Friday, April 17, 2020

4111. REYNA. Do guinea pigs suffer toothaches? Dragonfly series


USE THE FOLLOWING FOR OTHER VIDEOS. Remember "viewer discretion". Dragonfly series














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Apr 17, 2020. Reyna to edit the footages according to what is required in each of the 4 videos

BKTP VETERINARY EDUCATIONAL VIDEOS


STORY TELLING USING THE 3D's to sell a product or service
Details
Dialogue
Discovery
All wrapped up in Drama

*Use 3 D's in story telling. See:

 https://2010vets.blogspot.com/2020/02/story-telling-using-3ds-example-do-dogs.html
(Reyna --- References:  BLOG. NO. 4077
Blogs No. 4074, 2955, 4104 for video footages)

Use Images of similar conditions (dental disease, jaw abscess)  from other guinea pigs and rabbits.


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4 videos as follows:

Do guinea pigs suffer toothaches?
Overview. Video 1/4

Do guinea pigs suffer toothaches?  
Diagnosis. Video 2/4

Do guinea pigs suffer toothaches?  
Treatment. Video 3/4

Do guinea pigs suffer toothaches?  
Prevention. Video 4/4

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Do guinea pigs suffer toothaches?  
Overview. Video 1/4

HOOK.
Show the healthy guinea pig from Agnes - eating hay and drinking water, poop size and number. Active running. This is what a heathy guinea pig looks like.

Constrast to the case study. 1 minute of the video showing drooling, not well groomed, ears dirty, overgrown incisors. etc.  What happened to this guinea pig?



This is Video 1/4 discussing the overview of the case. This 5-year-old guinea pig had lose a lot of weight. The reason is that he had bad teeth. Hence he could not eat properly. His front teeth were overgrown (any image) and his molar spurs are entraping  his tongue or cutting his inner cheek.    

DETAILS




Do Guinea Pigs suffer from toothaches?  Yes, they do.  The most painful one must be the dental abscess. An abscess is a collection of pus. A dental abscess originates from the bacterial infection of the root of the cheek teeth. The infection leads to formation of pus. The pus accumulates and swells the under surface of the skin of the lower jaw. (ILLUSTRATION OF ABSCESS )

It is so painful that the guinea pig stops eating or eats very little. He loses weight fast. The presenting sign is a globular swelling around the lower jaw.  (IMAGE). Foul-smelling thick cheesy pus churn inside the thick-walled abscess (SYRINGE ASPIRATION FOOTAGE). The abscess turns into a ping-pong ball swelling as seen in the case of a 5-year-old Guinea Pig seen at Toa Payoh Vets in 2016 (VIDEO FOOTAGE OF SWELLING). 


DIALOGUE
“My guinea pig has overgrown front teeth again," Mr Chan said. "I have come monthly for the last 6 months to get his teeth clipped. He ate very well after clipping, but I had to come every month.

"Look at him today, " Mr Chan put the pet on the examination table. "He has lost a lot of weight. He is very light weight now.  His chin is wet with saliva. He looks like a run-down homeless person!"

"I have your records here," I showed Mr Chan that his last visit was more than 2 months ago. "You must have been busy. Your guinea pig missed his tooth trimming for 2 months.

"Your guinea pig could have had all his 4 front teeth extracted," I did advise last time. "This usually resolve your problem of having to come for monthly trimming." 

"It would have been too expensive for me. Will you trim his front teeth again?" Mr Chan requested.

"Look at this swelling on the left lower jawYour guinea pig now has a big swelling on his lower jaw, hidden by his hair," I showed Mr Chan the dental abscess. "That means you pet has infection of the root area of the molar. That abscess caused him to eat much less as he has a painful mouth!"







"What is your advice to treat him?" Mr Chan asked.

"As your guinea pig is malnourished, dehydrated and not eating, I need to give him fluid therapy and antibiotic injection to help him recover. (VIDEO OF SC INJECTION)

The next day, I will need to do an X-ray (IMAGE) to check which of his left cheek teeth is decayed and then, tooth extraction. is that Ok with you?"
.

