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Tooth Abscess
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JTB
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 Posted: Sun Dec 16th, 2018 07:10 am
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The horse dentist/vet came and checked out Little's teeth and lump. At present the lump is not worrying her so it was decided to let it all be, he floated her teeth as she had some sharp bits to take care of. All looked good in her mouth with nothing looking like it was brewing. If the lump flares up the next step is x-rays.
Many Thanks
Judy

DrDeb
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 Posted: Mon Dec 17th, 2018 02:35 pm
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Judy, you didn't mention a lump before. Please describe size, exact location, whether it is hot now or has ever been hot, and how it palpates (hard like a rock, soft but firm, soft and squishy, etc). Lumps that appear on jaw or skull are almost always something to be concerned about. Let me know. Cheers -- Deb

JTB
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 Posted: Tue Dec 18th, 2018 01:15 am
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Hi Dr Deb,
I tried to attach a picture but it is too big and I don't know how to make it smaller. I will try and Email it to you.

The lump has never been hot. It is on the off side a couple of inches below her eye, in the sinus region, I thought it looked like it could be tooth root level, hence the abscess idea. It is hard and never worries her when ridden or palpated. It is about the size of an old Aussie 50c piece. It got a bit puffy for a week and I thought it was bothering her a little bit then but still not hot. No eye or nose discharge. The puffyness was not there when the vet came just the hard as bone lump.

Many Thanks for you interest.
Cheers Judy

DrDeb
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 Posted: Tue Dec 18th, 2018 03:11 am
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Judy, to change the size of an image  you need some kind of software that is meant for processing images. Common packages are Photoshop, Photoshop Elements, Picture Editor. Your laptop or mainframe might have come with one of these already installed; look through your programs list.

When you find/obtain the software, boot it so that the program opens. Then browse to the file that is the image you want to send me/post in the Forum. Open that image.

Then go to "image", then click on "size". You will see two measures of size:
1. the width X height of the image;
2. the pixel density given as "dpi" (dots per inch).

Steps:
First, select the width to be 5.8 inches. The software will probably have a little sub-menu that lets you specify inches, cm's, tenths of an inch, etc. Once you select the image width, you don't have to worry about the height because (unless the button that locks the width to the height is unchecked), when you change the width the height will change in exact proportion.

Second, select the pixel density to be 300 dpi.

This will create a file of about 8 megs, which should post just right in the Forum. Before posting, you need to save the file. Save it in .jpg format -- use the sub-menu that will appear when you click "file" and "save as" (do not click the button that just says "save"; use "save as"). So you save it as a .jpg, and that's the format that will transmit over the Internet the best, and is also compatible with our Forum software.

After you save your file "as" a .jpg and post it in the Forum, you should also save it again as a .tiff. This costs more memory but guarantees that the file will not degrade over time. NEVER re-save a .jpg image as a .jpg; over the long haul, this creates the same effect as photocopying a photocopy, then photocopying the copy of the photocopy, etc.: eventually the whole image will just be "static".

I do really want to see the photo. Cheers -- Dr. Deb

DrDeb
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 Posted: Tue Dec 18th, 2018 03:32 am
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OK, I just received the image of the lump by EMail. I did forget to mention the alternative to learning how to use Photoshop, and that's called "ask the husband" -- LOL.

Little has a fractured molar, Judy. You need a consult immediately with a licensed veterinarian who has experience in equine dentistry. You need a diagnostic XRay right away, as a first step before deciding what else must follow.

Depending upon the training of the professional you employ, the fractured tooth will be removed (it MUST be removed) either through the mouth, or else by trephination of the skull. Trephination involves cutting a hole through the lump, through the skin and bone overlying the top of the bump. It is actually in many cases more convenient, especially as per the after-care that will be necessary, to do it that way; but intra-orally is fine too.

It's a good thing you've been taught how to have a good relationship with your horse. Unbroke, frightened, self-defensive horses often do not do well with dental surgery after-care, because what it will involve is you needing to pack the empty tooth socket with some kind of antiseptic-soaked gauze daily, and perhaps also apply a little counter-irritant at the direction of the surgeon. The object will be to get the empty alveolus to fill in with granulation tissue as soon as possible, so that when the mare chews she does not drive food material right up the empty alveolus, like a chimney, straight into the sinus where it will provoke a further, and worse, abscess.

