PDA

View Full Version : Teeth Malocclusion - treat?



IslandGirl
08-27-15, 02:20 am
Hi all,
Our gp Mimi, a 2.5 yo silkie has been losing a lot of weight. After a few vet visits and finally x-rays and blood work, they say her teeth (molars) are overgrown. She's still eating, but not enough to maintain her weight - I've been giving her critical care to at least try and stop her from losing more. She's on antibiotics and pain meds now - she seems to be eating a bit more (actually gaining a bit of weight back). The referral to a dental specialist estimate is $900-$1200. (We live in a pretty small community on an island and the dental specialists come from the mainland monthly). A big bill but I was thinking of going ahead until I read that her teeth will need trimming every month, and it sounds like the poor gps often have a lot of difficulty eating for ever more. Do the teeth really need trimming monthly?

I was so happy when I found out it was her teeth and not cancer or some untreatable disease - but now I'm realizing that the teeth is not a simple problem that is easily fixed.

Any thoughts? Good stories about guinea pigs who have had the dental surgery and gone on to have long and happy pain-free lives?

Thanks.

bpatters
08-27-15, 07:47 am
She may or may not need her teeth trimmed regularly. They could be overgrown because she injured her mouth somehow (hay poke, chewing the cage bars, etc.) and didn't chew regularly for a while. If that's the case, getting them trimmed once may take care of things.

You'd need an evaluation by a vet that knows something about rodent dentistry to see what's going on. She may have elongated roots (those do require repeated planing), or an abscess (which could possibly be treated with antibiotics and/or tooth extraction, but doesn't often have good outcomes). Or she could just have points on her molars that need to be clipped, and the visiting dentist should be able to teach your local vet how to do that.

Whatever the problem is, doing nothing isn't an option. If the molars are indeed overgrown, they will continue to grow until her tongue is trapped and she's unable to swallow. If it's an abscess, she's in pain, and it will eventually endanger her life. If it's elongated roots, you can maintain her for while on critical care, but the lack of chewing will eventually cause the molars to overgrow, and then you've got the tooth trapping problem.

If she is going to need the repeated planings, and if the dentist won't work with you to provide them at a reasonable cost (your estimate sounds WAY high), then euthanasia may be your kindest option. It's just one of those unfortunate things about guinea pigs, and there's no easy answer.

Here's some more information on teeth.

Keep us posted on how things go.

lunarminx
08-27-15, 07:59 am
I had my 5 year old done it cost almost $600 and 3 months later he needed it done again. Sadly we had him euthanized, we just could not justify the cost every 3 months or so. I read about the sling afterwards.
If you decide to treat go with the sling right away.

http://www.guinealynx.info/chinsling.html

bpatters
08-27-15, 08:01 am
The sling is appropriate for problems that arise from the jaw not working properly. It won't help with overgrown molars. She needs a diagnosis before she decides what to do.

IslandGirl
08-27-15, 08:50 am
Thanks for the replies. I agree, doing nothing isn't an option. My question about whether to treat was whether to treat or euthanize. I'll speak to the dental specialists today - they're dental specialists, not rodent specialists (and I don't think there's anyone around here who is - although I have a couple of friends who are vets who are helping me).

Her teeth on examination (even under sedation) appeared normal based on the vets I saw, but the x-ray showed differently. Her radiographic interpretation says:
"Skull: Several of the mandibular cheek teeth are over-grown with the reserve crowns bulging the ventral cortical bone margin and creating an undulated or series of bumps along the ventral mandibular margin. There may be mild over-growth of the maxillary cheek teeth, especially the 2nd and 5th cheek teeth seen on the left lateral view (I cannot be sure that they are of the left maxillary arcade but are visible on the left lateral view). The nasal passages appear normal. No evidence of bone abscess of the skull is seen.
Thorax: The mediastinal structures, cardiovascular structure, pulmonary parenchyma and the pleural space appear normal.
Abdomen: The patient has a normal (full) gastroenteric tract with a moderate t large gas buble in the cecum which is normal. No mass lesions, ascites or gross pathology are identified.

