Tooth abscess - advice please

[Zirach]

My 15 year old horse has had a yellow, smelly snotty left nostril for the past few weeks. He is very well in himself, eating well, not quidding, going well ridden etc.
We have tried standard antibioitics along with a supplement to help dry up the mucus for 2 weeks but sadly this has not worked and the snotty nose is back.
The vet is sure it is a tooth abscess but we havent yet xrayed the head to confirm this.

We are not insured for anything relating to oral conditions or teeth as a vetting when we bought him found a fractured tooth. The vet has advised that to remove a tooth is not a straight forward procedure and that it could spiral easily up to £10k which we simply do not have.

We want to try everything we can, we are on stronger antibiotics for another 7 days now (not sure of the name but pills and we have to crush them and adminsiter with a syringe as he will not eat along with a liquid dose). Has anyone else had anything similar happen? Could it be just a sinus infection? This is covered by our insurance.

Any advice good or bad much appreciated

 

[AmyMay]

Start with an x-ray and go from there. But it may be that surgery is your only option. However, £10k sounds very, very inflated.........

 

[WellyBaggins]

We had a horse with a fractured tooth/tooth abcess, he had to go to Liverpool and have the tooth removed, it did have complications and was expensive but the horse is now fine. It may be worth contacting a BEVA dentist as they can also remove rotten teeth (they are not supposed to but if a vet is present they are allowed!) This will be considerably cheaper but if there are complications the horse will need to be hospitilised, hence why we went with the Liverpool option! Definatley worth speaking to a dentist, they will be able to help!

If the sinisitis is only from one nostril it is very likely a tooth, sorry!

Good luck hope that helps!

 

[Zirach]

I fear it is a tooth and after reading some of the posts on here that removal probably is the only option. Does anyone have a recommendation for the Suffolk/Essex area? I also agree that the 10k seems inflated!

I have also noticed that someone has tried homeopathy and that worked Silicea rememdy - anyone tried that?

 

[Sam22]

Yes it could be just a sinus infection but the foul smell increases the likely hood of it being a tooth abscess. You really need to get a diagnosis and have the head xrays done then you can consider the options. If it is just the sinus then surgey to make a hole into the sinus and flush it should be £500-1k at the max. If its the tooth then in a 15yr old horse you should find someone experienced in oral tooth extraction and have the tooth removed through his mouth. This can be done with the horse stnading under sedation and is succesful in about 50% of horses- being older though it should be relatively quick in your horse. xrays probably cost £3-400, if tooth removed orally at first attempt up to £1500 but it could be half that if it comes out quickly. If the crown of the tooth is very damaged or crumbles the tooth won't be able to be removed orally and the horse will have to have a GA and have the tooth punched out from the sinus end into the mouth (repulsion). Probably cost £2-3K. The problem with tooth extraction is the high occurence of complications, especially in horses with concurrent sinusitis, which is about 30%. Removing a tooth inevitably results in a degree of damage to the alveola bone the tooth sat in and bits can easily be left behind despite the surgeons best efforts. The infection doesn't resolve and a second surgery is needed. £10K is the very worse case senario for a horse requiring 3 surgeries and having extensive complications - less than 5% of cases. As your horse is 15 the tooth roots will be much shorter than a younger horse hence it is easier to extract so I would estimate £3K as a realistic top end but be hopeful you would get a reasonable amount of change from this - depends on how long you need post op antibiotics etc as these quickly mount up. Just be aware that severe complications could rapidly escalate the price and you should know your limit before you get into anything.
so- if it is a tooth abscess get some quotes for oral extraction and then you know exactly what your looking at.

 

[Sam22]

Cambridge University equine hospital will almost certainly be your cheapest option and they will give you a quote and stick to it ( with conditions). I work in suffolk and really think the only other options are newmarket hospitals but they will be very expensive. Royal Vet College might be another good option.

 

[Zirach]

Thanks for the good advice everyone, I think we will wait until we finish the course of the stronger antibiotics (this week) I have a feeling that this wont clear it up, will then move to the head x ray and go from there. If Op needed I think I will maybe see if my vet can get me refered to the camb uni equine hospital, we really want to try all we can but are by no means wealthy and with this not being covered by his insurance we have to seriously weigh up the pros and cons especially if it turns to invasive and they have to drill in under a general with the possibility of re-occuring infection. Who would have thought a small thing such as a tooth would cause so many problems!