So the vet is going to take XRays to determine which tooth is fractured and the nature of the fracture; and then he's going to extract that tooth. The extraction can be done as a stand-up procedure whether it is a trephination or an intra-oral procedure; but it can also be done as a full-anaesthesia laydown. I've seen it done very skilfully by laying the horse down on a clean, grassy lawn; but also of course in a clinical setting on an actual surgical table. Full anaesthesia is more expensive; if it can be done as a standup, it will be less costly. But you must do as the surgeon advises.

You do not have a lot of time before you will have a pussy discharge from the nostril on the affected side. There will not be a discharge from the other nostril, as it is not connected to the source of the pus. Look for increasingly foul breath and for the horse to go off its feed and/or show some signs of mild colic. Again -- do not delay, because all these things will only get worse; this sort of problem cannot self-repair and the horse cannot help himself. Let me know what your veterinarian says. Cheers -- Dr. Deb

Attachment: Judys pony mare Little abscess lump SM.jpg (Downloaded 110 times)

JTB
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 Posted: Wed Dec 19th, 2018 07:07 am
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Wholly shit on so many fronts. I have a lot of photos stored as jpegs thinking they would be fine, I need to go and look at them and see if they are 'fading' will have a play with the reducing the photo size as I have an old photoshop but it always is a mystery to me. Thanks so much for the information on the photos, I was going to ask Hubby but he wasn't around when I was trying to post them. :-)

Poor Little!! How would she have fractured a tooth!!! I took my colt to Massey to be gelded as he had a retained testicle a few months ago. I have contacted the excellent Vet there to see who he would recommend. My Vet/Dentist said it was out of his hands if the lump flared up--needed further treatment. We have a local Vet/dentist who are closer, they might be the best bet for the xray. I will get onto it and keep you posted Dr Deb. Thanks so much for you time and will keep you up to date and send any Xrays.
Best Wishes
Judy and Little

DrDeb
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 Posted: Wed Dec 19th, 2018 03:11 pm
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Another horse probably kicked her in the head. Or else, she bit down on a pebble. Or -- her teeth are badly out of equilibration and the tooth that split is the first molar, the "M1", which is the oldest tooth in the head and the first to wear out with age. Of the three possibilities, I'm betting on "bit down on a pebble" since Little isn't geriatric I believe.

As to Photoshop: anybody at any time who has a question concerning Photoshop can write in here and ask me -- I've been using it since version 1.0 and can probably assist with that, or anything else having to do with graphics manipulation or production. Cheers -- Dr. Deb

JTB
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 Posted: Sun Dec 23rd, 2018 07:32 am
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Many Thanks Dr Deb re the photoshop will have a play making the images postable then start on my next scheme for Photoshop as I really want to get a handle on it for looking at hooves and all sorts of stuff!

Re Little's tooth, everyone's Birdies have flown away for Christmas so it will be mid Jan before I can get anything done.

I can get my usual vet to do the initial x ray and if there is anything further she would probably go to Massey or I can use other local vets who have two vets who do the dentistry. Both lots are away for the break.

Merry Christmas and Happy New Year to all who post and learn from this valuable forum. Huge thanks to you Dr Deb for all your energy and generosity for providing us with the space to learn so much about our friend the Equine.

Best Wishes
Judy and Little

JTB
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 Posted: Tue Jan 29th, 2019 07:59 am
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Hi Dr Deb and All,

Last Friday Little had her x rays of her lump. I got the results back yesterday.

She has a fracture on tooth number 107, plus a small abscess and now will have it extracted or I am getting a price on something called 'Endodontic treatment' when they try and save the tooth. Have you heard of this Dr Deb? I might have spelled it wrong.

I am waiting for a copy of the xrays and will post once I get them. Many thanks for the heads up on this.

Kind Regards
Judy and Little

DrDeb
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 Posted: Tue Jan 29th, 2019 10:32 am
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Judy, if it is possible to save a fractured equine tooth, this is technology so new that I am unaware of it.

'Endodonty' just means dental treatment done with reference to the inner parts of teeth. The commonest 'endodontic' human treatment is root canal, or nowadays, also putting in the metal peg that anchors an implant is also called 'endodonty'.

