Page 1960 - Cote clinical veterinary advisor dogs and cats 4th

980 Tooth Fractures

○ Acute: broad-spectrum antibiotics (e.g.,
amoxicillin 20 mg/kg PO q 8h for 10-14
VetBooks.ir • Tonsillar lymphoma (pp. 607 and 609)
days)
○ Chronic: based on C&S results
• SCC: surgical excision followed by chemo-
therapy and radiation therapy (p. 939)
PROGNOSIS & OUTCOME

• Tonsillitis: good prognosis, usually resolves
with underlying disease
A B • Neoplasia: poor long-term prognosis

TONSILLAR DISORDERS A, Intraoral view of a dog with marked bilateral enlargement of the tonsils PEARLS & CONSIDERATIONS
(arrows). B, Intraoral view of tonsils in a normal dog for comparison.
Comments
Differential Diagnosis TREATMENT • Therapeutic intervention for enlarged tonsils
A detailed list of potential causes is provided is rarely required.
on p. 1287. Treatment Overview • The most common cause of symmetrical/
• Treat the underlying disease. bilateral tonsillar enlargement is a reactive
Initial Database • Tonsillectomy is indicated only for the change in response to oral exposure to
• CBC, serum biochemistry profile, and following: antigen, such as the pet licking his/her anal
urinalysis to identify underlying systemic ○ Chronic recurrent tonsillitis unresponsive sacs or genitalia. Diagnostic investigation and
disease to antibiotic therapy and elimination of treatment should focus on these processes
• Feline leukemia virus (FeLV) and feline source of antigen (e.g., licking infected area) first and then on the tonsils only if necessary.
immunodeficiency virus (FIV) testing of cats ○ Marked tonsillar enlargement interfering
with swallowing or breathing Technician Tips
Advanced or Confirmatory Testing ○ Neoplasia: SCC If tonsillar enlargement is observed during
• Bacterial culture and susceptibility (C&S) or endotracheal intubation for any anesthetic
virus isolation in cases of primary tonsillitis Acute and Chronic Treatment procedure, notify the veterinarian so that
that fail to respond to routine antibiotics • Incidentally discovered bilateral/symmetrical investigation can be made into cause.
• If peripheral lymph nodes are enlarged, FNA tonsillar enlargement is often most appro-
of representative nodes for cytologic exam priately only monitored (watchful waiting) SUGGESTED READING
can identify lymphoma. while the underlying cause is sought and Radlinsky MG: Surgery of the oral cavity and
• General anesthesia and tonsillar FNA treated. oropharynx. In Fossum TW, editor: Small animal
cytologic exam or biopsy ○ Remove any recognized foreign body. surgery, ed 4, St. Louis, 2013, Elsevier, pp 394-396.
○ Specific indications: unilateral tonsillar ○ Address dental and periodontal disease.
enlargement or tonsillar enlargement ○ Address distant infection/inflammation AUTHOR: Peter M. Foley, MSc, DVM, DACVIM
EDITOR: Leah A. Cohn, DVM, PhD, DACVIM
that does not resolve (or worsens) despite and minimize licking.
identification and treatment of underlying • Primary tonsillitis with clinical signs and no
disease identifiable cause

Tooth Fractures Client Education
Sheet

Clinical Presentation
BASIC INFORMATION • Cats: more common in canine teeth (due
to trauma) or any teeth weakened by tooth DISEASE FORMS/SUBTYPES
Definition resorption (p. 982) American Veterinary Dental College (AVDC)
Breaking of enamel, dentin, and/or cementum Tooth Fracture Classification (www.avdc.org):
of the crown or root (or both) of a tooth; RISK FACTORS • Enamel infraction: incomplete fracture
common in dogs and cats • Dogs: chewing on bones, ice cubes, nylon (crack) of the enamel without loss of tooth
toys, cow hooves, rocks, deer antlers, and cages substance
Synonyms • Cats: high-rise syndrome, vehicular trauma, • Enamel fracture: fracture with loss of crown
• Dental fracture tooth resorption substance confined to the enamel
• Slab fracture: fracture of the labial/buccal • Uncomplicated crown fracture: fracture of
(or lingual/palatal) surface of a tooth ASSOCIATED DISORDERS the crown that does not expose the pulp
Attrition (wear from tooth-to-tooth contact), • Complicated crown fracture: fracture of the
Epidemiology abrasion (wear from contact of teeth with crown that exposes the pulp
SPECIES, AGE, SEX nondental materials), pulpitis (pulpal inflam- • Uncomplicated crown-root fracture: fracture
Any age (including deciduous teeth) mation), displacement injuries (tooth luxa- of the crown and root that does not expose
• Dogs: canine and maxillary fourth premolar tion or avulsion), tooth resorption (p. 982), the pulp
teeth commonly affected (due to aggressive and caries (bacterial infection causing tooth • Complicated crown-root fracture: fracture
chewing or other trauma) demineralization) of the crown and root that exposes the pulp

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