# Nasal discharge, sneezing after dental work



## Katie3939 (Mar 14, 2014)

Hello,

I'm new here and my name is Katie. Our dog Jack, a rescue pug very recently had ten teeth extracted by a vet dentist...A vet that does only dentistry.

He came home on pain meds and was supposed to be healed from surgery in two weeks.

Instead he was extremely unwell and developed aggressive sneezing, a dry hacking cough, and very yellow discharge from one nostril.

I took him to our 'regular' vet and he explained it is very unusual to see a dog with discharge from only one nostril, and it's a 'bad' sign. 

Jack had no temperature and no lung congestion. The vet suggested this was some form of sinus issue. He cultured the yellow nasal discharge and but him on an antibiotic in the meantime. Jack seems sicker than ever after three days on the antibiotic.

We're waiting on the culture to come back, but the vet said Jack may need an MRI (a costly expense that's only available at an extreme specialty clinic.)

Has anyone had any experience with this? He said it could also be nasal cancer, (Very rare particularly in a dog with a short muzzle) or nasal polyps.

I'm certain this was related to the dental surgery. (Surgery was only 2 and a half weeks ago.) He went into the surgery in perfect condition, and came out horribly.

Am beside myself. We'd appreciate any information about this kind of experience. 

Thanks so much,
Katie and Jack


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## Lurcherlad (Jan 5, 2013)

Did you speak to the vet who did the dental?

Maybe he picked up an infection in the procedure.


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## Twiggy (Jun 24, 2010)

I agree with Lurcherlad. I would most certainly want to speak with the vet that carried out the procedure as a matter of urgency.


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> Hello,
> 
> I'm new here and my name is Katie. Our dog Jack, a rescue pug very recently had ten teeth extracted by a vet dentist...A vet that does only dentistry.
> 
> ...


personally Im with you especially if he had upper teeth taken out or the problems were with upper teeth too and also the fact that he is a Bracycephalic breed aswell. Ive double checked on a couple of theories I had to make sure they were plausible before answering and have found the following that seems to have confirmed the possibility.

Some of the tooth roots in particular can interact or connect to the nasal sinuses.

If the extractions haven't healed well then food and bacteria can make their way up into the sinuses causing bacterial infection and discharge.

Another common problem that can sometimes happen is that pieces of bone or tooth root can be left in the socket and that can cause inflammation and infection too.

There is also something called root displacement where the roots can get pushed up into the Nasal passages.

It seems too that the theory of Bracycephalic breeds being more prone to dental problems in general and more prone to complications with extractions are borne out too.



> Some problems are associated with specific types of breeds. For example, many brachycephalic breeds have rotated third premolars that are crowded tightly against the fourth premolars, trapping debris and predisposing to periodontal disease and bone loss in that area. These third premolar teeth commonly require extraction to save the important fourth premolar, a major chewing tooth.* In some cases, the roots of the third premolars are separated from the nasal passages by only a thin layer of nasal mucosa, making it very easy to displace the root into the nose.* This particular area is also a common area to encounter excessive hemorrhage, making visualization more difficult.


See link below for full dental extraction complications
Complications from Pet Teeth Extraction - Veterinary Dentistry |

It may be the discharge that's causing the cough as well as the discharge, but you can also get a condition where infection gets into the blood stream from either bacteria in the mouth caused by decayed teeth and periodontal disease and after dental surgery, this can settle in the valves of the heart causing bacterial infection and something called endocarditis, really dogs that have any history of heart problems or severe oral infection should really have antibiotics pre and post surgery anyway as a matter of course, Mine was put on about 2 weeks antibiotics after dental surgery as standard and he doesn't have a heart condition, although he developed a tooth root abcess due to a fractured tooth on one of his upper carnassials. Endocarditis will cause lethargy, coughing, difficulty breathing . Endocarditis needs urgent aggressive antibiotic theraphy as if left it can cause heart damage. It may not be this and it is all to do with the discharge and nasal infection, especially as brachy breeds can have airway problems anyway at the best of times. Just in case though thought I would mention it.

I think he needs checking urgently either back to the dental specialists or another specialist I wouldn't be messing about with the GP vet or waiting for results in the meantime. If something is gone wrong then although antibiotics may initially help it wont longer term if there is an underlying problem causing the infection and discharge.


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## Sled dog hotel (Aug 11, 2010)

Have also found this too.

Oral Surgery

Oronasal Fistulas

*This is a term used to describe a hole or communication between the oral cavity (mouth) and the sinuses. When you have such a fistula or hole it allows mucus from the sinus to drain into the mouth. It also allows liquids (saliva, water, etc.) from the mouth to go up into the sinuses (often seen as dripping or drainage from the dogs nose).*

Clinical Symptoms

Patients with oronasal fistulas may present with a variety of symptoms.* The owner may notice sporadic or chronic sneezing. There may be a nasal discharge from one or both nostrils*. Sometimes patients will present with no clinical signs indicating the importance of thorough examinations and periodic teeth cleanings.

Causes of Oronasal Fistulas

The most common cause of oronasal fistulas is from periodontal disease that has led to bone loss around the tooth resulting in fistula development.* Other causes of oronasal fistulas include complications from past extractions, foreign-body penetration,* bite wounds, neoplasia as well as Inherited or developmental clefts of the lip or palate.

Veterinary Dentistry and Oral Surgery, dog & cat teeth cleaning, Arlington Dallas Fort Worth Vet Dentist, Jaw Fracture


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## Katie3939 (Mar 14, 2014)

Sled dog hotel said:


> Have also found this too.
> 
> Oral Surgery
> 
> ...


Thanks so much for your reply.

Yes, I took him back to the dental vet who removed the ten teeth. He is supposed to a 'world class' dental vet BUT I'm so disgusted with him!

He travels the southern coast of the USA, and so is not always in town. He examined the mouth to see if it was okay, and said the mouth was 'fine' and healed.

I too found the information about the fistula, and I thought 'that must be it', because sneezing and nasal discharge from one nostril are the classic symptoms.

He charge over 2000 dog 'biscuits' if you get my point, and IMO he should have re-exrayed the mouth to be certain there are no issues under the gums or with the bone!!

Our pug is still very sick. He is Baytril now, and we are awaiting the results of the nasal discharge culture our regular vet took.

The Baytril is not helping. He's been on it since Tuesday and today is Friday...No change.

My concern is that it's not bacterial. My regular vet said he may have to refer him for an MRI...That will cost a crazy amount.

It's not the money, we just want our Jack back!

The articles that were posted are excellent. The vet dentist who did this has a cavalier attitude, and I don't know what to do next other than the MRI.

It could be a fungal infection which is much more difficult to treat! It could be something called Lymphoplastic Rhinitus.

Found this article which is very interesting...Written by a vet dentist who is very aware of this. http://www.petforums.co.uk/newreply.php?do=newreply&p=1063587311

I appreciate any thoughts, ideas and links. Thank you so much.

Katie


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## Katie3939 (Mar 14, 2014)

Hi, I've been trying to post a response, and last time it said it would be reviewed by a monitor?

I'll wait and see if this posts and then rewrite my last post.

Thank you!
Katie and Jack


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## Katie3939 (Mar 14, 2014)

Sled dog hotel said:


> Have also found this too.
> 
> Oral Surgery
> 
> ...


Hi Sled Dog, Twiggy and Lurcherlad,

Jack is not responding to the antibiotic, and is much sicker than he was yesterday. Very, very sick.

This morning I woke up and couldn't find him. I panicked and he was laying so flat at the bottom of the bed beneath the covers...This is such a crazy nightmare. I was afraid he was dead. When I found him I just held him close the rest of the day, as I've done every single day since the surgery. Literally.

Before the dental work 2 and a half weeks ago, 3 weeks ago nest Monday, Jack was a pudgy pug. Am feeding him as much real human food as I can and while he's still eating he is now drifting.

I've called the dental vet tech continually since the dental surgery...First about his pain level which was very high...and then again after the first week. I kept saying this is 'wrong' and asking why, what...??? She said, "He'll be fine in another week"

I kept calling the dental vet tech and then went to my regular vet as I explained in my first email on Tuesday.

After that visit I Googled the internet about dental complications and found the link mentioned by Sled dog hotel! Good one! I had called my vet on Tuesday within an hour after seeing him, and found the info on oronasal fistulas and thought THIS IS IT! The symptoms are identical!!! I then called the dental vet tech back about it on Tuesday.

The vet tech said 'bring him in tomorrow morning at 9:30 am. She said they would 'fix it' if that's what they found.

My husband took Jack in on Wednesday morning and the vet was very cavalier and took just a minute to look at his mouth and said, 'his mouth is healed and fine'...That was the FIRST time my husband had ever even met him.

He didn't even have the courtesy to call after the surgery to see how he was or to meet with my husband who took him in and dropped him off!

We paid over 2000 dog biscuits...$ to this dental vet...But I just want my Jack back.

Today I finally came undone. He's so sick and the 72 hour window our vet gave me for the antibiotic is over...I specifically asked our vet when I might see improvement with the antibiotic. He said 72 hours...

Before the dental work the vet dentist required a CBC from our regular vet, I think that's fair and wise, and all blood tests were normal, hence the vet dentist did the x-rays and called me saying he 'needed 10 teeth extracted'...I was Shocked. I was only expected a cleaning with maybe one bad tooth? (if that!)

I won't share the name of the dental vet...Yet.

We live in Florida though, and dental vets are few and far between!

Thank you for your ideas, and any thoughts you can come up with.

I'm praying. Thank you so much! Please keep him in your minds eye.

Best, Katie and Jack


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## Katie3939 (Mar 14, 2014)

...............


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## victoria171168 (Apr 8, 2013)

Big hugs and basically l would be hammering on the door of the specialists demanding a full checkup.

It sounds like he needs to be in intensive care atm.

And yes some specialists dont do after op appointments. 

I would get your poor boy into emergency care now and dont leave until they admit him.
you know your baby better than anyone so dont let them fob you off


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## victoria171168 (Apr 8, 2013)

As a thought syringe feed himlike you would a baby animal as liquid food might be easier for him.


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## Lurcherlad (Jan 5, 2013)

Poor Jack! I really don't know what to suggest. 

Someone suggested getting him into intensive care, which may be a good idea. Maybe he needs intravenous antibiotics or something?

This is all very worrying as my Jack, a lurcher, is going in next Friday for a dental.

I have spoken to the vet and staff about the bacteria/abs/heart issue and they have assured me they give strong abs under anaesthetic and a course for post op.

I hope your boy turns the corner soon x


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## Honeys mum (Jan 11, 2013)

Poor Jack,
, so sorry to read all he has gone through,and you have done everything right yourselve, keep pushing the vet.
Hope everything goes well and that Your boy makes a quick recovery.
Big hugs for you and Jack.x


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## Sled dog hotel (Aug 11, 2010)

If he is not responding to the antibiotics, then they wont always unless it is the right one in high enough doses, different antibiotics deal with different bacteria strains, and if you haven't got the right one in the first place they wont help anyway. Either that or as mentioned before although there may be some infection there which could be due to the yellow nasal discharge (usually yellow/greenish discharge is a sign of infection) there is something else going on and it isn't purely due to infection alone. Which get back to the possible extraction/post extraction dental complications again especially as Bracycephylic breeds like bulldogs and pugs can have an higher incidence of complications anyway.

Have they run any further blood tests since the surgery? to see if there are any changes or clues there. Blood tests are never infallible anyway, just for example with kidney problems its not until about 75% of the kidneys are dysfunctioning that things like Blood urea nitrogen and I think creatinine too are elevated, same does for the liver. Often full Urinalysis picks up on things quicker then a blood test does as it shows changes earlier in a lot of areas.

Other thoughts the endocarditis I mentioned can be acute and sudden onset due to bacteria being released in the blood stream after oral surgery in fact bad teeth and periodontal disease can cause it anyway. The bacteria settles in the heart and valves and starts to cause heart damage, as it progresses you can sometimes get a mumour but not at first/always, so has his heart been checked (I think you need an ECG and other tests) Just still wondering if this may be a possibility, especially if he didn't have pre and post antibiotics. As mentioned when my boy had a carnassial extraction due to a tooth root abcess on a fractured tooth, first thing he had post surgery was an antibiotic injection to get in the system quicker then a two week or not so far course of high dose antibiotics to start the following day, the vet also checked his heart at the post op check too as well as the extraction site. If he had no Anti biotics at all or not until recently then maybe he has a severe infection and/or if the current ones are not right anyway they wont be making a difference.

