Severe malocclusion explained
Video's of her dental surgery.
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At 4 months old, Stella, a lion-head rabbit, suffered severe malocclusion of the incisors and molars. Unable to eat, she was starved, dehydrated and dangerously underweight (0.76 kg, or 1 lb. 11 oz.). Her head was oversized in proportion to the rest of her body indicating that her growth had been retarded.
Knowing that Stella would need medical help, an appointment was set up with one of the rescue’s veterinary partners for a general check-up and to be spayed, before the rescuers actually saw Stella. Immediately upon seeing Stella, it was obvious that she could not wait 5 days for medical help. It was quite likely she would not live that long. An emergency appointment was made within 24 hours with Dr. Morales at Prestonwood Animal Clinic (Houston, USA). In the meantime, Stella was fed a very watery mixture of Critical Care in an effort to nourish and re-hydrate her.
Dr. Morales was appalled when she saw Stella’s incisors, saying it was the worst case of incisor overgrowth she had ever seen. Stella’s incisors blocked the view of her molars so a radiograph of Stella’s mouth was taken before the incisors were trimmed.
Once the incisors were trimmed, Dr. Morales was able to see into Stella’s mouth with an otoscope. She was stunned by what she saw. Stella’s right mandibular molars had grown in every conceivable direction, except “normal”. The x-ray verified that Stella’s molar problems extended into her jaw. The roots were obviously out of alignment. Dr. Morales recommended that Stella be taken to another veterinarian who is more experienced in dealing with severe dental malocclusion.
Dr. Morales strongly advised against stressing Stella’s already compromised health by either spaying her or burring her molars in the near future. She felt it very likely that Stella would not be able to handle the anesthesia, and, the healing process would tax Stella’s body beyond its capacity. Dr. Morales prescribed a high dosage of meloxicam (Metacam) for one week, then decreased it for the second week. She also prescribed enrofloxacin (Baytril) twice a day. Subcutaneous fluids were also prescribed in case Stella needed help re-hydrating. Critical Care was also prescribed.
Dr. Morales gave warning that it’s possible that all we can do for Stella is keep her as comfortable and pain free as possible for as long as she lives, which may not be very long.
When Stella met Dr. May at Pearland Pet Health Center (Houston, US), 4 days later, her weight had increased to 2 lbs 1 oz. As Dr. May assessed the x-rays Dr. Morales provided, he agreed that Stella needed to gain more weight and strength before any surgeries were performed. He discussed the dental procedures needed and caretaking responsibilities such surgeries would require. He continued the Metacam and antibiotic treatments.
X-ray of Stella: courtesy of Dr. Morales
Comparison between a normal skull with correct occlusion, and that of Stella, with overbite of the lower jaw.
Two weeks later, Stella had gained in weight and strength. This time, Dr. May put her under anesthesia in order to assess what could be done about her malocclusion. It was decided that all of her mandibular molars were badly infected and the best course was to remove them as soon as possible. At that time, Dr. May removed all five mandibular molars. He also trimmed Stella’s incisors and ground down all of the remaining molars. Dr. May prescribed antibiotics: penicillin injections every other day, as well as marbofloxacin (Zeniquin); buprenorphine (Buprenex) and meloxicam (Metacam) for pain management; and an antibacterial mouth rinse 3 times per day.
In subsequent dental procedures, Dr. May removed a loose and fractured upper right. He also removed Stella’s lower incisors which have since grown back. Rather than remove them again, Dr. May decided to see if she can keep them, with frequent trimmings.
Stella was successfully spayed 5 months after her rescue. She has tripled in weight, eating “Critical Care”, some pellets, finely chopped vegetables, and even hay. Her dental issues will never end, but she is well on her way to living a pain-free life with her new bond mate, Parker.
Many thanks to Dr. Morales (Prestonwood Animal Clinic, Houston, US) for the permission to use Stella's X-rays.
Many thanks also to Dr. May (Pearland Pet Health Center, Houston, US) for his time and cooperation with the making of the videos.