A subglossal impaction was diagnosed in an American toad (Anaxyrus [Bufo] americanus), which presented because of a change in vocalizations. The obstruction was determined to be an impaction of ingested epidermal shed. Differential diagnoses for this clinical presentation include upper respiratory infection, nutritional secondary hyperparathyroidism, vitamin A deficiency, trauma to the oral cavity, or environmental changes. This case demonstrates a potential problem that can be associated with the normal behavior of keratophagy.