Pugs can be more at risk from anaesthesia in general due to being a bracycephalic breed, anaesthesia and the associated drugs do put stress on the heart, kidneys and liver and cause changes in blood pressure, usually with modern anaesthesia and pre testing and things like IV fluids and monitoring complications can be considerably reduced, but in a Brachy breeds they do have higher risks in general, especially if there was something subclinical going on that had not yet shown sign with symptom wise or on normal tests.

I noticed too that you said that the pain meds didn't seem to be having an effect or not at the dose rate he was initially on and that he was given a much higher dose that zonked him out for 5 days. Can you remember what the pain killers were and the dose, just a thought but pain killers can have side effects and cause complications things like Non steroidal anti inflammatories for example can have side effects, and can affect the liver and kidneys. Things like Metacam which is something called Meloxicam and there are several "brand" names also not only has side effects as a typical example you also have to be very careful about dosage and overdose. 

If he is still not healing either which I understand from your post then that's not right either, although if there is infection present or something wrong that's still setting up infection then it wont anyway. Infected tissue cant heal.
Sometimes you cant tell by looking either further diagnostics need doing to find things sometimes.

Getting back to the Oranasal fissures for example the hole wont close or heal, unless surgical repair is carried out. It says its vital that its diagnosed properly and the relevant repair is done. There is also the problem mentioned more common in Bracy breeds too of the tooth root deplacement up into the nasal cavity plus because of the confirmation of bracycephalic breeds.
According to the info it can happen more often.

Is there a good ER centre near you? I don't live in the states, but have watched programmes of ERs in the states and from the ones that Ive seen the equipment and veterinary specialist teams there seem second to none. Just wondering if its worth taking him somewhere like that to get a complete new set of eyes and experience on the problems, obviously together with the full history so far of course.

Whatever is wrong with the poor little guy its not right and so far the exisiting vets seem pretty clueless, Ive been to specialists in various areas and my experiences have been a lot better then what you have received so far from yours by the sounds of it too.

I really hope you can get to the bottom of it and help the poor little Guy, above Ive just really thrown suggestions as to what might be happening or contributed to his problems, hopefully it might offer soe more clues.


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## Katie3939 (Mar 14, 2014)

Many thanks for the well wishes, and Sled dog hotel, all your information is excellent.

What we've determined this far is that the Batril is not helping Jack 'feel better' but it the nasal discharge is now 'clear' and not bacterially infected, but the discharge continues, sneezing etc...

But mostly Jack is sick, lethargic, can't get comfortable, tries to be alone to sleep. 

Anesthesia for pugs is a complex concern, this is one of the reasons we used a vet Dentist...They used very light anesthesia. 

As for main meds they prescribed tramadol. 

The culture will come back hopefully Monday...Tuesday at the latest and we are hoping this might be a fungal infection because that's the best case scenario. Ironically, with mucus coming from one nostril only, it's almost always the case that a bacterial infection is secondary, but not primary...Sigh...

The vet already said he may have to refer him for an MRI. That's just a nightmare because nothing good can come after that.

This is such a puzzle to me. He went into the dentist perfectly fine except his teeth looked bad despite having them cleaned by our regular vet 2 years ago.

The regular vet told me last week that small dogs have genetic issues with bad teeth...Pugs are one of the bad ones...He also mentioned Maltese and Shih Tzu dogs.

In the meantime Jack still has his appetite and that is my biggest delight. Other than that he's down and out.

We feed him cooked human food. All soft.

Thank you so much for all your information, Sled dog....I too thought for sure this was an oralnasal fistula, and that's when the vet dentist looked in his mouth on a repeat visit, and said, 'his mouth is fine and healed'...End of story.

I don't believe this could possibly be unrelated to the dental surgery. The dentist did say surgery could have been a 'stress' on him and to have his blood work retested. I'd rather apply that 100. plus dollars to an MRI which would show ALL dental issues along with nose issues.

Just hoping the culture reveals something 'easier'? 

In the meantime Jack is the same. Sleeping, trying to get comfortable. Still has a runny nose, but it's clear and he's still sneezing.

Thank you all, if you read something thank you so much for sharing it with me. I appreciate it all!

Best,
Katie and Jack


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## Katie3939 (Mar 14, 2014)

Btw, here is Jack. An amazing surfer in the ocean, and on the lake.

Here's a video of him paddleboarding.

Pug Paddleboarding - YouTube


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## Lurcherlad (Jan 5, 2013)

Great piece of film! He looks very relaxed. Hope he is back on the board very soon


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> Many thanks for the well wishes, and Sled dog hotel, all your information is excellent.
> 
> What we've determined this far is that the Batril is not helping Jack 'feel better' but it the nasal discharge is now 'clear' and not bacterially infected, but the discharge continues, sneezing etc...
> 
> ...


Good news that at least the nasal discharge is at least clear so that it means hopefully infection is under control. Not so good news there is still a discharge or the poor little guy is still not himself.

Hopefully the culture will confirm that it is something straightforward so you an get on top of it.

Ive managed to find another good site that explains about the healing process or what should happen when its straight forward. It also explains about things that can delay healing, and infection too, so if needed may offer some clues.

Below are just excerpts from the whole thing which you will obviously need to read in context and fully.



> proliferation over the surface of the wound is a more rapid process than healing of the connective
> tissues, the surface of the socket frequently being covered in 7 - 10 days if there are no
> complications, with a normal appearing epithelial surface forming in 2-3 weeks. There is no
> longer any risk of infection entering the wound from the oral cavity once the epithelium has fully
> ...


Unless Ive misunderstood the above seems to talk about retained root tips and other debris that are sometimes shed and from what I can gather ca resolve itself although not always.
On the other complications of canine dental extraction I found it did also say the following.



> ROOT DISPLACEMENT
> In certain anatomic areas, there is a possibility of pushing a root into a location where it might cause clinical signs or be difficult to retrieve. The most common examples would be root displacement into the nasal passages, maxillary recess (located palatal to the upper fourth premolars in dogs), mandibular canal or retrobulbar space.
> 
> The above discusses the root being displaced into the actual nasal cavity.
> ...


Purely theoretical and don't know for sure, but wondering if there is a possibility that a part of the root could have been displaced into the nasal cavity and caused the problem, and if it did could that be absorbed or shed as it would if the problem was located in the wound site or healing socket, although even there from the above that doesn't seem to always happen, or does it just remain in the nasal cavity causing infections and problems unless removed.
Another question would be even if its displaced into the nasal cavity, would there be any evidence that it has happened if/once healing did take place unless looked for on radiographs or a scan.

As said just wondering and theoretical and hopefully it wont be needed if the cultures throw up the cause, but might be questions worth asking if they are needed.


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## Katie3939 (Mar 14, 2014)

Thanks all for your well wishes and Sled dog for your excellent digging...

Yes, Jack always loved to paddle board in lakes and even surfed in the ocean. He couldn't stand for anyone to go without him. 

Jack continues to be about the same with a few exceptions. He no longer wants to be petted, (at all) but will roll over on his back as if to say 'You can rub my belly' if you have to touch me, but really just leave me alone.

He was stuck to me like velcro for the last 8 years and now he will only lay at my and rest his head on my calf. This alone makes me shake my head because it feels so bizarre and also makes me sad. Pugs are amazing to snuggle with...This is new in the last few days. I know it means pain.

He can't seem to get comfortable and moves from one place to the next every 5, 10, 15 minutes. This from a dog who would lay in the sun without moving for over an hour.

A very odd thing I've seen lately is excessive yawning. Don't even know that I recall seeing him ever yawn. Now it seems every time I look at him he's yawning. I did a ton of research on yawning, and not surprisingly it's 'contagious' amongst humans and they say dogs sometimes yawn to show they're in sync with their owners, but neither my husband nor I have been yawning.

Finally found a good article that explains yawning increases blood flow to the brain. Am not sure how that fits in yet, but am keeping it in mind since it's happening constantly.

Sled dog, I also am concerned about the bone under the gums and nerve issues. The vet dentist looked inside his mouth last Tuesday, (Two weeks and two days after surgery) He said 'His mouth is fine and healed. But that's only what he could see with the naked eye. I want more information.

This is why the MRI is significant. If there's a blockage in one nostril, an MRI would show that, but Jack was perfectly healthy when he went to the vet dentist. An MRI would also show what's beneath the gum line, and I can't help but want to know what is going on there. How could this be a coincidence?!

The culture on the rotten infected nose discharge should be back tomorrow or Tuesday. It could show fungal or viral infection. 

Thank you for your thoughts. Sled dog, I have a diagram of the teeth they removed and want to see which ones near the canines and molars were removed. That's a big issue. The canine and molar teeth are the most significant (and difficult) but other teeth near the molars are significant too.

Best,
Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Behavioural wise yawning can be a sign of stress and anxiety. Dogs will yawn and also do things like a lot of lip licking when they are anxious and unsure about something too or not comfortable with a situation.

Rolling on their backs and exposing their stomachs and genital area often with a leg raised is also a submissive/behavioural sign too. You often see that too sometimes with other dogs even to difuse a situation. 

Hoping the cultures will show something. You can see from the video you posted what a happy outgoing loving little guy he was, and to see him behaving as you now describe must be so hard and so different to how he was before and usually.


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## Katie3939 (Mar 14, 2014)

The culture results did not come back today BUT I did notice a huge issue that I will be talking with my regular vet in the morning. He told me to talk to him first at this point, and I will but not for long if this does not get resolved immediately after the culture results are discussed.

Just a few hours ago we were sitting on the couch. Jack was laying with his eyes closed, and I was watching him. My husbands hand passed by the left side of Jacks mouth (the side that most of the teeth were removed from), and his hand came within a hair of touching Jack but didn't , and even with his eyes closed he made a huge flinch. This tells me that that's where the pain is! I cringed when I saw it.

The 'weeping' from the nose is on the right side, so it was assumed that maybe that was the side affected by the dental work, which didn't make a lot of sense.

Yes, a dog turning onto its back is a submissive sign and he is doing precisely that...Deflecting and saying, 'Please don't touch me, but if you must...do it here'

Also, after doing a lot of Googling I've learned that excess yawning and licking (which he's doing as well) is a sign of nausea in a dog. Who knew?

So he did, (does) have some sort of infection ,and yes, the culture will be important, but I feel like I have a clue as to which side is impacted.

Also, his left eye is only half open. I've been ignoring that, because he's been sleeping so much, and when he's very alert it will be round, but for some reason it's at less than 'half mast' when he's just 'being'. 

Thanks again for the research and wishes,
Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> The culture results did not come back today BUT I did notice a huge issue that I will be talking with my regular vet in the morning. He told me to talk to him first at this point, and I will but not for long if this does not get resolved immediately after the culture results are discussed.
> 
> Just a few hours ago we were sitting on the couch. Jack was laying with his eyes closed, and I was watching him. My husbands hand passed by the left side of Jacks mouth (the side that most of the teeth were removed from), and his hand came within a hair of touching Jack but didn't , and even with his eyes closed he made a huge flinch. This tells me that that's where the pain is! I cringed when I saw it.
> 
> ...


The eye could be a factor most deffinately, oddly enough, when my boy started to develop a root tooth abcess on an upper carnassial due to damage to that one tooth which at that stage I didn't know about, the first thing I noticed a day or so before was an eye that didn't look right. No redness or infection just that. Initially I wasn't concerned but a day or so later I noticed a swelling on his face, and when I went to touch it he snapped and growled, so guessing what was the likely problem he was straight to the vets who confirmed it. After the extraction the eye went back to normal so that could well be an indication something is going on still.

Im still wondering if there are any tooth root tips lodged somewhere? Either in the gum/socket or nasal cavity which its confirmed can happen especially in brachy breeds.

Ive found a link about dental radiology, and if you look on the link, amongst other things, there are x rays to check that there has been complete root and root tip extraction and if you scroll down further there are later radiograps showing two root tips that have been left. Headed dental extraction was not as straightforward as expected and two root tips were left. Now below those of the root tips it states dental radiographs were essential to find and remove these root tips. In fact the whole thing is about the importance of dental radiography in any dental procedures.

If that's the case, and no dental radiographs have been taken after the extractions to check that all is as it should be considering the number of teeth and work he has done bless him, or none have been done since he has been experiencing the pain and all the problems have they missed something, 
it may appear you cant tell just by physically looking which I think is all they have done. or aside from your own vet who I believe has just given antibiotics and cultures.

Dental Radiology

May have gotten it wrong, but it does beg food for thought.


