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  1. #1
    Join Date
    Mar. 29, 2006
    Location
    Humidity Central
    Posts
    662

    Default Old horse dental freakiness

    My 26 yo TB has been diagnosed, after much back and forth, as having hypercementosis. This is apparently a condition in which excess hard tissue is laid down on both the upper and lower jaw, and the upper and lower incisors are subject to essentially decaying away.

    After examining my horse, my vet declared this "freaky" and has been doing some intense research to find out more about the condition.

    So, any COTH wisdom on this particular malady? Any experience, thoughts, or suggestions?




    For those who want to wade through the history of the horse and his teeth, here's the last few years as seen through the Old Man's mouth:

    Up until 2001 – confirmed cribber; stopped cribbing on his own at about age 18. No history of any particular dental problems other than routine floating.

    2004 – sudden drastic weight loss, with bad smelling mouth. Vet 1 removed outer left upper incisor with a surgical closure of the gum. Weight was regained easily to body condition 5. Vet 1 indicated no other significant dental problems.

    May 2006 – Old Man was sent to semi-local retirement farm in excellent weight and overall good condition.
    July 2007 – Old Man was discovered at retirement farm in body condition 2-3. Lower incisors appeared slanted forward at extreme angle, but no smell or sign of tooth decay. Routine floating by Vet 2 and removal to a full care boarding facility led to immediate weight gain and complete recovery.

    Mid-2008 – Vet 3 removed right outside upper incisor using fingers only, with substantial bleeding but no other trauma. Vet 3 also performed upper incisor reduction that required heavy sedation and restraint of Old Man. Side note: after this procedure, Old Man showed strong aversion to treatment by Vet 3 for future routine care – extraordinary reaction for this horse. Incisor reduction led to improved cosmetic appearance of mouth; no mention by Vet 3 of any unusual status of dental condition.

    August 2009 – Old Man was floated by Vet 4, a specialist in equine dental care. No mention of any unique dental conditions.

    February 2010 –Bad smelling mouth and odd pattern of food retention along upper gum above incisors. When food is rubbed off/rinsed off, holes in gum appear above each incisor, showing hard ivory tissue underneath. Holes are each approximately the size of a nickel and are arranged exactly above each (remaining) incisor. Old Man’s teeth appear to be “stuck forward” relative to his jaw.

    Vet 4 (dental specialist) examines for approximately 30 seconds, declares it to be a tumor of long and complex name that he can’t remember, not malignant, and essentially untreatable.

    Vet 5 is consulted, who takes multiple x-rays (some at risk of having expensive digital plate bitten), and sends x-rays to vets at practices both local and across country, leading to tentative diagnosis above. X-rays (sorry, I don’t have copies to post at the moment) show teeth are definitely thrust far forward relative to the jaw. Side view shows what appears to be a large mass on both sides of incisors on both top and bottom jaw, but top-down view (the one taken at great risk to the plate) shows no mass in the center. Teeth in the center show dramatic loss of tissue and potential extreme decay.


    Sorry for the length, but I anticipate being eventually asked for history anyway...
    Last edited by Rebe; Feb. 26, 2010 at 12:26 AM.
    "She still had all of her marbles, though every one of them was shaped funny and rolled asymmetrically."



  2. #2
    Join Date
    Jan. 20, 2007
    Location
    Northern Kentucky
    Posts
    920

    Default

    No personal experience, but Equus did an article on this several months ago.



  3. #3
    Join Date
    Jan. 4, 2007
    Location
    TX
    Posts
    45,646

    Default

    As a way off possible diagnosis, check Millers Disease, where some fed too much bran and the head bones remodeled from a calcium/phosporus imbalance.
    That is hardly ever seen today, so it would not come to mind easily.

    I hope they can find a way to help your horse feel better, as it seems it is bothering him and his quality of life may be in question.



  4. #4
    Join Date
    Aug. 30, 2006
    Location
    Williamston, NC
    Posts
    1,515

    Default

    I don't know alot. You might find out more if you research chronic incisor periodontal disease. At some point the teeth may be reabsorbed. Usually horses with this (and it happens a fair amount with older horses) have a history of periodontal issues. Current thought goes like this: as a horse ages the angulation of the incisor teeth puts additional stress on the periodontal ligament which can lead to inflammation that triggers this syndrome. Treatment may include antibiotics, steriods injected around the teeth, extraction of all loosened/badly infected teeth. The horse can be in a great deal of pain. Occasionally the remaining teeth can be splinted to eliminate movement. This helps with pain control. From what I recall there are some cases where all teeth are extracted and a gingival flap is sutured over the raw tissue to speed healing.

