Mouth abscess

Also called soft tissue lump jaw

Description

Many cattle develop swellings/abscesses in soft tissue of the mouth, in the cheek area. These lumps are usually due to foxtail, cheat grass or some other sharp material in the feed that penetrates or lodges in the lining of the mouth and allows bacteria to enter and create an infection.

Abscesses in the soft tissue are common, and generally caused by a variety of bacteria including Actinobacillus, which is the same bacterium associated with wooden tongue.

Soft tissue abscesses may occur in cattle at any age, including baby calves, if they are chewing on coarse feed. By contrast, bony lumps don’t appear until later in life—in 2-year-olds or older. One way to tell the difference is whether the lump is moveable in the soft tissue or firmly attached to the bone. Once you’ve felt the difference between the two types of lumps, they are easy to differentiate.  

The bony lump is very hard and immobile—enlargement of the bone itself—whereas the soft tissue abscess can be moved around under the skin.

Signs
     
    Lump in the cheek area of the mouth on the side of the face

Causes

Many types of feed can cause abrasions and damage to the gums or cheek tissues.  Any kind of coarse feed could cause injury, and seed heads with sharp awns may poke into the mouth tissues and become embedded. In some part of the country cattle are fed a lot of cornstalks and beanstalks, and these may contain a lot of fibrous, tough material that could puncture the inner parts of the mouth.

Prevention

There’s not a lot you can do to prevent soft tissue abscesses in the mouth that show up as lumps on the outside of the face, except avoid weedy hay that contains sharp material like cheat grass seeds or foxtail awns.  

Treatment

If you know it’s an abscess, it can be opened to drain and flush out. These will usually heal with just one flushing treatment

Systemic antibiotics are generally not needed because it’s a local infection, and doesn’t have much contact with the bloodstream.  Systemic antibiotics circulating around the body in the blood don’t get to the abscess.  

The basic treatment is to open the abscess and establish drainage. There may be some scarring--accumulation of granulation tissue and a residual small bump--but most cases clear up completely. Sometimes the abscess will break and drain on its own, but it will heal faster if you can lance and flush it out.  

You need to wait until the infection comes to a head (with a pocket of pus) before you can do any good by lancing it. Often when you palpate those (feel the lump with your fingers) you can tell they have a softer center and you know there’s pus there. This center can be lanced and drained. First, however, you can check to see if there is pus in the lump before you try to slice it open.

Restrain the animal in a head-gate and tie the head to the side so it can’t move around. Poke a large-diameter hypodermic needle into the soft center of the lump. If pus comes out of it, or there is pus on the tip when you withdraw it, the lump is ready to lance.

Make sure the animal is well restrained while you are trying to lance the abscess. If the lump is low on the jaw or near the throat area, be very careful to not slice into vital structures like the jugular vein or carotid artery. If you haven’t done this before and are not comfortable doing it yourself, have your veterinarian do it.

The incision should be made at the lower edge of the soft area, for best drainage, making a vertical slit, which is less likely to cut blood vessels than with a horizontal slice. Make the slit long enough that it will stay open for drainage.  

The abscess will need to drain for several days; you don’t want it sealing over and getting big again. Be fairly aggressive in how much you open it, or it will close up and you’ll have to do it again in a few days. This might be one reason to have your vet do it if you are inexperienced. Some people are too cautious and don’t open it enough for adequate drainage and it doesn’t stay open.

Some abscesses can become quite large, with a lot of pressure from the buildup of pus. A great deal of pus may squirt out when you lance them. After draining out the pus that comes readily, flush out the rest with a large syringe, using a dilute solution of betadine—mixing it with warm water and squirting it into the opening. Keep squirting more in and letting it come back out, until no more pus comes with it. This will flush most of the bacteria out of there, and allow it to heal.

The infected area must heal from the inside out, so it needs to stay open for drainage of any remaining pus before it seals over again. If it seals over too quickly, retaining infective material, the area will swell up again with another abscess and will need to be opened and drained again.

If there is any question about whether you got all the infected material out of the abscess or whether the incision will stay open for adequate drainage, you can insert a betadine-soaked strip of gauze into the opening, with some of it hanging out. This will keep the slit from sealing over again right away, and the gauze acts as a wick to help any remaining fluid/pus keep draining out. This wick will eventually come out on its own as the wound heals, or can be removed a few days later.