What to do?

demi
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What to do?

Postby demi » Wed Mar 30, 2022 5:05 am

Rocky has a crack in her forth molar back, on the left. I have used a fully mobile (he advertises as such) equine dentist for several years that is very good. He’s been keeping an eye on this crack for two years. Today, he didnt have his X-ray machine with him (?) but said it needed to be exrayed again, that I should haul her in to his clinic. Well, I went to that clinic once to pick up some salve and it is a hard place to get to in a car, let alone a truck and trailer. It’s deep in the hill country and not on GPS so they type coordinates into google maps and send you the link. It’s over an hour drive that includes narrow one lane dirt roads, and many of the roads are unmarked. The driving instructions are impossible. I ended up having to turn around several times after calling them for further instructions.

My regular vet clinic is easy to get to, and well respected in the area. They use a Texas licensed EDP (equine dental provider) who is not a DVM, but Ive heard from a couple different people that he is especially talented.

The DVM dentist has her records with lots of pictures and background X-rays. The crack is in a tooth that could eventually cause a sinus infection and I do not want to take a chance with it. When i asked him if he would just come back with his X-ray machine he said if he had to pull it , it would be better at the clinic. Why then does he advertise that he is fully mobile including extractions?

Should I just take her to the EDP even though he doesn’t have the background X-rays?

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StraightForward
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Re: What to do?

Postby StraightForward » Wed Mar 30, 2022 12:50 pm

You should be able to get the background images sent to your regular vet clinic if the EDM feels they're important. However, I would think they would go mostly off the images they take. The DVM dentist might even be willing to talk to the EDP if needed. I'd just explain to them that you're unable to haul to their location, and will need to use another service for the extraction..
Keep calm and canter on.

blob
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Re: What to do?

Postby blob » Wed Mar 30, 2022 12:59 pm

I would be frustrated too, Demi. If he's fully mobile he should be able to do xrays out at your farm. So sounds like that was definitely not a fully honest advertising.

I agree with SF that it's worth getting xrays from your normal vet and having them sent over. The other option that I would probably be considering if I was you would be to just go ahead and do the extraction even without the xray. It sounds like with the crack, it's a bit of waiting game on when to extract and not if to extract.

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Re: What to do?

Postby exvet » Wed Mar 30, 2022 1:03 pm

I am not familiar with the rules and regulations related to the practice of veterinary medicine in Texas but in every state I've practiced in we are required to provide all or any part of a medical record to the owner if requested or sent on their behalf to another practitioner of their choosing. I agree with StraightForward that current radiographs will likely take the precedence over dictating next steps in Rocky's dental care; however, I'm the first to raise my hand and say I always like to have as much information as possible and would likely be inclined to compare the current rads to those taken in the past just to see if there has been any progression. If the current radiographs are unchanged or show little change from those taken previously it provides more confidence to making the decision to let things be for now.

As for pulling a tooth without radiographs, that again is somewhat dependent on the standard of practice for your area. I can say that having been privy to a couple of those who sit on our state board, the consensus should you be reported to the board for a dental case 'gone wrong' is that dental radiographs are an expectation of the standard of practice now. I personally would not perform a dental extraction without the use of dental radiographs both pre- and post-extraction due to my fondness for my license. As for what is best for the horse, honestly, radiographs are worth it.

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Re: What to do?

Postby Srhorselady » Wed Mar 30, 2022 4:36 pm

My .02 cents. I’ve had tooth extractions done both in the field AND in the clinic. The difference was which tooth and the possibility of the sinus issue. My quarter horse mares broken tooth could have gone into the sinus during extraction (it didn’t) so the vet didn’t want to chance it in the field. I have used both vets and an excellent equine dentist over the years. The equine dentist AWAYS referred to a vet with anything he thought could get dangerous. Usually he ended up doing the surgery in the clinic with the vets assistance since he had far more teeth experience. It’s definitely worth it to get their mouths fixed. BTW always X-rays out the wahzoo before and after!

demi
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Re: What to do?

Postby demi » Wed Mar 30, 2022 7:46 pm

Thanks for all the encouraging advice! I was a little frazzled worrying about it but after reading all your posts I felt better and called my regular vet. It turns out they consult with the dentist/vet that I use, and bring him in whenever necessary. So I’m hauling Rocky in tomorrow for X-rays. They will send the X-rays to the dentist and if he thinks the tooth needs to be extracted they’ll set up an appointment at THEIR clinic.

I’ve alerted the dentist to look for the X-rays tomorrow. Kind of odd that he didn’t tell me he goes to my regular clinic regularly, especially when I told him I didnt like the drive to his place.

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Chisamba
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Re: What to do?

Postby Chisamba » Thu Mar 31, 2022 12:54 pm

I NJ it is illegal for anyone who is not a DVM to do extractions. I don't even thing centrist is legal although lots of people use dentists there is no certification. So for me, it would be the vet clinic., but I also believe under those circumstances I would use a DVM.