Diagnostic Interpretation:
1. Dental disease with bilaterally over-grown mandibular cheek teeth, and at least two suspicious over-grown maxillary cheek teeth.
2. Radiographically normal thorax and abdomen.

Recommendations;
Most of the guinea pig dentistry that I review is from CT scans which provide great cross-sectional anatomy and detail, and I find that the degree of radiographic change present often under-estimates the actual pathology. Dentistry to remove dental spurs and improve occlusion (cannot assess either here) is reasonable, and depending upon the blood work results you may need additional imaging of the abdomen (ultrasound, CT) or of the whole patient (CT) to full assess."

IslandGirl
08-27-15, 08:55 am
They had to do blood work/urinalysis under sedation (same time as xrays) because their attempt to get it while she wasn't sedated didn't work. Unfortunately they still didn't get enough to do a full panel. The work they did do didn't suggest anything really abnormal. They suggested that I could take her back in to get more blood to finish the panel but I'm not sure what that would accomplish when her teeth are clearly an issue. Anyone have any insight on what they could find on blood that would provide more information about what's going on with her? They managed to get glucose, urea, phosphorus, total protein, albumin, globulin, ALT, AST, ALP, GGT, cholesterol, Icterus Index, Lipemia Index, a specific grav on her urine. All within normal range.

IslandGirl
08-27-15, 08:58 am
Hi bpatters - thanks. You mention more information on teeth - was there meant to be a link? I've read extensively on this site and others trying to gain information, but I'd appreciate a link to something you find particularly useful.

bpatters
08-27-15, 09:24 am
Sorry, I forgot to post the link: http://www.guinealynx.info/teeth.html.

I realize you're on an island and exotic vets are probably scarce or nonexistent. but full blood panels are almost never done on guinea pigs because of the difficulty of drawing enough blood for them. Their veins are tiny, and the jugular is the only one large enough and reachable enough to use, but it's very dangerous because of the possibility of rupture of the vein and severe bleeding. It's usually used only on pigs that obviously have serious illness that they've been unable to diagnose any other way.

Like you, I don't see the need for blood work when the problem is obviously the teeth. I'd suggest making the vet review any proposed course of action and having you agree to it before they proceed. And I definitely wouldn't agree to another blood draw. Apparently the abdomen looked normal on the x-ray. What I see is a radiologist doing a CYA maneuver so nobody can say s/he wasn't thorough in reading the x-ray.

lunarminx
08-27-15, 09:38 am
The sling is appropriate for problems that arise from the jaw not working properly. It won't help with overgrown molars. She needs a diagnosis before she decides what to do.


And after treatment she should start using the sling right away. I wish I did, I may still have who's there! Pinta used it for quite a few piggies with great success and that link offers a consultation for the vet to learn how it should be used.

lunarminx
08-27-15, 09:38 am
http://www.guinealynx.info/teeth.html

spy9doc
08-27-15, 02:50 pm
Based on my experience, there is absolutely no need for additional blood work. Getting some baseline bloodwork is sometimes helpful, but unless there's some pathologic process at work, there's no benefit in having it repeated. The radiographic report sounds spot-on for malocclusion. And, the symptoms you are observing backs that up.

I have a cavy with severe malocclusion and I have detailed his history and treatment in many posts over the past 4-5 months. My posts might give you a good bit of insight into what you are dealing with. Alas, I can't give you encouragement insofar as the repeat planings.

Chester has never been a hay eater and I suspect that is a component of his current issue even if the Vet says that his problem is genetic. His teeth have to be planed about every 4-5 weeks and of course he has anesthesia each time. We made the decision that we'd rather lose him to anesthesia than to have him euthanized. One of the vets almost killed him the last time when she slipped and nicked a blood vessel in the back of his throat. He subsequently had necrotic tissue on the left side of his teeth and throat and could barely swallow for weeks. He still eats agonizing slowly and his wheeker is broken! Poor little man can barely wheek, but it seems that he is improving. In theory, his teeth are growing down into his mandible and it's only a matter of time until he will be in too much pain to continue. That remains to be seen.

