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The vertical ramus in your cat is the flat vertical structure on the lower back part of your cat's jaw also referred to as the mandibular ramus. It is located adjacent to the temporomandibular joint and the lateral surface is attached to the masseter muscle. Defects of this bone including abnormal cell growth or infection in the bone causing deterioration of tissue that may cause conditions requiring part of this bone to be removed along with adjacent tissue of the jaw. Fractures that do not resolve may require the bone be modified and reconstructed with wires or other surgical implant devices. Disorders of the vertical ramus in your cat may manifest as swelling in the temporal region of the jaw and the inability to open and close the jaw properly. When symptoms appear, radiographs will be used to diagnose the cause prior to surgery to correct the condition and then utilized for planning partial excision of the vertical ramus in your cat. If required this procedure is performed by a veterinary surgeon under anesthetic.
Pre-operative planning may take place under anaesthetic as cats are not always cooperative with having their jaw examined, especially if an uncomfortable medical condition exists.
If symptoms indicating a problem on the vertical ramus of your cat's lower jaw manifest, your veterinarian will perform radiographic tests to determine the nature of the disorder and whether surgical intervention is necessary to correct it. Radiographs will then be used to plan surgery and excision of a portion of the vertical ramus to remove tumors and diseased tissue or repair fractures. Partial excision of the vertical ramus is performed under general anesthesia. If possible, an intubation tube and anesthesia will be used but intravenous anesthesia may be used if the lower jaw surgical site can not be accessed with intubation tube in place. Incisions are made in the lower jaw tissue over the vertical ramus to access this structure. Ligation of vessels to control bleeding will be performed as necessary. Tumors, infected tissue, and affected bone are removed. Bone is removed using surgical bone saws, drills, chisels or wires as appropriate. As little bone tissue as possible will be removed in order to preserve functioning and still address the medical condition. If possible the temporomandibular joint will be left intact to preserve jaw function.
If neoplasia exists, the tumor will be removed along with tissue margins of at least 1 cm for malignant tumors, preferably more, and 1 cm or less for benign conditions.
Incisions will be closed with sutures and your cat will be put in recovery after surgery for supportive care and monitoring. Post-surgery, your cat will be administered intravenous fluids. Cats are often given a feeding tube post surgery to provide nutrition until adequate healing occurs to allow normal feeding. Your cat will be monitored to ensure hemorrhaging and wound rupture does not occur and antibiotics and pain medications will be administered intravenously. Some cats are reluctant to eat while in a strange environment, and if this is an issue, your cat may be released home on a trial basis prior to eating in the hospital.
Any tissue with abnormal cell growth and tissue margins will be sent for analysis to determine the type of cells present and that tissue margins are adequate.
Surgical intervention to remove portions of your cat's jaw is not always well tolerated in cats and recovery may be complicated as a result.
Partial excision of the vertical ramus in cats provides effective relief of benign lower jaw disorders. However, for malignant neoplasm, prognosis is poor and euthanasia may be an option. Surgery to excise malignant tissue combined with radiation or chemotherapy may provide some relief for your cat's condition.
Because cats do not tolerate muzzles and other methods to protect the oral cavity, recovery can be difficult. An e-collar may be helpful in preventing your cat from scratching at their face and mouth. Your cat may need to be provided with a liquefied diet post-surgery and will require soft food for several weeks. Also, your cat may require help cleaning themselves if their jaw is difficult to manipulate after surgery. The surgical site must be monitored for signs of wound dehiscence or infection. Sutures will need to be removed post surgery and regular follow up with your veterinarian will be required to ensure fractures heal or infections and tumors do not recur.
The cost of lower jaw surgery to remove part of the vertical ramus on your cat’s mandible ranges from $1,000 to $3,000 depending on the amount of tissue that needs to be excised, cost of living in your region, and your pet's recovery from the procedure.
This procedure is not as well tolerated in cats who may have difficulty adapting during recovery.
Wound rupture may occur as well as infection of the surgical site which needs to be closely monitored post surgery. Problems with jaw functioning post-surgery may cause your cat distress and your cat may require assistance to cope during recovery with eating and cleaning themselves.
While oral tumors are not preventable, regular dental care of your cat will help to prevent periodontal disease and and uncover abnormal growths in your cat's mouth when they are smaller and more easily removed. Keeping your cat indoors will minimize the incidence of trauma to their jaw by preventing major falls, fights and motor vehicle accidents that can cause fractures requiring surgical intervention of the vertical ramus.
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