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## Katie3939 (Mar 14, 2014)

Sled dog hotel said:


> The eye could be a factor most deffinately, oddly enough, when my boy started to develop a root tooth abcess on an upper carnassial due to damage to that one tooth which at that stage I didn't know about, the first thing I noticed a day or so before was an eye that didn't look right. No redness or infection just that. Initially I wasn't concerned but a day or so later I noticed a swelling on his face, and when I went to touch it he snapped and growled, so guessing what was the likely problem he was straight to the vets who confirmed it. After the extraction the eye went back to normal so that could well be an indication something is going on still.
> 
> Im still wondering if there are any tooth root tips lodged somewhere? Either in the gum/socket or nasal cavity which its confirmed can happen especially in brachy breeds.
> 
> ...


Sled dog...Indeed! It is food for thought, and that article is brilliant. Thank you so much for finding it and sharing! I thought I'd Googled to the moon and back, but I'd not seen that article.

The info on root tips being left behind is actually 'hopeful' to me because it can be 'fixed'. That article you linked was so helpful!

Today was an important day because the culture came back and there was nothing indicating a fungal or viral infection.

I spoke to my regular vet and I said I felt the dentist should reevaluate Jack using light anesthesia and taking additional x-rays. I mentioned the amount of money Jack's surgery had cost and he could not contain his reaction. It was a version of 'wow'...

So he felt that was a reasonable next step. He also emphasized that if Jack had a recurrrance of the one nostril drip, that more antibiotics or different antibiotics would NOT help. I'd already researched the one nostril discharge, and KNOW now that a bacterial is always secondary to a primary problem when discharge is coming from one nostril only. Am glad I'd done my homework...

My regular vet said he would refer me to a major vet complex that has MRI and CT machines and if the dentist didn't find the cause that would be the next step.

Next I contacted the dentists assistant. He is willing to reexamine Jack with light anesthesia and new x-rays but he will not be back in town for an entire week.

In the meantime I asked the dentists assistant about pain management. She suggested I give him Tramadol and Rimadyl. My regular vet will prescribe and I'll pick up the meds tomorrow.

So Jack will have pain management for one week until he sees the dentist again.

Sled dog, am so hoping it's something that the dentist can 'fix' like the root tips mentioned in the article...Thank you for finding that and sharing your experience and the link.

Please though tell me why you said this is found in brachy dogs!!! I didn't see that! Where did you see that please...??

Sled dog...About your dogs eye, am so glad your dog was helped. How is he now?

Jacks left eye is half closed at most times since the dental surgery, but when he becomes 'Alert', (he's still food responsive) his left eye will become round. I find that odd, that it changes.

Thanks to everyone who has done research and sent well wishes, and a special thanks to Sled Dog for your exceptional research and input. Am very appreciate.

Best,
Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> Sled dog...Indeed! It is food for thought, and that article is brilliant. Thank you so much for finding it and sharing! I thought I'd Googled to the moon and back, but I'd not seen that article.
> 
> The info on root tips being left behind is actually 'hopeful' to me because it can be 'fixed'. That article you linked was so helpful!
> 
> ...


If you go back through the thread I posted about root tooth displacement and that it can be a problem in Bracycephalic breeds like bulldogs pugs etc in post number 4. Ive copied and pasted the bit about the tooth roots over to here.
Its not just tooth roots that can be left it can be bits of bone too for example.

Some of the tooth roots in particular can interact or connect to the nasal sinuses.

If the extractions haven't healed well then food and bacteria can make their way up into the sinuses causing bacterial infection and discharge.

Another common problem that can sometimes happen is that pieces of bone or tooth root can be left in the socket and that can cause inflammation and infection too.

There is also something called root displacement where the roots can get pushed up into the Nasal passages.

It seems too that the theory of Bracycephalic breeds being more prone to dental problems in general and more prone to complications with extractions are borne out too.

Some problems are associated with specific types of breeds. For example, many brachycephalic breeds have rotated third premolars that are crowded tightly against the fourth premolars, trapping debris and predisposing to periodontal disease and bone loss in that area. These third premolar teeth commonly require extraction to save the important fourth premolar, a major chewing tooth. In some cases, the roots of the third premolars are separated from the nasal passages by only a thin layer of nasal mucosa, making it very easy to displace the root into the nose. This particular area is also a common area to encounter excessive hemorrhage, making visualization more difficult.

The bit above about Brachy breeds was on the first link I gave you concerning
extraction complications that was a very recent one dated June 2013.

Complications from Pet Teeth Extraction - Veterinary Dentistry |

The article actually begins.
The common complications

INCOMPLETE EXTRACTION
When an owner gives consent for you to extract a tooth, that implies the entire tooth. Leaving fragments of teeth in place is not appropriate, may cause legal problems for the operator, may result in client dissatisfaction, may result in draining tracts, nasal discharge, unrecognized pain and damage to adjacent teeth.

So seeing as it is under common complications its not beyond the realms of possibility by the looks of it. Might be worth having a read of the entire article linked to above.

Kobis eye was fine after the op, as said the first thing I noticed a day or so before was an eye that didn't look right, and there was a slight watering of the eye too. His extraction went without incident, especially considering he is a Malamute and it was an upper carnassial the largest tooth and huge in a Large breed. He did have a post op Antibiotic injection though and also must have been two weeks of high dose antibiotics after.

If he does have something like this, then I should imagine that although the yellow discharge that indicates infection usually (greenish or yellow usually does) has gone now it may be due to the antibiotics, in which case once off them if there is something setting up infection it could well come back again.
Slightly different, but many years ago one of my dogs kept getting eye infections in one eye, a course of AB eye drops would get rid of it, only for it to return once he had been off them again. His turned out to be an inturned eyelash (or was that time many years later he developed dry eye) the inturned eyelash was setting up bacterial infection all the time, and once removed it was fine or until as I said several years later he developed dry eye but that was an entirely different thing.

One other thing I just though of too, which I have seen in one of the articles on canine dentistry, is that loose or decayed teeth are usually easier to remove for obvious reasons. Teeth that are not decayed and loose are harder to get out, dogs tooth roots are really long, the vets showed me Kobis when it was extracted, there is probably more tooth and root out of sight under the gum line or at least as much as you can see above. The vet told me that the carnassial on the other side was worn, probably due to chewing hard things over the years, but at the moment its healthy so my vet said it may last him his life out, but there could be potential problems in the future, so has put a check and watch on it, mine did say to remove such a healthy deep rooted tooth at this stage it could cause more complications and damage then leaving it until it became a problem. Another common thing that he mentioned amongst others is that you can even fracture the jaw if not careful. So it may not be a tooth root it could even be a bit of bone chipped or broke off that's causing problems maybe.

I know breeds like pugs French bulldogs etc, can have crowded and misplaced teeth where they grow in the wrong places. If you go back to the Brachycephalic bit above it talks about removing teeth to save other more important teeth, purely theoretical again, but if some of his teeth were removed for this reason together with the other things that can be more common because of their conformation then it does make you wonder if some of the teeth were harder to get out anyway, again making them likely prone to more complications.

Hope the extra pain relief does help him in the meantime. Its a very poor show on the vets part that he cant even be looked at for another week because he is away. In fact considering what he charged and the problems and service you have its very bad all round.


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## Katie3939 (Mar 14, 2014)

Sled dog, thank you for reminding me about the brachy dog issues. I have a drawing with the teeth that were removed but am not sure which ones are the premolars yet. 

I need to research that.

The dentist can't return before next week because he's seeing other patients in other towns and other states that he practices in. Vet dentists are not common, so many patients come in from out of town and out of state to get appointments, which is also the reason he travels.

He only spoke to me briefly before he did the extractions and I recall him saying Jack's teeth and gums were in a severe state, despite the fact they'd been cleaned two years earlier by a regular vet without x-rays. 

These small dogs have a genetic propensity towards dental problems, which btw dental disease can kill a dog, (or a human for that matter) because the bacteria can travel to the heart and other organs.

I read recently that a tooth is the only part in a dog that will can never heal on it's own.

I recall the dentist telling me that two of Jack's teeth were fractured, which surprised me because he doesn't eat bones, and even if he did he wouldn't be able to work with them very effectively because his tongue hangs out.

He did mention something about bone loss and gum disease, but think I mentioned I was so shocked that he needed 10 teeth extracted that's really all I heard. 

Am glad he will be doing new xrays. If it is a dental issue feel he can resolve it. He's a very highly regarded vet dentist amongst other vets. I'll reserve my personal opinion until this is resolved one way or another.

It's hard to imagine it's not a dental issue, because Jack was fine when he went in for surgery.

Also, the only other option my vet is focusing on is a nose tumor or nose polyps. Both of those situations are to awful. Ironically, brachy breeds are the LEAST likely dogs to develop nose cancer. It's usually dogs with long muzzles like collies and shepards.

Only 'something' in the nose like a tumor or polyps have the same symptoms...Discharge from one nostril only and sneezing. Tumors are usually cancerous, and polyps come back if removed. All this can only be visualized by an MRI. (The only other thing that causes these symptoms is 'something' lodged in the nose)...That can be 'fixed'.

Most people who have dogs with nasal cancer or polyps can not afford the MRI, and many of these dogs are Dx by vets who know the signs. With nasal cancer the dog will eventually begin to bleed from the nose. The prognosis for this is very grim, and without treatment, (which is hideous) the dog will die in a little more than a month. 

As I said I don't think Jack has that. Wrong breed, and the coincidence that his symptoms started with a dental surgery is absurd. Nasal cancer is very rare in dogs, and accounts for only one percent of cancers in dogs.

So having said all that, I am hoping! that this a dental issue where one of the situations explained by Sled dog is causing the problem. That would actually be a relief providing it could be resolved.

I'll share more next Tuesday after he is reexamine by the dentist with new x-rays.

Thank you again Sled Dog. You're the Sherlock Holmes of canine medical and dental issues! Please share if you come across any other info. The last article with the picture was great. Also, appreciate the specific information on the brachy breeds and tooth/root structure. Thank you again!

Best,
Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Your welcome, anything to help, I know what its like when your dog is sick and you don't know why and what a driving force it can be to find out and try to make them better. It could be co-incidence but it seems odd, that its all started after the dental extractions, and there are so many things that can go wrong having such a procedure and the symptoms do fit.

Really hoping that's all it is, and you can soon get him back to normal, keep us posted how he is getting on.


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## victoria171168 (Apr 8, 2013)

best wish's for a good outcome and dont be afraid to really push for answers.My specialist is at times exasperated and also amused by the fact I wont necessarily take his word for stuff without knowing why , where and what. I probably ask more questions than most but its good to know why sometimes.

there is nothing worse than knowing something is up with your baby and not knowing what it is, still there so I know how frustrating and worrying it is.


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## Katie3939 (Mar 14, 2014)

Thanks Victoria and Sled Dog,

I found a link which shows a good image of canine teeth. The birds eye view pictures are helpful. I'll pull out the copy I got from the dental vet and determine which teeth were pulled by name.

The most! important canine teeth in dogs are the molars and canine teeth. But in small dogs the issues can vary.

(Jack had one canine tooth pulled, but it

was the right bottom canine.) It's his left side that's hurting.

Here's the site I found helpful for seeing which tooth is which.

Dental Anatomy of Dogs

Best,
Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> Thanks Victoria and Sled Dog,
> 
> I found a link which shows a good image of canine teeth. The birds eye view pictures are helpful. I'll pull out the copy I got from the dental vet and determine which teeth were pulled by name.
> 
> ...


It may be possible because he has had so many teeth out (I think you said a total of 10 without going back over the thread?) that his problems may not be confined to one area alone perhaps and several problems may be occurring.
Although without dental radiographs being taking or an MRI its highly unlikely that you are going to know what exactlys going on until you get them done as they are the only way your going to know for sure.

Seeing as how you have now mentioned the lower right lower canine and the pain seeming to be on the left hand side I wondered if there can be any connection, I also remembered my vet mentioning about jaw fractures which can be a complication on extracting teeth. So focusing on lower canine tooth extraction to see what if any complications that can cause I had a dig about and found the following. It seems that canine teeth can have their own problems too.

Canine Teeth
Introduction
Canine (or cuspid) teeth present special problems in the dog due to their size and curvature.
The upper canines are separated from the nasal cavity by a very thin bone plate on their medial or palatal
aspect. Robust use of luxators will cause the apex of the tooth to be forced into the nasal cavity and create an
Oral Nasal Fistula (ONF).
*Lower canines cross the floor of the oral cavity, from buccal to medial, with the apex located at the caudal
mandibular symphysis. The root is, therefore, not accessible for much of its length. Over-robust elevation of
the lower canines may well cause symphyseal or horizontal ramus fracture of the mandible.*

I hadn't a clue what symphyseal or horizontal ramus fractures of the Mandible (jaw) are and in all honesty Im still not sure. I did find this on Jaw fractures though.

