Oral Nasal Fistula from “Trench Mouth”
Lucy, a 8 year old Burmese cat, was presented with rotten teeth, difficulty eating, bad breath and lethargy. She was slightly dehydrated.
On examination, we found several rotten back molars which had large amounts of tartar and hairs attached to them. The gums were very inflamed and had receded away from the teeth margins.
There was a hole in the mouth where the upper left canine had previously fallen out. The hole connected through into the nose as were able to flush saline into the hole and watch it come out the left nostril. These types of holes are called fistulas.
It had been formed when the canine tooth fell out leaving a large empty socket which had become infected. Destruction of the thin layer of bone between the root and nose had occurred creating a connection.
We ran blood test to make sure Lucy was in good shape for long surgery. All was normal. We placed here on an IV drip during the operation to keep the blood pressure up to her kidneys and correct the dehydration..
Under general anaesthesia using Isoflurane, we removed the rotten molars.
Using an electrocautery unit, we created two flaps of tissue adjacent to the hole and slid them across the hole. The two flaps met over the hole creating an H-shaped piece of plastic surgery. They were stitched together using a fine dissolving suture material.
Lucy made a good recovery. We placed her on some oral pain killers (Metacam) and antibiotics. She was a much happier cat at checkup 5 days later and was eating much better, even though she did not have and molars.
It is important that pets have annual health checks and vaccinations. It gives the vet a chance to check for health problems such as bad teeth and gums, sore ears, measurement &/or assessment of any lumps etc.