Virtopsy in a red kangaroo with oral osteomyelitis

This report describes the use of computed tomography (CT) in a nondomestic species. Postmortem CT was performed on a red kangaroo (Macropus rufus) and a diagnosis of oral osteomyelitis was made. CT examination revealed bony remodeling of the right mandible, an intraosseous lesion of the right temporal bone, muscle necrosis around the right mandible, and the absence of the right, first, upper molar tooth. Cardiac and intrahepatic gas and a distended intestine due to postmortem gas accumulation were also seen. All the lesions identified with CT were also identified by conventional necropsy, except the cardiac and intrahepatic gases. Virtopsy may be a useful procedure for the noninvasive identification of cause of death and as a guide for necropsy in animals.     

Aneurysmal bone cyst in a Holstein bull.

A 3-year-old Holstein bull was examined because of a mass involving the cranial portion of the right hemimandible and the oral cavity. The mass had been observed 2 weeks earlier. The bull had lost weight throughout the 45 days before admission, and was anorectic at the time of admission. An aneurysmal bone cyst of the mandible was diagnosed.     

Surgical treatment of a mandibular ameloblastic carcinoma with metastases to the mandibular lymph nodes in a pony

A 4-year-old Connemara filly was presented with a rapidly growing oral mass on the right rostrolateral mandible and a right mandibular lymphadenopathy. Radiographs of the rostral mandible revealed a lytic, infiltrative mass consistent with soft tissue and mineralised material, and displacement of tooth 403. A biopsy showed characteristic histopathological features of an ameloblastic carcinoma. Subsequent FNA of the right abnormally firm and enlarged mandibular lymph node confirmed the metastatic spread. Computed tomography of the head was performed for surgical planning, including sentinel lymph node mapping to rule out other lymph node involvement. An aggressive lesion, consistent with soft tissue of the rostral right mandible was identified with intralesional contrast injection showing drainage of contrast within the right mandibular lymph nodes (Sentinel node). Based on the infiltrative and destructive nature reported in ameloblastic carcinoma in humans, a rostral mandibulectomy was performed, along with complete mandibular lymphadenectomy. The horse recovered uneventfully from surgery. In the early post-operative period marked lymphoedema of the ventral mandibular region was observed, which resolved 4–5 days post-operatively. Optimal cosmesis was maintained post-operatively, and no recurrence has been observed to date – 12 months post-surgery.     

Odontogenic cysts in three dogs: one odontogenic keratocyst and two dentigerous cysts

Odontogenic cysts, which showed cystic radiolucency in the jaw bone by radiographic examination and computed tomography, were enucleated by operation in 3 dogs. One dog had a odontogenic keratocyst in the incisive bone of the right maxilla and another 2 cases revealed dentigerous cysts in the mandible. These cyst walls were enucleated or transpired by semiconductor laser. Afterwards, osteogenesis was confirmed at the defective part of jaw bone by extirpation of the cyst in all cases, and no recurrence has been noted in any cases. Odontogenic cyst is a disease which should be treated by surgical extirpation or transpiration.     

Repair of a Mandibular Defect With a Free Vascularized Coccygeal Vertebra Transfer in a Dog

Bilateral mandibular defects in a male mongrel dog were repaired. On the left side, a free vascularized coccygeal bone graft that included the median caudal artery and caudal vein was used to correct the defect. On the right side, the defect was bridged with a bone plate and screws. For further immobilization, the muzzle was temporarily taped for 3 weeks and a pharyngostomy tube was used for nutritional support. The dog was able to eat dry commercial food satisfactorily within 2 months of surgery despite mild malocclusion. Radiographs taken 2 months and 18 months postoperatively showed bony union with graft hypertrophy in the left mandible, whereas the right mandibular defect showed protracted nonunion. The results indicate that vascularized coccygeal vertebra transfer provides an alternative for the management of canine mandibular defects.     

