Root sepsis associated with insect-dwelling Sebaldella termitidis in a lesser dwarf lemur (Cheirogaleus medius).

Sebaldella termitidis is a rare fastidious microorganism of the Leptotrichiaceae family. A variety of closely related species are associated with severe and even life-threatening disease in humans and animals, such as Streptobacillus moniliformis, the etiological organism of rat-bite fever as well as members of Leptotrichia spp. and Sneathia sanguinegens, which have been reported from cases of septicaemia. In contrast, since its description some 50 years ago, S. ermitidis has so far never been reported as a vertebrate pathogen, nor has it been found aside from its natural termite host. A lesser dwarf lemur was presented with unilateral facial inflammation originating from rotten maxillary teeth and septic root abscess. Surgical intervention and root extraction significantly improved the clinical cause in that a pus-filled cavity underneath the right eye could be drained, sampled and flushed. Bacteria displaying substantial characteristics of S. termitidis were cultured from the sampled pus. Morphological features observed included strictly anaerobic regular Gram-negative rods. Significant shared biochemical properties included negative reactions for cytochrome oxidase, catalase, urease, nitrate reduction and indole production. Furthermore, 16S rRNA gene sequencing revealed 99.9 % sequence homology to the S. termitidis type strain NCTC 11300(T), from which it, nevertheless, differed with respect to rep and rep- and RAPD-PCR profiles. An affiliation of the lemur isolate described in this study with the type strain of S. termitidis as well as a clear discrimination from other members of the Leptotrichiaceae could also be confirmed by matrix-assisted laser desorption/ionization time-of flight mass spectrometry and Fourier transform-infrared spectroscopy. This is the first evidence for clinical disease caused by S. termitidis in a vertebrate species indicating a broader host spectrum of this rarely encountered microorganism.

Orodental diseases and dermatological disorders are highly associated in pet rabbits: a case-control study.

BACKGROUND: Dermatological disorders (DDs) and orodental diseases (ODDs) are a major source of morbidity in pet rabbits. Orodental diseases have anecdotally been associated with cutaneous disorders in rabbits. HYPOTHESIS/OBJECTIVES: The purpose of this study was to evaluate the possible association between DDs and ODDs and to determine whether ODD increases the risk of DD in pet rabbits. METHODS: This study was a retrospective review of 222 medical records of pet rabbits examined over 1 year in 20 private veterinary clinics. Records of rabbits diagnosed with DD were selected. Frequencies of ODDs and other variables were evaluated between rabbits with and without DDs using logistic regression. Rabbits seen during the same time period, but without a diagnosis of DD, were included as control animals. RESULTS: The prevalence of DD was 28.4% (63 of 222), and the prevalence of ODD was 23% (51 of 222). A significant association was present between DD and ODD. Rabbits diagnosed with ODD were 63 times (odds ratio 63.75; 95% confidence interval 23.9-170.2; P < 0.0001) more likely to be diagnosed with DD in comparison to rabbits without ODD. CONCLUSIONS AND CLINICAL IMPORTANCE: The results of this study indicate a strong association between ODD and DD. In particular, rabbits with ODD have a greater risk of developing skin disease later in life. Although coat condition and hair quality can be influenced by many biological and environmental factors, ODDs should be carefully considered as a possible underlying condition in rabbits showing DDs. More prospective studies are needed to evaluate whether this association is due to a behavioural disorder or a metabolic condition.

Radiographic appearance of maxillary sinus feed impaction in a horse.

A 15-year-old Belgian gelding presented in respiratory distress, with bilateral mucopurulent nasal discharge, and right-sided epistaxis. The horse had a 5-year history of dental disease and had been recently losing weight. Radiographs indicated tooth root abscessation of the right maxillary third molar tooth and probable maxillary sinus feed impaction. These findings were confirmed at surgery and necropsy. The stippled, granular radiographic appearance described here is highly characteristic of sinus feed impaction.

Computed tomography of the upper cheek teeth in horses with infundibular changes and apical infection.

REASONS FOR PERFORMING STUDY: Infundibular changes are frequently encountered computed tomographic studies of the equine maxillary cheek teeth but the possible importance of this finding is not known. Infundibular caries is a possible cause for pulpitis and apical infection in some horses. OBJECTIVES: To study the relationship between the 2 pathologies and the frequency of changes. METHODS: The maxillary cheek teeth 108-208, 109-209 and 110-210 of 25 horses were evaluated using computed tomography and both the prevalence of infundibular and apical infection changes as the possible link with apical infection evaluated statistically. RESULTS: The prevalence of infundibular changes was high in both normal and diseased teeth. Both apical infection and the occurrence of infundibular changes were more prevalent in 109-209 and 110-210. In spite of this, the 2 processes could not be linked to one another. No differences were noted between the left and right sides. CONCLUSIONS: A direct relationship between the 2 processes was not established statistically and other underlying causes for the high occurrence of both apical infection and infundibular changes in diseased and normal 108-208, 109-209 and 110-210 are considered.