Anyway, no human procedure will be anything like what would be done on a horse. And I would be very cautious around new technology. At the very least I would ask for a second opinion, from another veterinarian. If it could be done, it would be wonderful as saving you a certain amount of after-care. However, I would also foresee certain complications that could arise, so that ultimately you would wind up extracting a failed attempt to repair the tooth anyway.

Are you going to do this before our clinic? Because it's definitely going to bother Little to be ridden with a fractured tooth. Do you have another horse you could ride? Cheers -- Dr. Deb

JTB
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 Posted: Tue Jan 29th, 2019 05:32 pm
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Thanks again for the help, I will just get the tooth extracted. Little will have time off from riding now till she is fully recovered. She has had this lump since October so I am wondering if it would be better to act early Feb or could I leave it till the end of Feb? If I leave it till later I will have time to prepare my young horse for the clinic :-) I am happy to come and audit but riding is soooo much FUN!

What preparation can I do with Little to help her after care, so she is okay with it?

Best Wishes
Judy and Little

DrDeb
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 Posted: Wed Jan 30th, 2019 07:00 am
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Well, Judy, normally I would say 'don't wait to get the horse some help,' and indeed I already did say that. However, I trust your observations with Little. If you honestly can say she is not in much distress; if she continues to eat her full quantity of feed each day, even if more slowly than normal; and if your vet says 'OK', THEN I will say it's fine for you to come and ride in the clinic. Being at the clinic will only delay the extraction a few days. I admit, also, to desiring to meet your young horse and having you work with him under my eye at the clinic. Here's our opportunity to get started with one, entirely on the right foot so to speak.

As to what to do to make aftercare more pleasant for all parties concerned: the more you work with Little's head beforehand, the better. Most horses frankly do not like having their head, especially the muzzle, handled. So, this is not about giving treats, but about teaching Little that it feels good to have her muzzle handled. Once they're introduced to it, many horses love having their gums massaged -- i.e. you work your fingers around the front teeth as far back as the canines/bars. If she takes to this, it will be much easier for you to get into her mouth to change packing, which I expect will be needed.

I am, however, not absolutely clear on what your aftercare regimen is going to be -- because I don't know how they're going to do the surgery. If they trephine her, i.e. extract the tooth by making a hole in her face and then they take it out by pullling it upwards -- that has the advantage of not needing to get into her mouth two or three times per day. However, nowadays intra-oral extraction is far more common. They might also trephine her just for your convenience, Judy; the cutting of a hole in the bone of her face is actually not a big deal, for the bone in that area is rather thin. This is why it can swell up so when there is an abscess/buildup of pus putting pressure on it from below. So, ask your surgeon what the specifics of your aftercare regimen are going to be, and then write me back if you need to for more suggestions on handling. What we want to avoid is getting the mare resentful so that it becomes a daily fight resulting in needing to tranq her in order to change her packing. -- Dr. Deb

JTB
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 Posted: Fri Feb 1st, 2019 07:20 am
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Thanks again Dr Deb for the feedback. I have contacted the Vets to check if they feel it would be okay to leave it till after the clinic and should hear next week. Little has managed to gain 10 kgs since the lump appeared.
I would very much like your guidance with my young horse, China. Will see what falls into place.
Best Wishes
Judy and Little (who is enjoying her gums being massaged :-))

Last edited on Fri Feb 1st, 2019 07:21 am by JTB

JTB
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 Posted: Sat Feb 16th, 2019 06:03 am
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Hi All,

I am seeing if I can post these at the right size. These are Little's xrays and apparently they show a tooth root fracture and a small abscess. I am not sure of the offending area as I haven't had a sit down with a vet to show me what I am looking at. The offending tooth will be extracted early March. She continues to be her normal self. Cheers Judy

Attachment: Little0003-2-crp.jpg (Downloaded 27 times)

Last edited on Sat Feb 16th, 2019 06:16 am by JTB

JTB
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 Posted: Sat Feb 16th, 2019 06:04 am
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second image.

Attachment: Little0001-1-crp.jpg (Downloaded 27 times)

Last edited on Sat Feb 16th, 2019 06:15 am by JTB


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