Expert: Jana Connell RVT, CVT - 4/25/2011

Question
My two Chihuahuas and I live in the Baja, off of Mainland Mexico and do not have access to properly trained vets.  The local vet here misdiagnosed a carnissal abscessed tooth for an ant bite or bee sting.  Because of this, my nine year old, slightly overweight Chihuahua was on amoxitabs (8 days) and Prednizone.  After one week of being on these drugs, the swelling did not totally subside and the vet here then guessed that my dog had an abscessed tooth.  Having my dog “tranquilized” locally and having his tooth pulled by the local “vet”: was not an option for me.  So, I packed up my dogs and went to a Vet in the United States and had the dog’s Left top Carnissal tooth extracted.

On 14 April a US vet extracted the left top Carnissal tooth.  My dog was prescribed Metacam and Antirobe.  I gave him two 25 mg tabs of Antirobe, twice a day for ten days.  I also gave him one ml of Metacam once a day for seven days.  The dosage of the Metacam was one mg per pound which was 12 ml.  I have to say that the syringe included with the Metacam is designed for larger breed dogs, but I cautiously administered the.Metacam which was just a few drops per dose.

The problem now, is that the small bump under my dogs eye, though very small, has an area where the hair (and possibly outer layer of the skin) is missing.  I noticed this last night.  It was a very tiny area.  This morning, about eight hours later, the area with the missing hair is still very small, but about 3 X larger than last night.  There is no bleeding, or fluid coming from this area, at least very little to none as it is not obvious when I looke at the area.

The size of the affected area is a little smaller than the head of a Q Tip.  The Chihuahua’s face, the actual cheek area is very small, so I do not consider this to be such a small area that is affected.  Also I can’t imagine that this is a normal, and it looks “almost” like an open wound, or may become one.  Note please, that this dog is no longer on any meds, including any type of antibiotics.

This dog is eating normally and has since day # 1.  Day #1 is when I found this dog with a swollen face, one side only, about the size of a soft ball with eye swollen shut.

This dog continues to act normally, eats, eliminates and plays normally.

I need to know what is going on and if there is a way that I can fix it?   I can and will call the vet’s office (the closest US vet that is 5 hours away), but I called them in the past (they failed to have the dosage on the Metacam box) and it is impossible to “talk” to a vet.  I am very afraid that who ever answers the phone will make up an answer, or will not properly relay my dogs condition to and from the vet!

It will of course cost hundreds of dollars to make this trip to the US and is an unbelievable hassle to cross over the border but I most certainly am willing to do that if it is necessary.

PLEASE Advise.

Answer
It is very possible that a tip of the root was left inside or that another infection has cropped up. Carnissal teeth are three rooted and it is easy to leave a tip behind. But it is equally easy for another infection to set in from the dog eating or from a pool of bacteria being in there. Usually the antibiotics will take care of this so unless they were not finished, it could be that they need another type of drug to kill them off.

You could have the cheek area xrayed locally without sedation and then if there is no root tip left behind just start on some new antibiotics from a local vet.

But if there is a root tip the vet needs to remove it. What you are seeing on the cheek is what happens when these teeth first start to abscess. The roots are almost up to the cheek surface and this they form a tract to the surface and rupture through that way when infected.

I would call them and ask to speak to the vet tech or the vet. The fact that you are calling long-distance (tell them that right away) and that you had just had this dog up there will let them know that they need to get the vet to the phone. Most vets will speak to a client especially in a situation like this. You must be persistent but firm about it.

Those are the options you have right now Patricia. Call the vet first or have it xrayed locally.
Most likely it is an infection and not a left-over root tip but you have to be sure.