Ongoing mystery teeth issues? Please help!

[millyy]

Hi all, 

I have a one year old female who for the last 6 months has had problems with her teeth. A run down: 

Approx August- pawing and saliva on the right side of her face. Given painkillers as the vet suspected an ulcer or cut or similar. Issue continued- a dental under GA showed that an upper molar tooth was missing with no sign of broken root etc.- no idea how this had happened Teeth were burred smooth. 

She persistently ground her teeth and flicked out her tongue like a snake (this is still the case). Her mouth is usually partially open and slightly damp. Occasional days where she has pawed at her face again, but nothing major until november, when the problem arises again. Vet could see an ulcer/cut inside her cheek, so gave her painkillers and antibiotics. Pawing resumed on stopping the painkillers, so continued with them for a few weeks. 

January- Noticed bright white discharge from her eyes occasionally when grooming (disappears after a few seconds usually). Pawing at face again, excessive salivation, sneezing. Also noticed a couple of very thick (pus?) urine patches, but most urine was normal. Noticed blood from her mouth briefly- cleared up within 10 mins. Back to vet- another dental under GA. During that, one of her upper teeth apparently was very loose and fell out when he touched it, and another also had to be cut or pulled out (not sure which). The gap she originally had was apparently regrown, but the falling out tooth was right next to this original gap. He couldn't see any signs of an abscess, and burred down a few rough spots by the gap.

She was given painkillers but a week later was clearly still excessively salivating, sneezing and seemed uncomfortable, with eye discharge noticed a few times (mostly when grooming). She now has baytril (0.08ml 2x a day) and metacam as the vet suspects a respiratory infection- he doesn't believe there is anything wrong with her mouth as it looked fine when he'd finished. He couldn't see any signs of conjunctivitis. He also doesn't believe it is elodontoma as the root of the tooth that fell out looked normal. She's had the baytril for a couple of days now and it's not made a difference- if anything she's even more slobbery.

Has anyone else had experience of problems like this? The eye discharge and all the other symptoms lead me to believe there must be something wrong with her teeth, but them falling out just seems so odd if there's no abscess. I'm desperate for a solution- at the moment whilst she seems happy and eats well etc. she must be in discomfort if she's so drooly and teeth-grindy. 

[millyy]

Adding to that massive essay-

Thinking back, I'm a bit confused as the vet that gave her back to us after the last dental wasn't her normal vet that actually did the dental- but she said that he'd found an abscess and there was a horrible smell when the tooth fell out. When I asked him about it this week when I took her back, he said there was no sign of an abscess?

My partner did ask whether they could do an x-ray whilst she was under GA but apparently he said it wasn't necessary as it wasn't elodontoma.

[winic1]

I would insist on the x-rays. Teeth should not just be falling out. As recently mentioned in someone else's post, degu teeth roots do not look any different than the tooth itself, so it's very difficult to tell how much, if any, of the roots have come out.
Clearly something is going on up where it cannot be seen, inside her jaws or skull. Perhaps the roots are growing upwards as well, despite his denial of any problem, that can only be seen with an x-ray.

[savvy]

Is your vet experienced with degus?

[millyy]

I really did want x-rays done as I'm convinced there's something wrong that hasn't been fixed and it's not just a respiratory infection.

He specialises in exotics, but I get the impression he's not seen many (or maybe any) degus- I know he's seen a chinchilla with teeth problems before but I'm not hugely confident! Think I might have to ask about a referral if we can't get to the bottom of it very soon.

I was fairly convinced it could be elodontoma but that doesn't explain them falling out, and I doubt she's had an abscess for 6 months.

Edit: Next step will have to be an x-ray- so frustrating as she could have avoided having another GA by doing it at the same time. I don't see simply medicating as a likely way of solving whatever it is  

[savvy]

You don't say where you are based, but please take a look at the vet guide on this forum.

deguworld.proboards.com/thread/15521/vet-guide

It may help you find a vet who is experienced with degus. Members have added to it over time with their experiences.

[yasmin]

Welcome to the forum, millyy. So sorry, though, that your degu is ill.