If you scroll down far enough you will see a picture of a white poodle under which is text saying* left* mandibular jaw fracture as a complication of dental extraction. Under that are the radiographs of the dog, the text says jaw fracture as a complication of dental extraction evident the* right lower canine* was previous extracted.
Further down still you can see a photograph of the splint which says front view of the splint as it crosses the mandibular symphysis, which if you look goes from left to right across the front of the bottom jaw.
Im first to admit Im not knowledgeable enough to confirm for sure and its not altogether clear but it seems its confirmed that jaw fractures can occur from removing the lower canines, but the questions is does it mean that if you remove one on the right does it mean that a fracture can occur on the left side.

Dog, Pet Jaw Fracture - Veterinary Dentist - Wisconsin, Minnesota

There is also a caution
Mandibular Body or Symphysis Fracture
Many dental patients for extractions are elderly toy or miniature breeds. Beware of secondary
hyperparathyroidism and extensive bone loss due to advanced periodontal disease. Support the body of the
mandible with the palm of your hand during tooth elevation.
Great care is needed when extracting mandibular canine teeth to prevent symphysis separation. The
periodontal ligament fibres should be properly separated from the tooth before any forceps pressure is
applied. Note that the root is often more bulbous than the crown.

It seems too that there are some complex nerves in the mouth a jaw, this is talking about post operative treatment anaelgesia but it explains about the facial nerves.

Two main sensory nerves supply the teeth and jaws - infra-orbital and inferior mandibular nerves. Preoperative
regional nerve blocks on these nerves greatly assists comfort and reduces the need for powerful
analgesia during and immediately after surgery.

The infraorbital nerve is sensory to the maxillary teeth via the caudal, middle and rostral superior alveolar
nerves. These branches leave the main nerve trunk before it leaves the infraorbital canal. For a regional block
to be successful the needle must enter the canal by 20-32mm, depending on dog size, before depositing the
local anaesthetic. Once the nerve leaves the infraorbital canal it is sensory only to the upper lip and nose.
The inferior alveolar nerve innervates the mandibular teeth. All the branches to the teeth have left the main
trunk before it emerges from the three mental foramina. The only effective method is to deposit local
anaesthetic at the foramen on the lingual aspect of the caudal mandible where the nerve enters the bone. This
requires either an intra-oral approach or a ventral approach. The intra-oral approach is preferred as it allows
greater accuracy. The mandibular foramen is half way along a line between the crown on the last (third) molar
and the angle of the mandible. Position the needle at the opening of the foramen and deposit the dose whilst
securing the needle with a finger. The operator must be aware of two other branches of the mandibular nerve
close to the injection site - lingual and myelohyoid. Accidental anaesthesia of these nerves will desensitise the
tongue - possibly with disastrous consequences.

Im just wondering if there is something like a root tip or piece of bone or whatever complication if there are any could also be causing pain due to aggravating or interfering with the nerves.

There is also this bit too

Iatrogenic Damage to Deep Structures
This complication involves iatrogenic damage to the structures deep to the alveolar socket. Many teeth have
important structures located beyond the root apex.
Examples are:
· The infraorbital nerve and artery dorsal to upper premolar 4
· Inferior dental alveolar nerve and attendant blood vessels ventral to all lower premolars and molars
· Orbit and globe of eye deep to upper molar 1 and 2
· Hypoglossal nerve and artery lingual to lower molars 1, 2 and 3.

You really need to read the whole thing which is on the link below.
http://www.rvc.ac.uk/review/dentistry/shared_media/pdfs/extraction_print.pdf

Obviously this is all based on theory and exploring possibilities of things that could occur and go wrong and maybe causing the possible problems. Short answer is that if his problems are continuing, then there must be something causing them and the only way to find out for sure is to have more dental xrays to find out what might be going on.


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## Katie3939 (Mar 14, 2014)

Sled Dog, My greatest concern is a neural issue because to my knowledge it can't be seen on any test, with people or animals. 

His pain is so profound that I'm just hanging in there waiting until Tuesday morning when the dentist will take new x-rays and re-evalutate. 

In the meantime Jack is on a very hefty dose of Tramadol and a NSAI...I mentioned it prior, don't have the name off hand...Oh, it's Rimadyl. (Sp?)

Yes, the lower left canine tooth was removed. (Most of the 10 teeth removed were on the left side.

My 'nightmare' is that this is a neural issue. 

After more than three weeks of this, it will be four weeks on Monday, I'm just staring Jack in the face and seeing his pain. Caring for him, medicating him, and holding out until Tuesday. If this dentist finds nothing and continues with his cavalier attitude I will be on fire. Literally.

Not sure how much more pain I can witness. It's really come down to that. Watching it, trying to medicate with three different meds all day...The antibiotic, the Tramadol, and the Rimidyl. Seeing Jack in pain. It's a nightmare.

Thank you again for your thoughts, and well wishes.

Just want this to be over and get Jack back. It's been a horrible thing.

Thank you again!

Katie and Jack


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## Lurcherlad (Jan 5, 2013)

It's a nightmare for you and poor Jack 

My Jack had his dental yesterday and they removed a pre-molar and the one next to it. He came home last night having had both painkiller and AB jabs, and I have more to dose him with from this morning.

He seems ok but is obviously quiet and still a bit wobbly.

Following the story of your Jack, I am watching mine like a hawk and hoping that his recovery is swift and problem free.

My heart goes out to you - it's torture to watch your boy suffering.

I really hope you can find some relief for him very soon.

Sending healing vibes x


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> Sled Dog, My greatest concern is a neural issue because to my knowledge it can't be seen on any test, with people or animals.
> 
> His pain is so profound that I'm just hanging in there waiting until Tuesday morning when the dentist will take new x-rays and re-evalutate.
> 
> ...


So sorry the poor little guy is still in pain, there are so many things that could cause it post extractions. Hoping it is one of the things (and there seem plenty) that can be easily resolved once the x rays are done and they can tell whats going on. I know you explained about the canine dental specialist travelling and going to other practices and areas and that's why the delay, however it is still very bad that a dog has to be left in pain for all this time and no further diagnostics have been carried out. In the UK vets have to provide emergency cover, either by providing it themselves or if they don't do it themselves in conjunction with another practice who will take over if they are not available at certain times. It cant be the first and only time that there have been complications with a dog, and its very bad in my opinion that you have had to wait and the poor little guy has to have severe pain for all this time because the specialist isn't available and hasn't provided back up cover.

I hope Tuesday that you can find out what it is and the problem can be resolved very quickly.


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## Katie3939 (Mar 14, 2014)

I'm just waiting until Tuesday when the dentist will be re-evaluting him.

Sled Dog, Because he's the only dentist in many states, there really is no one else to step in and help out.

Vet Dentistry is a very! unique specialty, which is why we chose it to to begin with.

Yes, there are so many reasons why this could have happened. Anyone can make a mistake, no matter how confident or competent. (Sometimes I wonder if those two are at odds?) All I care is that's it's 'fixable'.

Nothing else matters to me. The option is sickening.

Someone said 'Nightmare?' Yes, that's the exact word. There really is no other. A perfectly healthy dog willingly goes into a vet office, tail wagging, (twirling in Jack's case) trusting, and comes out....Like this. Nightmare is the only word I can say at this juncture.

If you think of a kind thought for Jack our pug, or pray to the god you believe in or hope for...Please do. And I guess that's all.

Really, does he not look happy? He surfed in the ocean on pretty big waves by himself too...Amazing little rescue dog! Pug Paddleboarding - YouTube

Lurcher...I believe your dog will be fine!

Best,
Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> I'm just waiting until Tuesday when the dentist will be re-evaluting him.
> 
> Sled Dog, Because he's the only dentist in many states, there really is no one else to step in and help out.
> 
> ...


Thoughts are with you and Jack, hoping that you find out the cause Tuesday.
Please keep us updated how he is doing. x


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## victoria171168 (Apr 8, 2013)

Best wishes for tuesday


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## Katie3939 (Mar 14, 2014)

Thank you All very much.

It's been a hard day knowing tomorrow morning Jack is going back to be at the dental vet for what we are praying will be a resolution.

It's almost midnight here in the eastern U.S.A. The stroke before.

Jack it to be at his office at 9:30 a.m.

I'll share a.s.a.p.

Thank everyone for their well thoughts for Jack. Very much appreciated.

Best,
Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Thinking of you and Jack Today, hoping you will get all the answers ad they can resolve it quickly.


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## victoria171168 (Apr 8, 2013)

Hoping you finally get answers


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## Katie3939 (Mar 14, 2014)

Quick reply, will post more tomorrow.

Jack had surgery again today.

Not a good day. Jack has had a wicked response to the anesthesia, (I'm thinking this is anesthesia? Hoping actually. Because he's been moaning, growling and miserable since.) Have been reading about nerve blocks on dental surgeries, which the dentist did...Both today and during his first surgery.

There was discussion of nerve damage to the right side in addition to new surgery on left side today. THAT was revealing, because that (nerve issues) do not show in xrays.

Am really at my wits end and am still trying to process all of this but will share more tomorrow.

My husband and I met with this vet dentist today (first time he's ever met with either of us) and it was very tense. When he ended the discussion with 'we all need to hope and pray'...I don't even have the words...

What was he thinking when he did a 'quick' glance precisely two weeks ago today after I took him to my regular vet the day before, and this same dentist pronounced his mouth 'healed'. (No x-rays) Now he wants to pray?

Will share more tomorrow. 

Thank All here for all good thoughts and prayers that have been forthcoming for weeks now...

Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> Quick reply, will post more tomorrow.
> 
> Jack had surgery again today.
> 
> ...


So sorry that Jack has had to go through another surgery, Im hoping that although he may be in discomfort now or seems to be, that the discomfort will be short lived and he will soon be getting better. It could be the anaesthesia, it can make some dogs very vocal and growly, and being a breed who isn't particularly good with anaesthetics, its quite possible.

Await to hear your update and more information, but I hope that Jack is recovering and much better today once the anaesthetic begins to wear off more.

Thoughts are with you all. x


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## noushka05 (Mar 28, 2008)

Poor little Jack, so sorry to hear hes been having such a rough time, i really do hope hes over the worst & starts to pick up now. Good luck with him.


.


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## Lurcherlad (Jan 5, 2013)

Sending positive, healing thoughts to Jack and to you and OH.

Everything crossed for a good outcome.


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## Sled dog hotel (Aug 11, 2010)

Hope Jack is much better today.


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## Katie3939 (Mar 14, 2014)

Katie3939 said:


> Quick reply, will post more tomorrow.
> 
> Jack had surgery again today.
> 
> ...


Wanted to finish sharing now that I'm able to think. Jack had the left side of his gum opened up again last Tuesday. It was inflamed, infected and his own hair was in there. This was upsetting, because the dentist had announced his mouth well and healed two weeks prior! So all this had to happen afterwards when the cone was off.

During a discussion when we finally met with him, (one month and one day after the first surgery) he explained what they had done.

In addition he explained more! He had the xrays on a laptop and said he was going 'to be watching the right side' of his mouth. Why??? Because I had reported that Jack had been pawing and scratching at his right side after the cone came off.

He went on to explain that a molar on the right side that he had NOT removed may be an issue, and pawing and scratching was a sign of PAIN.

I was so confused at this point. Almost all the ten teeth that had been removed had been from the left side.

He explained that because the roots on the molar are so deep there can be residual pain there even after they pull the molar. (it's not been pulled yet.)

He said it has never happened to him in 20 years but he's read of it. He's suggesting he's having nerve pain beneath that tooth.

He asked me to keep a diary. Sure enough Jack is scratching at the RIGHT side of his mouth through the cone. Once the cone slipped off by catching on pillows and he immediately started scratching at the right side of his mouth. (Like a dog with a flea.)

Bear in mind all the surgery Jack had last week was on his left side. The dentist said pawing and scratching is a sign of pain.

This is why he wanted the diary.

Sigh. So it goes. He returns to the dentist vet in one week and two days.

The dentist is also a diplomat in pain management. He knows about pain, so am heartsick to see Jack scratching on the right side, even through the cone.

Also, he will lay on his left side when he was knocked out, but never on his right. Mostly lays on his chin.

So there appears to be a nerve issue on the right with the molar is what he's saying, and removing the molar not remove the problem. In that case there can be no worse pain than chronic nerve pain in a tooth.

Hope this makes sense to all.

Am very grateful to you All, for your thoughts, prayers, and research.

I will keep you posted!

