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Post by here to stay on Sept 19, 2017 16:26:13 GMT
My dear older horse Tessie has hypercementosis. In essence her upper incisors are desolving nubs and her lower incisors are changing shape rapidly. Then yesterday I found a broken off incisor in the shed.
The vet came out to check on her. The incisor was broken off below the tooth line and the gap was full of debris and stinking. The vet thought she had already had an abscess in the area. For the moment, I'm going to be flushing the tooth socket but she, a normally very agreeable girl, made it clear this was not going to go well.
He told me that her incisor on the other corner was loose and likely to go the same way. The only cure he said was surgery to remove the teeth and it was not often successful. I have been reading on the net of course and have seen several articles about successful surgeries in an individual but nothing on unsuccessful ones.
I'm thinking that surgery to remove all her incisors is something to maybe do now but want some outside info before insisting. Any help from anyone on this? Grazing is not required for her anyway so not having incisors will not be a survival factor. Just whether she will both survive the surgery and recover at her age and, of course whether I have the wherewithal to afford it if it proves horribly expensive.
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Post by horseyrider on Sept 19, 2017 18:46:01 GMT
I have no personal experience with hypercementosis, but I have had old, toothless horses before. If you can get her through the surgery and get her to heal, she can have a gruel made of Senior. I used to bring out hot water, pour it over a bucket of Senior and stir, let it soak up the water, add some more to make a slurry, and feed. They lap and suck it, and do just fine; one was even still in work.
If it was my horse, I'd invest the money in a second opinion and a trip to a specialist. Someone who does this sort of work all the time will be faster, have a better idea about sedation and general anesthesia in an older horse, and may even suggest some dentistry instead. They'll have access to ultrasound and xray for the skull, and would be able to give you more specific diagnostics. That might save her the trauma of having to pull all incisors. Not to mention hopefully saving some dough through fewer extractions.
OTOH, if they're coming apart so quickly, it sounds like the specialist might recommend extraction while he still has something mostly sound to grab. A lot of the mess comes from when the remains of the roots break and they're only partially extracted, and they're forced to go digging.
How old is she?
I feel for you about flushing the abscess. You're clearly someone who has been around horses for a long time; so as you know, as time goes on, if it doesn't hurt, they generally will learn to accept what we do. It sure is a rodeo in the meantime though, isn't it?
Sorry you have such a sucky situation. The old ones are the most dear. Bless you for taking such good care of her.
ETA: Did your vet pack the hole with cotton gauze?
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Post by here to stay on Sept 19, 2017 19:18:05 GMT
Tess is 26. And luckily this condition seems to effect only the incisors, not the molars, so she would still be able to eat hay. Apparently though her tongue is likely to hang out with no incisors to hold it in.
One of my dilemmas these days is that it is a 8 hour drive over a lot of 2 lane highway to get to the university. Or a 4 hour drive over the mountains on twisty steep roads. I'll do it if I have to but neither Tess nor I are really fit for it. I'm pretty sure she could not handle the mountain road.
And no, the vet did not pack it. I swear there is an abcess still draining as her mouth smells fresh after I've flushed but when she reached over to scratch herself, the wet spit she left smelled awful.
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Post by here to stay on Sept 20, 2017 18:17:35 GMT
This is going to be a long, painful project. The vet said taking out all her incisors is something he is not willing to do. He would take out the broken one and the other corner but even he said the others are likely to follow.
I asked if there was anyone closer than Davis to do it. He said no. He could not be more disinterested in her future.
The best I could get out of him is that I will see him in two weeks for xrays that he will send down to Davis for their recommendation.
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Post by feather on Sept 20, 2017 18:42:12 GMT
That is so sad that there are no other options for finding another dental vet and all that your horse is going through. These must be heartbreaking decisions.
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Post by aoconnor on Sept 20, 2017 19:52:07 GMT
I'm so sorry you and Tess are going through all of this. I would be finding a second opinion for sure.
As for the abscess, did your vet at least prescribe Uniprim to clear any infection there may be? Sheesh, that would have been the first thing my vet would do so that if surgery were an option you would be able to have it done sooner than later. I'm on my way to my vet to pick up some mess, I'll ask about this and let you know what they say.
