Tag Archive | EOTRH in horses

A Canine Switch

So Biz and I headed back up to the clinic on Monday to see about having two of his canine teeth removed, as they seemed to be causing him a lot of pain. After further consulting, we decided to try continuing the daily painkiller for awhile and then extract later if it is still needed.

If you are newer to this blog, you may not know that Biz has EOTRH, more officially known as equine odontoclastic tooth resorption and hypercementosis disease.  In very simplistic terms, it is kind of like osteoporosis of the teeth. The tooth root begins to break down and get spongy (the tooth resorption), and then the body tries to strengthen the weakening root by creating a ball of “cement” (the hypercementosis) around the damaged root.  The ball of cement presses on the gums, causing pain.  Not to mention the teeth become loose, and can eventually just break off either at or below the gumline.  More pain.  Interestingly, people and cats get their own version of this disease.  Something to look forward to!

Although it isn’t a new disease, it has become much more recently studied in horses, because, in the past horses didn’t live long enough for it to matter.  They died of something far more usual (colic, laminitis, etc.) long before some vet ever started poking around much in their mouths…  Horses are living longer, more leisurely lives, just like people, and now the diseases of old horses are becoming more common.

Biz is 30; considered an old horse.  Domestic horses, like people, have a wide variation in longevity, and most statistics point to an average lifespan of 25-30 years.  He has had 9 of his 12 incisors pulled already, and his canine teeth are now affected.  One canine had already broken off at the gumline sometime in the last year and healed over on its own.  That left three canines…  Two of these canines were the ones that we were eyeing for potential extraction today.

After we decided to go with the more conservative daily painkiller approach, the vets then went to do a routine float on his molars and cheek teeth, and get rid of a sharp edge on the one canine that seemed to not be a problem.  “Floating” a horse’s teeth is the process of filing down the sharp edges to keep them from pinching or poking the horse’s cheeks and gums.  The process of chewing hay and grass just naturally creates these sharp edges over time, as the teeth wear unevenly.  This too, can cause pain.  Most of the time anymore, floating is done with a power tool in the horse’s mouth. Biz LOVES this, I can assure you!  (that was pure sarcasm, in case it wasn’t obvious…)

Well, filing down that sharp edge on that one canine tooth (the one that had seemed to be the most stable), caused it to break off from the vibration of the floating tool.  It was immediately apparent that it was just suddenly very loose, and ended up having to be removed. A quick pull with a pliers and the entire crown of the tooth came out.  The root was left in, in the hopes that the gum will just heal over it.  This same thing actually happened with his other upper canine, and Biz is a great healer, so fingers crossed.

We are hoping that perhaps that upper canine, or the sharp edges on his molars and cheek teeth, might have been causing at least some of the pain that has made him so reactive lately.  And that solving those problems will make the daily painkiller work well for him, or even be unnecessary.  Sadly, Biz never did learn his words, and doesn’t even have fingers to point to a particular spot and say, “that’s where it hurts.”  He’s a prey animal, and prey animals instinctually hide pain…  And even worse, he HATES having his mouth messed with on his best day, so he’s always more inclined to act like it hurts EVERYWHERE!  Hopefully, we will know more over the next couple weeks, as he heals from today.

 

Biz, looking regal before the sedative…

 

So, in true Biz fashion, he lost the canine they didn’t plan to extract today, and kept the other two. He can’t ever just do the expected…  Touche’ Biz… You never can seem to stick to a plan…

How to Pull a Canine…

Biz’s canine tooth extraction surgery is coming up.  We postponed it a couple weeks ago after finding out the issue was not with his incisors, in order to give the vet some time to consult with specialists.  Said consulting has been done.  Monday morning, we are traveling back to the clinic to give it a go.  They will start with his lower right canine.  And ugh, it sounds awful…

When the vet called Friday to explain what he had found out about the procedure and how to best do it, “bone grinding tool, levering against jawbone, and risk if ligament has calcified” were phrases used…  Yuck.  I asked all my questions and he offered the option of having the extractions done by the dental specialist, but that involves either waiting longer until she will be in the area, or traveling two hours south.  Trailering Biz two hours south into the big city and its horrendous traffic doesn’t sound like a good time for a 30 year old man…  So we are going to give it a go at home.