Best,
Katie and Jack


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## Lurcherlad (Jan 5, 2013)

Poor boy 

Heartfelt wishes for an improvement in Jack soon x

My Jack had scratched one side of his face in the week leading up to his dental and extraction, on the right side. Had his five day check and we have some cream cos vet thinks it's just him scratching the skin that has been caught with his Back claws. I hope so.


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## Sled dog hotel (Aug 11, 2010)

So sorry that Jack has got to go in yet again and have another tooth removed.
What I cant understand is why when you had told him that the problem seemed on the right side, he didn't investigate it more while he was opening up the gum on the left side rather then wait and just watch.

I really hope the removal of the tooth on the right side resolves it once and for all.

Thinking of Jack and you all.


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## Sled dog hotel (Aug 11, 2010)

Just a thought but did the dentist say that Jack had all his full 42 teeth?
Or at least before they were extracted? Something was niggling in the back of my mind about something I had read about Bracycepahlic breeds dentition and dentition problems in general but couldn't recall immediately what.

The link below explains what can happen when 42 teeth get crammed into a brachycephalic mouth and complications that can occur.
I only asked because some of the overcrowding can cause teeth to be retained in the gum so don't erupt.

http://goarticles.com/article/Pet-Dental-Problems-in-Brachycephalic-Breeds/7535590/


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## Katie3939 (Mar 14, 2014)

Thank you for the thoughts.

Sled Dog, there is a lot niggling at my mind.

The article on brachy breed mouths is interesting. Jack is ten years old, and I am assuming he had all teeth. The dentist did not say otherwise. Two were cracked, and he had a lot of bone loss beneath the teeth. (We could see that on xrays.)

A lot of these issues are genetic in small dog breeds. Certainly in pugs.

The dentist did not remove the molar on the right hand side of the mouth. He showed it to us on the xray, he had felt it was 'okay' but referred to a shadow beneath it.

We took in so much information that day, that it was only a few days ago that my husband and I pieced together everything the dentist was saying.

Sled dog, I had also read some issues about brachy dogs mouths and those premolars. He did remove several premolars on the left side.

I think the left side is not going to be an issue at this point. (He's still healing on that side, and wearing the cone.)

They DID use nerve blocks on the right side to reduce the amount of anesthesia used. Guess who wrote this article on nerve blocks?
Nerve Blocks for Oral Surgery in Dogs | Clinician&#039;s Brief

Am wondering if the nerve blocks could in any be a cause for concern? If the nerve block on the right side could have been an issue?

In one week and one day he will take new xrays under anesthesia, but as most here know nerve issues can not be seen on xrays. (or any other imaging) He'll be looking to see that the left side is healed.

He said it's going to be a matter of watching and seeing what Jack continues to do with his right side. He still scratches at it through the cone, and does not lay on his right side which is an indication to me.

The dentist is not saying that removing that molar will cause chronic neuritis, but he's saying it's possible.

He did say we should 'hope and pray'...This caused me a great deal of concern especially since we'd already been doing so for one month and one day when he said that.

Also, they use the dental cleaning tool on the molar to see if it 'chatters'. If it chatters under anesthesia than it's a sign of a never issue. We didn't ask him if he did that, but we asked his assistant separately and she said 'no' it didn't chatter. I feel I've gotten 'lip service' from her in the past, so am not certain about that.

This dentist is literally world renowned, but when someone of that stature suggests 'we hope and pray' after a month...It's alarming. More alarming is Jack's preoccupation with the right side of his mouth.

Thank you again to All for your ongoing input and kind thoughts and prayers! I will keep you posted.

Best,
Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> Thank you for the thoughts.
> 
> Sled Dog, there is a lot niggling at my mind.
> 
> ...


I didn't sign in so didn't read the whole thing on the link you gave but I have managed to find the one below by someone else on the same subject which may explain things even better, and comes complete with photographs, don't know if that's any more help?

You need to read the whole thing the discussion at the end says this.

Discussion
Regional dental nerve blocks are relatively
safe when used correctly. Complications
resulting from oral nerve blocks have been
described in human dentistry; however, the
incidence is extremely low.13 Toxic doses of
bupivacaine have been reported to cause
cardiovascular toxicity and death in people,
although this is also very rare.14
Even though these complications are
uncommon in Pets, practitioners still need
to ensure correct dosing, choose an appropriate
needle size and length, identify appropriate
locations, insert and advance the
needle gently to avoid unnecessary soft tissue
trauma and aspirate before injecting the
bupivacaine. With practice and proper
training, dental nerve blocks are inexpensive
to perform and easy to learn. They will
significantly improve Pet care and be a valuable
addition to your pain management
armamentarium for your dental and oral
surgical procedures.

http://www.banfield.com/getmedia/8f...1c7ce6482ab/4_1-Dental-nerve-block-techniques

It says that complications are uncommon in pets, but as the discussion starts
are relatively safe when used correctly, I would assume that it doesn't mean that complications are impossible.

I looked up some of the complications that can arise with dental nerve blocks in human dentistry in case it offers any possible clues. although the anatomy may be different of course or to a degree.

Medscape: Medscape Access

This bit from you post is bugging me too

The dentist did not remove the molar on the right hand side of the mouth. He showed it to us on the xray, he had felt it was 'okay' but referred to a shadow beneath it.

That he felt it was OK but reffered to a shadow beneath it, being as the pain is coming from the right side still, I would want to know what this "shadow" is and if it may have some relevance or not.

Feeling it was OK is obviously not always enough, he looked at Jacks mouth and said it had healed, only to find out later that he had infection and hair in the site and had to open that again.
Yes things can go wrong sometimes and there can be difficult or uncommon circumstances happen with anything, but thought and felt is just not acceptable. Yes things do go wrong occasionally, but the upmost importance should be on finding out what and how you can put it right.


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## Katie3939 (Mar 14, 2014)

Sled dog hotel said:


> I didn't sign in so didn't read the whole thing on the link you gave but I have managed to find the one below by someone else on the same subject which may explain things even better, and comes complete with photographs, don't know if that's any more help?
> 
> You need to read the whole thing the discussion at the end says this.
> 
> ...


Sled dog, those are good links. I bookmarked them both. Please take a look at the link I posted about nerve blocks. I also wanted to point out who wrote it.

Your links are excellent.

I agree with your points, but at this point we really have no option put to try and move forward.

As for the right side of his mouth, the pawing and scratching...This is new since his original surgery.

The dentist is aware that Jack had pawed and scratched at his right side because I had reported it to his assistant. Ironically, I didn't remember that it was is his right side consistently.

So that is 'on the table'. He said 'that is a sign of pain', and that's when he discussed the molar. He wants to 'watch' that side and see. That's when the discussion of the shadow on the xray began.

I was disturbed that Jack had no pain (no scratching or pawing at his right side until AFTER surgery), and things got testy at that point.

I believe that after he announced Jack's 'mouth well and healed' Jack did a lot of licking, and that area was still fragile. So although I feel the dentist should have taken a look after we'd taken Jack to our vet at two weeks with sneezing and nasal discharge, (infection), the dentist should have re-exrayed. He didn't but here we are. Nothing can be done about then.

So all we can now is move forward. If in one week and one day when the cone comes off and new xrays are done, and the left side is 'healed'....I'm concerned about the right side, as is the dental vet.

At that point am guessing he can only remove the molar and see. I found an article today about trigeminal nerve involvement in dogs, and I thought how awful.

This is where it gets very concerning. If Jack ends up with chronic neuritis that's a very bad thing. A dog with chronic 24/7 pain. You can imagine the choice we'd have to make. Can't bear to think about it.

Dogs are VERY reluctant to show pain. All mammals are. It's a survival instinct. The smaller the animal, the less they are willing to show pain. Rabbits and guinea pigs apparently refuse to show pain.

Also, the bigger the dog, the more willing they are to show pain. So this is why Jack showing pain with the pawing and scratching on the right side is a significant sign.

Thank you again All,
Katie and Jack


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## Katie3939 (Mar 14, 2014)

I just received an email in response to mine from the dentist's assistant.

I had emailed and explained that Jack is scratching at the right side of his mouth, at the cone, and if the cone comes off he'll scratch at the right side of his mouth.

She responded that he suspects the lower right molar and neuritis and suggests removing it at an additional cost of 800 to 1000.00 

WHAT? Not that that's the main issue, but we've already paid him over 2100.00 plus several hundred to our regular vet.

I responded via email "WHY did he NOT remove the molar originally if that was an issue?" Why did Jack not paw or scratch at his face before the original surgery???

Am now feeling crazed over this. Sick that Jack is suffering, and just sick that this vet now wants more money for yet another surgery?

Emailed her back, but I'm just at a loss for words right now.

Thanks all...Again.

Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> I just received an email in response to mine from the dentist's assistant.
> 
> I had emailed and explained that Jack is scratching at the right side of his mouth, at the cone, and if the cone comes off he'll scratch at the right side of his mouth.
> 
> ...


It just seems to be going from bad to worse doesn't it, and all this time Jack is in pain which is the worse thing.

There doesn't seem to be that much information as regards to Veterinary Dental/animal Neuritis. Did find the link below which is Human that you may find of interest it does also mention an animal model study too so that may be worth a read to see if may offer any clues. It may be totally unrelated to Jacks problem, but it is interesting reading if nothing else.

http://www.cvc.uab.es/~jalvarez/JLL/website/6343_Lopez-Lopez_quintessence.pdf

I have managed to find one of the animal studies mentioned in the link above although that was carried out on rats.

An animal model for trigeminal neural... [Pain Physician. 2012 Mar-Apr] - PubMed - NCBI

I am still probably like you wondering what the shadow is on the xray under this tooth too and if that's of significance and causing the problem.

I really hope you get this resolved and quickly for poor Jacks Sake above all else.


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## Katie3939 (Mar 14, 2014)

Sled dog hotel said:


> It just seems to be going from bad to worse doesn't it, and all this time Jack is in pain which is the worse thing.
> 
> There doesn't seem to be that much information as regards to Veterinary Dental/animal Neuritis. Did find the link below which is Human that you may find of interest it does also mention an animal model study too so that may be worth a read to see if may offer any clues. It may be totally unrelated to Jacks problem, but it is interesting reading if nothing else.
> 
> ...


An email from the dentist today. Am so dumbstruck am not sure what to say.

Pasting:

I am really sad that Jack is still having difficulty. We do not know why the discomfort didn't manifest until after the first procedure. There is no way to determine this and I have no answer for it. We likely will never know. 
What we do know at this point that the discomfort is on the right side. We did not know that definitively prior. That is why I requested a daily observation and written diary. That said the tooth that we are extracting shows only suggestive signs on the x-rays that it MIGHT be the problem. If we extract that tooth and there is no resolution it either was not that tooth or we may have neuritis that may not resolve with time and medication. That said, if the signs do persist the next step is likely consultation with a neurologist and advanced imaging including MRI and/or CT scanning may be needed to determine a distinct cause. We discussed all of this at length in the exam room in detail at discharge last visit but I want to make sure that we are clear prior to proceeding.


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## Lurcherlad (Jan 5, 2013)

I can't believe he is asking for more money. I would have expected him to deal with it as part of the original procedure.

I really don't know what to suggest. 

Just wish Jack could get some relief from all of this and be set on the path to recovery.

My heart goes out to you - what a dreadful situation.


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## Katie3939 (Mar 14, 2014)

Lucherlad, I'm so glad you said that. It's insane. We've spent 2500.00 already in six weeks. Six weeks ago he jogged into the place like a youngster ready to meet new friends. Two surgeries later in six weeks he looks like an old man.

Am just sick over this. Literally sick.

Obviously it's not about the money. My husband and I are not vets or doctors or dentists. We're not rich or anywhere near. We are just trying to do the best for our very best friend.

Btw, Jack was a rescue. I did a ton, (since I was a teenager) of fostering, adoptions and working for a local no kill rescue (at now charge), at my own expense...Took in all kinds of dogs including several fighting dogs. One was a female bait pit bull in a fighting ring, another was a pit bull from the Katrina hurricane. So many big and small dogs that were not adoptable until they were rehabbed. One was a little blond mostly shar pei pup who had been starved and abused. Crazy. All were adopted to forever homes after fostering and a lotta lotta love and patience.

Patience and love can't fix pain though. Especially neural pain.

Jack was the only rescue we ended up keeping. So sound. He'd been surrendered by people who couldn't keep him. I thought I rescued him but he ended up rescuing us. Sigh.

That was almost 9 years ago. He's been an amazing athlete and surfs in the ocean and and paddle boards on the lake across from our house. Or used to.

