NOVEMBER 2008: FEATHER

"Feather" is an 11 year old, spayed, female, DSH cat, weighing approximately 13 pounds that was scheduled for a dental procedure, including prophylaxis with a full mouth radiographic series. It was difficult to evaluate her oral condition upon physical exam since she is very tempermental and not willing to tolerate much handling. Her pre-anesthetic blood panel was generally unremarkable other then a slightly lower then normal WBC count. At this point "Feather" was unable to be handled for the usual anesthesia induction protocol, so box induction was the chosen alternative along with intubation with a size 4.5, cuffed endotrachael tube. An Intravenous IV catheter was placed along with anesthetic monitoring devices and warming units once a temperature was established.

It is always a good practice to review the animal’s previous history in order to have a knowledgeable base of what has been done, what might need to be done and if any abnormalities exist in the anesthesia episode or previous procedures. Due to short-term maintenance being done on the computer system, we were unable to do a thorough review of “Feather’s history. What we did know was that she had teeth previously extracted due to tooth resorption and that she had crown tip fractures on all 4 canines. A full mouth radiographic series was started and to our surprise, there was evidence of mandibular fracture repair just mesial to tooth #309. We had immediately noticed that there was a significant symphyseal separation and that the mandibular incisors were positioned, # 301-303 lingually and # 401-403 more rostrally. It was quite clear once the healed fracture site was radiographed why this was all occurring. Tooth 309 showed no evidence of any periapical pathology or other signs of disease. Tooth 408 had tooth resorption apparent at the furcation site. Radiographically, none of the canines showed any periapical pathology although near exposure was likely since the pulp canal of a cat’s canine tooth can come within 0.5 mm of the crown tip. Therefore it is important to carefully assess the possibilities of any vital exposure. Tooth 408 would be surgically extracted and all 4 canines would be sealed with a dentinal adhesive and an unfilled resin. “Feather” received an injection of Convenia ®, a long term antibiotic and would go home with Metacam for the client to administer. Giving this cat oral medication would be difficult, so hopefully the owner would be able to at least give her the Metacam to decrease any inflammation and discomfort.

The importance of radiographs can never be emphasized enough. They will help to ensure a  thorough evaluation of the animal’s oral health subgingivally, expose any ensuing pathology and provide information that might otherwise, if hidden could compromise the process of providing the best possible therapy for this animal with the least risk to the integrity of the jaw and the surrounding tooth structures.

The radiographs included show the separation of the symphysis, the mandibular fracture repair site and a good view of the mandibular canines. The photographs also show the visual positioning of the incisors due to the symphyseal separation, the closure at the extraction site of 408 and an overall view of the left quadrants post prophylaxis and bonded sealant of 204 and 304.