January 2009
Dr Gerhard Steenkamp

A 7 month-old dog is presented for a suspected jaw fracture after a motor vehicle accident.  On clinical examination the dog does not appear to be in shock and you confirm a fracture of its left mandible.  The patient is admitted for surgery the following day.

a) How can you secure the mandible in order to minimize injury until surgery can be performed
b) Which basic principles should be adhered to when performing the procedure mentioned in a?

Memo

a) A temporary external co-optation in the form of a tape muzzle can be applied.  This will allow the dog to still lap water or food but support the mandible and protect it against further trauma by the patient itself.  Canvas muzzles of various sizes are available on the market which is inexpensive and easy to apply.
 

A tape muzzle in place for a jaw fracture

 
A canvas muzzle used in this patient.

b) The muzzle should never stick to the patient, always make sure the first layer of tape used (like micropore) are placed sticky side up (away from the skin).
Secure the muzzle with a sling around the head, made of the same tape and also
used with sticky side away from the skin.
A second layer is then used to stick to the upside down first layer placed on the
animal in order to strengthen the muzzle, and also to cover the sticky surfaces.
When the muzzle does not stick to the patient it is easy to remove it for cleaning
purposes or when the dog needs to vomit.

Always make sure there is a gap between the incisors big enough for the animals
tongue to protrude.  This will allow them some space to pant (important for heat exchange) and lap food or water.  Even more importantly this will allow a dog to vomit, if it needs to, without aspirating the vomitous.
Clean the muzzle and face regularly (after each feeding) to avoid moist
dermatitis.

Do not attempt this technique on brachycephalic dog breeds or cats, as there is
little space for them to be applied effectively and they may interfere with the
breathing of an already compromised group of patients (brachycephalics).