bit stumped

[maggiehorse]

hi a friends horse had to have vet this morning , large swelling in cheek which burst this morning and is very sore and hot to touch , horse is eating and drinking fine , no nasal discharge but does have a high temperarture and is slightly lethargic , vet though it might, any ideas possibly be a tooth abcess or maybe a foriegn body but neither usually have a temperature , so we are all a bit stumped , hes been put on 5 days antibiotics bute and an anti inflammitory injection...... any ideas?.

 

[Kyo's Mum]

Hmmm, worried about your vet! A large lump that is hot to toch and ruptures spilling out pus is an abscess, maybe tooth in origin or foreign body but it is a localised infection. Localised infections can get into the blood stream and cause sepsis, or at least generally drain the bodies resources, resulting in lethargy and a pyrexia (temperature)! Treatment is normally a poultice to draw out the infection (as long as there is no involvement of a sterile joint eg hock, or fractured skull) and antibiotics to curtail the offending bacteria. Anti-inflammatory may be required if swelling is intense, but you are only treating the symptom not the cause. Hope that gives you some peace!!

 

[maggiehorse]

hi kyo,s mum , what do you mean i should be worried about the vet ?

 

[Kyo's Mum]

'vet though it might, possibly be a tooth abcess or maybe a foriegn body but neither usually have a temperature , so we are all a bit stumped'

I assumed from your post that the vet thought it was unusal for a horse to have a tempersture when it had a facial abcess. Is this not correct?

An abcess is a localised infection, but it can have repercussions on the entire body. Common signs of localised infection are area is hot to touch, swelling, tenderness/pain, redness, pus or discharge. Signs that an infection is effecting the whole body is temperature/fever and lethargy. I am not a vet (just a human medical professional) but it is common enough knowledge.

 

[foxy1]

Strangles?

 

[maggiehorse]

dont think its strangles as swelling and burst point are on point of jaw bone and thers no swollen glands or nasal discharge

 

[maggiehorse]

as you say kyos mum youre not a vet so i think i,m more inclined to listen to mine

 

[Kyo's Mum]

There is no need to be rude but perhaps this article written by a vet will apease you, please see the bit I've highlighted in red for you

Dentistry Part 4: Periodontal Disease

Periodontal disease is one of the most painful conditions that can occur in the horse's mouth. The number one cause of premature tooth loss in adult horses (as in adult people) is periodontal disease. Periodontal disease can affect incisors, canine teeth, and cheek teeth.

So what defines equine periodontal disease? Equine teeth constantly erupt over the course of the horse's life, and the tissues surrounding the teeth undergo normal changes as this eruption takes place. The periodontium consists of the gingiva (gum), alveolar bone (the socket in which the tooth sits), periodontal ligament (which anchors the tooth in the socket), and the outer layer or cementum of the tooth. With normal mastication (chewing), the mouth of the horse is fairly self-cleaning; feed and calculi do not accumulate on and around the teeth. This is due to the work of normal host defenses such as saliva, white blood cells, antibodies, and "good" bacteria that are present in just the right numbers under the right conditions.

A disruption in these defense mechanisms will result in an opportunistic infection.

Salivary secretions normally function to clean the horse's mouth as it eats. Domestic feeding practices and processed feeds often lead to abnormal mastication and decreased saliva production. Decreased range of motion in the chewing cycle, malocclusions (misalignment) of the cheek teeth and/or the incisors, and trapped food material can lead to a deleterious environment within the mouth.

Normally, the lack of spaces between horses' teeth prevents feed from becoming trapped and collecting. Developmental abnormalities resulting in malpositioned teeth, malocclusions, and uneven pressures on teeth can create increased spaces between teeth and misalignment of the teeth, setting the stage for periodontal disease.

Feed packing in between or around the teeth undergoes decay and bacterial fermentation. This process and the resulting byproducts cause a breakdown of the periodontium. The gum begins to recede and forms a pocket. The pocket remains full of feed that continues to ferment and break down, gradually destroying the vital structures of the tooth or teeth involved, with the disease progressing towards the root. As the periodontal ligament is destroyed, the tooth becomes loose in the socket, and tooth loss is nearly inevitable. The horse will have long ago altered its mastication to avoid the painful area(s), exacerbating other existing dental problems.

[As the disease progresses and the infection migrates along the length of the tooth, an apical (around the root) abscess could occur. Abscesses involving some upper cheek teeth can lead to infection of the sinuses and a malodorous nasal discharge. Periodontal disease can cause blood-borne bacterial infection of other body systems (such as the heart) as blood and bacteria mix in the mouth. Some systemic diseases such as Cushing's syndrome can worsen periodontal disease and alter the outcome of treatment.