On a side note I had the care of a horse that had an extraction that went into the sinus. It was awful, the care and flushing was traumatic and the horse was never the same about trusting humans. Despite hour and hours of positive influencing she was always head shy, you could rarely get a halter in, she would strike out violently if she saw a twitch. Clearly the removal and recovery, ( done is some field in New Mexico) was not pleasant. When she got off the trainer at my place she was so thin staggering, could obviously not eat, I was in Tennessee at the time and my vet sent her to Auburn. They have this intake process where they basically ignore all the advice and walk off with the horse. I knew they were going to need me so I hung around. I heard snashing and crashing and the vet yelling at the students and I ignored the do not enter and ran to the noise. They had her in stocks, and had tried to twitch her and she was thrashing bsllustically. She literally lifted their stocks three or four inches out of the concrete. All the styrene ran away and the vet was trying to open the stocks to free her. I ran up threw the fucking twitch out the door and talked her down to where the vet could release the bar. Then gently circled the room while there was a lot of yelling and screaming. I told the vet I had been VERY VERY clear at intake that you could not twitch the horse, that she required full anesthesia, not sedation, it was all in writing. Anyway. It was awful the horse, the condition, the experience. So get it done by the right person

demi
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Re: What to do?

Postby demi » Thu Mar 31, 2022 5:20 pm

Thanks for sharing your experience, Chisamba. I also had a miserable experience with a horse that had a sinus infection from a broken tooth and that’s why I am so concerned about Rocky.

BUT!! The good news is that Rocky got xrayed today and the tooth looks ok. My regular vet took the X-rays. She said the pics looked good, but that they were still going to send the pics to the dentist because he’s the expert, and he can compare them to the background radiographs. The dentist called back while I was still there and said Rocky didn’t need to have the tooth pulled. We’ll still have to keep an eye on it but at least it is okay for now.

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Re: What to do?

Postby exvet » Fri Apr 01, 2022 2:12 pm

I am going to raise my hand and say I can't overemphasize the value of dental xrays. I have saved more teeth with their use than prior to the availability of using this modality. Without that view below the gumline, you simply have to make a call based on what you see and feel and we've been learning/realizing that hasn't always been the best choice (in hindsight). Extractions are traumatic even though we try to lessen tissue damage and address pain and comfort during and after the procedure. I don't condone allowing an animal remain in pain by leaving 'bad' teeth but radiographs have definitely been a huge game changer in my practice.

piedmontfields
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Re: What to do?

Postby piedmontfields » Mon Apr 11, 2022 7:31 pm

Glad you got the images done and a good report. That will be helpful for follow-up/tracking the tooth, too.

demi
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Re: What to do? UPDATE

Postby demi » Mon May 02, 2022 4:16 pm

I am hoping Rocky doesn’t have a sinus infection….

So the crack is on the left, both vet and dentist/vet looked at radiographs on March 31 and gave her the all clear with a recheck in 6 months.

Hauled her to a lesson two weeks later and when I got home, she had a little snot in the right nostril. Very unusual for her. Nothing more until this morning when she had snot in the right nostril again. Not much volume, creamy to greenish color. Both times she had clear discharge from the right nostril. The pollen has been ridiculous here in TX this year, as all over I guess, and one of my other horses has clear discharge from both nostrils. They all have pasture access 24/7 and they spend a lot of time in our oak filled pastures.

Im not sure if I should worry too much yet. I am thinking to continue working her, maybe just a little bit shorter sessions. Any thoughts?

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StraightForward
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Re: What to do?

Postby StraightForward » Mon May 02, 2022 5:01 pm

Did they look at her sinus cavity with the radiographs? Does she have any tearing up? Obie had to have a large cyst removed from his sinus, but the nasal discharge was always clear.

About a month ago a horse at our barn had discharge from one nostril. Owner was convinced he had strangles, but tested negative. It cleared up after about a week and no other horses caught it. Hope Rocky is better soon too!
Keep calm and canter on.

blob
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Re: What to do?

Postby blob » Mon May 02, 2022 10:01 pm

Is her temp normal?

If it is, it could be worth giving allergy pills for a couple days to see if it improves? They are fairly non-invasive and will only help if it's allergies.

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Re: What to do?

Postby Kyras_Mom » Sat May 07, 2022 1:14 am

I hope Rocky is OK. I have a similar issue with Kyra. She has a molar that broke a slab of it off a few years ago. Vet said to leave it be and that has been OK. No issues with it. Well, this year with her dental, the rest of that tooth has kind of disintegrated leaving only the root. Again, he said that the root did not appear to be compromised and just leave it alone but watch it. I am going to take my drench gun out and start rinsing that side of her mouth with water before I ride. I think she gets stuff packed up in the hole which causes a lot of tongue stuff which I have noticed that she is doing a lot of tongue stuff under saddle. I think she works her tongue to get that stuff out. Sometime when she is at the vet clinic, I will have them x-ray her head. I might take her into the clinic for her next dental which he suggested to decrease the interval to 6-8 months.

Susan

demi
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Re: What to do?

Postby demi » Mon May 09, 2022 12:41 pm

Sorry I havent gotten back to this sooner. So busy with my SIL and giving her and my brother the emotional support they need right now. and trying to buy another horse at the same time. Obviously my family needs come first so I’ve been “doing horses” only when I can fit it in.

Anyway, Rocky seems fine. I took her temp after Blob asked if it was normal. It was. She didn’t seem sick or even “off” in any way other than the snot. Well, the snot is gone and hasn’t come back. Allergy to all the pollen is my best guess.

Thanks for all the thoughtful responses. It helped me get through.


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