A bone, stick or other object stuck in a dog's or cat's mouth

Important note for owners

A pet with something stuck in its mouth is frightened and in pain, so it may bite even its owner. Your job is not to get the object out at any cost but to avoid doing harm: calm your pet, see what has happened and get it to a vet as soon as possible. Even if you managed to remove the object, the palate, gums and teeth are worth checking: a stick can leave a pressure sore, a sharp fragment a wound, and a hard bone a fractured tooth.

Most common possible causes

• —A stick across the roof of the mouth. A typical situation in dogs after playing with sticks: a piece of stick gets wedged between the upper back teeth — the fourth premolars or molars — and presses against the palate. The dog suddenly paws at its mouth, holds it open and drools. If the stick has been there for several days, a pressure sore forms on the palate and bad breath appears.
• —A bone ring on the lower jaw or canines. Rings of marrow bone, sliced across a long bone, can slip over the lower jaw and get stuck behind the canines, or fit tightly around a canine. The bone compresses the tissues, so the jaw and tongue swell, and the longer the ring stays in place, the worse the swelling.
• —A fragment of bone or toy between the teeth. A sharp fragment gets wedged between the premolars or molars or presses into the gums. Your pet licks its lips, chatters its teeth and chews on one side, and the gums in that spot turn red and bleed. A hard bone can also fracture the teeth themselves.
• —Thread, tinsel or a needle in a cat. Cats and kittens play with thread, ribbons and Christmas tinsel. A thread can loop around the base of the tongue while its other end ends up in the oesophagus or intestine; there may be a needle on the thread that pierces the tongue, palate or throat. This is an emergency: never pull the thread.
• —A fish hook. A baited hook can lodge in the lip, tongue or throat. Because of the barb it cannot simply be pulled back out, and fishing line hanging from the mouth must not be pulled: the hook may have been swallowed.
• —A stick injury. A dog running after a thrown stick catches it or runs onto it, and the stick pierces the tissues under the tongue or in the throat. The wound can look small from the outside, but wood splinters may remain in the tissues, and later neck swelling, an abscess or pain on swallowing appear.
• —Grass awns and seed heads. In summer, grass seed heads lodge in the gums, tonsils or under the tongue. In a cat, a blade of grass can get stuck behind the soft palate — the cat then sneezes, gags or swallows repeatedly.

How to tell that something is stuck in the mouth

You can usually tell from your pet's behaviour that something is in its mouth before you see the object. The signs appear suddenly — during play, a walk or while gnawing a bone — or, if the fragment is small, gradually over a few days.

• ✓Your pet paws at its face or rubs it on the floor and shakes its head.
• ✓The mouth is open or won't close fully; the lower jaw seems to hang.
• ✓Heavy drooling, sometimes tinged with blood.
• ✓Frequent lip licking, swallowing or chewing movements, teeth chattering.
• ✓Gagging, coughing, trying to bring something up.
• ✓Refusing food, or taking it and dropping it straight away.
• ✓Swelling of the tongue, lips, under the lower jaw or on the neck.
• ✓Bad breath, if the object got stuck several days ago.
• ✓In a cat: repeated swallowing, drooling, refusing food; a thread under the tongue is not always visible because it hides beneath it.

Why sticks, bones and threads are more dangerous than they seem

A stick pressing against the palate squeezes the lining of the mouth, and within a few days a pressure sore — a painful ulcer — forms there. Once the stick is removed, the sore usually heals, but I recommend having it checked so that a fragment in the tissues or a damaged tooth is not missed.

A bone ring on the jaw acts like a tourniquet: it blocks the drainage of blood and lymph, so the tongue and the tissues around the jaw swell quickly. The longer the ring compresses the tissues, the higher the risk of damage, so don't wait until the morning.

A thread under a cat's tongue cannot be pulled out safely at home. If its end is already in the intestine, the gut bunches up along the thread like an accordion, and a taut thread can cut through the intestinal wall. This may need surgery, so a cat with a thread under its tongue should be taken to a clinic straight away.

Wood splinters often cannot be seen on standard X-rays. If your dog ran onto a stick and injured its mouth or throat, a small wound does not mean nothing has been left inside: a CT scan or other investigations may be needed.