Endosurgical treatment of a retrobulbar abscess in a rabbit.

CASE DESCRIPTION: A 1-year-old sexually intact female Netherland dwarf rabbit was examined because of a 3-week history of signs of lethargy, decreased appetite, left unilateral exophthalmia, a previous draining sinus from a left maxillary facial abscess, and bilateral nasal discharge. CLINICAL FINDINGS: The rabbit weighed 1.0 kg (2.2 lb) and had a body condition score of 1.5/5. Physical examination revealed generalized muscle atrophy, bilateral mucopurulent nasal discharge, and severe left-sided exophthalmia. Diagnostic investigation revealed anemia, neutrophilia, severe dental disease, a superficial corneal ulcer of the left eye, and a retrobulbar abscess. TREATMENT AND OUTCOME: Stomatoscopy-aided dental trimming, tooth removal, and abscess debridement were performed. Antimicrobials were flushed into the tooth abscess cavity, and antimicrobial treatment was initiated on the basis of cytologic findings and results of bacterial culture and susceptibility testing. Two months after the initial surgery, minimal exophthalmia was evident and no further physical, radiographic, or ultrasonographic changes were evident. CLINICAL RELEVANCE: Stomatoscopy is a valuable technique that can facilitate diagnosis, treatment, and serial reevaluation of rabbits with dental disease.

Tooth root abscesses in llamas and alpacas: 123 cases (1994-2005).

OBJECTIVE: To determine features, outcome, and complications of surgical treatment of camelid tooth root abscesses. DESIGN: Retrospective case series. ANIMALS: 123 camelids with tooth root abscesses. PROCEDURES: Signalment, history, teeth involved, surgery performed, ancillary diagnostic tests, and short-term complications were recorded from each medical record. An owner questionnaire was used to obtain long-term (> 1 year) follow-up information. RESULTS: The most common surgical treatments included tooth extraction (n = 106) and apicoectomy (13). Owners provided follow-up information on 84 animals. Postoperative complications were reported in 42 of 84 animals. The most common complications included reinfection (n = 15), chronic draining tract (14), and osteomyelitis (14). Significantly more camelids that were in good or obese body condition at the time of surgery were alive at the time of follow-up, compared with those with thin body condition at the time of surgery. Camelids with 2 teeth extracted had significantly more complications than those with 1 tooth extracted. Thirty-four of 47 owners reported that they were completely satisfied with the outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Owners of camelids in poor body condition should be forewarned that such animals are at greater risk for complications following dental surgery. Clinicians should recognize that the number of teeth affected was not associated with a poorer outcome.

Treatment of mandibular osteomyelitis in two red-necked wallabies (Macropus rufogriseus) by means of intensive long-term parenteral drug administration and serial computed tomographic monitoring.

CASE DESCRIPTION 2 female red-necked wallabies (Macropus rufogriseus) were evaluated because of sudden-onset mandibular swelling, ptyalism, and hyporexia. CLINICAL FINDINGS Physical examination revealed a mandibular swelling with a fluctuant center in both wallabies. Hematologic analysis revealed leukocytosis with a mature neutrophilia and monocytosis in one wallaby (case 1) and a slight neutrophilia, hyperglobulinemia, and high serum alanine aminotransferase activity in the other (case 2). Cytologic examination of the swelling revealed a uniform population of gram-negative rods in case 1 and neutrophilic inflammation in case 2. Radiography revealed a soft tissue mandibular swelling with osteolucency around mandibular incisor roots in both wallabies. Computed tomography revealed changes consistent with chronic active mandibular osteomyelitis and reactive bone formation, but also sequestra formation not appreciable via radiography. TREATMENT AND OUTCOME Long-term antimicrobial treatment was initiated with clindamycin (17 to 21 mg/kg [7.7 to 9.5 mg/lb], IV, q 12 h for 40 to 55 days) and high-dose benzathine penicillin G (80,000 U/kg [36,364 U/lb], SC, q 12 h for 150 days). Serial CT was performed to evaluate response to treatment and resolution of disease. A CT scan 18 months after the initial evaluation revealed complete resolution of osteomyelitis and sequestra. CLINICAL RELEVANCE Advanced imaging and long-term treatment and management were integral to the successful outcome for these wallabies, given that the osseous changes visible on CT images were not visible on standard radiographs, guiding therapeutic decision-making. This report provides new therapeutic and diagnostic monitoring information to assist clinicians with similar cases.

