Second opinion on xrays

RE: Second opinion on xrays

Kate Richardson — Sat, 30 Nov 2019 16:43:11 GMT

[quote user="Evelyn Barbour-Hill"]Considerable loss of bone height on most teeth, especially the lower mandibular cheek teeth. Doesn't usually seem to result in pain. What are the gingivae like adjacent to, say, 308 and 408?[/quote]

Mild gingivitis but normal sulcus depth.

[quote user="Evelyn Barbour-Hill"]Otitis media may well manifest as apparent oral pain.A middle ear flush is indicated as both investigation and treatment.[/quote]

That's what I was thinking and might also cause nausea. Middle ear flush is the plan. I guess we could CT them, but it probably won't change. I've put him on antibiotics in the mean time, I get a bit nervous about interfering with the middle ear, especially as he has no ataxia currently.

Thank you

RE: Second opinion on xrays

Evelyn Barbour-Hill — Thu, 28 Nov 2019 18:23:45 GMT

I don't see anything which would account for pain.

Considerable loss of bone height on most teeth, especially the lower mandibular cheek teeth. Doesn't usually seem to result in pain. What are the gingivae like adjacent to, say, 308 and 408?

Upper canines are super-erupted.

Possible fragment of 309 is well buried in bone.

I don't think enamel is thinned on lower canines. Grooves are normal.

There is a tad of resorption at the apical end of 304 but even if it were greater it would not be painful.

I don't think the apparent lucencies represent early resorption, but even if they did, early resorption does not cause sensitivity or pain.

If one tympanic bulla is obscured, that's something that needs addressing. Otitis media may well manifest as apparent oral pain.A middle ear flush is indicated as both investigation and treatment.

RE: Second opinion on xrays

Kate Richardson — Thu, 28 Nov 2019 16:11:07 GMT

[quote user="Rob Davis"]You may not have realised but the patient name appears at the top of my screen when I click on the image.....[/quote]

No I didn't realise, but I do have permission to share the images. But I will be aware of that when posting images saved onto a file- not sure how to avoid it though other than taking a photo which never comes out as well?

[quote user="Rob Davis"]The only thing I can see is a possible remant of the mesial root of 309. It may be a complete red herring, but could potentially be a cause of oral pain.[/quote]

That was present on xrays 18m ago and hasn't changed, there is no inflammation associated with it. I don't think the teeth are the issue in this case, just wanted to be as sure as possible.

Owner also mentioned some ear irritation and asked me to check ears (typically at the point where we had extubated him....) and found both TMs were ruptured, so I xrayed his bullae and the Right bullae is more radiodense, no wall changes, so am wondering if he has otitis media (as has been tested for just about everything elsoe so far...) although has no ataxia/balance issues currently

RE: Second opinion on xrays

Rob Davis — Thu, 28 Nov 2019 15:52:43 GMT

You may not have realised but the patient name appears at the top of my screen when I click on the image.....

I don't think there is any visible resorption on the teeth you mentioned, though the mesial roots of both upper 08s are overlying one another so difficult to assess well. I suspect they are fine, but another view angled either caudally or rostrally should separate the root (SLOB rule to distinguish - Same Lingual Opposite Buccal).

The only thing I can see is a possible remant of the mesial root of 309. It may be a complete red herring, but could potentially be a cause of oral pain.

I think the canines look normal, and they often have deep grooves on the buccal aspects of the crown which I would consider normal.

Interested to hear other opinions....

RE: Second opinion on xrays

Kate Richardson — Thu, 28 Nov 2019 14:50:04 GMT

7yo MN British shorthair, been seen at main hospital past 2-3 weeks for inappetance, poss pancreatitis, but pli normal, asked me to examine teeth as Os thought he might have dental pain. Has had resorptive lesions in past. None evident on probing, no pockets and nothing obvious on xrays that I can see although poss some subtle lucencies within some teeth (107,108, 408) (which may be artefact?)- just doesnt look like typical resorption, but could it be early resorption and thus the teeth are sensitive? Does seem to be some enamel thinning on the lower canines and both have a longitudinal groove down the lateral aspect.

Or am I missing something glaringly obvious?

RE: Second opinion on xrays

Kate Richardson — Thu, 28 Nov 2019 14:39:45 GMT