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Post by here to stay on Sept 21, 2017 0:41:52 GMT
The vet mentioned a systematic antibiotic but said it would do more harm than good. I have been flushing it 2 to 3 times a day and I think it is helping. Anyway she is more perky today and the hole looks less angry.
In her usual good natured way, she is standing for the flushing pretty well. I use a large syringe and squirt right into the hole. The The blow back is definitely less stinky. I'm using plain water, warm from the house.
The lack of other resources and I'm afraid both Tessie's and my age has made a long haul problematic. There is only one other large animal vet in the county and he's cow vet. Even second opinions are long distance propositions.
However we will do what needs doing.
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Post by PNP Katahdins on Sept 21, 2017 16:01:21 GMT
Would someone at Davis be willing to talk to you about finding a competent specialist closer to you? We are lucky to be only an hour and a half from UW-Madison which has a good vet school. They have many excellent specialists, both large and small animals. They do understand that much of the state is a long ways from them though.
Maybe you can have a friend go with you to help with driving, it sounds like at least two full days and a night to take the better roads there and back.
Best of luck to you and Tessie.
Peg
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Post by horseyrider on Sept 21, 2017 16:55:23 GMT
Oh duh, I didn't realize you're a cheesehead, here to stay! There is a traveling equine dentist that I can heartily recommend, who travels all over the Midwest, and his credentials are impeccable. His name is Lance Rubin, and is one of the founders of the Equine Dental Providers of America. Here's a link to his bio and contact information. Scroll on down: www.equine-dental-providers-of-america.org/about-us/This guy is a genius. He will need a DVM to sedate, and it's not a cheap venture; but if you can get some other horse friends together to help reduce the cost and get him out, it would be well worth your while. He's one of the guys who, twenty years or so ago, started working on horses with motorized dental tools, and was part of the curriculum in certifying DVMs and DCs for animal chiropractic at the AVCA. This guy gets five out of four stars on his chart, IMO. He can help you.
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Post by horseyrider on Sept 21, 2017 17:05:32 GMT
Urg, I just saw you're not a cheesehead after all, here to stay. But if you check the website's referral page, there are quite a few traveling equine dentists in your state. I can't speak to their skills firsthand like I can Lance Rubin; but certainly you can find someone who would be more helpful than your vet. And if you use your vet for sedation, he just might learn a few things. When my equine vet first saw Lance work, he turned to me and said "Now I realize that all these years I've just been taking peoples' money." Doc invested in state of the art tools and continuing education, and consults with Lance on the really weird cases. I hope you can find some good help.
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Post by aoconnor on Sept 22, 2017 12:27:21 GMT
here to stay, it sounds like you are doing what you can, and that seems to working! I always worry about a deeper infection setting in, but if just flushing with warm water is getting the smell out, then the hole is improving! Do you have any Chlorhexidine by chance? If you do, or even Betadine or Iodine solution, you could add a little to the syringe and that may help clear any other bacteria lingering. Just trying to think of what else you could do to clean that hole! My vet was crazy busy yesterday when I went down, I wasn't able to talk to her about this. I'm sorry:-( I am going to text her later today, I will ask about it then.
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Post by here to stay on Sept 22, 2017 15:49:07 GMT
Thank you aoconnor, yesterday her 'hole' did not stink. I only flushed it with three syringes rather than the six or seven I had been doing. I have both betadine and chlorexidine. I will add a tiny bit. Hopefully it will not make her object to the process. Thanks.
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Post by aoconnor on Sept 23, 2017 16:31:29 GMT
Thank you aoconnor , yesterday her 'hole' did not stink. I only flushed it with three syringes rather than the six or seven I had been doing. I have both betadine and chlorexidine. I will add a tiny bit. Hopefully it will not make her object to the process. Thanks. Chlorhexidine is my favorite, it tends to really get at the bacteria better for my use. A tiny bit is all you need, my mixture is usually an ounce Chlorhexidine to a 1/2 gallon water. In a syringe the tiny bit will be just right! I have several mares in my herd that have extensive oral issues, including two of my girls that have holes in their gums from prior owners who never had them floated. I have had to flush and flush and flush, I know just what you're going through as far as that goes!
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