drainage was used in 16 dogs, and feeding tubes were placed in 17 dogs. Major complications necessitated repeat surgery in 5 dogs; two of which were feeding tube complications, one due to incisional dehiscence secondary to infection, one surgical re-exploration due to ongoing wound drainage, and one carotid ligation for ongoing oral haemorrhage. Short-term follow-up was available in all dogs, with long-term (> 6 weeks) follow-up available for 19 dogs (median 16 months [interquartile range 33 months, range 1.5-66 months]), with good outcomes and no evidence of dysfunction.

Conclusions: CT allowed assessment of the tissue trauma secondary to OSI, identifying the extent of the injury even in the absence of retained foreign material. CT allowed a guided approach to surgical and peri-operative management, with excellent outcomes reported in all dogs.

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