Vetnews | Augustus 2024 40 « BACK TO CONTENTS Regulars I Dental Column A 15-year-old 6kg neutered male Siamese cat was referred to our clinic for assessment of a swelling on the right maxilla. The referring veterinarian saw the patient a few weeks before and started treating the patient with cyclosporine, amoxicillin, clavulanic acid and meloxicam. The mass initially responded slightly to the treatment, but the referring veterinarian was concerned regarding the ulcerated and inflamed mucosa. Squamous cell carcinoma (SCC) was the working differential diagnosis in this case. A conscious oral examination was not possible due to the temperament of the patient. The swelling on the right maxilla was easily visualised. The patient was sedated and blood collected for a complete blood count and a minor medical profile. No abnormalities were reported on haematology or biochemistry. The patient was anaesthetized and computed tomography (CT) was performed of the head and thorax, as we routinely do for any mass that we suspect might be neoplastic. On the CT expansile bony lytic lesions were present in variable degrees, affecting all four the canine teeth. The most prominent of these lesions affected the right maxillary canine tooth (104) and caused facial asymmetry (Figure 1). There were several resorptive lesions around the roots of the 104 and to a lesser degree of the 204, 304 and 404. The 204, 304 and 404 were ankylosed. There was a solid and palisading periosteal reaction, particularly on the body of the right maxilla, and the palatine processes of the maxilla (Figure 2). There was also a periosteal reaction on the body of the left rostral mandible. The cancellous bone of the maxilla and mandible was replaced by tissue with an intensity equal to soft tissue or purulent material. At the level of 106, there was bone lysis creating an oronasal fistula with the ventral meatus of the right nasal cavity filled with soft tissue or fluid. The thoracic CT was clear with no abnormalities. Based on the CT findings, an osteitis or osteomyelitis was suspected. A thorough oral examination with dental charting and dental radiographs was conducted. Maxillary bone expansion in a cat Dr. Mareli van de Wetering and Prof. Gerhard Steenkamp Figure 1 A transverse image of the CT in a bone window depicting the bone expansion on the right maxilla at the level of the canines. Figure 2 A transverse image of the CT in a bone window where the oronasal fistula can be seen as well as the periosteal reaction on the palatine processes and body of maxilla Figure 3 Abscess at the right maxillary canine tooth
RkJQdWJsaXNoZXIy OTc5MDU=