"Will there be any other tests as my pocket is not deep."

"I will skip a blood test and biopsy and bacterial culture for effective drugs to lower your medical cost.  As for treatment, there are 3 options. The least expensive of the 3 treatments ---lance and drain the abscess (ILLUSTRATION). We will do this."

The owner consented to the procedures. The guinea pig was warded for at least 5 days.


DISCOVERY
ADVICES TO GUINEA PIG OWNERS:  


1. Monthly clipping of the overgrown front teeth is less expensive per trip as compared to surgery. However, owners tend to forget or delay the task. The guinea pig cannot eat properly, loses weight and develop dental abscess. (IMAGE OF DENTAL ABSCESS).

2.  Surgery to extract all the 6 overgrown front teeth of this guinea pig, if performed well will result in no more overgrown teeth.    

This is the end of Video 1/4. Please follow through to view
Do guinea pigs suffer toothaches?  
Diagnosis. Video 2/4




FOR MORE INFORMATION: Phone 6254-3326, 9668-6468, 
judy@toapayohvets.com, www.toapayohvets.com





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Do guinea pigs suffer toothaches?  
Diagnosis. Video 2/4



We use this 2-year-old male (Agnes' guinea pig) to demonstrate the procedures of diagnosis 

The guinea pig has 20 teeth. He has 4 front teeth called incisors. He has 16 cheek teeth called premolars and molars. He has no canine teeth. In addition, his teeth grow continuously. Therefore he has to wear down his teeth by continuous chewing of hard food like hay.

If he is fed pellets only and little or no hay, his teeth overgrow. How do we diagnose his dental condition?







  
Diagnosis consists of:
1. The Physical Examination
2. The Mouth Examination - Otoscopic examination or buccal gag.
3.  Dental X-rays.

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THE PHYSICAL EXAMINATION
1. General Examination
2. Visual Examination
3. Palpation with fingers

1. Physical Examination consists of general examination, visual check up and palpation

1.1  General examination - BCS, T, P, R, Active, EDUS, Heart, Lung ausculatation, Lymph node and abdominal palpation.

2.  Visual check up.   Check eye, nose, ears for discharge, inflammation, swelling, lumps and tumours.  Show opthalmoscope and otoscope examination.

2.1  Specific procedures for dental abscess are as follows:Wrap the guinea pig inside a towel. If he is fractious, sedate him.

Open the mouth with  thumb and forefingers/buccal gag (use buccal gag).

3.   Palpation of the side of the face where the upper and lower cheek teeth are located. I used my thumb and forefinger to feel the sides. As you can see in the video, the 2-year-old guinea pig did not object to my touching. That means he has no painful mouth or molar spurs.

3.1  Palpate along the junction of the upper and lower jaws for dental abscess. Could be hidden by the long coat esp. at the junction of upper and lower jaws.
Show how this is done in Agnes' GP.
1.4. If an abscess is seen in the mouth or around the jaw, it may indicate DENTAL DISEASE. The vet needs to identify and remove any problematic teeth. To do that, the vet will need to do X-rays of the mouth.
Insert an image of the case study with dental abscess.

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2. The Mouth Examination - Otoscopic examination or buccal gag.

 Wrap the guinea pig inside the towel or slight gas anaesthetic if fractious
Demonstrate with otoscope.
Then demonstrate with buccal gag as some vets may not have otoscope. 

3.  Dental X-rays to be done. Oblique  lateral view so that the cheek teeth do NOT overlap. Can see bone lysis etc  EXPLAIN THE X-RAY  text... 


The vet needs to interpret the skull X-rays in the video

3.1.   X-ray. Must take oblique view so that the cheek teeth do not overlap. Should take 2 views. See X-ray taken. Narrate the text and show the decayed tooth (M2).


