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Nothing could be seen inside his mouth but sure enough
his mouth remained a full 1 inch open despite digital pressure.
His owners had become aware of his difficulty in eating
over the last few days.
Ingrid had taken some good radiographs of the skull in
the hope of shedding some light. She had also scoured our
many text books to produce a list of possibilities or differentials.
Bone tumour, mandibular nerve neuropraxia, temperomandibular
dysplasia and masticatory myositis were all on the list.
Rare but well documented conditions that might lead to the
unusual presenting symptoms.
I examined the radiographs for a third time. There was
a peculiar shadow at the back of the jaw. Must be a tumour
I thought. I decided to re sedate "Jack" and re
x-ray the suspected lesion.
If this was cancer then the consequences for "Jack"
were grim.
It was important to focus on the abnormality already identified.
Subsequent x-rays reaffirmed the area of concern.
Whilst sedated I re-examined the inside of "Jack's"
jaws. Sure enough there was a bizarrely roughened patch
right at the back of his mouth. I poked and prodded.
Then quite unexpectedly a twisted piece of black plastic
popped up from under his gums. It was something "Jack"
had been chewing a few days earlier! And yes his mouth could
now be closed with ease.
A course of antibiotics to clear up the infection and "Jack"
would be cured!
You won't find that diagnosis in any text book! It just
goes to show it's not always rocket science.
Terry
Dunne BVMS, Cert SAO, MRCVS
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