One night while I was working at the St. Louis Animal Emergency Clinic a 4-year-old female spayed Labrador retriever named Shelby came in. Little did I know this would be a dog that I'll never forget. Shelby presented after recently getting her tongue caught in a paper shredder. Despite the owners' and the family pitbull's valiant efforts to rescue her, the traction on Shelby's tongue was too great and it gave way at the level of her epiglottis. Basically, Shelby lost her entire tongue. Despite this, Shelby presented bright, alert, and responsive but was a little head shy and per owners could be unpredictably "snappy" at times making an oral exam difficult without sedation. She had blood dripping from her mouth but the rest of her physical exam was within normal limits.
In order to provide the owners with a realistic prognosis (in terms of swallowing, prehension, laryngeal reflex, voice) and because the case was so unusual, phone calls were made to the University of Missouri Veterinary Teaching Hospital (UMC-VMTH), a specialty practice in St. Louis called Veterinary Specialty Services (VSS), and my father, Phillip Hornbostel M.D. (a general surgeon) for advice. I learned of a recent study done at UMC-VMTH which showed the prognosis for dogs after traumatic glossectomy (tongue excision) was excellent and explained these results to the owners. The owners were satisfied that an acceptable quality of life was possible for Shelby and opted for surgery.
The immediate and most pressing concern was blood loss. Stabilization was the highest priority since fatalities due to traumatic glossectomy have been reported. In Shelby's case, a preoperative bolus of fluids was given and was adequate for stabilization prior to anesthesia. Pain medication was also given. Preoperative bloodwork to determine if Shelby was anemic was done and her value PCV was 55% which is normal. Upon intubation an oral exam was performed revealing not even a "stub" of tongue, but only a small amount of tissue remaining at the back of the throat. The edges were trimmed and the remainder of the defect was closed with suture.
Shelby recovered well. Her red blood cell count after the surgery but she showed no clinical signs of anemia. She was offered water with a syringe 16 hours after surgery which she took relatively well. Just 24 hours post-op she was offered canned i/d meatballs but it was another 12 hours before she was successful in getting them to the back of her mouth and swallowing them. Shelby was eating and drinking well (syringe drinking) 36 hours later and likely could have gone home at this time. At the owners request Shelby was allowed a full 72 hours of recovery before returning home.
Shelby has been pretty famous since this "freak" accident and has even made the Channel 4 news in Saint Louis! At the time of the news story a few weeks ago she was still getting syringes of water which was likely not necessary but was a result of Shelby training her owners.
University of Missouri recommends kibble for these patients. One post-op patient ate canned food in the form of meatballs in order to get adequate daily water intake. Most of these dogs learn to drink water by scooping it out of the bowl. Another consideration might be a wall mounted watering device with a nipple attachment.
Quality of life was the owners' number one concern and they are thrilled at how much she still enjoys life, including food. All in all Shelby is a happy, albeit very lucky, dog.
NOTE: the most common reason for this traumatic even to occur with paper shredders is from children feeding food into them and dogs licking at the food. We recommend that you NEVER keep your paper shredder on auto feed and keep it out of the use of children. Dr. Emo works as an Emergency Room veterinarian in St. Louis, Missouri.
Shelby's owner wrote and article about her experience, to read more, click here