| Cool Cases Case 1 |
Cool Cases
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Cool Cases
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Incisor teeth after removal
Signalment: "Rolo" is a 16 yr. old QH gelding which was initially presented for a
routine dentistry. This was a new horse for the owner, and the previous owner had not
noticed any abnormalities. The new owner believed that the horse may have a dental
issue based on his eating habits and reluctance to be bridled.
Physical Exam: This gelding was slightly underweight, although he appeared alert
and responsive. He was reluctant to permit oral examination. After sedation, it was
noted that there were multiple abnormalities with the upper incisors. The lateral
incisor was fractured, and deviated laterally - which means that the tooth was
protruding out the side of his mouth. The remaining incisors appeared intact, but were
slightly loose. When manipulated, small, pinpoint pockets of pus were evident just
above the gum line.
Treatment: Radiographs were obtained of the upper incisors. All incisor roots were
decayed. It was explained to the owner that even though he had incisors, he was
unable to use them to prehend (due to the pain), and therefore, it would be best to
extract them. Additional sedation was given, and local blocks used. All incisors were
removed with roots intact. The sockets were cleaned and flushed. Due to the bacteria
present, it was elected not to pack the sockets. The owner was asked to flush the
mouth twice daily with salted water and diluted chlorhexidine. The horse was also
placed on oral antibiotics for 10 days and phenylbutazone for 5 days.
Follow-Up: At 2 weeks, Rolo was doing remarkably well, and had gained weight. 2 of
the sockets had still not healed to my satisfaction. After sedation, the sockets were
cleaned and dried, and packed with an alginate product mixed with antibiotics. This
product is designed to stay in the socket for a period of 4 - 14 days, and will fall out on
his own. 1 month following this procedure, the packing was out, the sockets all
healed, and Rolo was looking better than ever! There were no more eating or bitting
problems.
routine dentistry. This was a new horse for the owner, and the previous owner had not
noticed any abnormalities. The new owner believed that the horse may have a dental
issue based on his eating habits and reluctance to be bridled.
Physical Exam: This gelding was slightly underweight, although he appeared alert
and responsive. He was reluctant to permit oral examination. After sedation, it was
noted that there were multiple abnormalities with the upper incisors. The lateral
incisor was fractured, and deviated laterally - which means that the tooth was
protruding out the side of his mouth. The remaining incisors appeared intact, but were
slightly loose. When manipulated, small, pinpoint pockets of pus were evident just
above the gum line.
Treatment: Radiographs were obtained of the upper incisors. All incisor roots were
decayed. It was explained to the owner that even though he had incisors, he was
unable to use them to prehend (due to the pain), and therefore, it would be best to
extract them. Additional sedation was given, and local blocks used. All incisors were
removed with roots intact. The sockets were cleaned and flushed. Due to the bacteria
present, it was elected not to pack the sockets. The owner was asked to flush the
mouth twice daily with salted water and diluted chlorhexidine. The horse was also
placed on oral antibiotics for 10 days and phenylbutazone for 5 days.
Follow-Up: At 2 weeks, Rolo was doing remarkably well, and had gained weight. 2 of
the sockets had still not healed to my satisfaction. After sedation, the sockets were
cleaned and dried, and packed with an alginate product mixed with antibiotics. This
product is designed to stay in the socket for a period of 4 - 14 days, and will fall out on
his own. 1 month following this procedure, the packing was out, the sockets all
healed, and Rolo was looking better than ever! There were no more eating or bitting
problems.
click on images to enlarge
| Cool Cases Case 3 |
Signalment: 'Belle' was a 5 yr old paint mare that sustained an injury to the left side of
the face. Swelling was the initial presentation. After 1 week, the area started to
abscess. It was lanced and filled with purulent exudate (pus). The area was treated
topically, and the horse put on antibiotics and bute. After the initial improvement, the
horse was left with a chronic draining tract that would clear up, and then come back 4 -
8 weeks later. The horse was referred to the University for exploration. The area was
agressively debrided (cleaned up) and the horse was sent home on antibiotics with a
good prognosis. However, 3 months later the draining tract returned.