When not to postpone an exam

• ✓You managed to remove the object, but your pet still paws at its face, licks its lips or drops food
• ✓After playing with sticks or gnawing a bone, bad breath or blood on toys has appeared
• ✓A wound, ulcer or swelling is visible on the palate, gums or under the tongue
• ✓Your pet chews on one side only or refuses hard food
• ✓After a bone, a tooth looks fractured, has darkened or has a piece missing
• ✓A few days after a stick injury, swelling under the jaw or on the neck, or pain on swallowing, has appeared

Urgent help needed

• ✓Difficulty breathing, noisy breathing, choking, or gums that have turned blue or pale
• ✓Your pet is gagging, trying to bring something up or cannot swallow — the object may be in the throat
• ✓In a cat: a thread under the tongue, thread or fishing line hanging from the mouth, or a visible needle
• ✓A bone ring has slipped over the lower jaw or canines, and the tongue is swelling or changing colour
• ✓The mouth won't close, there is heavy drooling or heavy bleeding from the mouth
• ✓Your dog ran onto a stick and injured its mouth or throat, even if the wound looks small
• ✓After swallowing a bone, thread or hook: vomiting, refusing food, lethargy or a painful belly

What you can do at home

• ✓Stay calm and talk to your pet quietly. Put a small pet in its carrier so that it doesn't injure itself trying to get rid of the object.
• ✓If your pet allows, lift the lip in good light or with a torch and see what is stuck and where: between the teeth, across the palate, under the tongue, around the jaw. Take a photo — it helps the vet to prepare.
• ✓Only remove an object yourself if it is lying loose at the front of the mouth and comes out with your fingers without effort. If it is wedged in, held firmly or your pet resists, don't try.
• ✓Don't feed your pet before the examination: removing the object will most likely require sedation or anaesthesia.
• ✓Call the nearest clinic that provides emergency care so they are ready for you, and bring what is left of the object — a piece of bone, the thread, the hook packaging.
• ✓If you removed the object yourself but minor signs persist, send a photo or video for an online consultation on Telegram: I'll tell you how urgently your pet needs to be seen, although a photo does not replace an examination.

What not to do at home

• —Don't pull the object out by force or wiggle it: a stick splinters and leaves fragments in the tissues, and a bone can fracture a tooth or tear the gums
• —Don't try to cut or saw through a bone ring on the jaw yourself: your pet will move, and you can injure the tongue, lips or jaw or fracture a tooth
• —Never pull a thread, fishing line or string hanging from the mouth or wrapped around the tongue: there may be a needle or hook on the end, and part of the thread may be in the intestine
• —Don't induce vomiting: sharp bone fragments, a needle or a hook can injure the throat and oesophagus
• —Don't put your fingers deep into the mouth or reach into the throat — your pet may bite, and the object may move further down
• —Don't give bread to “push the bone down”, and don't give human painkillers — many of them are toxic to dogs and cats

What diagnostics may be needed

• ✓First of all, an assessment of breathing and general condition, especially if your pet is gagging or has swelling
• ✓A full examination of the mouth under sedation or anaesthesia: the palate, the area under the tongue, the throat and the spaces between the teeth
• ✓Dental radiography of the teeth that took the load: cracks and root fractures cannot be seen with the naked eye
• ✓X-rays of the neck, chest or abdomen if your pet may have swallowed something — a needle, a hook, a bone fragment
• ✓A CT scan, ultrasound or endoscopy may be needed — for example, if a stick has injured the throat or a thread has been swallowed

A frightened pet in pain won't let you look into its mouth properly, and the most important things are often hidden: a pressure sore on the palate under the stick, a fragment in the tissues under the tongue, a cracked tooth or a thread running down into the throat. That is why the object is removed and the mouth examined under sedation or anaesthesia, when the work can be done carefully, without jerky movements, and the teeth are checked on dental X-rays.

How treatment may proceed

• ✓Careful removal of the object under sedation or anaesthesia, with pain relief
• ✓A bone ring on the jaw is cut with a special instrument while the tongue, lips and teeth are protected
• ✓Examination and care of wounds: removing fragments, flushing and, if needed, stitches
• ✓A pressure sore on the palate from a stick usually heals once the object is removed; I recommend a follow-up check
• ✓A fractured tooth: endodontic treatment, or extraction when clinically indicated, after dental radiography
• ✓Antibiotics are not given automatically, only when clinically indicated
• ✓Deep throat wounds or a swallowed thread or needle may need surgery by a general veterinary surgeon
• ✓While healing: soft food and a break from chew toys

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How to reduce the risk

• ✓Don't throw sticks for your dog: use rubber fetch toys of a suitable size instead.
• ✓Don't give marrow bone rings, long bones or cooked bones — they get stuck, splinter into sharp fragments and fracture teeth.
• ✓Choose chews that you can dent with a fingernail, large enough that they cannot be swallowed and without holes the jaw could slip through, and give them under supervision.
• ✓Keep threads with needles, tinsel, ribbons and hair ties out of reach, especially if you have a kitten.
• ✓Store fishing tackle where pets cannot get to it.
• ✓After summer walks in long grass, check your pet's face and, if it allows, its mouth.

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