Now he's just so sick, sad, lethargic.

I have to email this dentist vet back and I don't think this is a conversation to be had in an email. But I do have to email him back. Any thoughts from wordsmiths would be very appreciated. It's late here, and I'm finally exhausted enough to sleep.

Thank you ALL for thoughts and for those who pray, I thank you for that.

Best,
Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> An email from the dentist today. Am so dumbstruck am not sure what to say.
> 
> Pasting:
> 
> ...


As far as I can see its really basically a disclaimer, and that if you decide to go ahead there is no guarantees and assurance that it will be resolved and that you are accepting the further extraction on those terms. In which case there is no come back or blame.

Bit like a rock and a hard place reallydo you go ahead with the extraction of the tooth with hope that there might be something that is possibly suggestive of the problem on x ray and put him through that hoping it will resolve it but there is no guarantees and if it doesn't solve it then you have to look elsewhere and go through other diagnostics in the form of a neurologis/scanst to see if its Neuritis or another problem anyway.

Just wondering if an MRI and CT scan would show up a) In more detail that tooth and any problems then a normal dental xray and would it be more definitive if that is the problem or not, and b) and also would it show if you and/or do have a nerve problem or not. In which case would/ could the correct necessary treatment be carried out and have more of a chance of working. I would assume but haven't checked a neurologist would be able to possibly do other tests to find out if its a nerve issue or not aswell.

If a neurology referral and scans and more diagnostics have a high or higher chance of finding out what this "shadow" is on the tooth and if and what significance it may have to the problem, plus locate any other underlying issues like Neuritis, are you better going that route first, then just another lot of anaesthesia and an extraction that may or may not be/solve the problem?
Not to mention the expense of something that may or may not work, when it may be better spent possibly finding out exactly what you might be playing with.

At the end of the day, getting a proper diagnosis if its possible and knowing what you are playing with or at least be a bit more sure, in which case you can possibly have a higher chance of getting the correct treatment and medication surely must be better then just trying different things and putting him under more procedures that might not even fix the problem especially as your not sure In the first place.

That's the logic my mind would be following to be honest. Maybe you should ask what a neurologist/scans can achieve as regards to a firmer diagnosis.

ETA as another thought, could the further diagnostics rather then just jumping in with the extraction, also likely find out what might have caused the problems in the first place?


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## Katie3939 (Mar 14, 2014)

Sled Dog, I think the email is him saying he is not sure removing the molar will stop the pain. Ironically Jack had only one tooth removed from the right side of his mouth. It was a small tooth near the front of his mouth.

My question is why did he have NO pain on the right side of his mouth before the first surgery? It seems that common sense suggests his pain (which I do believe is neuralgia), has some relationship to the first surgery. I can't get that out of my mind.

I'm not a vet or a dentist though, and if he believes this is an issue, what choice do we have?

As for neurologists, CT/MRI scans, that will not happen. We've already spent 2500.00 dollars and the above would be more thousands than I can imagine, and I truly believe it would come to nothing. Nerve pain is not something that can be 'imaged'. 

In the end a dog with severe nerve pain 24/7 even with pain medication is not able to live a good life. I can't even talk about what we would have to do.

I have to take this one step at a time.

Sled dog, he did not mention if Jack had all 42 teeth. I intend to get copies of the xrays on a disk, and i can ask him that, but he is not particularly interested in having a conversation. Apparently he feels the one ten minute conversation he had with us was sufficient.

Thank you again for your thoughts, prayer, and well wishes.

Best,
Katie and Jack


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## Katie3939 (Mar 14, 2014)

Sled Dog,

Additionally, I didn't mention that I agree 100% with your logic and thoughts. Absolutely.

If money were no issue, we would proceed in that manner. There is only one veterinary CT and MRI scanner in town. To see a specialist and have this type of imagining done is unbelievably expensive. Beyond words expensive. They have no 'regular' vets in their establishment. All the vets are specialists. Because this appears to the vet dentist to be neural, I believe that is a dead end. Neurologic issues are very difficult to resolve in humans much less animals. 

Just 8 months ago we paid a large sum to have a veterinary ophthalmologist remove a large cyst from Jack's eye. Our regular said he could do it, (at a fraction of the cost), but when we met with the ophthalmologist vet he explained why the method suggested by the regular vet would not work. It was very expensive, but we got what we paid for. In addition the vet ophthalmologist was exceptionally kind, friendly, and acted as if he had all the time in the world for questions, concerns, etc...

I just finished responding to the vet dentist's email. We said that if he were truly wanting to resolve Jack's pain and in good faith why is he trying to profit? He has already profited from the original procedure and Jack is in a terrible situation.

Sled Dog, you wrote..." It just seems to be going from bad to worse doesn't it, and all this time Jack is in pain which is the worse thing."

That sums it up. That is the fact, the truth. Jack is a shell of his former self. The happy healthy pug you saw on the paddle board is no longer here. He used to surf in the ocean and was an amazing little athlete and my constant companion. 

The pug laying next to me looks at me with beseeching eyes, and his pain shows in so many ways. His posture, his sighs, his lethargy, his lack of interest in the toys he played with every day. He no longer sits in the window waiting for passer-by. He only lies down and often seeks out a place to be alone. 

It's so ironic that he only had one small tooth removed on his right side, (9 on the left side), and it's the right side that's causing him so much pain. He paws and scratches at it which the dentist explained 'that's a sign of pain'...I would not have known that had he not said it.

And so it goes day to day. We're trying to make good decisions but the future looks bleak. It would be a wonderful and amazing godsend if it is the molar, and removing the molar resolves the problem!

Sled Dog, you have an excellent mind and are able to sort through complicated medical issues. I'm sure you've helped many people via this forum.

Thank you to all again for your kind thoughts and prayers. You all have been very helpful to me. 

Best,
Katie and Jack


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## Katie3939 (Mar 14, 2014)

Jack was due to have a third surgery yesterday to remove the molar on his right side. I emailed the assistant and said we'd like to wait and see how he acts with the cone off etc...(The dentist agreed to remove the molar without a charge.) The cone came off yesterday.

Felt that 3 surgeries and 3 anesthesias in six weeks is too much for any animal.

The cone is off and Jack is doing better, but still favoring his left side, won't lay on his right.

Although he's not back to playing with his toys or sitting in the window, he seems improved. Feel that my prayers have been answered at least part of the way.

Removing the molar may or may not fix what is surely a neural issue, but in my gut I feel it will be the answer.

Thanks to all who have sent their well wishes and prayers. 

Best,
Katie and Jack
.


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## Lurcherlad (Jan 5, 2013)

Katie3939 said:


> Jack was due to have a third surgery yesterday to remove the molar on his right side. I emailed the assistant and said we'd like to wait and see how he acts with the cone off etc...(The dentist agreed to remove the molar without a charge.) The cone came off yesterday.
> 
> Felt that 3 surgeries and 3 anesthesias in six weeks is too much for any animal.
> 
> ...


So glad to hear that there seems to be a little improvement in Jack 

We can only hope that he continues to improve. As you say, 2 ops is a lot for a little body to take and maybe getting the effects of the anaesthetics and meds out of his system may show some positive improvement and enable his body to cope with having the other molar removed.

Sending you and Jack massive healing vibes


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> Jack was due to have a third surgery yesterday to remove the molar on his right side. I emailed the assistant and said we'd like to wait and see how he acts with the cone off etc...(The dentist agreed to remove the molar without a charge.) The cone came off yesterday.
> 
> Felt that 3 surgeries and 3 anesthesias in six weeks is too much for any animal.
> 
> ...


Glad to hear that there seems to be some improvement, I really hope that the improvement continues. I agree though it is a lot of anaesthetic and procedure in a very short space of time, especially In a breed that doesn't always do particularly well with anaesthetics, and you have to be careful in general.
Also pleased too that the dentist has agreed that should it end up needing to be removed then at least there will be no charge although I know the main issue of course is getting poor Jack back to normal again and pain free.


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## Katie3939 (Mar 14, 2014)

Thanks Lurcher, Particularly for the massive healing vibes! Smiles...

Agree many times over that three surgeries and as many anesthesias is too much for a small dog in six week, or any dog or human for that matter!

Jack has had his cone off now for several days and he's still scratching at the right side of his mouth.

I'll email the dentist's assistant and schedule to have the right molar removed.

Jack has made it VERY clear that it's the right side of his 'head' that's hurting in that he won't lie on that side, and while I never attempt to touch the right side of his face, sometimes I do and can see him flinch.

The dentist made it clear that removing the right molar may not fix the problem but I sincerely 'feel' that it will.

Thank you again Lurcher!

Best,
Katie and Jack


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## Lurcherlad (Jan 5, 2013)

Katie3939 said:


> Thanks Lurcher, Particularly for the massive healing vibes! Smiles...
> 
> Agree many times over that three surgeries and as many anesthesias is too much for a small dog in six week, or any dog or human for that matter!
> 
> ...


Seems like you have no choice but to remove the right molar and hope for the best.

It would make sense that, as you have pretty much proved there is still a problem on that side, he would still be troubled by it so fingers crossed that will be the answer.

I truly hope that once that tooth is out he will feel so much better.


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## Katie3939 (Mar 14, 2014)

Jack is scheduled to have the molar on his right side removed on the 24th of this month.

He will not lie on the right side of his face. So this will be fairly obvious to see if this in fact is the problem.

If two weeks after the surgery he lies on his right side and stops scratching at his mouth, then it's clear.

9 out of the 10 teeth removed were removed from the left side, so it's very odd. Also, the one tooth removed from the right side was a small tooth near the front.

I think the reason the left side was such a big issue is that his tongue hangs out on that side.

Here's the video of him again paddle boarding. You can see his tongue situation here. 




(Can't wait to see him paddle boarding and surfing in the ocean again!) Don't know how to load pictures or I'd send some pictures across the pond of Jack surfing in the ocean!

Best,
Katie and Jack


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## noushka05 (Mar 28, 2008)

I have crossed absolutely everything that this scheduled dental will sort lovely little Jacks problems out once & for all

I loved the video, Jack is such an amazing little dog, really hoping he'll soon be back enjoying his surfing:thumbsup:


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> Jack is scheduled to have the molar on his right side removed on the 24th of this month.
> 
> He will not lie on the right side of his face. So this will be fairly obvious to see if this in fact is the problem.
> 
> ...


Really hoping that the removal will solve the problem, will be thinking you you all on the 24th.


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## Katie3939 (Mar 14, 2014)

Thanks all for the well wishes.

Jack's surgery has been moved to this Friday, April 25th.

Sled Dog, in talking with my husband I was wondering out loud about the 'shadow' beneath the right molar. Mostly because you questioned it.

His recollection is that the dentist was emphasizing the shadow to point out how long the roots of the molars are. 

Right now he's on Tramadol, (which the dentist's assistant recommended keeping him on.) Even with the Tramadol he's still having pain and is not himself. 

Am hopeful that this will resolve his pain. 

Very appreciative of the well wishes! Thank you all.

Best,
Katie and Jack


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## victoria171168 (Apr 8, 2013)

If its a neural pain gabapentin might be better as Tramadol never worked on my boy .

Good luck on the 25th


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> Thanks all for the well wishes.
> 
> Jack's surgery has been moved to this Friday, April 25th.
> 
> ...


Really hoping that the surgery will sort it out. My one got a root tooth abcess due to a fracture on his carnassial, that let bacteria in below the gum line and into the root of the tooth. I was just wondering if the "shadow" was some sort of infection beginning that was all really.


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## Katie3939 (Mar 14, 2014)

Sled dog did you have the fractured tooth removed? This dentist removed 2 of Jack's teeth because they were fractured. He said fractured teeth are very painful, but dogs are very reluctant to show pain.

This is why it's so disturbing to me about Jack. He's way past showing pain. Sometimes I hear him actually 'weeping'. We've had dogs forever and have fostered so many dogs that were abused, starved, and a Hurricane Katrina pit bull and a bait dog in a fighting ring. None showed pain.

So to hear an animal weeping, that's the only word I can think of to describe it. Very difficult.

Victoria, Gabbapentin is a brilliant idea! I will be asking about that!!

Am hoping this gets resolved. There's just no way to know, but based on his reaction to the right side of his face, it seems reasonable that it could be the molar.

I don't know if this is 50/50 or 100/0 in terms of odds..There's just no way to know for certain. Feel this is the next best move and that's all we can do right now.

Thank you all again for the well wishes. 

