Guinea pig incisor extraction

Re: Guinea pig incisor extraction

Evelyn Barbour-Hill — Wed, 29 Aug 2012 00:45:28 GMT

[quote user="Glenn Hodgson"]

I have not heard of the term "natural slough" before! Shedding/moulting? His pinnae edges look more like those of a calf suffering from septicemia > going necrotic round the edges and causing me to think that the entire pinnae may slough at some point in the not so distant future.

[/quote]

No, what I meant was is there an obvious dividing line where the necrotic bit is going to slough leaving the healthy tissue behind? It would seem not!

Will the Mostyns comment I wonder?

Looking at the radiographs again I think that what I thought was a misplaced third maxillary tooth may actually be the oral half of a broken third mandibular tooth. This would agree better with the open-mouth Xray appearance and your visual findings. Doesn't make any difference to the plan of treatment.

Don't cook dem teeth, a mouthful of dead teeth is a big problem.

Re: Guinea pig incisor extraction

Glenn Hodgson — Tue, 28 Aug 2012 23:09:45 GMT

Thanks both for the input.

Mark,

a handy way of measuring molar length over eyeballing/judgement, also good to show owners. I'll certainly use in the future. No nasal discharge at all and chest NAD. Re masticatory mm. atrophy, he had plenty of it. After "radical but gentle "" src="http://www.vetsurgeon.org/emoticons/v2/tongue-in-cheek.gif" /> burring with my motorised burr this guy could not close his mouth for 5 days, he is thankfully now chewing quite well. Would have considered a chin sling but his owners happily massages and nursed him through this , we get some REALLY dedicated Guinea Pig owners.

Evelyn,

All images are pre-op. I agree, the open mouth view looks deceiving.

The Molars looked remarkably normal on oral examination (other than being very long) given the radiographic findings. He'll be in early next week for further work as lower lingual spurs recurring, I'll re-evaluate the teeth you mentioned.

No signs re. middle ear disease I am please to say, I agree with your point though. I am more accustomed to canine bullae.

Both

Good to have input! I'll keep working away with him and hopefully update thread in coming weeks.

Re: Guinea pig incisor extraction

Evelyn Barbour-Hill — Tue, 28 Aug 2012 21:09:11 GMT

I can't agree about repeated aggressive burring.

Repeated proper oral examination and repeated dental correction/reshaping as necessary, yes.

(Also, while I'm here : I really don't think one should just refer to "burring the teeth" as if it were a single standard procedure. Dental shortening, reshaping, correction, as necessary, achieved by motor-driven burs, or hand instruments, or both.

And I think we have spoken of my dislike of the term "aggressive" before. Yes, I know it has a sort of specialised medical meaning, but "burring" should never be aggressive, even if the final result aimed for can be described as radical. Overheat the teeth or enter the pulp and the patient is in bigger trouble than before)

Re: Guinea pig incisor extraction

Evelyn Barbour-Hill — Tue, 28 Aug 2012 20:52:39 GMT

The radiographs are a bit dark for my taste, but:

Am I right in thinking that your fourth radiograph is post-op and the rest are pre-op?

Well, there are changes around the deep ends of all the teeth, which is hardly surprising, but they are not as severe as they might have been. The significant thing to me is what I presume is the third cheek tooth in the left maxilla, which is for whatever reason appears very short (maybe foreshortened) and diagonally displaced and gives the impression of being extruded (so I imagine it looked like an over-long tooth when you examined the mouth). The opposing mandibular tooth is worn pretty short, so I would guess that the maxillary tooth is wedged pretty firmly in its present position. The tooth distal to it, surely also left, appears elongated in the deep direction, and is either fractured transversely or surmounted at the oral end by a mass of calcified density. I would guess that the displaced tooth is blocking this one and causing all sorts of further deformation. Were you able to make any of this out on examination?

You have done a great job so far, I reckon. Quite probably he's all set to continue improving. I would not advise further major interferences to try to achieve some sort of perfect dental correction. If he's eating well and comfortable and there are no abscesses, be satisfied, and keep inspecting the mouth at intervals, maybe doing a little bit more correction. There might be trouble from the deep end of that fourth left maxillary, in which case you would have to try and break up the logjam by extracting the displaced tooth. But if the pig's eating and healthy, that's all you want.

The bony tympanic bullae look pretty thickened. Is there any sign of middle ear disease?

I've no idea about the ear tip necrosis. Any sign of a natural slough approaching?

Re: Guinea pig incisor extraction

Mark Rowland — Tue, 28 Aug 2012 20:01:35 GMT

Hi Glen,

This piggie has severe molar pathology.

Root elongation essentially forces the mouth open. A general rule of thumb is to draw 2 lines, one along the line of the mandible, the other along the line of the dorsal skull. Extending these lines rostrally should result in parallel or converging lines rostrally. As you can see (yellow arrows) these lines are strongly divergent. What this means is that the mouth is being forced open and saliva is falling out of the mouth. It will also result in incisor elongation. With time atrophy of masticatory muscles occurs increasing the dysphagia.

Also 1 root is extending into the nasal sinuses (red arrow) (are there any respiratory signs?). This is very common in degus also.

Agressive repeated burring, pain relief and syringe feeding will be required in this case. Bloods will also give an idea of metabolic profile.

Goodluck

Re: Guinea pig incisor extraction

Glenn Hodgson — Tue, 28 Aug 2012 19:36:29 GMT

Good evening. The other guinea pig is doing fine with three incisors.

I am looking for some interp. re the following radiographs if anyone is keen?

This pig presented to me recently as a second opinion with terrible molar pathology and a condition score of 2/10. His mouth was dramatically wedged open by his vastly overgrown molars and he now suffers from molar hair/food entrapment and buccal infections. In addition to this he presented with ear tip necrosis, moderate symetrical dermatitis, ventral alopecia , a 1cm abcess next to his penis and saliva scald on his chin....

We have burred his molars, under GA, and he is on flagyl, septrin, oral daktarin, probiotics, meloxicam and some ivermectin.

He has perked up considerably, is now eating for the first time in 4 months (pulp and hard vegetables but not hay) and has gained 40g over 3 weeks.

His skin has generally improved but his ear tip necrosis has deteriorated.

Blood work is arranged during his next dental.

I would appreciate any input regarding prognosis/progression.

Kind regards

Re: Guinea pig incisor extraction

Glenn Hodgson — Mon, 16 Jul 2012 17:24:24 GMT

Thank you all for the prompt replies!

Mark, I would love a radiograph, worth its weight in a case like this. There may be one to follow in the coming months once funds are available.

Kind Regards

Glenn Hodgson

Re: Guinea pig incisor extraction

Mark Rowland — Mon, 16 Jul 2012 15:45:16 GMT

As above but all I would add is that there is probably some stock in trying to convince them to get a head X-ray done (post it here if you wish) as this will help establish prognosis wrt on going infection or molar pathology. Goodluck

Re: Guinea pig incisor extraction

Ian Mostyn — Mon, 16 Jul 2012 15:35:10 GMT

Often with just one missing, the remaining incisor will do a good job of wearing down the opposite teeth but like Evelyn said, you may need to trim the teeth from time to time. there is also a fair chance it will regrow, depending on how much damage was done to the growing bud when the tooth was extracted. Most of a G-Pigs eating / chewing is done by the molars anyway and it shouldn't affect it too much if it is on a decent diet to start with.

Ian

Re: Guinea pig incisor extraction

Evelyn Barbour-Hill — Mon, 16 Jul 2012 13:46:46 GMT

Should do fine on guinea pig food.

You will need to trim the opposing tooth from time to time.