Case of the Month – Jan 15

Captain Bligh, a cocker spaniel, thought that he would kick off the new year with a spot of re-decorating. Unfortunately this involved a rather dramatic and messy series of events! Bligh’s owners came home one evening to find large pools of blood spread around the floor of their home which had come from one of their two dogs. Oddly there was no sign of ongoing, external bleeding from the dogs and they both appeared to be in good health and pleased to see them!  Armed with a sample of the gory secretion, some photos of the scene of carnage and both the dogs they arranged an appointment at Oak Barn Vets. A swift examination of the sample and both dogs confirmed it to be more likely vomit than faeces and a small patch of blood on Bligh’s shoulder suggested that he was the patient. After a full clinical examination it became clear that Bligh was showing signs of having an uncomfortable mouth. A swelling over his right muzzle and a bloody discharge from the base of one of his upper teeth suggested the cause to be a tooth root abscess. The likely course of events was that Bligh had swallowed a large volume of blood and then vomited, hence the pools on the floor. Pain relief and antibiotics were prescribed and Bligh was admitted for a general anaesthetic and full mouth examination with dental surgery and possible tooth extraction planned. A pre-anaesthetic blood test showed that Bligh was mildly anaemic from the blood loss and had a raised urea level, likely from swallowing and digesting blood. Once anaesthetised the cause of the bleeding and abscess became very clear. Bligh had a piece of stick wedged between two of his upper teeth and bridging the roof of his mouth!  This had likely become stuck there several days previously and over time the pressure from the stick against the roof of his mouth (his hard palate) had eroded a wound in the soft tissues. Pressure from the two ends of the stick had caused abscesses in the associated tooth roots hence the swelling on the side of his muzzle. For those of you who are not squeamish some images of his mouth with the stick fragment and then after removal can be seen in the gallery below. Over time the hole in Bligh’s hard palate had reached one of the major arteries supplying the roof of the mouth, the maxillary artery, and when this became damaged it started to bleed significantly. It is likely the large amount of swallowed blood made Bligh feel unwell and caused him to vomit.  Surprisingly he did not seem to be in any discomfort and was eating and behaving normally until the haemorrage had started. Having removed the stick fragment the artery was ligated and the bleeding thankfully stopped. The damaged tissues were thoroughly flushed and debrided and the wound left to granulate and heal. Over the course of a couple of weeks, and with the help of pain relief and antibiotic therapy, Bligh’s hard palate healed and the tooth root abscesses resolved without any teeth needing removal. The injury should cause no ongoing problems with Bligh’s ability to eat and chew as he is already proving! After talking to Bligh’s owners it appears that one of his favourite hobbies is to dig up roots and chew them up, possibly the source of his foreign body? It is worth bearing in mind some of the hidden risks of dogs being allowed to play with or chew sticks. Unnoticed foreign bodies such as this can cause erosions all the way through into the nasal passages in dogs, known as an oro-nasal fistula, which can present a real challenge to repair. If you see your dog or cat rubbing or pawing at their mouth, salivating or they have developed very smelly breath, these can all be signs of oral foreign bodies or infections and it is well worth having your pet’s mouth examined as soon as possible.