Best,
Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> Sled dog did you have the fractured tooth removed? This dentist removed 2 of Jack's teeth because they were fractured. He said fractured teeth are very painful, but dogs are very reluctant to show pain.
> 
> This is why it's so disturbing to me about Jack. He's way past showing pain. Sometimes I hear him actually 'weeping'. We've had dogs forever and have fostered so many dogs that were abused, starved, and a Hurricane Katrina pit bull and a bait dog in a fighting ring. None showed pain.
> 
> ...


My dogs was the upper carnassial the biggest tooth, and really big he is a malamute. The tooth had got damaged and first I knew was a weeping eye, and then I noticed a swelling on the face. Apart from he visual signs I noticed he didn't show any signs of pain and was eating perfectly normal. They removed his gave him an antibiotic injection and pain killer post extraction and he has pain killers and antibiotics for about 10 days after. His went by without incident and he was fine after.


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## Katie3939 (Mar 14, 2014)

Glad your dogs surgery went well Sled dog. Interesting you saw changes in his face? Jack had 2 fractured teeth and no symptoms.

The molar is the biggest tooth in any dog regardless of the breed. I wonder if breed makes it easier or harder to extract a tooth...

Jack's surgery is tomorrow morning to remove the molar.

Am glad it's the LAST dental surgery regardless.

Am hoping it helps!

Thank you all for your good thoughts!

Best,
Katie and Jack


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## Lurcherlad (Jan 5, 2013)

Wishing Jack (and you) the very best for tomorrow.

Hope it's the answer to his problems and he can get back to his normal self and back on the board! 

Take care x


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## Sled dog hotel (Aug 11, 2010)

Hoping the surgery goes well tomorrow and they do find its the cause of the problems, please let us know how Jacks doing.


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## Rosie64 (Feb 27, 2014)

I do hope every thing goes well with little jacks surgery and that it solves the problem I have a little pug myself and they are such loving trusting little dogs and it is heartbreaking to see them suffering as it is with any animal all our best wishes are with you


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## Katie3939 (Mar 14, 2014)

Thanks to all for the good thoughts and well wishes. Am very grateful.

It's 8:30 p.m. here on the Atlantic (east coast) in the U.S. and Jack is to be at the dentist at 8:30 a.m. 

I'll post in the afternoon or perhaps on Sat. Usually he is a wreck after these dental surgeries from anesthesia and perhaps the pain. He gets very whiney and growly and sleeps sitting up because of the cone. It's hard to watch. I hold him the entire time.

Thank ALL again. 

Best,
Katie and Jack


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## victoria171168 (Apr 8, 2013)

Best wishes todays surgey gives you what you want and no more pain


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## Katie3939 (Mar 14, 2014)

I just got a call that Jack is out of surgery and I'm waiting for my husband to pick me up so we can get him together.

Wow, and Sled Dog, I hope you're reading...

The dentist believes it was the alveolar nerve that was definitely causing the problem.

Sometimes, removing the tooth resolves the problem and sometimes it does not and the dog is left with chronic neuritis.

I looked up alveolar nerve while I was talking to her and it is the place where most nerve blocks are done in dentistry! Wow. Jack had no pain before the first surgery and then had pain???

Reconstruction of the inferior alveolar ... [Plast Reconstr Surg. 2012] - PubMed - NCBI

This is a huge piece of information. I can only say I hope removing the molar helps and resolves the issue.

More on this nerve: Medscape: Medscape Access

We won't know if this is going to be resolved for two weeks, but it should become very clear afterwards.

I'll let you know more after we speak to the dentist.

Best,
Katie and Jack


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## Lurcherlad (Jan 5, 2013)

Glad he's through the surgery - finger's and paws crossed here for a successful outcome!


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## Katie3939 (Mar 14, 2014)

Thank you Lurcherlad!

We're hoping for that as well.

The dentist had left and only the dental tech was there to answer our questions.

She said that human dental issues and animal do not cross over because of anatomy. Okay...

She said that when the dentist removed the molar the socket was 'empty and that there was no bone beneath. 

I think that's what the dentist was referring to with the shadow beneath the molar. The tech said x-rays alone do not tell the full picture, but when he began scratching at the ride side of his mouth the dentist re-evaluated the x-rays and questioned that tooth.

We are going to give Jack every benefit of the doubt for a full recovery.

As an aside though the fact that he went in to the first dental surgery with NO pain this is mysterious to me. 

The dentist's notes said that this may not resolve and that he could end up with chronic neuralgia. She said to give it 2 weeks. Geez, we've waiting this long what's another 2 weeks? The answer is 2 more weeks of waiting and 2 more weeks of Jack's recovering if he does. We really are hoping this is it.

I said if that was the case he was doomed because the Tramadol wasn't really helping and she said they have other meds they use with nerve pain. I asked which ones and the only one she mentioned was Gabbapentin.

So there you have it.

Jack is home and better than prior surgeries. No cone because the molar is too far back for him to get to. Also, he's not whiney and growly like he was the last two times. 

So far, that's a good sign.

Best,
Katie and Jack


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## Rosie64 (Feb 27, 2014)

So glad jack got through surgery ok everything that can be crossed is, for a full and trouble free recovery and and end to his pain big (( hugs)) to you all


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## Sled dog hotel (Aug 11, 2010)

Glad Jack is through the procedure safely and I hope it does resolve the problem.

As regards to the use of veterinary use of Nerve blocks and anatomy and nerves in the dog, the link below should help. Im pretty sure I linked you in an earlier post to this one, but in case you missed it.

http://www.banfield.com/getmedia/8f...1c7ce6482ab/4_1-Dental-nerve-block-techniques

There is more on veterinary Nerve blocks and tecniques below too.

Advanced dental local nerve block anesthesia


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## Katie3939 (Mar 14, 2014)

Thanks all...Will know for sure in two weeks. Jack though is doing better after this surgery. He's very disoriented but is not whiney or growly. But totally disoriented. Have no way to know why.

Don't have a lot of faith in speaking to the dental tech...Sorry, I just don't.

Sled Dog, the links you refreshed me on are interesting, because the nerve they talk about is the one in question.

It's the Inferior Alveolar Nerve. (IAN for short) She denied they used this block yet there it is in the link you sent. So I question this.

It's a very common nerve block in human dentistry. This is where she cut me off quickly, that's there's no real connection between the two based on anatomy.

Okay, I get that, but it would seem that there would be some comparisons. People have been pulling teeth since humans existed, and I'm sure they've pulled animals teeth for almost as long.

There must be more in common than just the basic composition of a tooth which is how she kind of summed it up. (To shut me up?) Not sure but obviously I'm neither a doctor nor a dentist and the dentist didn't bother to be there, (It was only 2:30 p.m. when we got there)...And he couldn't stick around? 

At one point I looked at his assistant and said, 'You know, I'm not a doctor or a dentist so I have to ask questions?" She seemed put out. I guess most people don't ask. Just pay and go. Three surgeries with the same dentist in a short time period will make one start to ask questions. Regardless that we didn't pay for this one. 

On a positive note...We ARE hoping for the best here and will continue to hope for that. We're hoping for a continually progressive improvement. He's to be on Tramadol for five days due to the surgery but is supposed to he 'healed' and well enough to be without pain meds after that.

Thank everyone again for your support! It's been a blessing.

Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> Thanks all...Will know for sure in two weeks. Jack though is doing better after this surgery. He's very disoriented but is not whiney or growly. But totally disoriented. Have no way to know why.
> 
> Don't have a lot of faith in speaking to the dental tech...Sorry, I just don't.
> 
> ...


As the links are specifically veterinary dental and pretty specialist unlike some of the information you get on the net that is sketchy or inaccurate then I would think its pretty safe to assume that they would be correct.

Hoping once the anaesthesia has worn off Jack will be much better in the morning and also that over the coming days when any post surgery pain and soreness has worn off he will be back to normal.


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## Lurcherlad (Jan 5, 2013)

How is Jack doing?


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## Katie3939 (Mar 14, 2014)

Hi Lurcherlad, Thanks for asking.

He's still scratching at the right side of his mouth. He also paws at the left side of his mouth, which happened before but we've been so focused on the right side we didn't pay as as much attention to the left because most of his attention was on the right side.

There will be no more surgeries. The question becomes about Jack's quality of life and what's reasonable to expect him to live with.

This is a very difficult topic. 

The vet's asst. said to give it two weeks. It will be one week this Friday. I think if all were well then he would not be scratching. His pain meds from the surgery are done.

It's just a very tough situation at this point because we know what's what. He has chronic neuritis. I can't imagine having tooth nerve pain 24/7.

This vet has given us very little of his time in terms of speaking to us. Three surgeries and one conversation total. 

I watch Jack carefully and hope to see improvement but he scratches at his face like a dog goes after a flea. He's not himself. Doesn't want to play or sit in the window...Often goes to lay alone and hide.

Appreciate all the input and am grateful for this forum. Thanks to all who've shared their thoughts and feelings!

Best,
Katie and Jack


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## Lurcherlad (Jan 5, 2013)

Sorry to hear it was not a miracle cure, but maybe there is still time for some improvement.

Just a thought - have you looked inside his mouth at the inside of his cheeks? Difficult with a small dog, I know, but my Jack had scratched a sore just on the edge of the lip which he has been wanting to continue scratching, also after a tooth extraction.

I was also worrying that he was feeling pain in the jaw, much like your Jack, but even though it's been very slow healing (partly because he would scratch - wouldn't tolerate a cone, but had a thick sock on foot, but also because the wound was constantly wet), we seem to be turning the corner. 

Have been bathing with salt water and he will only occasionally want to scratch. I'm hoping that means it is the sore rather than anything else, and occasionally - say after eating - it stings.

I'm sure it has been ruled out, but maybe worth having a look yourself, in case he has sores or ulcers on the inside of his cheeks? A long shot I know, but we're clutching at straws here 

Anyway, keeping everything crossed that the next few days show a marked improvement, at least enough to feel that you are on the right road.


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## Sled dog hotel (Aug 11, 2010)

So sorry that as yet Jack does not seem any better. Hoping that there may be some improvement in the next week or so.

Can they not try another form of pain relief at least for the moment to see if it makes any difference?


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## Katie3939 (Mar 14, 2014)

Thank you for that idea Lurcherlad. Which tooth did your dog have removed?

The vet tech said to give it 2 weeks. Tomorrow is one week. 

Sled Dog, the other prescriptions to use are Gabbapentin. It's approved in dogs and is used for nerve pain. A dog his size can take 100 mg 3 times a day.

So we'll see a week from tomorrow when I speak to the vet tech again.

And yes, we're hoping he'll have some improvement in the next week. Scratching and pawing at the mouth though are signs of pain. This vet dentist is also a diplomat in pain management. If he hadn't told us that, we would not have known for certain.

Thank you again All...

Best to you and your dogs!
Katie and Jack


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## Lurcherlad (Jan 5, 2013)

Katie3939 said:


> *Thank you for that idea Lurcherlad. Which tooth did your dog have removed?*
> 
> The vet tech said to give it 2 weeks. Tomorrow is one week.
> 
> ...


It was a molar, plus 2 small pre-molars. I'm pretty sure he doesn't have tooth pain, as the scratching has steadily decreased, commensurate with the healing of the sore on the corner of the mouth. In fact, today he hasn't even scratched it once, so I'm hoping now the healing of the sore has gone past the itching phase and we can leave the sock off soon.

Wish the story was the same for your Jack


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## Katie3939 (Mar 14, 2014)

Lurcherlad,

Thank you for your reply. What is a 'sock' in the UK??? We don't have that term in the states. 

Usually Jack came home wearing a cone, but this time he didn't because the molar is so deep in the mouth that he can not get to the molar stitches so does not need a cone.

Thanks so much for clarifying this!

Best,
Katie and Jack


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## victoria171168 (Apr 8, 2013)

A sock is a foot covering in the UK.

Best wishes for a full recovery,try the gabapentin it really helped Max where Tramadol didnt


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## Lurcherlad (Jan 5, 2013)

What is the latest with Jack? Any improvement?


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## Katie3939 (Mar 14, 2014)

Hi Lurcher,

Thank you for asking. How are you and yours doing?

Jack had his third and last dental surgery 3 weeks ago yesterday and he has not had improvement. Additional surgery would be of no benefit. He has chronic neuritis. In laymen terms it would be like having chronic tooth pain 24/7.

He is on 100 mg of Gabbapentin 3 x a day, (he weighs 22 pounds) so that's quite a lot of medication. They're also suggesting we add a NSAI such as Metacam or Rimadyl to synergise with the Gabbapentin.

It's been difficult because we are trying to look at this from his perspective, (chronic pain on pain meds every 8 hours), and it's difficult. It's human nature to want/try to see the positive but I have to wonder if we're being selfish. Would it be more humane to let him go...

