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TokyoParrot June 7th, 2010 04:21 AM

Dental question-- hole in jawbone
Hi everyone,

I recently adopted a 2-kg Chihuahua from the local rescue group. He is perhaps 15 or 16 years old, very frail in general but has many good days and loves life.

He has horrific teeth-- only 4 left, all wobbly and painful looking, but he is in too poor health to be able to handle anesthesia, so we have not been able to remove them.

When he eats, he rubs his nose on the carpet (appears to be attempting to scratch an itch). He rubs frantically on the carpet after every bite, forehead to nose, over and over until it starts to become raw. He has also scratched up both corneas as a result of this urge to scratch the top part of his face after he eats. (We are using eye drops to heal the corneas and he also has an Elizabethan collar to limit the scratching behavior.) This has been going on for about 2 or 3 weeks.

The vet suggested that he is "trying to get out of his cage" (definitely not it-- he does it after eating, regardless of whether he is in his cage). I was thinking it was an allergy, but he hasn't shown any allergies thus far, and he does this after every meal, though again, just recently.

Last night, I noticed he has a large hole in his upper jawbone (on the side of the jawbone rather than the crest/"hilltop" where teeth would be on the ridge). I cannot see how deep it is-- cannot see any backside to the hole. Looks like it opens up to something hollow behind it. This is not a socket from a tooth that fell out.

I assume that that is the source of the pain/itchiness-- eats something, which then gets into the hole and into... what? Big void under the jawbone? Would this be painful? I thought teeth were painful because of exposed roots (i.e. nerves), but this is something else, perhaps? No teeth left in that part of the mouth at all.

I have an appointment at the vet tomorrow but wanted to see if anyone had any off-the-cuff guesses as to what *might* cause a hole to open up in the jaw. (More specifically, I need to go look things up in Japanese before I go to the vet, so I wanted to get a head start on thinking about what the cause of that might be. I'll Google in advance the vocabulary I need for the discussion. Once I spent 5 hours at the vet for the dog's gall bladder issues but I didn't know the word "gall bladder" in Japanese so it was a bit hard to follow the vet's explanation.)

I understand that no one can give medical advice, but I was thinking that if anyone had experienced this before, it would give me a head start on the issue.

hazelrunpack June 7th, 2010 11:01 PM

Ouch! That sounds painful! :( I've got no advice, but I did want to send some :goodvibes: along for the vet visit! I hope he can make your dog more comfortable! :grouphug:

MyBirdIsEvil June 8th, 2010 07:16 AM

I'm not sure about the scratching. It's really only during eating? Maybe the act of chewing is irritating his face for some reason.

As far as the hole, I'm not sure what would cause that other than an infection in his mouth.

Timas mom June 9th, 2010 07:21 PM

I would think he is expressing the pain of the infection and dental disease he has by rubbing his face.
The hole could be an abcess or a lost tooth.
All pretty serious. He must be in a great deal of pain.

Try wetting his kibble or switching to canned food and add a bit of water to it.

Good luck at the vet!

TokyoParrot June 10th, 2010 11:51 PM

Thanks for the replies, everyone, and apologies for being slow to follow up on this. It looks like he has an "oronasal fistula", so whenever he eats, the food/liquid goes up into his nasal passages, causing the intense itching/pain.

It looks something like this:

Over the last two days the problem has gotten much, much worse (hole has grown) and now this sweet dog growls and then bites me whenever I go anywhere near his mouth. I am unable to hand feed him now, and he won't eat on his own even though he cries all day that he is hungry. The situation is only correctable by surgery, but his gums/bones are too far gone to make that possible.

He is also unable to sleep from the pain-- used to sleep 20 hours a day, now sleeps barely at all.

I can't believe how quickly this happened. Quality of life is now bad enough that I am likely to ask that he be put down at our next vet appointment tomorrow night.

The worst part is that he doesn't look "ready to go". All my other elderly animals have made it known through their look or demeanor that they were ready to move on, but this one still has a lot of spunk left in him despite his overall frailty, so this is really eating at me. But he just lies on his bed, eyes wide open, obviously entirely mentally alert but staring at nothing, waiting for time to just pass, and doesn't want to be touched, so I know it's time.

hazelrunpack June 11th, 2010 09:28 PM

I'm so sorry, TokyoParrot! :grouphug: I know how difficult a decision you're faced with!

Please let us know how it goes today at the vet.

TokyoParrot June 13th, 2010 08:31 AM

Went to the vet last night and the dog decided he wanted to stick around a while longer. Perked up and actually walked around the vet's waiting room looking totally cute and later ate something by himself (not force-feeding), so doing well, or as well as can be hoped at this point.

He got another IV for nutrition, and IV antibiotics and painkillers. Currently he is on painkillers and high-calorie food to try to keep his weight up-- really skin and bones after not eating for so long.

We (vet & I) don't see him lasting particularly long, but if he is determined to stick around a while, I am thrilled to have him, so all is well right now.

hazelrunpack June 13th, 2010 04:45 PM

I'm glad he rallied a bit and got a bit of a reprieve. I don't have to tell you to cherish every moment with your little darling. :grouphug: He's such a lucky boy to have such a loving family!

TokyoParrot July 29th, 2010 11:47 PM

My poor Chi died last week, after a month of sticking it out. He had decided at one point in there that he [I]fully[/I] intended to stick around for another 20 years, and at one point we almost thought that he would pull it off. He ended up succumbing to renal failure.

His jawbone pretty much dissolved on both sides of his face, so he ended up having gaping holes on both sides of the top jaw that led right into his nasal cavity. They say that the state of your teeth indicates your the state of your overall health and I really felt that to be true in this case. Just as this was happening, everything started to fall apart-- heart, liver, kidneys, you name it, it was failing. The vet ultimately said it was just a question of what would kill him first, and then three days later, he was dead. :( For the final month we had him on IV antibiotics, subcutaneous nutrition, and pain killers.

I had originally thought that I would have him put to sleep when the problems first became clearly painful, but the dog was very adamant that he was NOT ready to go. Even on the night we finally put him to sleep, after a day of tics that turned into spasms and then full-body convulsions, he was NOT ready to go, and instead was entirely ticked off that any of this was happening to him.

This was the first pet I've had that didn't "look" or act ready to go, so it was a hard decision, but a necessary one. He died getting a head massage, his favorite thing in the world, and the death itself was clearly not painful and an obvious act of mercy.

I got him from a dog rescue group a year ago as a dog nobody wanted because he had all sorts of health issues even then, but he lived a full 15 months, way longer than anyone had expected.

He died very intensely loved and wanted and very much appreciated as a truly amazing addition to the family.

I hope that when I meet death I go out the same way, sliding into home plate....

Thanks, everybody, for your support.

hazelrunpack July 30th, 2010 12:04 AM

:grouphug: I'm so sorry, TokyoParrot! What a lucky boy he was to have come to you, though! He couldn't have been more loved.


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