Oral Surgery

There are many different types of oral surgery performed at WCVDS. They are dependent on the issue, whether it be trauma, cancer, a fractured jaw etc.

Extractions

During our Complete Oral Health and Assessment Treatment (COHAT), your pets teeth will be explored, probed and radiographed (if needed) to determine if there is any concerns.  In some cases, our patients require that one or many teeth be extracted, whether from fracture,  advanced periodontal disease, stomatitis (allergy to plaque) or resorptive lesions etc.  Prior to an extraction, a local block (freezing) is placed.  Once the tooth is desensitized it is surgically removed and the gingiva is closed with an absorbable suture that will dissolve on its own in 15-20 days.  A 7 day recheck is recommended to check that the surgery site is healing as expected.

Tumour Removal

When a patient presents with an oral tumour there are different protocols followed depending on the type of tumour.  Typically, we require current blood work and chest radiographs to accompany the referral so that we have the most information we can ahead of time.  If a biopsy has be performed at your regular clinic, the results should be sent with the referral.  If a biopsy has not been performed at your referring hospital, our recommendation will be to have a lymph node harvested and a biopsy performed here, followed by a second procedure to remove the tumour once we know what disease your pet has.

A lymph node harvest is done to determine if the possible cancer has spread.  This will help us determine the necessary extent of surgery for your pet.  The lymph node harvest will involve an incision on your pet’s neck, so they will need to go home with a harness at discharge, as a collar will rub the surgery site.

The biopsy will tell us exactly what type of tumour we are treating and how extensive the surgery must be for a complete excision.

Once all of the results from the lymph node harvest and biopsy are back (usually 5-10 business days)  we can go ahead with our second procedure.

A maxillectomy is a removal of a portion of the maxilla (upper jaw) and a mandibulectomy is a removal of a portion of the mandible (lower jaw).  These procedures can sometimes be extensive  and do have risks associated with them.  These risks should be discussed with the specialist during the consultation.  Home care instructions will be provided and in some cases a feeding tube may need to be placed, or overnight care at Canada West Veterinary Specialists or Vancouver Animal Emergency Clinic may be recommended.  Pain management will be sent home with your pet to keep them comfortable.

Cleft Palate Repair

A cleft palate is an opening between the mouth and the nose that happens when the tissues separating these two cavities do not grow together properly in the developing fetus.  This birth defect can occur in the lip (cleft lip), or along the roof of the mouth (cleft palate).  Purebred dogs and cats have a higher incidence of cleft palate, and brachycephalic breeds, with their short stubby faces, are most commonly affected.

Cleft palates require surgical treatment to prevent chronic nasal and lung infections and to help the animal eat.  The thick soft tissue (“mucosa”) covering the remainder of the hard palate can be rotated or rolled inward and sutured in place to cover the hole  Alternatively, flaps from the inner surface of the lip or from skin on the cheek or forehead can be used.

The surgery is difficult on very young animals so ideally the surgery is delayed until the patient is 5-6 months of age.

Speak to your veterinarian for more information about the diagnosis, risk factors, and aftercare.

Brachycephalic Syndrome and Treatments

Certain breeds of dogs and cats are prone to difficulties breathing because of the shape of their head, muzzle and throat. The most commonly affected are the “brachycephalic” breeds.  Examples of brachycephalic breeds include the English bulldog, French bulldog, Pug, Pekingese, Boxer and the Boston terrier. These dogs have been bred to have relatively short muzzles and noses and, because of this, the throat and breathing passages in these dogs are frequently undersized or flattened.  Persian cats also have a brachycephalic conformation.

The term Brachycephalic Syndrome refers to anatomical changes which affect the ability of the patient to breathe, including an elongated soft palate, stenotic nares, and everted laryngeal saccules.

Elongated soft palate

A condition where the soft palate is too long so that the tip of it protrudes into the airway and interferes with movement of air into the lungs.  This can be shortened with a scalpel or a laser to open the airway and can significantly improve “snoring”.

Stenotic Nares

Malformed nostrils that are too narrow or which collapse inward during inhalation, making it difficult for the dog to breathe through its nose.  The nostrils can be made larger with our laser to allow for easier inhalation.

Everted Laryngeal Saccules

A condition in which tissue within the airway, just in front of the vocal cords, is pulled into the trachea (windpipe) and partially obstructs airflow.  The tissue can be resected with our laser to open the airway.

Some dogs with brachycephalic syndrome may also have a narrow trachea (windpipe), collapse of the larynx (the cartilages that open and close the upper airway), or paralysis of the laryngeal cartilages.

Information provided by www.acvs.org/small-animal/brachycephalic-syndrome

Facial and Jaw Fracture

information provided by http://www.avdsonline.org/info/fracture.html

The main way for a jaw to fracture is by a traumatic insult (hit by car, a fall, fighting). However, there are instances where the jaw is weakened by a disease process, and can be broken without any real trauma. The two most common causes are advanced periodontal disease and malignant oral tumours.

There are numerous techniques for the repair of jaw fractures. The type of fixation selected depends on the type of fracture as well as the surgeon’s preference.

Fractures need to be kept non-mobile so that they can heal and not continue to cause pain.  Wiring, plates, intraoral resin splints and bonding of the teeth can all be used.  Several techniques may be used in combination.  Dental radiographs are used to confirm healing and are usually taken 6-8 weeks after the repair.  If wires, splints or bonding has been placed they may also need to be removed at this appointment.