HELP needed, dog with persistently discharging sinus tract face!

RE: HELP needed, dog with persistently discharging sinus tract face!

Rob Davis — Fri, 12 Oct 2018 18:37:00 GMT

[quote user="David Mills"]If you got a ct then what? Unlikely to be treatable surgically. Odd recommendation really. [/quote]

Why not treatable surgically? Odd comment...

RE: HELP needed, dog with persistently discharging sinus tract face!

Anthony Todd — Fri, 12 Oct 2018 10:35:04 GMT

[quote user="Julie Innes"] Nurses swear blind they have been oiling it...[/quote]

Been there many times! Have you taken the head apart and checked free movement of the gears? These are high speed low torgue drills so the handpiece will seize easily. Really need oiling after auroclaving as we found the oil didn't seem to stay on the shaft after autoclaving.

There used to be/is a firm called Kent Dental something who had all the bits and e-Bay has replacements too, at unbelievable prices, making the heads etc. almost disposable.

But I'm a dinovet and you can't transpose human dental equipment across species...

Search this on e-Bay

Dental Marathon Electric Micromotor N3 Straight Contra Angle Handpiece Pink UK-D

RE: HELP needed, dog with persistently discharging sinus tract face!

Julie Innes — Fri, 12 Oct 2018 08:39:24 GMT

[quote user="Martin Atkinson"]We had this issue recently. Depends on what system you have, ours is electric not air driven and there is a little rocker switch on the control unit that changes from forward to reverse drive and is neutral (i.e. off) in the middle position. This is normally never changed, it is always in forward drive but it must have got flicked to neutral unknowingly. Fortunately a nurse had the sense to realise this before there was too much swearing and sending the unit off for repair! Any chance you have a similar problem?[/quote]

Afraid not. Ours is an air system (we previously had a system like yours, so I know what switch you are talking about!) Nurses swear blind they have been oiling it...

RE: HELP needed, dog with persistently discharging sinus tract face!

Julie Innes — Fri, 12 Oct 2018 08:37:36 GMT

Thanks all! We xrayed with the catheter in the tract, no obvious FB or abscess. I did consider salivary gland, Michael, as I've had one of them before, but the discharge definitely isn't saliva. As I said, we ended up removing the 2 teeth just in case and flushing copiously, back onto antibiotics for a more prolonged course (as you suggested, David), although we have given him a couple of months of antibiotics previously (after swabbing) and still it came back... We swabbed again yesterday too. Not really sure what else we can do!

As luck would (not!) have it, he is a bitey sharky little shih Tzu, so you can't get near him to even clean the area without sedation. We clip it up and clean it, as the discharge gathers and hardens on the skin (O's can't clean either!) but obviously would be nice if we could bathe it daily..

RE: HELP needed, dog with persistently discharging sinus tract face!

David Mills — Fri, 12 Oct 2018 02:05:12 GMT

Does grass grow in Scotland beyond June?!

Even so. Many inhaled fbs (more serious) now treated with prolonged abx than bumbling around with an endoscope or surgery.

Just treat 2-3months abx. If you got a ct then what? Unlikely to be treatable surgically. Odd recommendation really.

RE: HELP needed, dog with persistently discharging sinus tract face!

Charlotte Marshall — Thu, 11 Oct 2018 23:37:02 GMT

I agree, last time I saw something similar it was a grass seed.

RE: HELP needed, dog with persistently discharging sinus tract face!

Rob Loxley — Thu, 11 Oct 2018 18:31:13 GMT

I've seen a number of grass seeds round the eye, with variously, temporal swelling/abscess, retrobulbar swelling and various discharging sinus tracts. Further imaging (CT) would sound reasonable

RE: HELP needed, dog with persistently discharging sinus tract face!

Michael Woodhouse — Thu, 11 Oct 2018 17:31:08 GMT

What's the discharge like? Parotid duct involvement?

RE: HELP needed, dog with persistently discharging sinus tract face!

Rob Davis — Thu, 11 Oct 2018 16:38:24 GMT

[quote user="Julie Innes"]Sigh. Somewhat typically, the injectable contrast medium- having not been used in who knows how long- has taken umbrage and apparently wandered off to seek a new life elsewhere, so bang goes that idea! [/quote]

If you don't have any suitable contrast medium, you could try gently inserting something solid, blunt-ended and radio-opaque into the sinus tract before radiographing. Gutta percha points work well, though appreciate most will not have these, but a periodontal probe or similar can be used.

RE: HELP needed, dog with persistently discharging sinus tract face!

Anthony Todd — Thu, 11 Oct 2018 15:49:41 GMT

Recent thread suggests the surprisingly radio-opaque nylon tights would be a less messy more available substitute?

Probably the cut-off leg from the previous thread is still available??

RE: HELP needed, dog with persistently discharging sinus tract face!

Martin Atkinson — Thu, 11 Oct 2018 14:09:49 GMT

[quote user="Julie Innes"]Of course, today was also the day the dental drill decided it too had had enough and won't turn [/quote]We had this issue recently. Depends on what system you have, ours is electric not air driven and there is a little rocker switch on the control unit that changes from forward to reverse drive and is neutral (i.e. off) in the middle position. This is normally never changed, it is always in forward drive but it must have got flicked to neutral unknowingly. Fortunately a nurse had the sense to realise this before there was too much swearing and sending the unit off for repair! Any chance you have a similar problem?

RE: HELP needed, dog with persistently discharging sinus tract face!

Evelyn Barbour-Hill — Thu, 11 Oct 2018 12:42:21 GMT

CT should be informative.

Other ideas, which I'm sure you've thought of: foreign body? Small bony sequestrum? Small tooth root remnant?

Get some more Omnipaque and do it again?

[quote user="Julie Innes"] Of course, today was also the day the dental drill decided it too had had enough and won't turn [/quote]

Who forgot to oil the turbine, then?

RE: HELP needed, dog with persistently discharging sinus tract face!

Julie Innes — Thu, 11 Oct 2018 12:26:13 GMT

Sigh. Somewhat typically, the injectable contrast medium- having not been used in who knows how long- has taken umbrage and apparently wandered off to seek a new life elsewhere, so bang goes that idea!

Wasn't keen on putting barium into a sinus just in case.

Rads really weren't a whole lot of use. We catheterised the sinus tract, seemed to come to a blind end in the maxilla. Colleague removed the back 2 molars as a precaution (one came out pretty easily, other not easily, but roots intact. Of course, today was also the day the dental drill decided it too had had enough and won't turn

If this doesn't settle now, I think I will be referring the dog for CT.

Is it too early for drink??

RE: HELP needed, dog with persistently discharging sinus tract face!

Julie Innes — Thu, 11 Oct 2018 10:43:41 GMT

Thanks, beats, funnily enough I thought of that after I posted, but wasn't sure! It's actually my colleague's case, but I'm going to see how she is getting on with him just now! Will keep you posted

RE: HELP needed, dog with persistently discharging sinus tract face!

Beats — Thu, 11 Oct 2018 10:33:50 GMT

probably of no help, but could you put a catheter in sinus tract and put a little omnipaque or equivalent iodine contrast in after you take your plain xrays to see where it's going?