Points, Spurs, and even occlusal surface

[BellaBella]

Hi everyone, it's been forever and a day since I've posted on here.

So, Bella, my 10/11 year old girl has recently had both a spur on her lower jaw and points in her check teeth. Two separate visits, the first caught the spur. She has only been eating critical care since early November. They took ex rays and did not show root elongation.
Two days ago, we went to the animal dental center in Annapolis, MD and the Dr. said her occlusal surface is even, the spur on the bottom was taken down and she had points in her check teeth that he took down.
It's only been two days now since this visit, and she is still only eating cc, though right now not too much since they gave her bupenorphine post op and I guess she doesn't feel so great.

My question is, at this point all indications are that this is not malo, should I continue to work on this? Has anyone dealt with an older chin who came back from this?
She acts like herself, plays and runs about, just hasn't been able to eat her hay or really chew on sticks or anything. I'm not sure how far to take this?

 

[ticklechin]

Prior to this, has she had dental issues? Is she a pellet hog or does she eat hay? Chins especially if this is a first filing can take a week or two to return to eating, depending on the amount of tooth structure removed the teeth can have exposed nerve endings that take a bit of time to re-mineralize.

 

[BellaBella]

Hi Dawn,

Bella has always been a hay girl, but since this started she has only been able to eat some pellets, leaving dust behind, and the leafy part of alfalfa hay outside of the cc. This is the first time I've ever had teeth issues with her.

My other chin, Kiwi, is a pellet hog. She eats more hay when I put it on the top level of her cage.

 

[ticklechin]

1st time on a 10 year old I personally would not worry too much. I had one who needed to be filed every couple of years since he was 4, he was just a lazy chewer, his range of motion when chewing did not encompass the entire occlusion. I just offered him a variety of hays-1st and 2nd cut timmy, alfalfa and oat hay to give him a range of textures to chew. He lived until a botched vet appointment took him at 17 years old.

 

[BellaBella]

Whew! I am somewhat relieved to read that!

How worried do I need to be about the bupenorphine and her not wanting to eat much? She eats the cc off a spoon, I don't need to force her, but since this procedure she is avoiding food more than not. Poops have slowed, not stopped, and she is on metacam .025ml once a day. She gets gas drops right after eating, sometimes before if she won't eat and that usually helps. Then I let her out to run around and work it through.

She is returning to her cage way earlier than usual and still not too into the cc.

Should this wear off on its own or do I need to do something ?

 

[ticklechin]

Opioid meds used for chins causes nausea in some cases, they feel like crap. I use it as a last resort med for pain, I have found that metecam and tramadol used together provides good pain relief without the opioid side effects. Her not wanting to eat still is more than likely due to the sensitive teeth rather than the pain med this long past the procedure. It can take a week or two for her to return to eating on her own, in the mean time you need to feed.

 

[BellaBella]

Update: it's a week since last posted, and 10 days since her filing. She's eating cc willingly and some pellets. Won't touch hay, and eyes are still watering some.

 

[BellaBella]

19 days post filing and she is only getting worse. Still not eating hay, won't even look at it. Drooling a lot, mostly out of left side of mouth, eyes still watery and some discharge - could there be an eye infection now? I'm just back from the dental place, and after his exam he said he got a pretty good look in her mouth and there is no redness or irritation that he can see, her occlusal surfaces are nice and even. He basically sent me on my way with the name of an exoctics vet in VA, Stahl exotic,but their website doesn't mention dental at all.
She's lost weight and is now frustrated, she flung her pellets all over the place last night.
I think I can feel bumps along her jaw line, but neither vet I've seen has thought there was root elongation. I don't know what to do now.

 

[BellaBella]

Ok, update to my last update. I have an appointment with Stahl Exotics tomorrow at 2 p.m.

I hope they can help.

 

[Stackie]

She very likely could have root elongation. The only way to know is to get head x-rays again. A lot can change quickly. Some vets even miss the elongation if they don't commonly see chins and know what to look for on the x-rays.

 

[BellaBella]

That's what I'm afraid of. Then my only option is to put her down, right? This sucks. A lot.

I have her X-rays, if anyone can look and tell me. They're from beginning of November.

 

[Stackie]

Unfortunately there is no fix for root elongation, you can only manage the symptoms but yes it is very painful and quality of life must be considered. The kindest thing to do is put them down.

Go ahead and post the x-rays. Dawn is very good at reading them and I can usually get a good idea what's going on from them, too.

 

[BellaBella]

Ok, here you go :broken:





I have a few more but photobucket is giving me trouble.

 

[BellaBella]

 

[ticklechin]

I don't see enough elongation in those x-rays to cause symptoms in my opinion, I would want new x-rays to see if you are dealing with something new like a abscess, or cracked tooth, gingival issue or something along that lines. The x-ray in my opinion shows slight to moderate elongation with no malocclusion, chin should not be showing symptoms. Is the chin on any pain relief? I would want, if this was my chin, to use tramadol with metacam to see if the chin will start eating with moderate pain relief.

 

[BellaBella]

I have continued her on the .25 Metacam originally prescribed after the first filing. She seems to want to eat and is frustrated, as she flung her pellets everywhere yesterday morning.
I will pass your thoughts on at my appointment today.
Thanks Dawn, that gives me some hope that I'm not just prolonging the inevitable and drawing out her pain needlessly.

 

[BellaBella]

Ok, latest update:

He found some spurs close to the gum line and at the far back of her mouth, mostly on her left side which is where she has been drooling from the most. Took new xrays, he said he didn't see any elongation to worry about and didn't see anything else of concern. He did say her molars were growing at an angle that was making it tight for her tongue.
Hopefully, this last filing will do it, and she'll eat soon by herself.
She is now on .006 tramadol and continuing the .25 metacam.

Feeling like the dental center wasn't the right place to go - if I coulda skipped that step and gone straight to Stahl... coulda woulda shoulda.

fingers crossed!

 

[ticklechin]

Make sure you are feeding her enough so she won't be p$ssed because she can't eat. At least 60ml of critical care a day, some can take over 120ml a day, broke up in 4-6 feedings.

 

[ticklechin]

And some good news too!

 

[BellaBella]

I'll have to measure to see how much she's actually eating. I just mix it up in a small bowl, about 1/2" deep in the bottom. She eats a good deal, and I try to do 4 feedings a day. Luckily I live close to work so I can come home at lunch.

I got some apple banana flavor while at this vet, hopefully that inspires more eating!