In dogs and cats, the cervical region is a frequent location for bite wounds, complicated by potential damage to many superficial vital structures (eg, airways). Bite wounds may initially appear innocuous; however, considerable deep tissue and vital structure devitalization may be present without overt signs. Limited causative data exist to guide treatment.

Records of 55 cats and dogs with cervical bite wounds were reviewed. Fourteen (25%) had injury to vital structures, including the airway in 9 (17%) cases; of these 9, airway injury was surgically confirmed and treated in 6 (11%). The trachea and larynx were equally traumatized; no significant species or patient size differences were noted, although there was a nonsignificant trend toward presence of airway injury in smaller dogs. Nonsurgical or local surgical treatment was successful in 80%; the remaining required surgical intervention, typically delayed, involving primary repair (3 involved temporary tracheostomy placement). Only 6 patients developed minor complications, including seroma and persistent infections. Overall success was excellent, with 96% surviving to discharge.

Bite wounds are challenging because of variations in severity, bacterial inoculation, and potential for hidden compromised structures below relatively small skin punctures. Many vital structures (eg, airway, esophagus, neurovascular bundles) are prone to damage. Cervical SC emphysema or radiographic pneumomediastinum, even without external wounds, should raise suspicion of airway involvement. Wound exploration is key to determining the full extent of injury and identifying critical structure compromise. Thorough oral and airway examinations should accompany this evaluation, as damage to recurrent laryngeal nerves can result in laryngeal functional deficiency. Despite these concerns, overall prognosis remains excellent with few patients requiring major surgical intervention.—Jason Bleedorn, DVM, DACVS

Airway injury associated with cervical bite wounds in dogs and cats: 56 cases. Jordan CJ, Halfacree ZJ, Tivers MS. VET COMP ORTHO TRAUMATOL 26:89-93, 2013.