Rachel Perry's Activities

Necrotic lesions in mouth.

Charlotte Marshall — Mon, 20 Apr 2026 07:08:46 GMT

I have a client with a French Bulldog. Unfortunately he is typical in that we cannot examine his mouth conscious. 6 weeks ago my colleague knocked him out to investigate pain and smell from the mouth She found a necrotic lesion on the right maxilla and had to remove 104,105 and 106 she thought he had had a foreign body which had caused secondary changes. She checked the rest of the mouth at the time and found no other lesions.

He appeared to make a full recovery 4 - 5 weeks later the owner noticed a smell again. I knocked him out 6 weeks from the original sedation to discover 2 new necrotic lesions one on the left maxilla and one on the left mandible. I had to remove 206,207 and 208 and 306 and 307. The lesion on the mandible was particularly bad with necrotic bone with loose spicules of bone. The original lesion had healed completely.

Any ideas why the dog has had these repeated lesions which developed very fast?

VICE

Arlo Guthrie — Wed, 18 Mar 2026 10:19:29 GMT

As I am sitting here buried under the hood building all sorts of new things into VetSurgeon and VetNurse, I have been giving some (more) thought to the purpose of these forums.

It's not 'somewhere other than Facebook or Linkedin' because that battle is lost.

But actually, the one thing I still believe passionately, is that VetSurgeon offers a far superior platform for scientific discussion.

Provenance of author
Long form responses allow for nuance
Easy to refer back to (ie creates a knowledgebase)
No algorithm manipulating what you will see, so less of an echo chamber.

These are all things which really are better than other platforms.

I've joked recently about the profession needing an equivalent of NICE for assessing the cost-benefit equation of, well, everything, objectively.

And as I was walking in the hills this morning, I thought perhaps that's it. VICE. We could just have regular discussions about any aspect of clinical care or equipment, analyse the cost-benefit equation, and then summarise. Possibly then drop the summary into a new knowledge base, but we can get to that later.

Whaddyathink?

Anyone up for giving this a trial run? I'm minded to start with something dental, or something orthopody. Maybe dental radiography, the discussion started the other day would be a good starting point.

I am thinking it could run as follows: Topic opens with a summary of available evidence today. Follow by discussion introducing any other evidence. Challenging existing evidence. Getting some data on cost. Then finally concluding with some kind of rating, based on the cost/benefit analysis. Or perhaps better than a star rating system, a standardised cost per annum figure. I'm thinking: cost of procedure amortised over extended lifespan (or cost of procedure over extended qol).

How the law doesn't protect pets against over-treatment

Arlo Guthrie — Mon, 05 Jan 2026 16:29:24 GMT

In this film, I talked to Peter Fordyce MRCVS about what the law says about our responsibilities towards animals, and some of the human factors which can cause owners and vets to overtreat our animals, sometimes at the cost of their welfare, in spite of the law.

Veterinary Controversies and Ethical Dilemmas is available to buy here: https://amzn.to/3X2I76z

What do you think are the most common veterinary myths?

Arlo Guthrie — Wed, 19 Mar 2025 15:20:46 GMT

I'm thinking about topics to cover in films, beyond the causes behind the rising costs of veterinary care.

One idea floating about is to put the record straight concerning the more common myths which surround medications, other treatments or surgery.

Especially ones which come packaged with: "but the breeder told me, so it must be true!"

What do you think would be helpful films to make. Ones you could direct an owner to, to back up what you are telling them?

(Someone on vetnurse suggested 'lepto isn't safe' / 'only need to give it for one year')

Back problems from doing dentals and surgery

Stigen — Thu, 16 Jan 2025 07:41:36 GMT

hi, I had a dental yesterday that involved 30+ extractions. After a few hours of bending over a tiny dog, combined with much stress I got a kink in the back. I have had prolapse a few years ago, but still able to be a clinician. Now I am unmovable, and really stiff.

Anyone have some suggestions of ergonomics and excercises for back strengthening. I wanna keep doing my job, but every day are surgeries on tiny animals that require me to bend in all sorts of positions. I have signed up to a yoga centre, but not started yet.

Does anyone use a mechanical device for sharpening their dental instruments?

Beats — Mon, 03 Jun 2024 10:49:07 GMT

Does anyone use a mechanical device for sharpening their dental instruments?

I was looking at this and wondered if anyone had any opinions to share:

LM-RondoPlus sharpening machine - LM-Dental

I watched a video from someone a few years ago sharpening their dental instruments on a mechanical device and then showing them easily slicing through paper and I thought that looks like a way I could finally train folks to sharpen dental instruments that when they are lifted they are already sharp reliably.

