Peaches was bitten on the head by a dog.
The trauma occurred on July 28 and reported initial loss of vision and superficial trauma. Luxation noted.
When Peaches was referred on August 16 she was able to see but had a corneal ulcer and inability to close the mouth. Bloods showed mild hypoalbuminaemia. There was an ulcer in the oropharynx.
A CT was performed the same day which showed a left TMJ luxation with dorsal displacement of the mandible. There was a mandibular symphyseal fracture. Manual reduction of the joint was attempted, but failed.
I examined the cat for the first time on August 17 and obtained consent for a pharyngeal intubation, left sided condylectomy and wiring of the symphysis.
At surgery a left-sided zygomatic approach was made, the condyle was resected with an osteotome and the jaw was able to occlude in a normal position. A 1.2mm orthopaedic wire was placed around the rostral mandibles and tightened.
Peaches recovered well from anaesthesia, but secondary to the initial trauma, the oropharynx ulcer and the swelling secondary to pharyngeal intubation, Peaches was unable to swallow effectively. She developed aspiration pneumonia secondary to inhalation of food and saliva.
I placed a mushroom tipped gastrostomy tube on August 21 and all oral feeding and medication was temporarily suspended.
Peaches was discharged on August 24 where her owners continued to feed her via the tube at home.
I re-examined Peaches on September 8 where the gastrostomy tube was removed without any complication. Peaches was reported to be eating very well at home and had good prehension and mastication ability.
Paragon Veterinary Referralswww.paragonreferrals.co.uk
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