We're due to spend time at the beach soon and that may help. He surfs in the ocean, runs on the beach, (has a sip of beer at a beach bar afterwards) and the beach is his favorite place to be. Am hoping to see (and photograph) him there and in my gut believe it will show me his capacity for enjoying life. If he's not interested in the beach then it will be very sad to see. 

Maybe some of you have seen his web pictures and if you have you can see he is as energized and enchanted with the beach as we are. Runs, swims, surfs and enjoys the water and the sun as much as any person I know.

So there it is. Not much more to say. Day to day I'm very aware of his need to be comforted and I hold him tight and love him hard. We are trying to find our way with this and it's an extremely tight rope to navigate. Even talking about it seems impossible but I don't want to look back some day and think 'Oh, he was hurting so much, and we let him'...

Wishing all the best,
Katie and Jack


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## Lurcherlad (Jan 5, 2013)

I am so desperately sorry that the last extraction has not given him the much sought for relief.

I have indeed watched him on the surf board - what an amazing little chap he is 

I agree, taking him to the beach and seeing how he is there will be a good indicator of his ability to regain a quality of life that makes it worthwhile to continue with the management of his pain. I shall keep everything crossed that he shows some positive signs. I dare say, he must be quite depressed at the moment, after all he has been through and that must be contributing too to his sad demeanour. A day at the beach may just lift his spirits and take his mind off his pain.

You have certainly moved heaven and earth to find a cure for his pain, no-one could have done more. I hope you don't have to make that final decision, but if you do, it will be because you have no alternative. As they say, better a day too early .............

Fingers crossed for a happy trip to the beach.

Take care x


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## victoria171168 (Apr 8, 2013)

Also talk to a holistic vet as they with acupuncture,etc be able to help


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## Sled dog hotel (Aug 11, 2010)

I am so sorry that the further surgery doesn't seem to have given Jack the relief that everyone hoped for. Its must be so hard for you all, especially seeing a dog who had such zest for life be in so much pain. Hoping that the trip to the beach will lift his spirits and you may see some of the Old Jack again.


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## Katie3939 (Mar 14, 2014)

Thank you for your kind thoughts Lurcher, Victoria and Sled Dog,

I appreciate all of you and the input you've given and your kind thoughts and prayers. 

It's a very difficult situation. 

I do think time at the beach will be very, very telling because just a few months before his first dental surgery we spent time with Jack there and he was racing my husband on the beach, (am so glad I took pictures), and he surfed and swam. He was his whole self. So the beach will.

Having a discussion about euthanizing a perfectly healthy dog because of chronic pain is a horrible thing. 

Am hoping adding the NSAI will help a bit also. I can order them on the internet and it will be less expensive than getting them through a vet.

Wishing everyone well.

Best,
Katie and Jack


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## SusieRainbow (Jan 21, 2013)

I'm wondering if some sort of nerve block injection would help ? Maybe worth researching.


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## kristyj (Aug 20, 2014)

Hi, I am new to this site and came across this thread. I have read about Jack and all the problems he has been through. I am so very sorry he, and you/your family has been through this. How is he doing now?


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## Lurcherlad (Jan 5, 2013)

I have been wondering too. Any news on Jack?


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## Katie3939 (Mar 14, 2014)

Thank you for asking about Jack. Apologies for not having posted in so long to update you on him.

Jack is taking 150 mg of Gabbapentin aka Neurontin 4 times a day and 50 mg of Tramadol at bedtime. This is a huge dosage of Neurontin for a 20 pound dog (he's lost about 3 pounds) but when I tried lowering his dosage I'd catch him scratching at his mouth...A sign of pain.

That amount of Neurontin kept him zonked out but fairly recently he has seemed to try and act like the old Jack...Sitting in the window barking at passers by, paddleboarding in the lake and trying to play with his toys if one of plays with him. He is adjusting to this dose.

We're due to spend a huge chunk of time at the beach soon at the beach and that's his favorite place so we're hoping he will act more like his old self.

For those of you who don't remember Jack here's the Youtube video of him paddle boarding on the lake 




Everyone here has been s supportive of Jack and me and I'm very grateful.

I'll post more about him, especially when we get to the beach,

Best,
Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Thank you for updating, I often thought of Jack and wondered how he was doing, and when we didn't hear for so long was worried and feared there wasn't an improvement. Im glad that the medication is giving him a decent quality of life again and the old jack has re-appeared again.


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## Lurcherlad (Jan 5, 2013)

Agree with SledDog - happy to hear that Jack is at least getting some quality in his life and the pain management seems to be working.

Here's hoping things continue to improve 

Hopefully, this has given you a little bit of relief too - so stressful for you to see your little lad suffering, and for so long.

Take care and hope Jack keeps well :thumbup1:


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## Katie3939 (Mar 14, 2014)

Again, many many thanks to everyone on this site. Those of you who were there for us from the beginning, others who popped in with a kind word or an idea...All are very much appreciated.

Wanted to share something that has given Jack more joy in his life then I can begin to describe is his food. He was getting 50% of this homemade food before his dental surgery but afterwards due to dental pain he is on it 100%. This is food that is not only human grade but is delivered to the dog deli by the same company that delivers food to restaurants...the meats, veggies and fruits.

I've never heard of this concept anywhere else in the United States so I'm guessing there's no such place in the U.K. It's a 'dog deli' for dog meals. All meals are prepared for your dog, and designed according to breed and health issues. Fresh meats, eggs, vegetables and fruits are used, both cooked and raw and each packet of food is one serving of food. It is stored in the freezer and taken out every few days as needed. I pay 45.00 for a month of custom formulated food for Jack. It's worth every penny and more.

I've cooked for a dog before but the owner of this deli is so meticulous about every detail of every order...% of protein, calories etc...The owners name is Charlie. I know you can't get your dogs food shipped across the pond but if anyone is enterprising and wants to start an amazing business, this has been a godsend to many dogs locally.

Called Rick's Dog Deli. Here's the website. Rick's Dog Deli

It's given Jack so much joy in addition to optimizing his health. He's a real foodie. Maybe this post will encourage others to cook healthy meals for their dogs!

I'll post again after Jack has a prolonged time at the beach and let you know how he does surfing, swimming and running on the beach. If he can/will do those things, I'll be thrilled.

Wishing the best to everyone reading this and also to your pets!

Best to all and thank you again for your kind support,
Katie and Jack


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## Katie3939 (Mar 14, 2014)

Dear All,

Wanted to share an update and again thank everyone who was there for us in a difficult crisis.

Before I give an update want to share that Jack is a rescue. I worked as a volunteer for many years for a 'no kill' rescue as they're called here in the U.S. We'd taken in many fighting dogs that weren't fit for adoption and rehabbed them in fostorcare. Our last dog was a Hurricane Katrina pit bull.

The day he got adopted I took Jack who had been living in a crate outdoors in 100+ degree heat. He hadn't been adopted because one eye was completely white. The shelter had fallen on hard times and I decided to take him as a foster and have his eye 'fixed' surgically by our personal vet on our dime. I knew he'd get adopted quickly.

It turned out to be an infection and while he healed my husband and I remarked repeatedly on how 'sound' Jack was. What a sweet and loving little dog. We'd always been terrier people...Loved and beloved by bull terriers.

So we kept Jack. My only 'foster failure.' He had been surrendered and his owner surrendered all his paper work with him. (Very unusual.) The owner had paid 1600.00 dollars for him from a pet shop and when I traced his fake AKC papers I found that he came from a horrible puppy mill. No matter, he was a delight.

Jack will be 12 years old in August.

I want to share that with a hefty dose of Gappapetin aka Neurontin a nerve medication several times daily he is doing really well. I wanted to see him at the beach before reporting back to all on this forum. To see how he did at the beach...His favorite place. He's doing pretty great.

He's back on the paddleboard and surfing in the ocean. Pretty amazing. 




He has a Twitter page: https://twitter.com/jack_pug

Please stay in touch.

Thank you all for your help with a special thanks to Sled Dog Hotel and Lurcherlad. So many people helped. Am very grateful to all.

Katie and Jack


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## Sled dog hotel (Aug 11, 2010)

Katie3939 said:


> Dear All,
> 
> Wanted to share an update and again thank everyone who was there for us in a difficult crisis.
> 
> ...


So pleased to hear that Jack has his life back and doing all he wants to do again and back at his beloved beach.
I often wondered how he was getting on, thank you for updating.
Way to go Jack. xx


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## Rott lover (Jan 2, 2015)

victoria171168 said:


> Big hugs and basically l would be hammering on the door of the specialists demanding a full checkup.
> 
> It sounds like he needs to be in intensive care atm.
> 
> ...


I agree whole heartedly with this post


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## LazyLacy (Jun 15, 2015)

Hello Katie, I came across your post while searching for these same symptoms for my dog, Lacy. How is Jack doing?

My Lacy had dental work done two months ago and has slowly been getting worse. She was just sneezing a lot at first and I told my husband I wanted to take her back to the vet, but he wanted to wait and see if she would get any better with time. She is now having green mucus coming out of her snout and she has been scratching which I read is a sign of pain. She had six teeth extracted and she is restless, she sleeps but she moves around too much. Sometimes she wakes me up in the middle of the night just wanting to be cuddled. After reading your posts I freaked out and I made an appointment with her Vet for this coming Wednesday and I hope they can give me a good prognosis. I would cry with her in my arms if she goes through what your poor Jack went through. I hate to see her in pain, as her pain is also mine.
I really hope Jack is well and thriving!


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## hootah3 (15 d ago)

Katie3939 said:


> Hello, I'm new here and my name is Katie. Our dog Jack, a rescue pug very recently had ten teeth extracted by a vet dentist...A vet that does only dentistry. He came home on pain meds and was supposed to be healed from surgery in two weeks. Instead he was extremely unwell and developed aggressive sneezing, a dry hacking cough, and very yellow discharge from one nostril. I took him to our 'regular' vet and he explained it is very unusual to see a dog with discharge from only one nostril, and it's a 'bad' sign. Jack had no temperature and no lung congestion. The vet suggested this was some form of sinus issue. He cultured the yellow nasal discharge and but him on an antibiotic in the meantime. Jack seems sicker than ever after three days on the antibiotic. We're waiting on the culture to come back, but the vet said Jack may need an MRI (a costly expense that's only available at an extreme specialty clinic.) Has anyone had any experience with this? He said it could also be nasal cancer, (Very rare particularly in a dog with a short muzzle) or nasal polyps. I'm certain this was related to the dental surgery. (Surgery was only 2 and a half weeks ago.) He went into the surgery in perfect condition, and came out horribly. Am beside myself. We'd appreciate any information about this kind of experience. Thanks so much, Katie and Jack


 *o Your dog has a oronasal fistula. It's *


Katie3939 said:


> Hello, I'm new here and my name is Katie. Our dog Jack, a rescue pug very recently had ten teeth extracted by a vet dentist...A vet that does only dentistry. He came home on pain meds and was supposed to be healed from surgery in two weeks. Instead he was extremely unwell and developed aggressive sneezing, a dry hacking cough, and very yellow discharge from one nostril. I took him to our 'regular' vet and he explained it is very unusual to see a dog with discharge from only one nostril, and it's a 'bad' sign. Jack had no temperature and no lung congestion. The vet suggested this was some form of sinus issue. He cultured the yellow nasal discharge and but him on an antibiotic in the meantime. Jack seems sicker than ever after three days on the antibiotic. We're waiting on the culture to come back, but the vet said Jack may need an MRI (a costly expense that's only available at an extreme specialty clinic.) Has anyone had any experience with this? He said it could also be nasal cancer, (Very rare particularly in a dog with a short muzzle) or nasal polyps. I'm certain this was related to the dental surgery. (Surgery was only 2 and a half weeks ago.) He went into the surgery in perfect condition, and came out horribly. Am beside myself. We'd appreciate any information about this kind of experience. Thanks so much, Katie and Jack


 *My dog had the same symptoms. He had a oronasal fistula. It's caused during tooth extraction, creating a hole between the mouth and nasal passage. He **had to have surgery to close the hole in his gum between his mouth and nasal passage. *


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## Burrowzig (Feb 18, 2009)

hootah3 said:


> *o Your dog has a oronasal fistula. It's * *My dog had the same symptoms. He had a oronasal fistula. It's caused during tooth extraction, creating a hole between the mouth and nasal passage. He **had to have surgery to close the hole in his gum between his mouth and nasal passage. *


The original post was from 2014, and we've had no update since 2015. You can check the dates of threads or posts easily, if you look.


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