Once an adult cavy starts losing weight it is difficult to put weight back on them. He's fed a massive amount of Critical Care in addition to his regular veggies and pellets. We try to put some weight on him knowing that when he has dental work, he probably won't eat for a couple of days. We always know when its time for dental work because Chester will pick up food.......and drop it and will begin to gnash his teeth in pain

You have to decide if the repeated dental work is something you can afford. Our Vet isn't terribly expensive, and we have made the decision to keep Chester alive as long as his quality of life is good. My boy is a real fighter and I know that he will cling to me with his last breath.

All the best with your girl!

IslandGirl
08-27-15, 09:33 pm
Hi spy9doc -thanks for your reply - I have read through your posts and they've been very informative. If you don't mind my asking - how much do you pay to get Chester's teeth planed? I can't afford $1000/mo to get her teeth planed - I'm hoping that it isn't genetic and 1 treatment will solve the problem. I know, I'm hopeful (naive?). It sounds like most instances of malocclusion are genetic. If the tooth issue is genetic would it have shown up before now? She's about 2.5. We adopted her when she was about 1 from a family that didn't feed their guineas hay on a regular basis - we started giving hay as soon as we adopted them. Makes me wonder if our other guinea might have teeth issues (although there are no weight issues with her! ;-))

I didn't manage to connect with the dentist today - I'll ask if they think that her teeth are genetic or if they can be treated and the problem solved with 1 treatment. I'd appreciate any tips from anyone on specific questions I can ask (from previous helpful posts it looks like long roots is an indicator of genetic issue?)

I'm still hoping I can find a solution to treat our sweet Mimi and keep her happy and pain-free at a cost we can afford. She's a sweet little girl, and it's so sad to see her like this. She's stopped squeaking (although in the last couple of days she's done a bit of purring when petted but she'd stopped before then), but still gets excited about treats like grass and cucumber and corn husks/silks. Sigh.

spy9doc
08-28-15, 01:39 pm
Honestly, I no longer hold onto the receipts from the Vet. But, I just looked through my online banking and think that $165 or less is probably a good number. That varies because sometimes we need to buy meds, and other times not. I'll look back through records and if I can come up with a more precise figure, I'll let you know.

spy9doc
08-31-15, 05:18 pm
Chester stopped eating on Friday and I had to syringe him all day Saturday and Sunday. So off we went to the vet this morning for an emergency visit.

Some good news for a change. The Vet said that Chester's mouth is much improved and that the previously necrotic tissue is looking much better. He apparently had one large spur that was causing him to hide in his cozy all day and not come out for food or anything else.

Usually, he wants nothing to do with food when he has had dental work. He hasn't stopped eating since we arrived home! Yes, he eats slowly, but after more than an hour, he's still working on the plate.

Today's visit was $157.

IslandGirl
09-07-15, 11:12 am
Thanks for the info. The firm quote we got is $800 and apparently the dentist can't tell the cause of the problem. Of course I'm talking to an assistant once removed (it's a vet assistant at the vet hospital that the dental specialist visits). So we've decided to get her teeth done once and I hope that will solve the problem because we can't afford repeated treatments, but we want to give her a chance. Fingers crossed! I'll look in to the sling too - try and get more info on it.

IslandGirl
09-07-15, 11:23 am
Ok this is kind of funny - I looked at the chin sling thread and noticed it was Dr Legendre - which as it turns out is the vet who will be doing the dental surgery on Mimi. So he should be a good one to ask ;-)

IslandGirl
09-07-15, 11:29 am
Duplicate post

IslandGirl
09-07-15, 11:31 am
Spy9doc - good to hear the good news about Chester!

IslandGirl
09-07-15, 11:32 am
Where did you get your sling? I can't see where to buy one....

bpatters
09-07-15, 11:52 am
IslandGirl, use the mailer at Guinea Lynx to contact the user Pinta. She's the chin sling expert.

And there's no better rodent dentist in the world than Legendre. If he can't fix your pig, she can't be fixed.

IslandGirl
09-16-15, 11:24 pm
Bpatters - yes from what I've read it seems like he is. Makes me feel better about her chances.

IslandGirl
10-08-15, 02:18 am
bpatters - Mimi had her teeth done today and she'll need a treatment in another 3-4 weeks. I want to get hold of a sling but I don't see @Pinta listed as a member to contact her - any hints?

