Hanna's Tooth Trauma

User avatar
Tehuantl

Post   » Mon Feb 04, 2019 5:30 pm


Good Afternoon,

I have two female piggies, Hanna and Mia. The weekend before New Years I noticed Hanna having issues with eating. When I examined her mouth I found she had a broken lower incisor that was still stuck in her mouth and bent back, trapping her tongue. The other one was completely missing except for a small portion that remained above her gum line. I am at a loss to what she hit in her cage to cause such trauma. It is a large C & C that I built myself, and that they have been in since we got them almost 2 years ago.

After much scrambling we found an emergency facility to take her to and have the partial broken tooth removed. I could not get it to come out and I feared hurting her. When we got back home we didn’t have critical care right away, but I improvised with pellets crushed in a mortar and organic veggie baby food. Once we got the critical care I started feeding her every time she told me she was hungry or about every 3 hours.
She would still try to eat, but to me it looked like she was in extreme pain. She would rear into a 3 point stance, or even on her rear legs and freeze, with her head cocked to one side. I did get her some pain medicine from our regular vet and it has helped. Her teeth grew back, but were so skewed, they had to be trimmed. She has lost a large amount of weight and now seems to rely only on the critical care. I do get her to eat the treats I have, but I break them into pieces. She is still doing what appears to be jaw jacking and wiggling her ears when chewing the treats on occasion. Nothing like she was doing before the pain medicine.

I am due back to the vets this week as her teeth have grown almost past each other. The uppers seem to grow from top and curve left. The lowers seem to be growing normally and are straight. Her uppers appear significantly longer then her lowers. I am trying my best to help her, but I am at a loss as to what to do. To see a specialist for dental I would need over $1000 and have to travel a significant distance. I am on limited income and cannot afford this.

She has had no signs of infection or abscess. Her back teeth are still being kept up to snuff. With the many visits she has had, the vet did keep looking into her mouth with an otoscope. He did not see any signs of sores or other issues. Her coat is a bit rough, not as bad as it was. She does have a little bit of tearing in her right eye with a bit of crusty formation.

I have tried to find more resources in my area, but it seems the nearest rescue is several hundred miles away in another state. I fear surrendering her to the Humane Society, as I fear she will just be euthanized.

Are there any suggestions as to ways to improve her diet? I know critical care is a great tool, but I have to order it online and it doesn’t always reliably show up. I need to help her put on weight in a healthy way, and all critical care seems to do is maintain her. How many tooth trimmings could it take? What is the rough proportion of length between lower incisor length, and upper incisor length? Could the misaligned teeth have caused her jaw to become misaligned?

Thru this ordeal she has displayed a zest for life and is one tough piggy. I just want what’s best for her, but am fearful also I may be prolonging the inevitable. I don’t want to give up on her, but my resources are limited. I am willing to learn to do anything for her to help her.

Thank you for any input for this sad, first time guinea mom.

bpatters
And got the T-shirt

Post   » Mon Feb 04, 2019 6:35 pm


What you need is an exotic vet with rodent dental experience. Dr. Loic Legendre (https://www.wcvds.ca/about-us/) will consult with vets about dental problems, and he's world renowned for his expertise with guinea pig dentistry. If I were you, I'd ask my vet to contact him and see what he says.

Has she had skull x-rays? And a thorough look at the back teeth with something other than an otoscope? Both of those are needed to accurately diagnose dental problems.

Good luck, and I hope something will work out for her and for you.

User avatar
Lynx
Celebrate!!!

Post   » Mon Feb 04, 2019 8:31 pm


I am sorry she is having these issues. An xray (as bpatters suggests) is a valuable diagnostic tool to figure out what is going on. Can she close her mouth completely? Is the jaw slightly skewed?

If you have not, I suggest reading all the dental pages to get a better idea of what might be going on.
www.guinealynx.info/malocclusion.html
www.guinealynx.info/teeth_broken.html
www.guinealynx.info/teeth.html

If you are not doing so now, be sure to weigh daily so you can keep track of how well she is doing.
www.guinealynx.info/weigh.html
www.guinealynx.info/handfeeding.html

User avatar
Tehuantl

Post   » Wed Feb 06, 2019 10:19 am


She is in for an X-ray and blood work now. I gave the links to this site and the chin-sling etc to my vet and he did read some of it and agreed to use the information as a resource. I also gave him Dr. Loïc Legendre contact information. I also called the Madison Vet teaching school and they are willing to help as well for both us and my vet.

I have observed that her jaw seems to be skewed to one direction. She tries to eat, but it bothers her and when she tries to chew on the right side she looks like she is yacking and ear wiggling. Her mouth is not hanging open, nor is she drooling or squeaking when she tries to chew. Her right eye is the one that looks a bit watery and gets a little bit of crusting.

I am giving her more then the recommended amount of critical care daily, but the calorie load just does not seem to be enough.

She is a stubborn little fighter. She was eating her critical care and Mia our other guinea pig was trying to sneak in and steal some. Hanna would do what amounts to a backhanded slap to the side of Mia's head with her paw, all the while latched on and eating her critical care.

The biggest issue is cost. The best rodent Vet in the state wants $1000 just for me to walk thru the door. I am working with my vet, but he will not do surgeries. He is however going to work on her teeth while she is sedated if need be after the x-ray.

I am hoping for the best, but worried a lot.

User avatar
Lynx
Celebrate!!!

Post   » Wed Feb 06, 2019 10:37 am


Okay, with one eye possibly watering, an xray could tell if there was an elongated root on that side interfering with her eye.

