DEAR DR. FOX: Our 4- or 5-year-old female orange and white spayed cat, Emma, developed something on her right cheek that I noticed last July. It first appeared to be about the size and color of a small garbanzo bean. I scratched at it -- there was no indication of blood, but it was whitish and firm, and the small scratched area seemed to kind of crumble off. At the time, my older Persian/Himalayan was failing due to polycystic kidney disease and his care was the priority. He eventually passed away.
Not long after, the growth on Emma's face was gone, but in the place where the growth had been, there was a sort of disc resembling the base of an acorn. There was no blood and no sign of anything under the surface, just a space where it looked like the growth had popped off. I had no idea if it just fell off or was scratched off.
Now there is a growth in the same place again. It is about a half-inch in diameter and growing straight out. The top is flat, it's the color of garbanzo bean and the texture is dry and firm. Again, there's no indication of blood, though Emma is not interested in me messing with it.
About three months ago, I took her to a vet for a flea-related issue and asked the vet if she could identify the growth. She said she had never seen anything like it and didn't know what it was. I have since sought more information on what this might be. It doesn't match the description of a botfly. I have Googled fungus growths, but can't come up with much else other than ringworm, and it's not that.
Is there anything you think it could be? I do not have the resources to go from vet to vet, nor do I want to put her through biopsies and such. I kind of thought a fungus, as it seems to resemble the ones seen on trees and such. Any thoughts? -- C.H., Toms River, N.J.
DEAR C.H.: Without personally examining your cat, which is one limitation of my long-distance diagnostic and treatment suggestions, my first thought is that your poor cat may have an upper tooth abscess. These will sometimes erode through the thin facial bone and appear as a swelling that may become fibrous and hard, or soften, burst and then scab over.
I suggest a visit to a veterinarian specializing in dentistry or one able to do an X-ray of the maxilla/facial area and check out my provisional diagnosis. Treatment is surgical removal of the tooth and cleaning out the fistula caused by the abscess.
DEAR DR. FOX: My 4-year-old border collie has a broken canine tooth in his lower jaw. He came to me this way two years ago. The tooth is broken vertically, with the tooth pulp exposed to the back of his mouth. The vet who examined him right after I got him indicated that removal of the tooth would be a very big deal, with great risk to his jaw. She said that he might live his whole life without it being a problem. During his most recent exam, my vet (a different one) said that while he is currently just fine and doesn't seem to be bothered by the broken tooth at this point, chances are quite high that sometime down the road, it will become an issue.
I don't know where to go from here. The whole "If it ain't broke, don't fix it" notion makes good sense to me. However, adopting a wait-and-see position with this and potentially having an older dog with a jaw infection doesn't feel like a good way to go either.
Is there such a thing as capping or crowning this kind of tooth in a dog? Are there other possible remedies for this that don't involve such invasive surgery? -- L.T.
DEAR L.T.: A broken canine tooth is a big deal when it comes to possible infection, tracking bacteria through the soft tissue into the jaw, subsequent bone infection and the possibility of tooth pain and associated difficulty eating.
You must have your veterinarian check around for a veterinary dental specialist who would be the best choice to remove this tooth under general anesthesia with careful resection to avoid damage to the jaw. The veterinary dental specialist may offer to perform a root canal and cap the tooth or remove the tooth and put in an implant. While the latter is controversial and likely to only be of aesthetic value to you and not benefit your dog, advanced dental procedures, once the exclusive domain of human dental surgeons, are now one of the good, though costly, services now available for companion animals.
(Send all mail to firstname.lastname@example.org or to Dr. Michael Fox in care of Universal Uclick, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.
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