I have, unfortunately, alot of experience with degus with teeth issues. Here are my thoughts:

Elodontoma at age of one-year would be very unusual.

I have never heard of a degu's teeth falling out like that. Likely the cause of some sort of physical damage, I think.

The eye discharge and sneezing would seem to indicate either a respiratory issue or some irritation to nasal cavity (including elodontoma). I think treating it with Baytril and Metacam and starting with the theory that it is a respiratory infection makes sense. Also there could be an infection – possibly a result of the original abscess (which may have healed so it is no longer evident?) – higher up. Baytril could help clear this up as well. It can take several days or more before the antibiotic noticeably takes effect.

That said, the open mouth could possibly indicate the beginnings of a temporal mandibular joint dysfunction (hopefully not). Is she eating normally? Can she open a sunflower seed with her mouth?

The vet likely doesn't want to waste your $ doing x-rays because there is a good chance that it will not show anything and many pet owners don't appreciate that. However, if she needs to be put under GA again, I would ask for an X-ray to rule out elodontoma or the existence of some other condition that can be seen by x-ray.

Hope this helps.

[deguconvert]

I don't understand not doing an X-ray, especially when the client has asked about it and the degu is already asleep. It is one thing to save money, but if there are questions that cannot be answered except by the use of an X-ray and the client is willing, then do it. I think an X-ray is truly needed in your case.

BTW, welcome to the forum, Millyy! I hope we can be of help and great encouragement to you!

[animalmadchloe]

I would press for an xray something is going on that you can't see possibly overgrown roots. Good luck x

[moletteuk]

How do you feel about the vet? Clearly they have the skills to do basic dental work, but their reluctance to discuss things with you openly, the discrepancy about the abscess and the reluctance to do the xray suggest to me that you may be able to find a more experienced degu vet or dental specialist.

To be honest, and as you seem to keep coming back to in your post, I think elodontoma (overgrown roots) does fit except for the young age. I think the only way to diagnose this is through xray, you need to see the teeth and roots in position to see if any are projecting higher than any other. This is obviously quite a complex case though, so as Yasmin says, it could equally have infection as the main cause or something else entirely.

Are they really doing the work under general anaesthetic? It is usual to do dental work under gas sedation.

You may find this other current thread of interest, it is another young degu with severe dental issues including loose teeth and mouth not closing due to overgrown teeth right at the back:
deguworld.proboards.com/thread/20983/youngish-dental-problems-specialist-enquiry?page=1

[millyy]

Thanks for all your replies.

I've done some searching and found a couple of more experienced exotic vets about an hour away so I think that'll have to be our next port of call if these antibiotics don't kick in and make a difference.

She's no good at eating fiddly things as she is missing most of her front toes (poor broken little girl!), but she did just about manage a sunflower seed and generally she's eating ok. She's never been much of a pig and is only 185g but I've been keeping a close eye on her weight and she's pretty much maintaining it steadily. In the past 2 weeks she's been squinting a bit when eating though which makes me think she's uncomfortable eating, and she's taking her time over her food. She does also flick her tongue out a lot and occasionally looks almost like she's gagging a bit, opening her mouth wide and moving her jaw.

I've just read through that other post- was really interesting and reassuring to hear that there was a happy outcome! Don't think it's the same as with my little girl but it did make me wonder whether perhaps her tooth grinding is responsible for the falling out teeth. Either that or there's something going on in her upper jaw- abscess, tumour, who knows

It was definitely under anaesthetic as he went over the risks with me beforehand. I'd much rather a light sedation though if that's an option!

[goolover]

millyy - Sounds like you are on the right track hun, just push for a x-ray if thats what you need, although I think finding an alternative vet will make getting an x-ray less of a problem. Had the same issue recently where my local vets didn't want to do much apart from prescribing baytril and painkiller so I found a great one a little further away. Have similar problems with one of my girls who is getting x-rays this week and on friday night she turned quite poorly so i'm keeping the hot water bottle hot and giving her meds and lots of attention to make her more comfortable until the morning. I know how helpless and frustrated we feel but it can have a positive ending. Good luck. Will let you know the outcome for my girl too x

[moletteuk]

I would certainly try the exotic vet if you have found a couple of candidates, give them a ring and ask about their experience. We see dental work under sedation regularly on the forum, I can't think of a case where it wasn't done under gas sedation, I think they normally use isofluorane, that would appear on an itemised bill.