Soecara
10-08-15, 04:31 am
A quote from this page over at guinea lynx - http://www.guinealynx.info/chinsling.html "To purchase a chin sling and for veterinary and physical therapy consultation contacts, please have your vet or animal dentist email Pocket Pet Concepts Inc. at [email protected]".
I don't know if that is still current information but it is worth looking into.

Also to contact pinta you will first need to make an account over at guinea lynx, then if you click on pinta's name on any of pinta's posts it will take you to a page where you can send her a message from, here is a thread that pinta has posted on http://www.guinealynx.info/forums/viewtopic.php?p=2199895#2199895

IslandGirl
10-08-15, 12:32 pm
Thanks Soecara - I'll look in to it.

IslandGirl
10-08-15, 12:33 pm
Mimi is not eating well at all - she seems less able to chew than even before the surgery. She mouths a piece of grass and obviously wants to eat it but can't. I'm giving her critical care. Anyone with experience - how long can I expect this to continue before she starts eating?

bpatters
10-08-15, 12:42 pm
It will help if you cut things in matchstick sized pieces and stuff them in her mouth back toward her molars. If they trimmed her front teeth, they may have gotten them too short and she's unable to pick things up. If that's the case, it should resolve itself pretty quickly, as guinea pig teeth grow very rapidly.

Did they give you any pain medication? If not, see if you can get hold of some. Guinea pig mouths are really small, and it's very hard to plane the back teeth without nicking the gums at least once or twice. That makes it hurt to chew, so the pig isn't willing to eat. A couple of days of something like metacam can ease over the rough spots and get them eating again.

IslandGirl
10-08-15, 12:51 pm
Yes she's on pain meds. Thanks for the tip about the size of pieces. Dr. Legendre seemed hopeful about her case because although her teeth were overgrown he didn't see the 'bad' complications he sometimes sees. It's just so hard to see her like this!

IslandGirl
01-23-16, 05:59 pm
Thought I'd post an update. After getting Mimi's teeth done for the first time on Oct 7, she lost a bit of weight immediately afterward, then appeared to be doing a bit better, but not really gaining any weight. I found the tip to cut up the hay/grass very helpful - she could eat small pieces but not nip the bigger ones. She did seem to get perkier. Then we had her teeth done a second time (Dr. Legendre said he planed the teeth down to the gum the first time but anticipated a second treatment was necessary) which we did Nov 5th. She hadn't gained any weight by that treatment and I was feeding her critical care. After the second treatment she lost more weight, at one point dipping below 600g (she was 630g when we had her teeth done the second time). I was really despairing. However, after a couple of weeks her manner was definitely far perkier and she was back to her squeaky self and seemed to have more energy, even if she wasn't gaining weight. I continued to give her critical care but she seemed to eat less 'real food' when I did so I tried not to give her too much because I wanted her eating on her own. Following Dr. Legendre's instructions we've stopped pellets (I gave her pellets still after her first tooth treatment just because I was desperate for her to eat and it seemed that was what she would eat), and only feed her hay, grass, plus give her veggies and fruit as treats. After a few weeks of her still not really gaining any weight (and despair on my part) there seemed to be a shift and she started gaining, and as of today she's 874g! I know, still small for a guinea pig, but when we adopted her a couple of years ago she was only 838g (and her previous owners didn't feed her any hay) so she's now the heaviest she's been since we've had her. She squeaks like mad and eats constantly. I've very happy and I hope it continues! Obviously we don't know the long-term prognosis, but I thought I'd post it because relative to some other stories about malocclusion she seems to be doing fairly well. FYI I bought a chin sling but I couldn't figure out how to use it properly. She's a silkie and her hair seemed to be a problem, and trimming it didn't seem to help. Next time we see Dr. Legendre I'll ask him about it.

lunarminx
01-23-16, 06:13 pm
I'm so glad she is doing so well. You and the doctor have done a great job with her. When do you see the doctor again?

bpatters
01-23-16, 07:15 pm
As you've found out, it's hard to get an adult guinea pig to gain weight. They can, but it takes a long time.

I'm glad she's doing better.

And there's no better rodent dentist than Dr. Legendre, as far as I know.