Download - ALWAYS LOOK FOR THE POSTIVE “When it is dark enough, you can see the stars.” -Persian proverb
ALWAYS LOOK FOR THE POSTIVE
“When it is dark enough, you can see the stars.”
-Persian proverb
Diseases of Digestive SystemOral cavityEsophagusStomach
Small BowelLarge Bowel
LiverPancreasRectumAnus
Chapter 2
GI system
GI tract: mouth -> anusAccessory structures
Teeth, tongue,_____________, liver, pancreas, ______________
Diseases
Oral cavityEsophagusStomach
Small BowelLarge Bowel
LiverPancreasRectum
Anus
Periodontal Disease is plaque-induced inflammation of gums Progressive
gingivitis, gingival hyperplasia, peridontitis with vertical bone destruction, and peridontitis with horizontal bone destruction
The end result is _____________________Periodontal means “around the tooth”
EtiologyFood particles, bacteria collect around gum line and form plaque (tartar)
• Causes gingivitsMinerals in saliva collect in plaque and harden to form ___________ which adheres
to teeth• 3-5 d to harden• Causes bad breath• Protects the bacterial environment
Oral Diseases: Periodontal Disease
Oral Diseases: Gingivitis
Gingivitis—earliest signs of Periodontal DiseaseInvolves only the ______________ of the gums_______________ inflammation of gumsGingival hyperplasia (may also be breed- or drug-related)Cause—accumulation of tartar on teeth
Tartar is conducive to bacterial growth_____________ produced by bacteria damage tooth attachment and
cause inflammation
Without intervention, gingivitis progresses to:Periodontitis— _____________ condition:
Loss of gingival root attachment (receding gums) Alveolar bone _____________Loss of teeth
Oral Diseases: Periodontal Disease
alveolar bone
Normal Gingiva
Periodontitis—irreversible condition:Alveolar bone resorption
Gingivitis—reversible; earliest signs of Periodontal Disease
Oral Diseases: Periodontal Disease
Mild tartar more tartar severe tartar >50% bone lossMild gingivitis more gingivitis _____________ tooth is loose____________ min bone loss moderate bone loss should be pulled
Calculus builds up under gums Separates teeth from gums to form ___________, which encourages
more bacteria to accumulate and growBacteria secrete toxins/enzymes that cause detachment of tooth from bony
socketWBC’s invade area and release their enzymes to destroy bacteria
• These enzymes also cause detachment of tooth from bone
Pockets get deeper and deeper• Weakens bone
• Can cause ___________________________
Other sequellae Bacteria enter blood stream
Can cause micro-abscesses in liver, kidneysCause _______________ on heart valves
Oral Diseases: Periodontal Disease
Oral Diseases: Periodontal Disease
Iatrogenic mandibular fracture resulting from excessive force extraction of a lower molar tooth
Oral Diseases: Periodontal DiseaseSigns
HalitosisReluctance to chew hard foodPawing at mouthOral pain; personality changes_________________________________Increased salivationFacial swelling; tooth loss
DxComplete oral examPresence of tartar (plaque) on teeth
Oral Diseases: Periodontal DiseaseRx
Dental scalingwith ultrasonic scaler
Root scaling/planing (below gum line)with thin ultrasonic tip; ____________________
Gingival curettagewith curette against inner surface of gums
(gingival pocket’s diseased soft tissue inner surface)
Polishing to smooth the tooth surface and prevent tartar buildup
Irrigation to remove diseased tissue and plaque
Oral Diseases: Periodontal disease
DOXIROBE GEL controls ___________ and promotes rebuilding of periodontal structures
*contains Doxycycline, an antibiotic
Oral Diseases: Periodontal Disease
Plaque prevention gel
Applied once a week
Oral Diseases: Periodontal Disease
Client infoGood oral hygiene is necessary for all pets
______________________________Routine dental cleanings performed at veterinarian’sTreat gingivitis early before irreversible lesions occur
Extractions are sometimes necessary to clear up infections_______________ food may promote better dental health by
