Abscess Figure 2f

Figure 2f: Tooth abscess
Case history and photos

History and Diagnosis

On 6/13/02 this hairless dumbo rat was discovered to have an abscess involving not only a tooth or teeth, but of the mandible as well.

Treatment

Treatment was begun at the home by applying moist heat to the area of the abscess with the hopes of drawing it to a head. As this was without success, the abscess was then lanced using a small sterile lancet. The area of the abscess was found to have thick yellow to green pus, which was gently expressed. Following removal of pus, the abscess was then irrigated with Betadine solution via syringe. However, due to the extent of abscess formation, veterinarian C. Brown DVM, was consulted the following day, and surgery scheduled for that same day.

The location, size and involvement of abscess, as well as planned tooth extraction precluded the use of anesthetics by mask inhalation. With this particular rat a pre-sedation drug, butorphanol 0.25mg, was given, and tube intubation for anesthetics was attempted. However, due to swelling and poor visualization, it made tube intubation impossible. The following injectable anesthetic agents given IM, were ketamine 15mg and acepromazine 0.5mg initial dose, followed by an additional dosing with ketamine 10mg to maintain sedation throughout procedure.

*Dr. Brown notes here: that as a relief vet he has only the drugs at the permanent vets office to work with. He prefers to use (when doing injectables which he’d rather not use on rats) those drugs that he can combine and reverse such as with the presedation drug butorphanol, and for sedation a smaller amount of ketamine with either zylazine, or Domitor (generic- medetomidine ) that can be easily reversed if necessary.*

Once sedation was maintained, the abscess was incised, debrided, and then flushed with copius amounts of sterile saline. A small blunt dental probe was then inserted into the abscessed area to determine area of communication between the abscess and the tooth root. The first molar lower left was discovered to be infected and was extracted with the use of a small root elevator, sliding the tooth out. Attempts were made to extract the opposing molar without success.

Outcome

The rat remained stable throughout the procedure and into the first 10 minutes of recovery, but then succumbed.
Followup of this rat’s history showed long term respiratory infection that had up to the date of surgery been treated with antibiotics.