Narrartive and point to every word to analyse and explain the formation of
the dental abscess



ADVICES TO GUINEA PIG OWNERS:  


1. Blood test is advised but not done in this case. The owner wanted to reduce medical costs. A blood test will show either normal or increase/decrease in total white cell count. if the total white cell very high = bacteraemia. If low = septicaemia.  (SHOW SOME IMAGES OF BLOOD COLLECTION BOTTLES)

2. Bacterial culture for antibiotic sensistivity tests is advised. This was not done to reduce medical cost.

3. In the diagnosis of dental abscess, the three procedures are recommended:

1. The Physical Examination
2. The Otoscopic examination or use of the buccal gag to examine the mouth properly.
3.  Dental X-rays - The lateral view must be oblique.. 

This is the end of Video 2/4.  Please follow through with Do guinea pigs suffer toothaches?  
Treatment. Video 3/4


FOR MORE INFORMATION: Phone 6254-3326, 9668-6468, judy@toapayohvets.com, www.toapayohvets.com




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Do guinea pigs suffer toothaches?  
Treatment. Video 3/4


Dental abscesses are swollen or infected wounds that originated from the teeth. If there is a long delay, the guinea pig becomes emaciated, malnourished, dehydrated and die.
(X -ray and image and video footage)



Treatment involves 3 steps.
1. Clipping of the overgrown front teeth.
 Clipping of the molar spurs (Two images below).
2. Removal of the dental abscess --- 3 methods
    2.1  Incise and drain - least expensive, but may recur.
    2.2  Surgical removal of the encapsulated abscess (as in a subcutaneous tumour removal). Stitch up after excision of the capsule. 
    2.3  Marsupialisation in cases where there is recurrence after incision and drainage procedures.
3. Extraction of the decayed molar tooth. 






 If your guinea pig is affected by a swelling at the angle of the jaws, take it to the vet for a formal diagnosis. The cause of the abscess will then determine how the wound is treated. The abscess may be caused by fighting wounds or it may be a dental abscess.

Antibiotics, drainage, and surgery are all common treatments. 


There was a gigantic left dental abscess. Pre-treatment include injections of fluid and baytril (videof ootage)

GAS ANAETHESIA BY MASK.





(VIDEO FOOTAGE OF CLIPPING OF OVERGROWN FRONT TEETH


Why is the mouth painful? The lingual spurs of the molars grow
inwards, cutting the tongue or trapping the tongue inside the two
rows of spurs. So the guinea pig cannot swallow or drink water properly.

The buccal spurs of the molars grow outwards, cutting the cheeks. Painful infected
cheek ulcer cause loss of appetite and dehydration as the guinea pig
eats and drinks very little to survive. He becomes emaciated
and malnourished. Death will be the end of him.  

The incisors have had been trimmed before photography. A mouth
gag is used to open the mouth and you can see the molar spurs
very well. If there is no mouth gag, an otoscope may be used to check the
inside of the mouth for the existence of the molar spurs. 







DENTAL ABSCESS Medical and surgical treatments are required. Three surgical treatment options are available for the treatment of dental abscess. 1. INCISION AND DRAINAGE. At Toa Payoh Vets, I incised and drain the abscess. I made a long incision, drained out the pus. Daily irrigate the wound with antispetics for 7 days. The owner can continue at home for another 7 days. The abscess may recur later. Cheapest method. Least anaesthetic risk. (some footage from the video - clipping bald the swollen aea). Aspiration alone is not effective as the pus forms.. The decayed molar tooth can be extracted when the guinea pig is in better health.  The owner has to return for this dental work. However, the owner did not return for dental work or had gone to another vet.

2. ENCAPSULATED ABSCESS SURGICALLY REMOVED. Remove the capsule of the encapsulated abscess. The stin wound is stitched up. An eliabeth Collar is worn. Daily cleaning of the wound for 10 days. Antibiotics. There will be no recurrence. The guinea pig was in poor health and therefore not done till he was rehydrated and stronger.
3. MARSUPIALISATION. Ooening up a big hole, drain the abscess and stitch the mucosa (inside layer) of the abscess to the skin, creating an open wound. The wound can be flushed daily. (ILLUSTRATION OF THE PROCEDURE) SHOWING THE EVERTED WOUND WITH MUCOSA STITCHED TO SKIN.

