Wednesday, August 15, 2018

3235. INTERN. A hamster's chin wound does not heal for over 4 weeks. Why? Jaw abscess


Setting - Singapore. A metropolis of around 6 million residents. Most of them live in high-rise apartments. The people had just celebrated National Day on August 9, 2018. Dogs form the majority of companion animals. There are a few who love Syrian hamsters. This is a case study of a rare occurrence of jaw abscess in one Syrian hamster in Singapore.




Ang Mo Kio HDB apartments


Members of Parliament for Ang Mo Kio













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Some 4 weeks ago, the owner consulted Vet 1. She used a needle to aspirate and drew blood. The owner came to Toa Payoh Vets for a second opinion. An abscess was obvious at this time. This was lanced and drained. 3 long cuts were made by me deeper into the muscle. The wounds of the two cuts healed but the 3rd did not close.   

Oral antibiotics and cleaning for over 2 weeks. Yet this wound oozes pus and does not close for the past 4 weeks after lancing and draining the abscess. Why?

July 18, 2018 images from owner via WA

July 18, 2018 images from owner by WA. Two foreign bodies look like bone fragments. The owner did not come for consultation but gave more antibiotics. Yet pus still oozes and the wound does not close.  






Aug 12, 2018
Text message and short video clip from the owner to Dr Sing

Good morning dr sing, I hope you are doing well.

Just want to check in with you, mary has recovered back to her usual activities. However, the wound seems to not be able to close by itself and we are still cleaning it everyday. Able to squeeze a little bit of liquid/blood. Is this normal?









Aug 14, 2018. the owner came to me to get the answer.


"There is something inside the wound, e.g. hairs preventing wound closure," I said.
"Gas anaesthesia is needed to do a proper examination as the hamster is very active and
prevents my closer inspection!"

Diagnosis under anaesthesia.
Foreign body (bone fragment of the left submandibular bone, i.e. low jaw) was embedded inside. I used forceps to extract. Evidence is in the image and actual bone was given to the owner.

Aug 14, 2018. Bone fragment extracted at Toa Payoh Vets


The wound should heal after removal of this piece of bone.

In conclusion, the abscess was likely to be caused by the infection of the submandibular bone at the root of the lower incisor tooth. Infection broke down this area. Bacteria formed the pus which appeared as a lump first.

The lower front teeth were abnormal. The right lower front tooth was cracked lengthwise. The right lower front tooth displayed a black streak as if it was stained with tartar. However, both teeth were solid and strongly attached to the jaw bone. The abscess would be to the left of the front teeth, from osteomyelitis (bone infection) of the left mandible by bacteria.





VIDEOS of case study






Conclusion.



A first-time rare case of a "jaw abscess" seen. At Toa Payoh Vets, in the last 3 years, we see an average of 5 hamster cases per week but have not encountered such cases.

 In rabbits, jaw abscesses due to tooth root infections are common. The jaw bone infection lead to large jaw abscesses. Infections of the jaw bone lead to broken bone fragments presented during abscess lancing and drainage. (see images below).






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