This is a story about a dog with a huge tongue and a veterinarian performing groundbreaking surgery on it.
Raymond Kudej is a professor and small animal surgeon at the Cummings School of Veterinary Medicine. He often works with brachycephalic????? Or short-headed â???? Dog breeds, such as bulldogs, pugs, and Boston terriers. The shape of their head makes these breeds prone to breathing and other upper respiratory problems.
A few years ago, he read a study published in the journal Veterinary Surgery, in which the veterinarian measured the tongue volume of 16 brachycephalic dogs in relation to the airway area. They found that compared with dogs with medium-sized skulls, the ratio of air to soft tissue in short-headed dogs was reduced by about 60%.
â???? This paper is the first to objectively assess the relative size of the tongue in these dogs when it becomes blocked, but it does not discuss ways to make it smaller, â???? Kudjie said. â???? My first thought was that reducing the tongue might work. â????
This idea came from his investigation of human sleep apnea. Humans have fat cells at the bottom of the tongue, and weight gain will cause the tongue area to become larger. One potential treatment for patients with sleep apnea is to reduce the size of the tongue with surgery to make breathing easier.
Humans have different types of tongue reduction surgery, and Kudej initiated a study to explore what he believes is the most effective method for short-headed dogs. He checked the safety and beneficial effects of these procedures on the animal carcasses donated to Foster Small Animal Hospital for teaching and research. At that moment, someone called and entered the hospital. He needed to help a dog whose tongue was too big to eat.
The caller was Maureen Salzillo, head of the Operation Pawsibility Project, an animal rescue organization based in Rhode Island. She recently rescued a one-year-old bulldog named Bentley, which needs medical attention. His tongue was so big that he always spit it out of his mouth, and he ate a bowl of rice for more than 30 minutes.
â???? Dogs are stoic, â????? she said. ????? He figured it out. I have to bury my entire face in a bowl when I eat and drink, making it messy. He can’t swallow in the right way. He drools so much that he needs multiple towels to wipe it clean. ? ? ? ?
Salzillo wanted to make Bentley more comfortable, so she took him to see several different veterinarians for help. Someone had a biopsy of Bentley’s tongue, but the results did not reveal any problems. Another suggestion that Bentley tie the tongue lace, this condition limits the ability of the tongue to move and can be corrected by surgery. But Salzillo is an experienced dog owner, and he has a foreboding that mobility is not a problem.
â???? At the same time, we changed Bentley’s food and gave him anti-allergic drugs because his mouth was very swollen in addition to his tongue, â???? she said. â???? We replaced him with a specialty food for dogs with sensitive skin and allergies. It helps to solve the muzzle problem, but it does not help the tongue. ? ? ? ?
When she called Foster Hospital to make an appointment, she said that she had a conversation with a liaison officer and gave Bentley’s medical history in detail. The contact person forwarded her information to Kudej, and Kudej called her back immediately.
â???? This is the source of the sense of surprise. I am conducting this research, this is a dog with enlarged tongue as a clinical case. Really rare? ? ? ? Kudjie said.
By November 2020, during the COVID-19 pandemic, Salzillo took Bentley to Tufts University for an examination, where Kudyi agreed that the dog was not tied. He just has a huge tongue. Bentley’s tongues are heavy, and the weight on his teeth keeps them growing sideways at a 90-degree angle. And his mandible, usually in the shape of a small bowl supporting the tongue, is completely flat.
â???? This dog is suffering, â????? Kudger said. â???? There was an ulcer on the surface of his tongue due to trauma, because it was too big. â????
He told Salzillo that he had never performed tongue reduction surgery on patients, even though he had performed operations on donated corpses. Knowing the unprecedented nature of the procedure, she is willing to let Kudji continue.
The cost of surgery is high, and the special dog food needed to control Bentley’s allergies is also very expensive, so Salzillo began to raise funds for Bentley’s medical expenses. She printed a T-shirt with Bentley’s face and it said “Save Bentley”? ? ? ? Smile, “???” and sell them on her social media channels. By February 2021, the shelter had raised most of the funds needed for the operation.
An abnormally enlarged tongue is called megaglossia. The surgery performed by Kudej is a midline tongue resection, which reduces the size of the tongue by removing tissue from the middle of the muscle instead of the sides where the arteries are located. Avoiding arteries under the guidance of a CT scan, Kudej is able to remove the tissue from the center of the tongue to make it thinner and smaller.
At first, Kudej was not sure whether the operation was successful. The first stage of healing is inflammation, so swelling will appear in the first few days. But after the third day, the swelling began to decrease, and about a week later, Salzillo was able to take Bentley home to supervise his continued recovery. However, caring for a 75-pound sick dog is not easy.
???? Bentley can’t move his tongue because the muscles of his tongue are still healing. He couldn’t eat anything, so I made small meatballs from his wet food, asked him to open his mouth, and then threw them into his mouth, â???? she said.
In the end, Bentley recovered completely and performed very well. Salzillo said that his quality of life has improved significantly, and now he is like a different dog, even though he continues to eat a special diet to control his allergies. He even found an eternal home for a loving family.
â???? Bentley did a great job, â????? the family said in a statement. â???? He can eat and drink much better. With his energy and attitude, he is like a puppy again. We are very grateful to Dr. Kudej and his team at Tufts University for helping our boys live a better life. â????
This may be the first tongue reduction surgery performed on a living patient. Kudej could not find any description of such an operation in the veterinary literature, although he admitted that it might have been performed but there was no record.
In October, Kudej will present his research on tongue reduction surgery in brachycephalic dogs at the 2021 American College of Veterinary Medicine meeting, including Bentley’s clinical cases. In addition, an abstract of an upcoming paper will be published on Veterinary Surgery with lead author Valeria Colberg, a veterinary surgery intern who conducted this research in collaboration with Kudej.
â???? Bentleyâ????s case of megaglossia is something I have never seen before, and I may never see it again, â???? Kudger said. â???? I don’t believe in fate, but sometimes the stars just line up in a row. â????
Post time: Aug-29-2021