4. The next step. EXTRACTION OF THE MOLAR (SEE -RAY) . The decayed tooth must be extracted using rodent-dental set. It may be near the ventral opening of the abscess and can be pulled out using forceps.








TIPS AND ADVICES
  • An abscess in the mouth or around the jaw may be a symptom of dental disease. Your vet may need to identify and remove any problematic teeth. Skull X-rays arf needed.
  • Get surgery if there is a jaw (dental) abscess. If the abscess is severe, your vet may recommend the more detailed surgery rather than incision and drainage.

    This surgery is called Encapsulated Abscess Removal. it will completely remove the abscess  This is needed when the vet cannot fully drain the abscess or if other, underlying problems are contributing to the abscess.

    The other surgery is called Marsupialisation. The vet makes a long surgical wound. He stitches the inside layer (mucosa) of the wound to the skin. The sutures will remain on your guinea pig for up to two weeks.  You will need to syringe saline into the wound to flush out any pus and debri daily for around 2 weeks. Let the vet know if you prefer him to do it in his practice.

    The guinea pig wears an Elizabeth collar to prevent scratching of the wound Painkillers will be prescribed. Hone nursing by daily cleaning of the wound is important.  
Medications are usually are delivered by mouth.
  • Baytril and Bactrim are the most common antibiotics given to guinea pigs.
  • If it is a fungal infection, he may be given Griseofulvin.
  • Many common antibiotics, such as Amoxycillin and tetracycline, are toxic to guinea pigs when given by mouth. However, they may be injected under some circumstances, as this has less impact on your pet's gut health. 
As guinea pigs are strictly herbivorous animals, one veterinary report the recommended antibiotic treatment for odontogenic abscesses is a combination of fluoroquinolones and metronidazole.

This is the end of Video 2/4.  Please follow through with Do guinea pigs suffer toothaches?  
Prevention. Video 4/4


FOR MORE INFORMATION: Phone 6254-3326, 9668-6468, judy@toapayohvets.com, www.toapayohvets.com
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Do guinea pigs suffer toothaches?  
Prevention. Video 4/4










Prevent the guinea pig from chewing or licking the wound. Your guinea pig or its cage mates may try to lick or nibble the area. If so, take a chewing deterrent (which you can buy at a pet store), and dab it around the wound. Do not put it in the wound itself.
  • Your vet may give you a special collar that you can put on your guinea pig to prevent it from chewing the wound.
TIPS AND ADVICES

1. FREQUENT INSPECTION.  check your guinea pig's jaw frequently feeling for any lump or swelling along the jaws.  They may be dental  abscesses.



2. WEIGH WEEKLY. Any weight loss will alert you to a possibility of overgrown incisors or molar spurs before dental abscess develops. 


5
Feed the guinea pig a healthy diet. The abscess may have caused your guinea pig to lose its appetite. As it recovers, it needs a healthy, well-rounded diet with plenty of Vitamin C. Offer your guinea pig its favorite treats during this period, and make sure it has plenty of water.[12]
  • Give your guinea pig softer hays to eat, such as oatmeal hay, instead of bristly or sharp hay. This will prevent future mouth and jaw abscesses. Hay should be 80% of the diet, not pellets.
  • Make sure that the pellets you feed the guinea pig are fortified with Vitamin C.
  • If your guinea pig refuses to eat, you should take it back to the vet. You may have to feed it with a syringe.


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https://www.youtube.com/watch?v=U_4advn9Gpc&feature=youtu.be
GUINEA PIG -
treatment


https://www.youtube.com/watch?v=TskAWOfFPVw&feature=youtu.be
summarisess the case history and diagnosis but not the treatment

clipping the overgrown front teeth
1:43 to

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In introduction or conclusion of the 4 videos,
USE SOME OF THESE IMAGES TO SHOW WHERE THE GUINEA PIG IS STAYING -  SINGAPORE SCENES













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