Squamous cell carcinoma causing blindness and ophthalmoplegia in a cat

Ophthalmoplegia and blindness caused by squamous cell carcinoma were reported in a cat. Unilateral functional deficits of cranial nerves II, III, IV, and VI and of the sympathetic nerve supply caused blindness, complete ophthalmoplegia, and Horner syndrome. Radiography and computed tomography revealed a proliferating bony lesion associated with the right tympanic bulla, right temporal bone, right side of the mandible, and left frontal bone. A focal area of bony destruction involved the right sphenoid bone. The cat was euthanatized and necropsied. Squamous cell carcinoma was identified invading the bones and rostral part of the right side of the skull. The tumor had extended through the sphenoid bones into the region of the cavernous sinus and had surrounded the cranial nerves passing through this region. It also had invested connective tissue surrounding the optic nerves and had invaded the right globe through the lamina cribrosa. This represents an unusual distribution for ocular cranial squamous cell carcinoma in a cat.     

Diagnostic value of magnetic resonance imaging and computed tomography for oral masses in dogs

The purpose of this study was to determine the diagnostic value of magnetic resonance imaging (MRI) and computed tomography (CT) in oral masses of dogs. Nineteen dogs underwent clinical, MR and CT examinations. Eleven malignant and ten non-malignant masses were evaluated. Osteosarcoma was the most commonly found malignant oral mass and gingival hyperplasia was the most commonly found benign mass. The results showed that MRI provided more accurate information regarding the size of the masses and invasion of adjacent structures although MRI and CT show similar accuracy in assessment of bone invasion. Calcification and cortical bone erosion was better seen on CT images. Whereas contrast-MRI provided useful additional information, contrast-CT had no added benefit. In general, oral masses located in the caudal mandible, oropharynx and maxilla are better evaluated using MRI, once the histological type has been verified.     

Multicentric leiomyosarcoma in a young male horse

A 2-year-old male Thoroughbred was evaluated for multiple firm, raised nodules of the maxilla and mandible that had been present since 6 months of age. The horse was evaluated as a yearling with a final histologic diagnosis of fibrosarcoma. As a 2-year-old, the colt made a loud upper airway sound and was agitated after strenuous exercise. Results of upper airway endoscopy indicated severe narrowing of the nasal passages and pharynx with normal resting function. Radiography revealed multiple circular bony lesions in the mandible, maxilla, multiple long bones, and cervical vertebrae. Biopsy specimens of the left mandible and right facial bone were obtained. A diagnosis of leiomyosarcoma with extensive metastatic bone formation was made on the basis of histologic features and the immunohistochemical staining properties of the biopsy specimens. Because of the diffuse distribution of the lesions, prognosis was guarded; 4 years after diagnosis, the horse had not pursued an athletic career.     

Rib metastases from a non-tonsillar squamous cell carcinoma in a dog

Metastatic spread to the ribs in a 15-year-old, male, neutered, Irish setter is reported occurring secondary to an oral squamous cell carcinoma (SCC). The dog presented with a history of a rapidly growing SCC of the right upper incisive region, which was confirmed by histopathology as a SCC. Thoracic radiographs showed bony lesions associated with the body of the right third rib, and the fifth and seventh costal cartilages. A rostral partial maxillectomy was performed as palliative treatment for the oral mass and a core biopsy of the lesion on the third rib was performed. The rib lesion was identified histopathologically as a metastatic SCC. A review of the literature of oropharyngeal SCC and the metastatic potential of non-tonsillar SCC is presented, in particular metastatic bone disease. This case report suggests possible implications of metastatic bone disease for treatment and prognosis for future cases of non-tonsillar SCC.     

Cytologic features of a feline inductive odontogenic tumor

The feline inductive odontogenic tumor (FIOT) is a rare entity among oral tumors in cats, the cytologic features of which are not well characterized but may prove useful. A fine‐needle aspiration biopsy was performed on the right mandible between the permanent canine (404) and permanent fourth premolar (408) of an 8‐month‐old female mongrel cat. Cytologic smears showed epithelial cells and occasional spindle cells with extracellular homogenous acidophilic material in a hematic background. The initial diagnosis of benign tumor was confirmed by histopathologic examination of the biopsy specimen. This report describes the cytologic findings in a case of FIOT.     

Facial swelling and discharging lesions associated with abnormalities of the mandible in kunekune pigs

Abstract

CASE HISTORIES: Four adult kunekune pigs developed facial swelling at the base of the right ear that ruptured and discharged food material. A further six pigs that had similar clinical signs were reported by members of the New Zealand Kunekune Association who responded to an email survey, one of which was confirmed by post-mortem examination.

