Unusual dental presentations: A case review (Proceedings)

Case # 1

CASE SUMMARY: "Diamond" is a 12-year-old female spayed Dalmatian that was presented for swelling under the left eye for a two-week duration. The RDVM thought there was involvement of the upper 4th pre-molar and possible the first molar. The patient was placed on Baytril but then was switched to clavamox after they were referred to the Dentistry service for dental radiographs and treatment. The patient is also on synovi chews and previcox for osteoarthritis and proin for urinary incontinence.

Diamond's physical exam was within normal limits and her awake oral exam revealed moderate dental tarter on all her teeth and a small red nodular tissue was present above the left 4th pre-molar.

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Case #2

CASE SUMMARY: Banjo is a 5 year old male intact German Shepherd Dog who presented to the small animal dentistry service for a 3 month history of non-healing tooth extraction sites. Banjo was originally seen by his RDVM in October for suspected bilateral carnasial tooth abscesses. At that time both of Banjo's maxillary carnasial teeth were extracted and the sockets were packed with blood-stop hemostatic gauze. Banjo presented a month later to his RDVM for swelling in the area of the extractions. Banjo was anesthetized and both sockets were found to contain purulent material, hair, and other debris. Both sockets were flushed and oral clindamycin was also prescribed. The swelling reoccurred once the antibiotics were finished and Banjo was anesthetized by his RDVM whom flushed the pockets, applied Doxirobe and Consil putty to both sockets. Oral clindamycin was again prescribed. CURRENT HISTORY: About one year prior to his dental problems Banjo had an incident where a bone had become wedged between the upper carnassial teeth and the teeth had to be removed by his RDVM. Banjo has had no previous medical illnesses or surgeries. Banjo is up to date on vaccinations and currently receives a monthly flea and tick prevention. PHYSICAL EXAM FINDINGS: T- 101.8 P - 96 R - pant MM - pink CRT - <2s BCS - 5/9 EENT - 3cm swelling under left eye. Unable to palpate the swelling due to pain. Unable to adequately assess oral cavity due to patient resistance. Eyes clear and bright OU. Ears clean and free of debris AU PLN - no peripheral lymphomegaly present on palpation CVR - no murmurs ausclutated. Pulses strong and synchronous. Lung sounds clear bilaterally ABD - non-painful, no masses or organomegaly on palpation. Derm - no gross abnormalities Neuro - no abnormal findings MS - no abnormal findings UG - no gross abnormalities. Intact. PAIN SCORE: 1-2 CURRENT WEIGHT: 38kg

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Case #3

CASE SUMMARY: Presenting Complaint: Oronasal Fistula Current History: Pez is a 3 year old male castrated mixed breed dog who was rescued from the Pittsboro shelter approximately 2 weeks ago. He is currently in foster care with Animal Rescue. He was found with the fistula, which is suspected to be from a trauma in the past. He occasionally coughs, especially after eating or playing. Physical Examination Findings: Some coughing while walking around exam room. Sutures caudal tissue overlying penis, neuter surgery was performed one week ago. 1.5 cm X 2 cm oronasal fistula. Severe halitosis. Right canine tooth missing. Angulation/deformation of rostral maxilla. Current Weight: 9.2 kg

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Case #4

CASE SUMMARY: Routine Dental Cleaning Current History: Macy is a 9yr old female spayed mixed breed who presented to the Dentistry Service on 11/18/09 for a routine dental cleaning. Macy has never had a dental cleaning before and presents today with moderate dental calculus, discoloration of her lower left canine and mild halitosis. Macy is an indoor dog who is let out into a fenced in yard. Six months out of the year she lives with another dog. Her diet consists of Science Diet Senior dry 1.5 cups BID. She is not receiving any medication or supplements. She is up to date on her vaccinations (wellness visit 5/09 - did CBC/Chem/HW), she occasionally receives Frontline and Heartguard. Macy was adopted as a rescue when she was 8 months old and has no prior medical history. Physical Examination Findings: T 101.4F P 120bpm R pant MM pink CRT <2sec Wt: 28.5kg Hydration: adequate Attitude: BAR BCS: 7/9 EENTO: OU clear with lenticular sclerosis, AU clear of debris, no nasal discharge, throat palpation within normal limits, moderate dental calculus and mild halitosis PLN: left popliteal lymph node moderately enlarged CVR: strong synchronous pulses, no arrhythmias or murmurs, lung fields clear bilaterally MSI: ambulatory x4, well muscled bilaterally, hair coat smooth, no lameness noted; 3x4cm area of traumatic alopecia on dorsoproximal tail UG/GI: tense non-painful abdomen, no organomegaly or masses palpated, no masses palpated in mammary chains.

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