Physical Exam: Belle was alert, in good flesh and eating well. However, she still had
a small draining tract on the left side of her face that was tender to the touch. It had a
foul odor that I believed was coming from her mouth. Oral exam was completely
normal, with no evidence of odor, discharge, loose teeth, etc.
Treatment: Skull radiographs were taken, with a metal pin inserted into the wound.
The draining tract was clearly associated with the root of 1, possibly 2 teeth. It was
determined that the best course of treatment would be to extract the tooth/teeth. Belle
was heavily sedated at my facility, with local blocks performed. Although difficult, the
affected teeth were extracted without complications. After extraction, when the tract was
flushed, the fluid came out of the socket. One of the roots were fractured, and the other
tooth was abscessed. The owner was asked to flush the wound daily, and keep Belle
on antibiotics for 10 days.
Follow Up: at 3 weeks, the wound was completely healed, and the owner reported that
the horse had a more relaxed, less painful look in her eye. 6 and 12 months later the
tract has not recurred, and routine dentistry to maintain the lower arcade showed
complete healing of the sockets as well as the facial wound.
the face. Swelling was the initial presentation. After 1 week, the area started to
abscess. It was lanced and filled with purulent exudate (pus). The area was treated
topically, and the horse put on antibiotics and bute. After the initial improvement, the
horse was left with a chronic draining tract that would clear up, and then come back 4 -
8 weeks later. The horse was referred to the University for exploration. The area was
agressively debrided (cleaned up) and the horse was sent home on antibiotics with a
good prognosis. However, 3 months later the draining tract returned.
Physical Exam: Belle was alert, in good flesh and eating well. However, she still had
a small draining tract on the left side of her face that was tender to the touch. It had a
foul odor that I believed was coming from her mouth. Oral exam was completely
normal, with no evidence of odor, discharge, loose teeth, etc.
Treatment: Skull radiographs were taken, with a metal pin inserted into the wound.
The draining tract was clearly associated with the root of 1, possibly 2 teeth. It was
determined that the best course of treatment would be to extract the tooth/teeth. Belle
was heavily sedated at my facility, with local blocks performed. Although difficult, the
affected teeth were extracted without complications. After extraction, when the tract was
flushed, the fluid came out of the socket. One of the roots were fractured, and the other
tooth was abscessed. The owner was asked to flush the wound daily, and keep Belle
on antibiotics for 10 days.
Follow Up: at 3 weeks, the wound was completely healed, and the owner reported that
the horse had a more relaxed, less painful look in her eye. 6 and 12 months later the
tract has not recurred, and routine dentistry to maintain the lower arcade showed
complete healing of the sockets as well as the facial wound.
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| Cool Cases Case 2 |
Signalment: 'Jake' was a 13 yr old Hunter Jumper. The owner reported that
recently, he had gotten dangerous, and would rear, and even flip over backwards
when riding. The trainer thought it was behavioral, and suggested selling the horse,
but the owner wanted to rule out other possiblities.
Physical Exam: Jake was well mannered on the ground, but when his poll was
examined, he was extremely painful on one side. Oral examination revealed a large
ridge.
Treatment: Reduction of the ridge, which was causing his jaw to be locked, and a
follow-up treatment by a chiropractor had Jake performing again within 2 weeks.
recently, he had gotten dangerous, and would rear, and even flip over backwards
when riding. The trainer thought it was behavioral, and suggested selling the horse,
but the owner wanted to rule out other possiblities.
Physical Exam: Jake was well mannered on the ground, but when his poll was
examined, he was extremely painful on one side. Oral examination revealed a large
ridge.
Treatment: Reduction of the ridge, which was causing his jaw to be locked, and a
follow-up treatment by a chiropractor had Jake performing again within 2 weeks.
Normal Poll
Molar Ridge/Step
Normal Poll
click on images to enlarge
Painful Poll