FEBRUARY/MARCH 2010: CORA

"Cora" is a 10 year old, mixed breed dog weighing approximately 12 pounds. She was presented by a local animal welfare group for oral evaluation. Upon exam, it was estimated that she had advanced periodontal disease, tooth loss and most noticeable, a large area of gingival recession and obvious bone loss surrounding her upper right canine, tooth #104. Debris was packed around the tooth causing irritation and a rancid odor. A regimen of antibiotic therapy and pain medication was prescribed for "Cora" and she was scheduled for her procedure the following week. A full mouth radiographic series along with a periodontal cleaning and extractions or treatment as indicated would be done.

Following the usual protocols of pre-anesthetic blood evaluation, IV catheterization and anesthesia procedures, "Cora" underwent the therapy described above. As expected, a large oronasal fistula was present at the site of tooth 104, the largest I have ever witnessed. The radiograph shows the extent of the bone loss at the site of this tooth, progressing mesially and distally. Teeth 104 and 106 were removed (tooth 105 was missing), and gentle curettage performed. Copious gentle flushing of debris and closure of the large mucoperiosteal flap was done and secured with 4.0 Monocryl sutures. The flap was under no tension so healing was expected to be complete. Several other teeth were extracted and Cora's remaining teeth were cleaned and polished. Although the cleaning is normally performed prior to the extraction process, this method was chosen due to the amount of teeth and periodontal therapy needed to be done. She was only able to retain a few, healthy teeth.

The most important point that can be derived from this case is that client education is a critical part of the oral health treatment plan presented by any veterinary hospital concerned with excellence in oral care. If the client doesn't understand or realize "why" there is a need for consistency in home care and the "need" for annual professional evaluation and treatment, then the importance due these processes will go unnoticed. The end result will be a progression of disease that should have been addressed along with needless pain and suffering of their animal that could have been avoided. If we all do our part and "teach" our clients the importance of preventive oral care, maybe the most prevalent disease in dogs and cats will someday lose its unfortunate #1 status.