Oral Surgery Case Study
Trixie – Technical Surgical Notes
August 19, 2005
An 8 year old DSH spayed calico presented with coughing and sneezing over 5 day duration.
Examination yielded some upper airway congestion, kidneys slightly small and irregular surfaced on palpation. All other systems normal, except for dentition which showed severe gingivitis and periodontal disease. Plan was to try antibiotic trial, then clean and x-ray teeth.
August 31, 2005
Patient presented with sneezing and coughing up phlegm, still lethargic and vomiting after coughing spells. Exam yielded increased respiratory effort, tracheal auscultation of a high pitched wheezing on inspiration. No cough illicited. Cat is rubbing right side of face.
Otoscopic exam: Right inflamed Tympanum opaque in lower right quadrant. Left ear wax ball adjacent to tympanum.
Dental exam: Red appearance to fauca of pharynx, resorptive lesions and periodontal disease with painful response, broken canine teeth. Other teeth need detailed exam under sedation.
Recommend: Chest xrays, cbc chem. panel, oral, pharngial and otoscopic exam.
September 16, 2005
Owner agrees to sedation and oral and otoscopic exams. Full mouth xrays taken which reveals 26 root tips in place. Owner notifies us that previous oral surgery had taken place at another hospital, and the pet had gradually become more ill after surgery and began losing weight.
Owner agrees to let us remove all remaining root tips, bone chips and to repair bone damage from previous drilling. Acell and consil (a synthetic bone graft particulate) was placed into all open sites and closed with vicryl. In addition to oralnasal fisula repair resulting from abcesses forming at the apical roots of the upper canines and communicating with the sinus passages. This had created secondary sinus infection and sneezing. Nerve blocks were placed pre-surgical. Clindamycin drops and buprenorphine was sent home.
Our patient made a full recovery and was eating the same night she went home. With the removal of pain and toxic bacteria from her system, she began gaining weight and resumed her regular playful activities. Though the severeness of her oralnasal fistulas took a few months to heal, our patient and client are much happier.