History

This is a previously healthy 2 year old, male castrated DSH cat that lives with one other cat and one other large breed canine. The patient was observed to get to close to the large breed canine while he was eating a bone and sustained trauma to the head/face. The owners noticed later that the cat was holding his mouth open and that there was a small amount of blood coming from the mouth. On presentation the patient was unable to close his mouth completely and the tongue was protruding out of the right side of the mouth. The mandible was mal-aligned and deviated to the right of the maxilla. There was a small amount of blood coming from the patient’s oral cavity. No fractures were palpated.

Diagnostics

A lateral and DV view of the patient’s skull were taken. The radiographs revealed a cranial subluxation of the left temporomandibular joint. No fractures were observed. Sedated oral examination revealed a fractured upper left first premolar and a gingival abrasion. No fractures were palpable during manipulation of the mandible and the jaw was unable to be closed completely.

Treatment

The patient was anesthetized with propofol and placed in right lateral recumbency. The mouth was opened and a distraction device was placed between the molars. The rostral portion of the mandible was manipulated as to close the mouth until the left TMJ joint was felt to have popped back in place. The mandible was tested for proper alignment and was not observed to re-luxate. A tape muzzle was placed over the patient’s mouth and secured behind his head and neck to limit the amount that the mouth could open. The patient was discharged with oral buprenorphine and a soft diet.