Diagnosis and management of a retrobulbar abscess of periapical origin in a domestic rabbit.

Retrobulbar abscessation is the most common orbital disease of rabbits, and the lesions are notoriously difficult to treat successfully. This article describes the diagnosis, surgical treatment, and long-term management of an extensive abscess located within the right maxilla and retrobulbar space of a domestic rabbit. Preoperative assessment and long-term monitoring were achieved with a combination of radiography, ophthalmic ultrasonography, and CT. Extraoral rigid endoscopy via a fenestration in the maxilla was used to facilitate surgical debridement of the lesion, and extraction of multiple cheek teeth has been fundamental to achieving control. The long-term use of topical and systemic antibiotic preparations and nonsteroidal anti-inflammatory medication is discussed.

"Lumpy jaw" in exotic hoof stock: a histopathologic interpretation with a treatment proposal.

"Lumpy jaw" of artiodactyls and macropods, although often considered a manifestation of actinomycosis, is actually an osteomyelitis, perhaps commencing with a dental root abscess or trauma to the jaw. Anaerobes may be cultured from the lesions, and vegetable matter may be impacted in them. It is a chronic disease and difficult to treat. Successful treatment may include draining the abscess, cleaning the cavity with saline and antibiotics, flushing with a combination of hydrogen peroxide-sodium hypochlorite and Betadine, and apicoectomy and endodontic filling when active inflammation has subsided.

[Fractures of the canines require attention]. / Een hoektandfractuur verdient de juiste aandacht.

Hardly any attention was paid to a barely visible fracture of a canine tooth (104) in an 18-month-old dog. When the dog was 6-years old, a fistulous opening was seen on the bridge of the nose. A year later, radiography revealed a periapical process. The investigations performed and treatment given are described, as is the correct way to handle fractures of the canines.

Equine dental disease part 4: a long-term study of 400 cases: apical infections of cheek teeth.

Of 400 horses referred because of equine dental disease, 162 suffered from primary apical infections of their cheek teeth (CT), including 92 with maxillary CT infections and 70 with mandibular CT infections. Maxillary swellings and sinus tracts were more common (82 and 26% incidence, respectively) with infections of the rostral 3 maxillary CT, than with infections of the caudal 3 maxillary CT (39 and 5% incidence, respectively). Nasal discharge was more commonly present with caudal (95%) than rostral (23%) maxillary CT infections. Mandibular CT apical infections commonly had mandibular swellings (91%) and mandibular sinus tracts (59%) and these infections were closely related to eruption of the affected CT. A variety of treatments, including medical treatment, apical curettage, repulsion and oral extraction of affected teeth were utilised in these cases, with oral extraction appearing to be most satisfactory. Infections of caudal maxillary CT with a secondary paranasal sinusitis were most refractory to treatment, with a complete response to the initial treatment achieved in just 33% of these cases. Most other cases responded fully to their initial treatment. The long-term response to treatment was good in most cases.

Periapical abscesses of cut canine teeth in cynomolgus macaques.

Periapical abscesses of canine teeth in a group of 47 male cynomolgus macaques are found to be associated with a procedure, involving cutting the canine teeth, used to make non-human primates less hazardous. Examination of 150 canine teeth in dry specimens revealed 30 cut teeth with no exposure of the pulpal chamber and 107 cut teeth where the dental pulp had been exposed. Of those teeth which had the pulpal chamber exposed by the cutting procedure, 85 (79.4%) showed clear evidence of osseous changes consistent with abscess formation in the apical regions.

Radiographic examination of mandibular lesions in barren-ground caribou.

Dental anomalies were observed in 43 of 1,226 barren-ground caribou (Rangifer tarandus groenlandicus) taken between 1966 and 1968. In five of these 43 animals, the mandibles had deformities which radiography showed to be the result of dental abscesses in four cases and probably of a trauma in the other. The absence of actinomycotic lesions of the jaw bones of these 1,226 animals, and of more than 500 examined previously, indicates that "lumpy jaw" is rare in barren-ground caribou. The authors suggest the use of radiography to determine the nature of bone growth on skeletal remains, in the absence of soft tissues for examination for Actinomyces, either microscopically or by cultural methods.

Endodontic surgery for treatment of a fistulated molar abscess in an orangutan.

An adult Bornean orangutan was treated for bacterial labyrinthitis, which was a sequela to a molar abscess and maxillary sinusitis. Antibiotic therapy and endodontic surgery led to complete remission of clinical signs.