CLINICAL FINDINGS: Inside the mouth of each pig there was an opening at the junction of the body and ramus of the mandible just lateral to the most caudal visible molar that was impacted with masticated feed. The food packed into the mandible resulted in infection and progressive erosion of the medullary cavity of the bone until it reached the ramus where it eroded through the lateral cortex. The feed material then tracked through the soft tissues to form a subcutaneous abscess, which eventually ruptured resulting in a draining lesion. In Case 2, which had had the lesion for 2 years, the cavity in the mandible was lined with mucosa that had healed to the skin to produce a fistula. In all four pigs there was also a lesion in the left side of the mandible that was not as developed as that on the right side.

DIAGNOSIS: The facial swellings were produced by feed material that had impacted into the mandible through an opening immediately caudal to the cheek teeth and then emerged through one or more lesions in the lateral aspect of the ramus of the mandible.

CLINICAL RELEVANCE: Although it has not been previously reported, anecdotal reports and our survey suggest that this condition may occur relatively frequently in kunekune pigs. It should be considered as a differential diagnosis for facial swellings and discharging lesions in these animals.     

Facial swelling associated with impaction of the deciduous and permanent maxillary fourth premolars in a dog with patent ductus arteriosus

A three-year-old Labrador retriever was referred for decreased appetite, a painful swelling in the region of the maxillary right fourth premolar, and a heart murmur indicative of patent ductus arteriosus (PDA) diagnosed 1.5-weeks prior to presentation. Oral examination and intraoral dental radiographs showed impaction of the maxillary right fourth premolar surrounded by reactive alveolar bone. Necrotic bone, remnants of the deciduous maxillary right fourth premolar, and the impacted permanent maxillary right fourth premolar were removed following surgical exploration of the area. The PDA was repaired without complication 2-weeks following oral surgery. The extraction site was healing appropriately, and the dog's inappetence and painful facial swelling had resolved.     

OSSIFYING AMELOBLASTOMA IN A HORSE

The features of an ossifying ameloblastoma in a 5-year-old gelding are described. The tumour developed in the angle of the right mandible and microscopically consisted of multiple follicles and islands of epithelial tissue adjacent to which were trabeculae of bone, osteoid and compact collagenous tissue.     

Mandibular fracture repair in a harbor seal

A 30-year-old captive female harbor seal (Phoca vitulina) bit down upon a metal ring within a hoop-net normally used to assist in securing the seal for routine physical examination. Radiographic examination performed under general anesthesia revealed a unilateral closed fracture of the rostral left mandible between the first and second premolar teeth. The rostral fragment was displaced ventrally and slight laxity of the mandibular symphysis was noted. The fracture was repaired surgically using an oral dental acrylic splint incorporating circumferential mandibular cerclage wire. The mandibular symphysis was stabilized using interdental wire between the right and left canine teeth. The fixation device was removed following evaluation of radiographs that showed signs of bony union 12-months postoperatively.     

Amyloid-producing odontogenic tumor and its immunohistochemical characterization in a Shih Tzu dog

A 10-year-old, male, Shih-Tzu dog presented with swelling of the right lower jaw caused by a mass arising from the right mandibular gingiva. Radiographic examination revealed bone lysis of the right wing of the mandible. Histopathologically, the growth was characterized by indistinctly lobulated nests, islands, and strands of proliferating odontogenic and squamous epithelial cells, intermingled in close association with large numbers of irregular extracellular deposits of amyloid and amorphous calcified substance. Immunohistochemically, both epithelial components stained strongly positive for cytokeratin (AE1/AE3); the squamous epithelial cells also reacted strongly with neuron-specific enolase (NSE) and S-100 protein, whereas the odontogenic epithelial cells displayed weak immunoreactivity to NSE and partial reactivity to S-100 protein. The amyloid deposits were AE1/AE3-negative. The growth was diagnosed as an amyloid-producing odontogenic tumor.     

Malignant nonteratoid ocular medulloepithelioma in a llama (Llama glama).