 

[AmyMay]

seriously weigh up the pros and cons especially if it turns to invasive and they have to drill in under a general with the possibility of re-occuring infection.

They would just remove the tooth - so the chances of re-infection would be minimal.

 

[LMuirEDT]

Best thing is to get it xrayed and then you will know what you're dealing with either way. Good luck!

 

[I_A_P]

10 k does sound a lot. My old mare got a tooth abcess (there was no puss etc just a lump visible on ehr face about the size of an egg). She had the whole tooth removed and i think the total bill including all visits etc was about £4k (thinking about it she was also lame at the same time so included nerve blocks and a cortisone injection for that as well).

 

[Irishlife]

My mare had a tooth abcess and it was awful while it was developing to the extent the vet thought she had a fracture as she could not bring her head off the floor. As she had uncharacteristically reared and gone over backward it was a bit of a red herring. Two weeks later during which time she was very ill a large lump appeared on her face and she was much more perky and the vet said it was a tooth abcess and give it time to settle down. So she had the lump and was not in any pain and discomfort so carried on for a year riding etc then when I fell pregnant decided to put her in foal. Vet advised it could be as well to remove the abcess in case being pregnant triggered it off in which case it would not be possible to operate in foal.

So she had the tooth removed under GA and the vet left an open cavity plugged with gauze in her face which we had to flush through with dilute Savlon every day (this was 20 years ago!) and then replace the gauze in the hole. She recovered completely and the tooth was huge and the vet wouldn't let me have it as he wanted it for his specimen cabinet.

So X-ray first, they can become dormant like in my case but even so, better out than in.

Good luck

 

[K27]

My boy had a tooth root infection (the tooth was ok) as a 4 yr old, came in with lump on his face no other symptoms- got Vet straight out- they Xrayed and the xray confirmed the infection- he was given an extra long course of Baytril, which shifted it- and then he was re xrayed-

On the otherhand maybe it could be sinusitis? but this is sometimes caused by bad teeth (but not always I don't think)- so even if it was sinusitis, be careful as although the insurance may cover you in this instance, you might find you won't be covered if the cause does turn out to be the tooth!, I had a horse that had a bad bout of sinisitis (teeth was definitely not the cause) and again she was treated with Baytril and it did clear it up, but took a long time, oh, and the smell was absolutely vile!!.......

I'd speak to your Vet again and see what they suggest, I was told once that taking a tooth out under GA is quite major and invasive, and can also cause probs to surrounding teeth....

 

[Zirach]

Just had the xray, sadly as the tooth has been worn down to gum level there is nothing to 'grab' so to speak so we have to have it taken out by replusion. Luckily we can have it done by an outside, specialist surgeon at our vets equine hospital so it will keep costs down. I have been looking on the internet and the operation seems pretty hardcore and only has a 50% success rate so heres praying we will be one of the lucky ones.

 

[LMuirEDT]

Well at least u know what ur dealing with now. Fingers crossed it goes well.

 

[Leaf]

hello, one of mine had the same syptoms sometimes more snot than other days but always out of the one nostril the vet and i decided to book him in for x-rays nasil swabs on the day that the dentist was also there (he said tooth i said sinus we had a fiver on it!!) the x-ray showed nothing and the swabs were negative dentist tidied up his teeth but they were fine. Decided to blast it with massive does of abs did the trick for five months then the snot was back blasted again and we have been fine for 1 yr (touch wood) My insurance excess is 500 as I have a few and all in it cost 250. I hope this helps.

 

[Zirach]

Hi everyone - back again! The replusion went well, and x ray's showed all the tooth had successfully been removed. There was no need to flush. Bone flap has been done, op took 3 hours under GA, but after a week at the equine hospital on intravenous antibiotics, cap removed and he came home. A further week of antibiotics in food, turnout 24 hours staples then came out, bone flap neatly healed. All looking well for the next couple of weeks. Now the bottom of the bone flap has got infected inside, hot, swollen,pus dribbiling out of the corner of the bone flap.