    There was a thought circulating a few years ago that hypercementosis is a form of arthritis. I believe this has been completely ruled out.

    In all honestly I think you have to balance out your horse's age, the treatment required, his physical condition, and his level of pain before making any treatment decisions.

    Please share any info you find out.

    If anyone has access to the Equus article and willing to scan or email to me I would greatly appreciate it.



  5. #5
    Join Date
    Jun. 22, 2008
    Location
    Outside Ocala FL - Horse Capital of the World
    Posts
    6,193

    Default

    Does it look anything like this:

    http://www.advancedequinedentist.com/enamel_hypoplasia

    That's the only thing I have ever seen so far, and only on the internet.
    There are friends and faces that may be forgotten, but there are horses that never will be. - Andy Adams



  6. #6
    Join Date
    Jun. 22, 2008
    Location
    Outside Ocala FL - Horse Capital of the World
    Posts
    6,193

    Default

    I could not find the Equus article online, here is all they have on the dentistry topic:

    http://equisearch.com/horses_care/health/dentistry/

    You might be able to back order it, I think it was the article on Unusual Dental Condition - Which was in the Case Report section of issue 378. I think they charge 5 bucks per back issue to order them, and I could not find the article online.

    Teeth and Dentistry
    Causes of teeth grinding (HO) 377/12
    Unusual dental condition (CR) 378/25
    Mysterious chronic condition (CR) 380/29
    Cause of a “thunk-thunk” sound (C) 381/77
    Color of horses' teeth (HO) 383/13
    Bridle shyness (HO) 384/19
    Your Aging Horse: Dental Problems (F) 384/32

    http://www.equisearch.com/equus/equu...ex%5F111109/#T
    There are friends and faces that may be forgotten, but there are horses that never will be. - Andy Adams



  7. #7
    Join Date
    Mar. 29, 2006
    Location
    Humidity Central
    Posts
    662

    Default

    Quote Originally Posted by Bluey View Post
    As a way off possible diagnosis, check Millers Disease, where some fed too much bran and the head bones remodeled from a calcium/phosporus imbalance.
    That is hardly ever seen today, so it would not come to mind easily.

    I hope they can find a way to help your horse feel better, as it seems it is bothering him and his quality of life may be in question.
    Bluey - I don't think it's the bran disease - he's gotten the occasional bran mash on cold nights throughout his life, but no way that it would be excessive.

    Quote Originally Posted by NCSue;4711868Z
    In all honestly I think you have to balance out your horse's age, the treatment required, his physical condition, and his level of pain before making any treatment decisions.
    I know it seems odd, but the Old Man's quality of life is extraordinarily good. He looks and acts about half his age, he eats well, he holds his weight pretty well, and he goes out and literally romps in the pasture every day. He is very stoic about pain, but he honestly isn't showing any distress over these freaky teeth. I've already made my decisions about level of treatment for problems such as colic or founder that eventually are likely to arise (i.e. no heroic measures - I consider that unfair to an older horse).



    Quote Originally Posted by MunchkinsMom View Post
    Does it look anything like this:

    http://www.advancedequinedentist.com/enamel_hypoplasia

    That's the only thing I have ever seen so far, and only on the internet.

    No, it doesn't look at all like the link you attached. I might actually try to overcome my aversion to all things photography related and get some pictures of his incisors to post (wish me luck with that!).

    Quote Originally Posted by NCSue;4711868Z
    If anyone has access to the Equus article and willing to scan or email to me I would greatly appreciate it.
    Yes, please, if someone can access that article and post or e-mail it, that would be great. There's a real deficit of searchable info on the web (Vet 5 concurs on this!).

    Thanks to all for your feedback. I'll let you know how the Old Man does going forward.
    "She still had all of her marbles, though every one of them was shaped funny and rolled asymmetrically."



  8. #8
    Join Date
    Jun. 22, 2008
    Location
    Outside Ocala FL - Horse Capital of the World
    Posts
    6,193

    Default

    A bit of information I found on-line on this topic:

    http://www.thehorse.com/ViewArticle.aspx?ID=14029

    Your vet might be able to read this full article:

    http://www.ncbi.nlm.nih.gov/pubmed/19010701

    A lot of medical terminology in this one:

    http://vet.sagepub.com/content/44/4/533.full

    This one has some treatment options:

    http://www.lathamdvm.com/articles/eotrh.shtml
    There are friends and faces that may be forgotten, but there are horses that never will be. - Andy Adams



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