Tooth root abscesses in New World camelids: 23 cases (1972-1994).

OBJECTIVE: To determine typical clinical and radiographic findings in a group of New World camelids with tooth root abscesses and to determine outcome after medical and surgical treatment. DESIGN: Retrospective case series. ANIMALS: 23 llamas and alpacas with radiographic and clinical evidence of tooth root abscesses. PROCEDURE: Disease history, signalment, physical and radiographic examination findings, bacteriologic culture results, treatment, and short-term and long-term outcome were retrieved from the medical records. RESULTS: Local swelling was the most common clinical abnormality in camelids with tooth root abscesses. Mandibular molars were affected most commonly, and bacteriologic culture of samples from lesions often revealed facultative anaerobic bacteria. Antibiotic treatment for at least 30 days, surgical extraction of the affected tooth, and a root canal procedure were used successfully to treat tooth root abscesses. CLINICAL IMPLICATIONS: Both surgical and medical treatment of tooth root abscesses may lead to successful resolution of clinical signs in New World camelids.

Diagnosis and surgical treatment of periapical infection of the third mandibular molar in five horses.

Diagnosis and treatment of periapical infection of the third mandibular molar in 5 horses was assessed. In 4 of 5 horses, there was a recent history of dental work performed. Diagnosis required multiple imaging techniques. Radiography revealed evidence of periapical bone lysis or tooth root lysis of the third mandibular molar in 3 of 5 horses. Sonographic examination was effective in identifying abscesses within the masseter muscle and defects of the lateral cortex of the mandible in 4 of 5 horses. Nuclear scintigraphy was diagnostic in 1 of 2 horses examined. All horses were treated by repulsion of the affected tooth. The surgical approach involved elevating the masseter muscle from the caudal portion of the mandible. This approach provided excellent access to the affected tooth with minimal postoperative complications. All incisions healed with good cosmetic results.

Atrophic rhinitis of pigs: abattoir studies.

The snouts of 2701 pork, bacon and heavy pigs killed at five abattoirs in England and Scotland during March to July 1974 were examined for evidence of atrophic rhinitis. Lesions were graded 1 to 5 according to severity. Suspicious lesions were present in 75-7 per cent of the sample. There was obvious atrophy of the turbinates in 44-7 per cent (grade 2 to 5) and severe atrophy in 17-5 per cent (grades 3 to 5). Foreign bodies were found in or between the posterior cheek teeth of 5-3 per cent of the sample. There was frequently an associated gingivitis. Other lesions seen included black discolouration of the teeth, severe tooth wear and osteoarthrosis of the temporomandibular joint. It was concluded that the incidence of atrophic rhinitis could have increased markedly since the last survey of the United Kingdom was undertaken in 1956/57 and some form of disease-monitoring service was urgently needed.

Fluorosis in dairy cattle.

The investigation of a high incidence of arthritis in 21 dairy herds disclosed elevated fluorine levels in bone samples. In every herd except one, where herbage and water was contaminated by industrial fall-out, the main source of the fluorine was from mineral supplements; In a few herds, purchased cake or grain balancers contributed to the abnormal levels. Over 100 cows with arthritis had fluroine levels in the bone of between 2000 and 8000 ppm, or were in herds whose diet contained excess fluorine. Characteristic tooth lesions often confirmed the link between arthritis and fluorosis. Sixteen out of 31 samples of mineral supplement contained dangerous levels of fluorine (3000 to 13000 ppm). Grain balancers contained up to 400 ppm F, and dairy cake had levels as high as 140 ppm F. There was a statistical correlation between a high incidence of damage to peri-articular structures, resulting in debility and loss of production, and elevated bone fluorine.

Acute and chronic alveolitis/osteomyelitis ("lumpy jaw") in small exotic ruminants.

Tooth-related abscesses in small captive ruminants are most likely foreign body-induced periodontic-endodontic lesions. The instigating cause may be abnormal texture of dietary material. Bacteria, though probably not the initiating cause, significantly contribute to pathology and morbidity. Extraction of severely affected teeth is an effective although sometimes challenging mode of treatment. Periodically complications may arise, which vary in difficulty of treatment. Prevention may be the alteration of the major forage component of the diet to textures that are less coarse and stemmy, and the alleviation of any crowding and sanitation problems.

The use of calcium hydroxide in the treatment of abscesses in the cheek of the rabbit resulting from a dental periapical disorder.

Abscesses on the jaws of 10 rabbits resulting from diseased premolar or molar teeth were treated by extraction of diseased teeth and injection of calcium hydroxide paste into the abscess cavity. The abscesses did not recur (follow-up period 3-38 months, median 24 months).