Basically, they will cut off the crown of the tooth (the part above the gumline), then grind away a portion of the jawbone to expose the root to make it easier to access and extract.  This, although it sounds terrible, is the better way to go because it reduces the pressure on the jawbone that occurs when they have to lever against it trying to loosen the tooth.  Hopefully, the ligament that is holding the tooth below is still relatively healthy, and has not calcified, because that bony calcification makes it harder to remove the root.

If, and this is a big if, he is tolerant and the extraction of the right lower canine goes well, then they will try to also pull the left lower canine.  If it’s too difficult, or takes too long, and they are concerned about his reaction or how long he is sedated, then it will be left for another day.

I’m cringing as I write this.  It sounds painful.  Biz on his best day doesn’t like people messing with his face and mouth.  A power tool grinding his jaw bone is going to be interesting. Not sure there are enough drugs in the world for him to tolerate that easily.  But leaving him in pain isn’t an option.  So all I can do is pray that it all goes well, and be there in whatever clothes I don’t care about getting blood on, pulling his ear to distract him, talking to him, and holding him up when he’s sedated.  It’s just what we do.

Getting down on his level – waking up from the sedative a few weeks ago…

 

I am going to need more than one glass of wine when I get home Monday.  For sure.

 

The Surgery that Wasn’t… Yet…

All has been pretty quiet in Biz news lately… He’s been doing well, using his three remaining front teeth and his mostly-worn-down molars to eat a complete diet of equine senior pelleted food.  Sometimes he gets beet pulp, if he likes it that day…  His weight has been good, and his skin has been good, and he’s overall just been hanging out – good.  I like that.

About 10 days ago I noticed he didn’t want me to look in his mouth at his incisors, which I do whenever I am out to see how they are doing.  At some point they are going to have to go.  Last Friday night he REALLY didn’t want me to look in his mouth…  NOT. FOR. ONE. SINGLE. SECOND…  He’s hurting…

Saturday morning I was on the phone with the vet’s office to discuss proceeding.  Antibiotics, painkillers and a vet appointment at the clinic this morning to x-ray and remove those last three teeth.  I was sure of it…

Well Biz had another thing in mind.  Because he can never do anything the easy way…  The incisors are fine.  Still stable.  Instead, it is the canine teeth; the two lower canines in particular.  And don’t get me started on why horses have teeth called canines?

Canines are harder to extract, because the roots are more deeply embedded in the jawbone.  It means a harder surgery, longer healing time, and more potential for complications, especially when both sides of the mouth are affected.  So his x-rays and photos were emailed off to an equine dentistry specialist, and my vet will consult on the best option.  Pull the whole tooth, or cut the tooth off at the gum line and let the gum heal over the root of the tooth.  Biz, it seems, already decided that the second option is the preferred method, because one of his upper canines has already broken off at the gum line, and the gum has healed completely over without us even noticing…  The body is a fascinating thing…

 

Getting down on his level – waking up from the sedative…

In a couple weeks, we will make the return trip up to the clinic for round 2.  Wish an old man luck!  Sometimes it’s hard being 30…

Four to Go on Wednesday

Biz saw the vet for his annual checkup a few weeks ago.  At 28 years old, he is remarkably healthy.  No comparison of horse age to human age is truly accurate, but a 28 year old horse is generally believed to be about the equivalent of an 80 year old human.

His weight is great – his blood work is good.  His eyes are clear and bright with no sign of cataracts.  The only exception to his great health is his teeth.  Followers to this blog will know that Biz has had 3 teeth pulled over the last couple of years – this Wednesday he will have 4 more pulled. His disease, EOTRH, has progressed, and his teeth have deteriorated significantly in the last year.

I would be lying if I said I wasn’t a little worried – he has done really well with the extractions so far, but he has only had 1 pulled at a time previously.  4 is a much bigger deal.  This will be our first round with his upper incisors too – I am not sure if there will be differences with the extractions or in his healing process.

Biz looks a bit like a toothless Mr. Ed here!

Biz looks a bit like a toothless Mr. Ed here!

I wouldn’t be doing this (and the vet wouldn’t be recommending it) if there wasn’t a big chance that Biz is enduring a lot of pain due to these diseased teeth that are hanging on.  As horses are prey animals, they mask their pain – it has got to be pretty bad before a horse will let you know…  We are hoping that this surgery will relieve him of the pain.

I’ll be keeping my fingers crossed that everything goes smoothly, and that he heals quickly.  Please keep us in your thoughts on Wednesday!