What do you do with split hard palate after trauma in cat?

Beats — Fri, 03 May 2024 12:30:14 GMT

I'm thinking of an RTA with presumed maxillary fractures and a midline split hard palate.

Options appear to include:

1) Primary suture apposition

2) Lateral incisions and undermining of hard palate and then primary suture apposition

3) Wire (in some form) from 108 to 208 tightened enough to close gap

4) other materials from 108 to 208 holding together to close gap

5) encircling around maxilla with 40lb nylon leader line

I have done options (2) and (3) before, most recently doing option (2) on Sunday alongside an esophagostomy tube, and has done well (although did take until today to eat voluntarily, possibly mostly due to anosmia?). However I'm conscious that is more oral trauma than option (1), is more effort than option (1), and if option (1) is similarly reliable then perhaps I should try that next time instead. I used 5-0 monocryl plus simple continuous.

Many thanks!

Root fragment in mandibular canal

Stigen — Tue, 21 May 2024 14:58:03 GMT

I had a difficult dental today. I saw some leftover roots on an xray, buit the gum line was already overgrown the area, so maybe an old fractured tooth. The root fragments were quite tough to get out, one of them seems to be ankylosed at the bottom. I ended up punching through into the mandibular canal, and a very small fragment went in, and shiftet position. The canal was too narrow for me to reach with my instruments, and dog had been to long in anasthetic, so just had to close it up.
Would you reccommend to do further surgeries to try to recover this small piece, or just monitor by occasional xrays and based on clinical picture?

Should these carnassials be extracted or are there any other options please?

Aly Malcolm — Tue, 14 May 2024 14:16:19 GMT

1 yr old male cat mandible seems too narrow for mouth and carnassials are impinging and causing ulcers bilaterally lower gum, should these be extracted or are there any other options please? When the mouth is shut the carnassials fit in these ulceration holes

Which prophylactic antibiotics do you use for orthopaedic surgeries?

Holly Lee — Mon, 12 Feb 2024 23:52:22 GMT

Hi,

I just wanted to canvas opinion from vets doing orthopaedic procedures e.g. fracture repairs, cruciate surgeries, patellar surgeries (with or without orthopaedic implants) as to what prophylactic antibiotic (pre- and post- surgery) you use and what led you to that choice.

I am auditing my practices use of 'critically important' antibiotics and trying to review some of those uses. Specifically in this case looking into the justification of 3rd generation cephalosporins as prophylactic courses in orthopaedic surgery.

Obviously I will do literature searching as well but wanted to see what the general approaches tend to be and where the decisions originate from.

Thanks in advance, Holly

What are your favourite dental suture materials?

Kate Richardson — Wed, 07 Jun 2023 14:19:23 GMT

What are your favourites please (for cats and dogs)

WHAT WOULD YOU DO: Cat over grooming ventral abdomen?

Arlo Guthrie — Thu, 07 Dec 2023 09:46:41 GMT

This is the first of what I plan will be regular opportunities to discuss what you would recommend in a variety of different clinical scenarios.

Our aim here is to focus on value. ie which tests and diagnostics will give the owner / animal the best value.

The rules for these discussions are here: https://www.vetsurgeon.org/f/clinical-questions/30841/what-would-you-do-discussions-rules-and-objectives

And with no further ado, our first question posed by Gillian Mostyn (Thanks Gillian)

What would you do for a 4 year old cat which is over-grooming its ventral abdomen.

What’s happened to 304?

Neil Wheadon — Sat, 06 Jan 2024 17:13:47 GMT

8 month old dog

Clinically well, imported from Mexico

Also on 404

What to do?

Neil

PS I think I know what caused it

Could I have some dental xray machine recommendations please?

Joyce Whitehead — Tue, 28 Nov 2023 18:51:43 GMT

As a practice that currently does not have dental radiography we are considering investing. So could I have top tips and recommendations Please? We would prefer a stand mounted head that can be moved away for storage and space purposes. DR presumably best (our current xray system is DR). In addition do practices generally charge per image, or whole mouth? Is it included in your standard quotes or as an add on? Obviously we have to work on a price that makes it useable but with some return on investment.

All advice welcome!

How useful is dental polishing after descaling?

phil barr — Tue, 12 Sep 2023 14:57:25 GMT

Hi all,

The prompt about posting to this thread today came at a good time as we were having a discussion regarding the benefits or otherwise of polishing post dental descaling. Can I ask for opinions on the usefulness of this procedure - many of our vets apparently do not polish at all & believe it is unnecessary.

Thanks in advance,

Phil