OCTOBER 2008: KITTY

Kitty is an 11 pound, male, DSH.  He was admitted for castration and extraction of a fractured left lower canine tooth.  His physical exam was normal except for the fractured tooth, moderate calculus accumulation, generalized gingivitis and severe periodontitis in the mesial portion of the mandible.  His blood work was all normal.

Kitty was pre-oped with Hydromorpone and  Metadomidate intramuscularly.  And IV catheter was placed in his cephalic vein and Propofol was slowly administered for induction.  A 4.0 clear endotracheal tube was placed and he was maintained with Isoflurane and O2.

He was neutered and we cleaned, probed and charted the mouth.  Finances are an issue with this case so full mouth radiographs and treatment for anything other than the fractured tooth were declined.  A radiograph was taken which showed severe osteomyelitis with a retained root with a widened canal.  The lower incisors are also involved.

We called the owner and obtained permission for extraction of the retained root and the incisors.  The owner consented to care.

A regional nerve block of Bupivicaine and Lidocaine was administered around the left middle mental foramen.  Time was given to allow the block to take effect.  A #15 surgical blade was employed to cut two releasing incisions and a small feline molt elevator was used to elevate the tissue from the bone and visualize the fracture tooth root.

A #2 winged elevator was used to elevate the tooth from its socket and the lower incisors were extracted with same elevator. A FG #699 pear shaped was used to debride the bone surrounding the extraction site.  Consil was placed in the remaining 4 walled socket.  The mucogingival flap edges were debrided and closed without tension with 5-0 Monocryl.

A post-op injection of Hydrmorphone was administered as well as an injection of Clindamycin SC.  Kitty recovered uneventfully and ate some baby food 1 hour post-op.

Kitty was discharged with Clindamycin 25mg twice daily for 2 weeks and Buprenorphine transmucosally three times daily for discomfort.  The post-op phone call reported that Kitty is eating well and bright and alert.  We scheduled a 1 week post-op recheck with a dental technician specialist.