Partial Mandibulectomy in Cats

Partial mandibulectomy in cats is performed on the lower jaw to remove abnormal cell growths, damaged tissue from infections, or unhealed fractures. Resection of the lower jaw can include:

• Unilateral rostral mandibulectomy, partial removal of one side of the lower jaw
• Bilateral rostral mandibulectomy, partial removal of both sides of the lower jaw
• Total mandibulectomy, removal of one entire mandible or removal on one entire mandible and a portion of the other mandible

Up to 75% of your cat’s lower jaw can be removed, if required, to address disease conditions. Partial mandibulectomy is not as commonly performed in cats than in dogs, as it can be complicated by their smaller size, less excess oral tissue for reconstruction, and more difficulty adapting to and recovering from the procedure. If necessary, partial mandibulectomy will be performed under anesthesia by a veterinary surgeon.

Partial mandibulectomy is performed under general anesthesia. If possible, 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 to access the lower jaw bone. Litigation of vessels to control bleeding will be performed as necessary. Tumors, infected tissue, and bone are removed. Bone is removed using surgical bone saws, drills, chisels or wires as appropriate to the area being removed. Any teeth attached to the bone being excised will also be removed. Bleeding will be controlled with gentle manual pressure.

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.

Repairs will be made using excess skin tissue and suturing of incisions where tissue has been removed. Your cat will be put in recovery after surgery for supportive care and monitoring. Intravenous fluids will be provided. Cats are often given a feeding tube post surgery to provide nutrition until adequate healing occurs to allow normal feeding. If no complications such as wound rupture or hemorrhaging occur, your cat will be released when they can eat and drink. 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. Painkillers will be provided. Antibiotic will be provided at the time of surgery, but are  usually not required post-surgery as good blood supply to the region naturally prevents infection.

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.

Partial mandibulectomy in cats provides effective relief of benign lower jaw disorders. However, cats do not tolerate this procedure as well as dogs and functional recovery may be more complicated.

For malignant neoplasm, prognosis is poor due to the aggressive nature of oral cancers and euthanasia may be an option. In such cases, partial mandibulectomy may provide temporary relief for your cat's condition and combined with radiation or chemotherapy your cat's life expectancy may be extended.

A feeding tube, liquified food or soft food should be fed for at least two to four weeks post surgery. The oral cavity will need to be flushed out with a sterile solution and pain medications administered if prescribed. Monitor the surgical site for complications such as bleeding or infection. Avoid manipulating your cat's oral cavity more than necessary. Check to ensure that remaining teeth do not interfere with the surgical site during normal usage and contact your veterinarian if they do. Your will need to follow up with your veterinarian after 2 weeks for suture removal and post-surgery examination and periodically for several months post surgery to ensure healing and functioning of the jaw resumes. An e-collar may prevent your cat scratching or interfering with their mouth during recovery. If malignancy was discovered, follow-up treatment with radiation or chemotherapy may be scheduled. Your cat's tongue may stick out post surgery; your cat may learn to adapt to this and compensate for it. If your cat has problems cleaning itself, you may need to assist with a damp cloth and warm water periodically.

The cost of this procedure in your cat can range between $1,500 and $4,000 including radiographs, lab work, anesthetic, procedure, post-surgical supportive care, and medications.

This procedure is not as well tolerated in cats as in dogs, and cats may have more difficulty adapting during recovery. Cats may particularly have trouble controlling their tongue and cleaning themselves. 

Cosmetic appearance will be altered, however most pets are not concerned with this as relief of the underlying medical condition and associated pain and discomfort is of more salience to your cat. 

Since cats have less excess oral tissues for conducting reconstructive repairs than dogs, reconstruction can be more complicated and will require a veterinarian with experience in such techniques.

Wound rupture is a common complication with this procedure and the surgical site needs to be carefully inspected to ensure that this is addressed if it occurs.

The cause and prevention of oral tumors is not well understood. However, daily dental care and regular inspection of the mouth will help you notice abnormal lumps or bumps when they are smaller and more easily removed, and also help control dental disease which may predispose your cat to infection and fracture.