A 6-year-old female llama presented with buphthalmos of its right eye owing to the presence of an intraocular mass. The affected globe was enucleated and submitted for microscopic examination. The intraocular mass was diagnosed as malignant medulloepithelioma. Within the following months, the llama developed soft tissue masses, which completely filled the right orbital cavity and expanded the cranial portion of the right mandibular bone, and enlarged mandibular lymph nodes. Euthanasia was elected 30 months after the initial diagnosis. The carcass was submitted for postmortem examination, which revealed the presence of medulloepithelioma metastases within the right orbit, mandible, mandibular lymph nodes, lungs, liver, and mesenteric and sublumbar lymph nodes. The primary intraocular tumor and its metastases were composed of neoplastic undifferentiated neuroepithelial cells, which formed tubules, Flexner-Wintersteiner and Homer Wright rosettes, and rare solid sheets. Electron microscopy showed that tumor cells were connected by desmosome-like junctions and contained rare intracytoplasmic basal bodies. Neoplastic cells were positive for vimentin, nestin, microtubule-associated protein 1B, S-100 protein, and glial fibrillary acidic protein (GFAP). To the best of the authors' knowledge, this is the first report of a malignant nonteratoid ocular medulloepithelioma with distant metastases in a llama and of the ultrastructural and extended immunohistochemical characterization of a nonteratoid medulloepithelioma in this species.     

Ameloblastic odontoma in the mandible of a llama

A 4-year-old llama had an aggressive, multiloculated, expansile bone lesion involving the rostral mandible. The mandibular lesion was imaged using radiography and computed tomography. Antemortem diagnosis of an ossifying fibroma was made histologically. Postmortem findings showed the lesion to be limited to the mandible. Final diagnosis was ameloblastic odontoma.     

Endodontic disease of the mandibular first molar tooth secondary to caudal crossbite in a young Shetland sheepdog

A six month-old intact female Shetland sheepdog was referred to the University of Illinois Veterinary Dental Clinic with a left-sided mandibular deviation and a thickened left ventral mandible in the region of the first molar tooth. On oral examination, left caudal crossbite was diagnosed. Dental radiographs revealed endodontic disease of the mandibular first molar tooth involved in the crossbite. Because of the difficulty of treating caudal crossbite and the potential of a pathological mandibular fracture, the endodontically affected tooth was extracted. Ten months following the extraction, mandibular deviation and alveolar bone lysis were resolved, but alveolar ridge resorption was present. The abnormal occlusal relationship caused by the caudal crossbite may have led to movement of the tooth, resorption of the tooth alveolus, and irreversible pulpal damage. Although not employed in this case, use of alveolar ridge preservation techniques can prevent mandibular bone loss after extractions.     

Dental implant replacement of the mandibular first molar tooth in a dog

A new dental implant system was used to replace the mandibular right first molar tooth in an eleven-month-old male/intact, utility trained German shepherd dog. The permanent mandibular right first molar tooth had been extracted as treatment for an extensive carious lesion when the dog was 9-months of age. There were no complications associated with placement of the dental implant. However, peri-implant osteomyelitis occurred secondary to a traumatic oral wound 6-months following implant placement. The 17-month post-operative examination indicated that the implant system used in this case could be maintained in a working dog that uses extreme bite forces. However, periodontal inflammation and vertical bone loss exposing the implant fixtures were noted during oral examination. Further clinical applications are required to determine if the periodontal inflammation and vertical bone loss noted in this case were complications associated with the implant, maturity of bone at the time of implant fixture placement, general biting/chewing forces placed on carnassial teeth, or the oral trauma that occurred 6-months following implant placement.     

Surgical management of ameloblastic fibroma in the cat

A 14-month-old spayed female domestic short-haired cat was presented for evaluation of a rostral mandibular mass diagnosed from biopsy as an ameloblastic fibroma. Radiographs of the mandible demonstrated marked osteolysis and cortical expansion. A rostral mandibulectomy was performed extending from the caudal edge of the second premolar on the right side to the caudal edge of the canine tooth on the left side. Histological evaluation of the excised mass confirmed the diagnosis of ameloblastic fibroma. Follow-up evaluation at eight months revealed normal oral function with the exception of occasional saliva soiling of the chin. The owner was satisfied with the cosmetic result.