How to Recognize It

Recognition of equine periodontal disease is the first step to successful treatment. It is very difficult for an owner to identify periodontal disease. Signs might include halitosis, dropping feed, weight loss, and performance problems. Or signs might be as subtle as "just not right" or mildly depressed. Many horses do not exhibit outward signs.A thorough oral exam using specialized equipment is necessary.

Gingival recession and bleeding tissues can be observed, as well as any abrasions to the gums from rough feed material or foreign objects such as twigs or briars.

Feed will have a tendency to collect around damaged teeth, retained cap roots, or the caps themselves before they are shed. Periodontal disease is generally a transient problem in young horses as deciduous teeth are shed, but it can be severely painful and cause difficulty eating in the case of a young horse with malpositioned teeth.

Overgrowths of the teeth, hooks, waves, ramps, points, etc. can cause abnormal feed accumulation between or around teeth. Spaces between teeth, rotated teeth, or crowded teeth will tend to collect feed material. Calculus often forms on the canine teeth, incisors, and in abnormal spaces between the cheek teeth, and it can lead to periodontal disease.

Any areas of trapped feed or periodontal pocketing should be noted on your horse's dental chart in order to follow the progression of healing during subsequent treatment. The integrity of the teeth and surrounding tissues might be evaluated using radiographs. Intraoral radiographs are especially useful to evaluate periodontal structures.

Treatment Step 1

The first and arguably the most important step when treating equine periodontal disease is the correction of any malocclusions or overgrowths. It's important to use good thorough dental examinations to diagnose malocclusions at a young age and begin treatment to prevent associated problems. Depending on the age of the horse and the severity of the malocclusions, these corrections might need to be performed in stages and could take many visits over months to years to accomplish. In some cases, complete correction might not be possible due to age and severity of the problems present, and maintenance with the goal of comfort for the horse should be implemented.

During the exam of your horse's mouth, your veterinarian will be able to assess the severity of any malocclusions and make a plan with you for the correction of the overgrowths. Your vet might also choose to refer you to a more specialized dental practice for your horse's care. You should in no way fault your veterinarian if he or she chooses this route. Equine dentistry is a difficult, often messy, smelly, and bloody adventure, and in the case of periodontal disease, this goes double.

Those of us who have chosen to treat more advanced dental problems are well-equipped to handle the job and are able to schedule the time it takes to work on these cases. Many times a referral practice does initial treatments and the referring veterinarian does follow-up care.

Periodontal disease that is diagnosed early can often be treated by simply correcting the malocclusions that contributed to the problem in the first place. Regular maintenance of your horse's teeth will then help prevent a reoccurrence of periodontal disease. In more advanced cases, other treatment options might be implemented.

Treatment Step 2

Once the periodontal disease has been located and any overgrowths corrected, the feed and debris will be cleaned out of the area. Due to the painful nature of periodontal disease, the horse will require proper sedation. Often, local anesthesia or nerve blocks (similar to use of novocaine in people) are very helpful to keep the horse pain-free during treatment.

The veterinarian will use a combination of dental picks, forceps (to grasp and extract large feed particles), and irrigation to clean out the feed near the surface of the pocket. Mild or superficial periodontitis might readily respond to this type of cleaning.

There are high-pressure irrigation systems available that use a baking soda and disinfectant slurry for the treatment of equine periodontal disease. These machines, similar to those used in human and small animal dentistry, also contain high- and low-speed drills, air, and water delivery, a sonic scaler, and suction.

Once the affected area has been cleaned, the veterinarian will use a mirror and a periodontal probe to assess the extent of the disease. Malpositioned teeth might require careful reshaping to help prevent them from catching food and possibly allow them to reposition over time. The next step in treating these more extensive pockets involves protecting them from additional feed entering and beginning the disease process again before healing can start.

There are a variety of materials the veterinarian can use to protect the area. A sustained-release, biodegradable antibiotic might first be placed in the pocket to aid healing. Then a "bandage" of acrylic material can be placed to protect the antibiotic and the pocket. This material usually comes in two parts that, when mixed, harden to a rubbery consistency, allowing it to be form-fitted over the pocket.

The veterinarian will also consider prescribing a course of systemic antibiotics, depending upon the severity of the disease. She or he might also advise that you feed your horse exclusively pelleted feed for a number of weeks to allow healing to take place. Rough hay and forage can dislodge the impression material patch; complete or senior feeds (fed in the correct quantity) will sustain a horse through a period of time to allow healing to take place.

