Sebastian's tooth root abscess

MaryEllenCG

Post   » Sat Feb 13, 2021 9:41 pm


Hello! Sebastian (6 years old) had an abscess on his chin lanced two weeks ago yesterday. The vet said it was a tooth root abscess -- she drained it, and sewed the wound open so it would continue to drain. We've been flushing it three times a day, initially with a surgical scrub liquid, then with warm water (the vet's recommendation, since, when we flush the wound, the liquid squirts up from around his lower incisors into his mouth, and she didn't want him ingesting the surgical scrub). He went back to the vet to have the stitches removed yesterday. Our concern is this: the wound is still producing pus when we flush it out. Sometimes it's just a little, but earlier today it was a fair amount -- about the size of a small pea. It's been producing pus off and on for two weeks. The vet says it's not ideal, but not too out of the ordinary. She's more concerned that, when she saw him yesterday and flushed out the wound herself, water still came up from around his teeth. She gave us Betadine to flush the wound with for another couple of weeks (or for as long as the wound stays open), and he's still on Bactrim, .4 ml twice a day. She also gave uis silver sulfadiazine cream to put on the wound after we flush it. She wants to see him in two more weeks, to see how he's healing. She's concerned that she'll have to pull his lower incisors.

So, I have two questions: one, is the presence of pus in the wound as alarming as it seems? I feel like, after two weeks on antibiotics, and having it flushed out, there shouldn't be pus. And two, if he does need his teeth pulled, what can we expect? He's almost 6 1/2 years old, so any surgery is worrisome to us, but obviously we want him healed up and healthy. I'm worried that he'll have a lot of trouble eating if he loses his teeth.

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Lynx
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Post   » Sat Feb 13, 2021 11:20 pm


Some infections are persistent and hard to get control of. Pulling teeth sounds like it might be risky. If teeth are pulled out, the opposing teeth may overgrow. There is some risk in removing teeth.

I wish I had more knowledge and could advise you better.

p.s. flushing with warm sterile saline solution is a good choice.

MaryEllenCG

Post   » Wed Feb 17, 2021 12:20 pm


We're still flushing it twice a day with the Betadine, which he hates, of course. There was just a bunch of pus in the wound. It doesn't smell bad, and it's not warm to the touch, though. The vet also suggested using a warm compress on his chin a few times a day -- he hates that too, poor little guy, but maybe it's helping?

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Lynx
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Post   » Wed Feb 17, 2021 8:57 pm


Warm sterile saline is also good for flushing. It sounds like you are keeping on top of it. Good to hear it does not seem infected. I hope you see progress soon.

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ItsaZoo
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Post   » Thu Feb 18, 2021 12:30 am


Hopefully if it stays open and clean, it will start to heal from the inside.

MaryEllenCG

Post   » Thu Feb 18, 2021 2:03 pm


That was the initial hope, but... as of today, the vet is even more certain that the tooth will need to come out. We have an appointment for the 24th -- we're all still hoping that things will improve by then, but that hope is increasingly slim. It's a lower incisor, so hopefully the extraction won't be too awful. Poor little guy.

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Lynx
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Post   » Thu Feb 18, 2021 3:41 pm


Has this vet done a dental extraction on a guinea pig or will you see a veterinary dentist? I would imagine this requires skill and experience to (it seems) remove the tooth and root(?) while avoiding any damage to the jaw bone.

I wish you the best.

MaryEllenCG

Post   » Fri Feb 19, 2021 9:44 pm


She's done extractions before. She's the recommended guinea pig vet around here -- our previous vet, who is so good with piggies, just moved cross country, alas. I don't know what other option we have besides the extraction, if the infection's not healing.

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Lynx
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Post   » Sat Feb 20, 2021 8:13 am


I wish you the best. Let us know how things go. I do think losing an incisor is not as bad as losing a molar as it will be easier to watch for overgrowth of the other incisors if there are issues. Generally with a broken tooth, the opposing incisors can help to keep the remaining teeth a good length. Pictures showing regrowth of a broken incisor here:
http://www.guinealynx.info/teeth_broken.html

MaryEllenCG

Post   » Sat Feb 20, 2021 2:00 pm


Yeah, we've had piggies with broken incisors in the past. I think he'll be okay, I just hope the can extract just the one tooth and not both incisors, but I've been told in the past that they usually have to take both?

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Lynx
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Post   » Sat Feb 20, 2021 10:18 pm


I can't answer that question. I also hope they can just do one.

MaryEllenCG

Post   » Sun Feb 21, 2021 8:19 pm


Me too!! We just want this resolved. Sebastian cries so much when we flush out the chin wound, it's obviously painful. Poor little buddy.

MaryEllenCG

Post   » Wed Feb 24, 2021 2:58 pm


The vet just called -- Sebastian's troublesome tooth is out! She said it came out much more easily than she expected, because it was VERY diseased. Lots of thick gunk came out with it -- she said it was much worse than it had looked when she drained the abscess. So she's confident that removing that incisor was the right course of action. He's awake, and they're going to see if he'll eat a little hay, and give him some Critical Care, and we can pick him up in about an hour. They did only have to take the one tooth, so that's good. She thinks he'll heal up just fine. He's lost a little more weight, but we're sure it's from the stress of having the abscess drained, and then having to have the wound flushed multiple times a day. And I'm sure his mouth hurt! Poor little buddy.

Thanks for all the advice and commiseration, I really appreciate it!

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ItsaZoo
Supporter in 2020

Post   » Wed Feb 24, 2021 10:07 pm


So glad to hear he came through the surgery so well. It sounds like your vet is quite skilled, and I hope he makes a quick recovery and starts taking food on his own. Best wishes!

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Lynx
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Post   » Wed Feb 24, 2021 10:15 pm


Will they give you some pain reliever for him? Metacam/meloxicam? It can make a world of difference.

I hope he heals up well!!

MaryEllenCG

Post   » Thu Feb 25, 2021 12:18 pm


He's on gabapentin for pain -- the vet wants to avoid meloxicam if possible because he was diagnosed with an ulcer last month. (He's had a tough time recently!!) He seems to be doing well on it. He's eating fine, snuggly, almost as cheerful as usual. Once he heals up from the tooth extraction she'll evaluate him, for the ulcer.

MaryEllenCG

Post   » Tue Mar 30, 2021 6:25 pm


Sebastian seemed to be healing up from his tooth extraction just fine, and then the other day, we noticed that his chin had a swollen lump on it that was painful to the touch, and... the abscess is back. The vet tried to examine it last night, and it burst as soon as she touched it, so it got an unplanned draining. She's doing a culture, and today she called and said she wants to sew it open, have us flush it out again, and see how he does. I'm just in tears -- flushing it out was so stressful and painful for him before. I hate that he's going through this all over again, and we don't know why the abscess came back.

bpatters
And got the T-shirt

Post   » Tue Mar 30, 2021 9:14 pm


Did the vet remove the sac around the previous abscess? They often recur if the sac isn't taken out.

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Lynx
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Post   » Tue Mar 30, 2021 9:27 pm


Yes, supposedly the walls of the abscess generate the pus.

I am so sorry it has come back. I totally sympathize with you about the stress and worrying about the pain.

I have read about antibiotic beads being used in some difficult situations. An infected oral cavity, for example. The beads are made by hand and can use stronger antibiotics since they are not administered orally or systemically.

MaryEllenCG

Post   » Fri Apr 02, 2021 8:26 pm


We'll ask about that, thank you!

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