Mandibulectomy and maxillectomy (Figure 3) are the most common surgical procedures for gingival tumors in dogs and cats. For specimens, margins should be inked for histopathology and evaluation. Potential complications include hemorrhage, infection, dehiscence, incomplete excisional margins, mandibular drift, malocclusion, anorexia, dysphagia, and mass recurrence. Seroma formation is common at the lymph node dissection site.
Although novel techniques to restore the mandible are becoming available and involve either a 3D-printed implant11 or plate reconstruction and bone morphogenic protein, they are not commonly used.12 Clinicians should be prepared for blood transfusion. After maxillectomy or mandibulectomy, most dogs will eat within 24 to 48 hours postoperation and do not require placement of a feeding tube; however, feeding tubes should be considered for radical resections, especially radical maxillectomy. Although it is generally believed that cats do not do well after maxillectomy or mandibulectomy because they will not eat postoperatively, this has not been the author’s experience. There is potential for success with these procedures in cats. Feeding tubes are critical for cats, because they may not readily eat after surgery, and hepatic lipidosis is possible after even short periods of anorexia. A recent study of 8 cats that underwent radical mandibulectomy found that 6 cats ate on their own 3 days to 1 month postoperatively and had an estimated mean survival time of 712 days.13 A feeding tube is recommended in both cats and dogs after glossectomy.
In dogs and cats, multimodal pain control (primarily with a combination of opioids, NSAIDs, and local anesthesia) is recommended. Patients should be maintained on IV fluids and monitored for pain, hydration status, and evidence of ongoing hemorrhage. A patient’s ability to eat postoperatively may depend on the amount of tissue resected, amount of postoperative swelling, degree of pain control, and patient’s willingness to eat; canned food of different consistencies should be offered. Patients should wear an Elizabethan collar postoperatively.