removing tartar before it calcifiesOnce it calcifies, tartar must be removed professionally
http://www.youtube.com/watch?v=-qnbJZWycdg&feature=PlayList&p=480B67A7E8907594&playnext_from=PL&playnext=1&index=5
Oral TraumaCauses (many)
Falls, fights (bites), burns, blunt trauma (HBC)______________________ in cats
Fractured: hard palate, mandibular symphysisTongue injury from biting own tongue, dog fight, eat
from tin can in garbage, FB(Foreign body)
Cats playing with needles, thread; strangulate tongueElectrical, chemical burnsGunshot wounds, fish hooksBones lodged in teeth
Fx mandible—cat; HBC
Oral Trauma
Signs History or signs of head trauma Increased salivation Inability to close mouth; due to:
PainFracture/dislocationFB
Reluctance to eat (same reasons) Presence of foreign object
Dx PE of oral cavity X-ray to r/o embedded FB
Oral Trauma
RxDepends on type of traumaControl bleedingProvide _______________________
IV fluidspain relief
Insure adequate airwayRepair/extract damaged teeth, fracture
Client infoLike kids, if animals can get into trouble, they will
Discourage chewing on electric cordsDon’t leave caustic/toxic chemicals outKeep pets in fenced yard or on leash when outsideAnimals still eat well without entire tongue
Oral Neoplasia
Relatively common in cats and dogs; __________________ and squamous cell carcinoma most common
SignsDepend on location and size of growthMore common in malesAbnormal food prehensionIncreased salivationTooth loss Oral pain
DxHistology of massX-rays to r/o metastasisBiopsy of LN to r/o metastasis
Squamous cell carcinoma (Upper R 3rd incisor)
Bone loss around lesion
Rostral maxillectomy was curative
Oral Diseases: Oral Neoplasia
Benign neoplasiaPapillomas______________
Oral Diseases: Oral Neoplasia
A gingival (buccal mucosa) melanoma involving a dog's caudal mandible
and temporomandibular joint region. Above: An invasive feline oral squamous cell carcinoma (courtesy of Jon Slattery)
Oral Neoplasia
RxSurgical excisionPartial removal of mandible/maxilla if bone is involvedRadiation therapyChemotherapy
Client infoPx for malignant tumors is ________________ even with
aggressive therapyBenign lesions have good PxAnimals (esp cats) with bone removed may need nutritional
support (feeding tube)
Oral Diseases
http://veterinarydentistry.posterous.com/
Salivary Mucocele
Accumulation of excessive amounts of______________________
Most common lesion of salivary glands in dogs; rarely seen in cats (following trauma)
Cause is unknown (tight collar, choke chain??)
SignsSlowly enlarging,_______________, fluid-filled swelling on
neck or under tongueReluctance to eatDifficult swallowingBlood-tinged salivaRespiratory distress
Salivary MucoceleDx
Clinical signsParacentesis shows thick, _________________
RxAspirate fluidSurgical drainageRemove salivary gland; insert Penrose drain x 7 d
Client infoCause is unknown; trauma may be involvedWithout removal of gland, excess fluid will continue to
accumulateSome cases may resolve spontaneously
Removal of mandibular salivary gl
Lip-Fold DermatitisOften seen in breed with _________________(spaniels, setters, St. Bernard, bulldogs, bassets)
Constant moisture in the folds from saliva causes bacterial growth
Food, hair, moisture cause irritation, erythema, and fetid odor
Signs Halitosis Collection of debris in lower lip fold
Dx Clinical signs
Rx Dental cleaning Clip hair Clean out folds (food) Medicated wipes Sx is ________________
Lip-Fold Dermatitis
Client infoKeep lip folds ______________ (for the rest of animal’s
life!!)Flush/clean lip folds
with 2.5% benzoyl peroxide shampoo chlorhexidine malaseb pledgets (chlorhexidine + miconazole)
Drying agents like corn starch several times a dayGood dental hygiene will help prevent it