Pink teeth in a 10 months old Cane Corso

 

30595139_1823183557733595_5657871534119714816_nDr Elena Carmen Nenciulescu

Bucharest, Romania

 

 

 

Hera, a 10 months old female Cane Corso, was presented on the 15th of October 2018 for a dental consultation. She had pink teeth, a strong halitosis, „wasn’t eating like she used to” and showed signs of pain (didn’t let anyone touch her mouth or look at her teeth).

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Crown fracture with pulp exposure 304 and 404

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Image 1 – Abnomal density of the cortical bone

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Image 3 – X-ray of the rostral maxilla

 

 

 

 

 

 

 

 

 

 

 

 

 

X-rays showed a very large pulp cavity in all teeth, very thin dentin and enamel, crown fracture with pulp exposure in 304 and 404 (Image 2), but also an abnomal density of the cortical bone in the mandible (Image 1) . The owner reported that the deciduous teeth were pink too.

 

 

 

 

 

 

 

 

 

 

 

 

The dog previosly had 2 surgeries in both elbows in another clinic (bilateral elbow dysplasia). Hera is also blind with both eyes (there is no vascularization in the eyes).

Antibiotics (amoxicillin with clavulanic acid 20 mg/kg/12 h) and analgesia (meloxicam 0.1 mg/kg/day) were immediately started and the patient was scheduled for a dental procedure a week later.  CBC and routine biochemistry were normal.

The dental examination under aneshesia revealed 6 crown fractures with pulp exposure (109, 110, 209, 210, 304, 404). We extracted these teeth and tried to seal  with the remaining ones. The dental extractions were very difficult, but the healing was good (as you can see in the images from the second dental procedure).

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Image 4 – Complicated fracture 304

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Image 5-404 pulpar granuloma and 404 extraction

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Image 6- 404 pulpar granuloma and 404 extraction

At this first dental procedure (Images 4 – 11), we took a blood sample to see what were the vitamine D3, calcium and parathoyroid hormone levels. When results came, we found out that Hera had hypoparathyroidism (PTH level was 1.2 pg/ml, almost 16 times lower then the physiologic range) and recomanded a thyroid ultrasound, which is not availiable unfortunately.

Also Vitamine B12 was low, so the patient recieved treatment for that too.

 

 

 

 

 

 

 

 

After the first procedure, the recovery was fast, the dog started to eat the next day, but only very soft food.

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Image 8- Clinical view of the right maxilla

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image 9-Clinical view of the right maxilla

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Image 10 – Clinical view of the right mandible

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Image 11 – Clinical view of the left maxilla

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Image 12 – Clinical view of the right maxilla and mandible – tooth wear of all teeth is more pronounced

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Image 13 – Clinical view of the lower incisors that are even „pinker” then the first time

The second dental procedure (Images 12 – 16) together with  the ovariohysterectomy took place on the 23rd of February 2019, when we performed extractions of 208 and 209 retained roots and full 405 was extracted for histopathological examination (that will be performed at Histovet by Dr. Teodoru Soare). The recovery was even better than the first one. Hera received clindamycin 11 mg/kg/day, 7 days and meloxicam 0.1 mg/kg/day, 4 days. Unfortunatelly, because a second set of radiographs were not available for this dental intervention.

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Image 14 – Closer look of the right maxilla

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Image 15 – Left upper premolars

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Image 16 – Left maxilla and mandible

 

 

 

 

 

 

 

 

 

 

 

The dental pathology of this patient might be a very rare congenital dental condition called „shell teeth”, in which teeth have large pulp chambers and insufficient coronal dentin. The treatment of this dental disease is full mouth extractions, but given the very high level of difficulty of the extractions, we chose to extract only the fractured teeth. It may be a consequence of a congenital hypoparathyroidism, which would also explain the other pathological signs (blindness, bilateral elbow dysplasia).

Hera is a very interesting case with high didactic value. She remains supervised for evaluation of her clinical evolution.

Both interventions took place at QincyVet and were performed together with Dr. Raluca Zvorasteanu.

BRAIN TUMORS- 3 CLINICAL REPORTS

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DR SVETOSLAV PENCHEV

United Veterinary Clinic

Varna, Bulgaria

CLINICAL CASE 1

Old Dogs with sudden onset of seizures

 

The 1st clinical case is about 13 years old, castrated Belgian shepherd with acute onset of cluster seizures. Before 5 years the dog was operated ( total mastectomy and ovariohysterectomy) , because of mammary gland tumor.  Another vet made the blood analysis and there is no change in laboratory results. Contrast MRI study  was performed.

MRI findings:1 2 3 4

There are two, oval shaped, T1 hypo- and T2 hyperintense,  intraaxial mass lesion with cystic component. One is in right piriform lobe and another one is in the left olfactory bulb/ frontal lobe. The masses nonuniformly enhances following contrast administration, with more intense enhancement peripherally.  Mass effect with mild brain edema surrounding the lesions is present.5 6

 

Thoracic x-ray show :7

Multifocal nodules with soft tissue opacity in lung parenchyma

The reason of seizures are  metastatic brain tumors in  the right piriform lobe and in the left olfactory bulb and there are multifocal metastatic nodules in the lungs. Although the dog was operated ,  the primary mammary gland tumor is the reason of this condition

There is no feedback with the owner about dog`s condition.

 

CLINICAL CASE 2 8

Next case is about a 9 years, female, not castrated Labrador retriever with acute onset of cluster seizures. The dog present  proprioceptive deficit on the right fore and hind limb. There is no history of previous seizures.  By abdominal palpation mammary gland mass was find.

There is no change in the blood analysis.

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MRI findings:

There is   oval shaped T1, T2 mixed intensity mass in the parietal part of left cerebral hemisphere with surrounding brain edema. Mass margins are well defined on T2. Peripherally enhancing following contrast administration is present with mass effect and midline shift to the right

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Thoracic x-ray show multiple oval shaped masses with soft tissue opacity

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In this case we have the same condition. The metastatic lung and brain disease are due the primary mammary gland tumor.

The dog`s owner prefer to euthanized the dog, because the seizures getting longer and stronger.

 

 

 

 

 

 

CLINICAL CASE 3

The last case is about a 9 years, not castrated, female Jack Russell terrier with depressed mental status from a month and acute onset of seizures. The dog reacted with hypersensitivity in right cranial nerves, proprioceptive deficit in left fore and hind limb and proprioceptive ataxia. MRI contrast study was performed. MRI findings:    17 18 19 20

 

 

There is a one, irregularly shaped, T1 hypo and T2- mixed intensity intraaxial mass involving the right midbrain. The mass intensely, but nonuniformly, enhances following contrastadministration. There is a mass effect and surrounding brain edema.

In this case there is no history of neoplastic disease. This midbrain mass has a characteristic of primary tumor and It is the cause of the seizures.   Every dog after 5 years of age, who presented with a new onset of seizures should be suspected for a brain tumor. The most common indication for brain tumor in dogs are seizures, especially seizures that began for the first time in a dog older than five years of age. Other signs suggestive for a brain tumor include abnormal behavior, vision problems, circling motions, uncoordinated movements and  lethargy.