We called vet, he advised to go back on antibiotics and we are applying hot compresses 2/3 times a day on the site that the pus is leaving the head. He due to come back end of week.

We also feeding silicia homeopathic to help purge the infection.
Anyone else had something similar happen after this type of operation - any further suggestions?

 

[Dippy]

Hi - I have just come across this thread, and as I have a similar problem myself, I would be gratefull for an update on how your horse is doing please?

My mares tooth is fractured, and x-rays show the root is also in several pieces making extraction through the mouth unlikely. Although there is a small swelling and an unpleasant odour she has no nasal discharge and seems well in herself. This is currently being treated with antibiotics while we are awaiting further advice. Interestingly - she had the same tooth successfully operated on 9 years ago following a tooth abscess, basically she had root canal, this was a new procedure at the time, and was successfull enough to last for the last 9 years!

Therefore, I have an exclusion of tooth abscess on my insurance policy, so would also be interested to know the approximate cost of your op?

Many thanks for any help/advice.

 

[bj666]

Id get in touch with your dentist , my friends horse had an abscess for a whole year !!!! Yes a whole year !!! It cost a fortune in anti-biotics .... the Vet eventually gave in and refered him to a practice that removed the fractured tooth , he had a hole drilled in the bottom of his jaw to let the infection drain and it sorted it out within weeks , you wouldnt of known he had a hole in his jaw ! Of course the hole in his skin healed over and no doubt the hole in his jaw will of healed . I dont know how much it was but it certainly wont of been 10k !

 

[Zirach]

My story sadly didnt have the best of endings, but I think we were just one of the unlucky ones. Newmarket (via Catley cross - brilliant vets btw) had to extract the tooth through his head as the remaining tooth had worn down so much that there would be nothing to get hold of through the mouth.
This operation itself went successful, however the seal that was used to plug the 'gap' failed and subsequently the wound re-infected a several months down the line. This can happen apparently.

We had to make the decision of another op, to go back in through the head and re-clear the wound, re-plug and check if any fragments left. They did this however the infection did not clear up despite stong antibiotics and several months in the equine unit of having the wound 'drained' and he went downhill, the infection went to the rest of his head and there was basically no hope for him. This happened over a year and we made the devestating decision to have him put to sleep. The operation cost us around £6k - he wasnt insured for teeth either as the same tooth had a crack picked up in the vetting and was therefore excluded.

HOWEVER! Please do not give up hope, you will probably find that after a few weeks of mega strong antibiotics that this clears up without any further issues. I think BAYTRIL is the strong one they use.

I genuinely do think we were just unlucky and the antibiotics did not work on his infection, hence needing the op, and then we were in the % that has to be re-operated on. The actually operation itself WAS succesful, it was a secondary infection that actually caused his sad demise. In fact before the site got re-infected, we took him to a show 2 weeks before the infection came back (as he was so well in himself) and he actually won a class and came second in another - this was showing, so it just goes to show that although after the op (if indeed you need to go to that stage) the wound may look rather scary (be warned), it does heal really well.

Of course there is always a risk with GA and because it is a tricky op due to the location (head) and the geography of the horses mouth the costs can add up. But it may not come to that with your boy if the antibiotics work.

If the infection does clear up/gets worse, A dentist would not be able to assist you for the actually removal as if it cannot be extracted through the mouth, due to the nature of the op and GA a vet would have to undertake.

Ours is a worst case scenario story, the best of luck, please let me know how you get on. If you have any more questions please pm me xxx

 

[Zirach]

I meant to also say that our tooth was an upper molar, I think this makes a difference as the lower molars are slightly easier to get to and dont involve going in through the head to 'punch out'.

 

[kinglouis]

My horse had a tooth abcess, lower right of the mouth. It showed up on the x-ray and she had a course of antibiotics - 14 days - which were injected into her. she was x-rayed 6 weeks later & it was gone. I can rummage and dig out the vet bill to get teh name of the antibiotics if you are interested?