Crappy about the high cost of the "best rodent vet". There are many excellent vets who are more reasonable. If you can track down any rescues in Wisconsin, perhaps you can get more ideas if needed. It is encouraging your vet is working with you.

User avatar
Tehuantl

Post   » Wed Feb 06, 2019 2:34 pm


I have my answers. She needs emergency dental work as her upper molars have grown almost to within touching distance to each other. She also has a chronic ear infection that has led to calcification. My vet gave me the pain killers (Meloxidyl)to help her and waved some of the charges. I also have been given an antibiotic (Enrofloxacin).
I have managed to schedule a visit with the Veterinary School of Medicine in Madison, a 2 hour drive away. I am working on financing it, but I also need a way to increase her calorie load. The critical care is not enough. Is there any recommendations? Any additives to put in her critical care to help increase her calorie intake? I am feeding her every 2-3 hours up to 50 cc/ml at a feeding. I am even sleeping on a futon next to her cage so I can wake up to feed her when she calls for it. She needs a denser calorie load then critical care alone.

Any thoughts?

User avatar
Lynx
Celebrate!!!

Post   » Wed Feb 06, 2019 8:29 pm


Some suggestions that have come up over the years (like Ensure) are just not appropriate for a guinea pig's diet. I understand your frustration in feeding her. Once the molars are trimmed, she should be able to eat better. How soon is the appointment? Be sure to get pain medication post trim as it will help, from everything I have read.

Sending the best wishes your way.

User avatar
Tehuantl

Post   » Wed Feb 06, 2019 10:51 pm


I have the appointment tomorrow and a hotel set up as they may need to keep her overnight. It will most likely be a 3 hour drive one way. We are going to also have an ice storm tonight and then late in the afternoon, so I am going to head out in the window of best weather. I can see that once she has proper tooth balance she will pig out...no pun intended. I am just worried about complications. I pre-cut a pound of her hay into 1 inch strips and have a survival package. I am taking them in a larger travel cage so they will be comfortable and strapped in, in the back seat.

My vet gave me a 2 month supply of oral painkiller, so I am set there.

Thank you for the best wishes. I am also grateful for this website as well. It has been a very helpful guide and given me hope.

User avatar
Lynx
Celebrate!!!

Post   » Wed Feb 06, 2019 11:26 pm


I hope the teeth trim goes well. You have all our best wishes.

bpatters
And got the T-shirt

Post   » Wed Feb 06, 2019 11:56 pm


Yes, good luck to you. Please keep us posted on how the both of you do.

User avatar
Tehuantl

Post   » Sat Feb 09, 2019 10:08 am


I have her prognoses.

CT Scan
1) Chronic right otitis media and externa, regional osteomyelitis (bacterial, Fungal) of adjacent skull and temporomangibular joint. Ddx: less likely, agressive bony neoplasia (osteosarcoma, chondrosarcoma)
2) Sever multifocal bridging crown elongation and peridontal disease of cheek teeth, bilaterally.
3) Reactive mandibular lymphadenopathy. Ddx: less likely, metastatic.
4. No CT evidence of pulmonary or lymphadenopathy.

Basically she has a bad ear infection that spread to the bone. She was asymptomatic. The damage to her incisors brought the other issue to a head as her TMJ has been eaten away and she has only one left. Her cheek teeth got out of control at this point as she could not chew properly. I have some pictures I took of her CT, but the software they use prevents me from getting the actual files. I can upload what I have if people wish.

Despite her issues she presented to them as an underweight, but healthy guinea pig. They are really good at hiding issues. The vet told me they were surprised to see her in such good condition with what her issues are. Her body condition score was 2.5 (where 1 is emaciated, 3 ideal, and 5 is obese)

She will need dental procedures in the future as her right jaw is essentially floating with no joint.

I plan on following the recommendations and keeping her happy. She already is showing improvement at home. I gave her small cut veggies and she ate a good 1/8 cup on her own. It was good to hear her chewing on her own again.

I am just glad I had this site. It gave me the knowledge to be able to respond quickly to her needs and keep her fed with critical care and such. I just wish I had gotten her in sooner. But with the life threatening cold weather and snow we had, I am lucky she hung on.

She is one tough piggy, and the vets were amazed when I told them she was climbing in her cage last week. Something I was under the impression they don't really do. She has no neurological symptoms at present, but she will have to be watched. It is time to reinstall the guinea pig camera.

Her medication is Azithromycin 40mg/ml, 22.5 oral susp. I give her 0.6 ml once every 24 hours. This is the best one they have for treating infection in the bone. But there is no assurance the bone will ever be clear of the infection.

Her pain medication is Meloxidyl (meloxicam) 0.26 ml daily for 10 days. I have been given enough for longer in needed, but am hoping she will be pain free soon.

I will say this, I am glad I trained my guinea pigs to accept eating and drinking from syringes early on. You may never need to have to resort to that measure, but better safe then sorry. It allowed for early intervention with critical care on my part and no resistance from her. She quite enjoys critical care...of course I did get the apple banana flavor to start. She will eat the regular as well though.

She has been strolling around her cage this morning and warbling happily.

User avatar
Lynx
Celebrate!!!

Post   » Sat Feb 09, 2019 11:06 am


Thanks for the thorough explanation of your findings. Keep track of the antibiotic as azithromycin may cause issues in some guinea pigs:
www.guinealynx.info/antibiotic_advice.html

There is free software online that allows viewing of some sorts of files. I don't know if yours is one, but if you care to email whatever files they are working with, I may be able to sort through them and post a few images:
Image

My current computer does not have the software installed (last computer died) but I may still be able to figure it out.

I imagine getting adequate food into her is paramount.

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