Large dental abscess treatment

[Gizboo]

Hi All, I noticed before the weekend that one of my guinea pigs, Blackjack, had started to develop a lump under his jaw. It came on very quickly, I usually stroke him under his chin so I could tell straight away something wasn't right, a few hours later it was much bigger and over the weekend it seemed to grow more. Monday morning I managed to get an appointment for him at my local exotic vets. They took a look and told me that it was a dental abscess and because of the position, squarely under the middle of the jaw its likely to be from one of his lower incisors.

The vet told me dental abscesses can be tricky to manage and recommended doing some imaging to identify which tooth is causing it and to have surgery to marsupialise the abscess and also to extract all four incisors to prevent the abscess returning.

I was quite shocked that the vet recommended extracting all four incisors but he assured me that Blackjack would still be able to eat using his molars. I’m just after some advice on whether this seems like the best way forward? I’ve had a read through other threads posted here about similar issues and it doesn’t seem like the norm to have all four incisors extracted so I’m concerned this might be a little extreme?

*To give some more background Blackjack will be 5 years old in June, he’s still eating and behaving normally since the abscess first appeared. Around 6 weeks ago he went to the vets for a dental because he had been off his food and when they examined him they saw that there was a slant in one of his lower incisors so he had a dental operation to bring all the teeth back into alignment. He was much better after the surgery, eating and behaving as normal, he’s usually a very happy chappy. This abscess has been the only issue since, almost 6 weeks after his op.
Vets also recommended doing CT to be sure which tooth was causing the issue but I opted for an X-ray since it was slightly cheaper than the very expensive CT, and vet seems very sure its related to one of the lower incisors.

 

[Piggies&buns]

I’m sorry to hear this.

Antibiotics (Azithromycin), painkillers, surgery on the abscess - all would be within what I would expect.

Removal of all four incisors? There are piggies who do have to have incisors removed but it can often mean they require assistance with picking up food and eating.

I’m going to tag @furryfriends (TEAS) as she has lots of experience with dental issues and she may have advice to help here

 

[furryfriends (TEAS)]

Please don’t agree to the removal of all the incisors. In most cases they don’t need to lose any, although occasionally the incisor the abscess is under may be lost. Guinea pigs don’t cope as well as rabbits do, after having all incisors removed. Marsupialising the abscess along with twice daily flushing and a good antibiotic, such as azithromycin, your piggy should make a good recovery.

 

[Gizboo]

Please don’t agree to the removal of all the incisors. In most cases they don’t need to lose any, although occasionally the incisor the abscess is under may be lost. Guinea pigs don’t cope as well as rabbits do, after having all incisors removed. Marsupialising the abscess along with twice daily flushing and a good antibiotic, such as azithromycin, your piggy should make a good recovery.

Thanks both. So if I go ahead with just the marsupialisation it will be a case of flushing the abscess twice daily and treating with antibiotics until (hopefully) the infection clears? What does flushing the area involve?

I will call the vets and ask if we can go ahead with the marsupialisation but not the extraction, since it does seem to be a bit extreme.

He is currently on 0.7 ml Baytril (antibiotic) twice daily and metacam (0.45 ml also twice daily).

 

[weepweeps]

I’ve had a piggy with a very large tooth root abscess. It was marsupialised. He was given a 6 week course of the antibiotic Zithromax and pain medication. I flushed it three times a day and managed to keep it open for 10 days so it could drain (although not much came out of it) and heal from the inside. He did eventually lose one incisor. But he managed well with only three. Good luck I hope it gets sorted out and he’s soon feeling better.

I bet it’s been there 6 weeks and was brewing when he had his dental as Peppers first signs was going off food, losing weight and having slanted incisors.

Also the Zithromax did stop his appetite so he was syringe fed for 8 weeks.

Here is his thread if you’re interested
Dental? Pepper is off to the vets tomorrow

 

[Gizboo]

I’ve had a piggy with a very large tooth root abscess. It was marsupialised. He was given a 6 week course of the antibiotic Zithromax and pain medication. I flushed it three times a day and managed to keep it open for 10 days so it could drain (although not much came out of it) and heal from the inside. He did eventually lose one incisor. But he managed well with only three. Good luck I hope it gets sorted out and he’s soon feeling better.

I bet it’s been there 6 weeks and was brewing when he had his dental as Peppers first signs was going off food, losing weight and having slanted incisors.

Also the Zithromax did stop his appetite so he was syringe fed for 8 weeks.

Here is his thread if you’re interested
Dental? Pepper is off to the vets tomorrow

Thanks so much for this!

I found Pepper's thread whilst I was searching through posts about dental abscesses, really helpful!

I spoke to the vet earlier and asked if it would be okay to go ahead with the marsupialising only and leave the teeth alone. He pushed back against it, said it wouldn't be the recommended advice and that he was sure the abscess would come back unless the tooth (and all the incisor teeth) were extracted but I said I'd be keen to try to get rid of the abscess first before doing any tooth extraction so he agreed. Really hoping I can get rid of the abscess so that we don't need any more surgery.

 

[weepweeps]

Thanks so much for this!

I found Pepper's thread whilst I was searching through posts about dental abscesses, really helpful!

I spoke to the vet earlier and asked if it would be okay to go ahead with the marsupialising only and leave the teeth alone. He pushed back against it, said it wouldn't be the recommended advice and that he was sure the abscess would come back unless the tooth (and all the incisor teeth) were extracted but I said I'd be keen to try to get rid of the abscess first before doing any tooth extraction so he agreed. Really hoping I can get rid of the abscess so that we don't need any more surgery.

I’m glad Peppers experience could help another piggy. That seems like a good plan. Get rid of the abscess and see what happens to his teeth. Keep us posted on how everything goes. We are here to support you and your piggy through this.

 

[furryfriends (TEAS)]

We’ve had many piggies fully recover from incisor root abscesses, and haven’t removed the incisors. I could sort of understand them suggesting removing the tooth with the abscess in the root, but why would you remove healthy teeth and make it difficult for the guinea pig to eat?!?

 

[Freela]

We've had dental abscesses opened up and lanced/marsupialized before, without removing any teeth. I would try that first before okaying the removal of any teeth (especially not all the incisors, some of which are bound to be healthy!)