In the most advanced cases, a tooth or teeth might require extraction. Again, your local veterinarian might feel more comfortable referring these cases as the extractions can prove difficult.

Whether the pockets are cleaned and treated or a tooth is extracted, you should expect your horse to require frequent follow-up visits as the area heals.

Take-Home Message

With your horse's health and comfort the primary goal, it is important that periodontal disease and related dental problems are diagnosed and treated early for the best possible long-term results. The goal of treatment is a healthier, better functioning mouth, and ultimately, a happier, longer-lived horse.

By Drs. Colleen Porter and Thomas Johnson




Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.

Copyright © 2012 BLOOD-HORSE PUBLICATIONS. All rights reserved.

 

[maggiehorse]

thank you kyos mum , i was not being rude at all sorry you thought i was , i,ll pass this article on to his owner , the vet suggested she get the dentist out to look at his teeth and hopefully the bloodwork will be back tomorrow which may help to narrow down the cause

 

[Kyo's Mum]

Glad I could help. Dental abcesses in two legged mammals can have nasty effects on other areas of the body if not treated because the infection can track to other places and cause issues (particularly in the brain in humans), and because the mouth has such a good blood supply the bacteria often get picked up and deposited in places around the body (predominantly the heart). Hope you get some answers tomorrow and that the horse makes a speedy recovery x

 

[Miss L Toe]

thank you kyos mum , i was not being rude at all sorry you thought i was , i,ll pass this article on to his owner , the vet suggested she get the dentist out to look at his teeth and hopefully the bloodwork will be back tomorrow which may help to narrow down the cause

The vet's comments raised my eyebrows too: the idea that an EDT on his own will be able to sort this out is pretty unlikely, as the article indicates, the horse may need specialist treatment which should be carried out in an equine clinic rather than in his stable environment.
Investigations seem likely unless the infection has subsided.

 

[maggiehorse]

sorry , forgot to mention , toothman is a qualified vet specialising in dentistry hes coming tomorrow to have a look , as for further investigations , vet clinic etc the horse is not insured and owners have very limited funds so its a worry what will happen if its something serious

 

[littlescallywag]

Horse at my yard had a undetected abscess in his jaw. Poor little bugger had the shakes,very high temperature and couldn't eat/drink at all.
Took weeks to heal and had tracked up into his salivary gland and damaged it.

 

[Kyo's Mum]

Hi maggiehorse,
how is your friends horse doing? Did the bloods show up anything? Also did the vet take a swab of the pus for a sensitivity test? Hope alls well

 

[maggiehorse]

hiya
bloods showed a very high white bloodcell count which we expected nothing else of note . equine vet attempted to look at his teeth yesterday but even with heavy sedation horse was very distressed about opening his mouth so hes going to come back friday , the swelling is subsiding today and the horse is much brighter in himself , untied himself this morning and nicked off while owner was emptying barrow , i found him in my stable munching hay lol

 

[AmyMay]

Any type of infection can set up a temperature.

 

[Kyo's Mum]

Hi Maggiehorse,
glad the boy is feeling better in himself , and hopefully his mouth will be less painful on Friday so the dental vet can help him! The white cell count is indicative of the infection having spread from his mouth, poor little soilder .

Good luck to you all for Friday, keep us posted x

 

[AmyMay]

The white cell count is indicative of the infection having spread from his mouth

No, it is indicative of him having an infection.

 

[Kyo's Mum]

Um, excuse me but an encapsulated infection such as an abcess, cyst or empyema does not always cause a pyrexia. The infection must be picked up by the blood in order for the immune system to react, they can all cause it, but they can also exisit in isolation.......

 

[AmyMay]

Um, excuse me but an encapsulated infection such as an abcess, cyst or empyema does not always cause a pyrexia. The infection must be picked up by the blood in order for the immune system to react, they can all cause it, but they can also exisit in isolation.......

I have no idea what that means, sorry.

But increased white blood cells indicates an infection, not the spread of an infection as implied by your post.

 

[AmyMay]

an encapsulated infection such as an abcess, cyst or empyema does not always cause a pyrexia

Have just looked up pyrexia - to see what it meant, and see that it is a fever. So I wonder now if this post was in response to my first post

Any type of infection can set up a temperature.

If it was, you can see that I used the word can.

Hope that clarifies things for you.

 

[mightymammoth]

Thanks for sharing that article it was very useful

 

[Kyo's Mum]

Hi Victoria1980x, the article came from an American magazine called The Horse. There are loads of great veterinary type articles you can access on their website thehorse.com and it's free to register!

 

[maggiehorse]

they,ve put him up for sale today