It's probably worth you doing some experimenting with diet, both in terms of getting as much food into her as possible and in terms of nutritional content making a difference to dental health. Have a look at our feeding guide deguworld.proboards.com/thread/16425/degu-feeding-guide
You will likely have to perform a balancing act between encouraging her to eat and keeping her weight up as much as possible and getting the nutritional content as good as possible. The main places to start are feeding lots of forage in a variety, including some fresh if you can, and also a high calcium seed mix would be good as this is high calorie and high mineral content so beneficial on both counts.

[millyy]

Goolover, I'm so sorry to hear about your little girl, I hope she's ok!

Definitely was a full GA. Will definitely have her seen by another exotic specialist now...

I have an otoscope at home and am trying to get her used to having her teeth checked- she's getting better at it, and I've been able to have a look at her upper molars. There's nothing obviously wrong (other than the missing teeth!) but I'm hoping getting her used to it will make her appointments less stressful.

She does seem a bit drier today though which is good news!

[goolover]

millyy - Thankyou x Is that what that equipment is called, a otoscope, i've been calling it a mouth microscope thingy rofl.

[moletteuk]

Wow, I never knew the proper name, my vet calls it the 'scope, how fantastic having your own one, I'm sure this will be very useful in getting her used to it and allowing you to do some monitoring of her dental issues.

I was just chatting with another member about full GA for dental work, so it's not unheard of after all.

Good to hear she is a bit drier.

[bouncy]

Scaredy had a general for his last lot. It meant they could also inject a dose of Metacam at the same time. Little lad was so confused about not being allowed to drink from the syringe that day!

[millyy]

Update: Took her to a much more experienced (and therefore expensive!) vet about an hour away and she had a full dental a couple of weeks ago. Unfortunately even this vet has resisted doing an x-ray (apparently as it wouldn't help because they're never clear enough- which I know to not be entirely the case) and my partner didn't push for it when he took her in, so no clues there. Sadly he has to take her to this vet as I can't get time off work to go, so I'm reliant on him passing messages!

I've been in contact with a couple of vet/researchers who have written papers on degu and chinchilla dental diseases, and so far it seems like she is a bit of a mystery case- but really can't tell without an x-ray or CAT scan. I've read so many research papers on small animal teeth now though, I might go into business myself!

She seems much better, but still doesn't close her mouth completely and still has eye discharge at times. I am planning for her to go back for an x-ray, but think we may delay until her teeth need burring again so that it can be done under the same sedation.

You cannot believe how angry I was with my partner when he told me they weren't doing an x-ray last time...   To be fair I do think this vet is much better and knows his stuff, I just don't know if it would be overly rude of me to send him the papers I've been reading to explain why I really do want an x-ray done...   I want to know what is actually causing the problems, rather than just treating the symptoms, but don't want to come across as one of those 'google hypochondriacs' (I am a biologist so have a pretty good understanding of what I've been reading- but of course not the same expert experience as a specialist exotic vet!)

But at least she's less slobbery now! 

[moletteuk]

Good to hear she is doing better Have you tried phoning the vet? Our vets don't seem to mind speaking on the phone once you have paid for treatment and have an ongoing case, so that could be a way for you to talk direct to the vet. I think giving them papers is a difficult think to judge if they would be offended, but I have plucked up the courage and offered information before and they didn't mine. I think you won't find many vets that see a lot of degus, so it's pretty understandable and something they often acknowledge that they don't have a lot of specific knowledge of degus. I find vets are much easier to talk openly with and get them to think out loud with than human doctors, and they usually cotton on when you have an interest in the subject, like you with your biology experience, so I would go for it.

[millyy]

I did try phoning today to discuss how she's still not quite right, but it just kept ringing whenever I was able to catch a moment. Will try again and maybe subtly mention my concerns about elodontoma and/or overgrown roots.