 

[Holly Hocks]

Just found this post - I had a nightmare last year with a mare with a tooth abcess - to the extent where we nearly lost her due to the vet at the hospital who decided that she knew best and would not listen to the owner (me). After a couple of months of being treated for primary sinusitus (even I knew it wasnt) they removed the tooth under general anaesthetic after they ballsed it up trying to remove it under local anaesthetic. Several infections later she returned home and has been ok (touch wood) since. If it is a tooth abscess or fractured tooth, then you will have to get the tooth removed - antibiotics may make it dormant for a while, but it WILL flare up again in the future. Even after nearly three months in hospital, and several complications, my bill was £6500. So I think a normal cost without complications would be in the region of £3000. Good luck and I hope you get it sorted.

 

[Dippy]

Dear Zirach - many thanks for your reply. Apologies for it taking me a while to get back to you.

My mares tooth has now been removed (its also an upper molar). The removal procedure was done over 2 days using a local anestetic (extraction through the mouth). She is still on antibiotics and the 'gap' is being plugged at the moment while we wait for it 'fill in'. But she is very well in herself and the infection has improved. Having regular check ups so keep on top of things. No idea what the cost will be - has cost £300 so far, but have not yet had bill for removal - I'll look forward to that one!!

 

[Zirach]

Have moved this to top for amycamycamyc

 

[amycamycamyc]

Have moved this to top for amycamycamyc

thank you so much Zirach!!

This wasn't even the post i was thinking of but its fantastic, just what i needed. Scary how many of these teeth extractions seem to get reinfected. My mare is on round three of vet college now post having the tooth out, and in between visits has had baytril, 'normal' antibiotics and daily wound cleaning for nearly six months. I think the plan is now to go in from the outside of her jaw and scrape the remaining infection out, as the antibiotics aren't getting to it so it must be in the bone (with no blood supply). That my uneducated guess anyway, find out from vet tomorrow.

Anyway thank you again for going out of your way to find this for me

 

[Zirach]

No problem, good luck!! I think the problem with our boy was he was getting on a bit and he started to go downhill quite rapidly. It is amazing what they can do nowadays, we couldnt afford the equine hospital as teeth were excluded under the insurance so we had him a our equine unit and the newmarket surgeon came down. Cant fault them in any way however, it is just one of those things. Let me know how you get on xxx

 

[mrsh2010]

Wish I'd found this thread sooner - to all that have had this problem with the "upper Mollars" please can you tell me whether any of yours' were the very last mollar? If so I'd love to talk to someone.

My boy has cost me (my insurance company) £4k so far, he's going back in for day surgery next week, as the plug fell out and the infection is still continuing. Vet treatment has been on going for over ten weeks now and I don't know what to do for the best, so would love to speak to someone that's been through this.

Please get in touch and I will update on the whole story

Thank you

 

[happy_talk]

Mine has had 2molars out this year 209 and 210. This isn't the last molar though. Afaik the plug is meant to fall out as the scar tissue that forms pushes it out. I was told that if it didn't come out after 3 wks, then she would need it removed at the vets. Snotty discharge continued. She has also had her sinus flushed and 2 more courses of antibiotics. 2 trim sachets a day. Touch wood we have been months without continuous snot, and now only get occasional snot (one off sightings if you like) and no smell.
Is the day surgery to replace the plug?? Or are they planning to flush the sinus?

 

[mrsh2010]

Thanks - I've replied on the other thread too, but the day surgery is for both, they want to flush the sinus and replug the hole in the gum.

Basically they've said that without the packing food is going to continue to get up into the area, and therefore keep re-infecting. But having spoken to a very nice lady last night, the infection should not keep reoccurring unless there is still something there causing the discharge

Update on my thread

 

[happy_talk]

it probably took 2-3 months to the hole where the teeth were in my horse to completely fill with scar tissue. I'm fortunate to have a local vet who let me borrow the practice gag so that I could empty the hole of packed food periodically (1-2/ week). Initially it was tightly packed and difficult to remove, but it improved.
I was also advised only to feed soft food - no spiky chaff, like hifi or alfa. Grass being ideal. feed from the ground and to keep the horse is light exercise to encourage air circulation and mucus production in the sinuses to help them flush/drain themselves. but i'm sure you've already been told this.
Good luck