updated April 19, 2009
PLEASE seek the advice of a licensed Veterinarian about your prairie dog's health!!
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What is Odontoma?
From what I have learned through the prairie dogs that I have shared my life with, other prairie dog pet owners, Vets that care for prairie dogs, and a few dental specialists, Odontoma is a benign odontogenic neoplasm that generally forms at the root of a tooth. It has been diagnosed in humans and other mammals, including prairie dogs. The general consensus is that it occurs following trauma to teeth, and is also believed to be genetic in some cases. The rate of progression varies among prairie dogs, but generally, symptoms begin to appear approximately two years from the date of injury. Since prairie dogs have continuously growing teeth, trauma puts them in a high risk category for odontomas. If tooth trauma occurs, the swelling of any surrounding soft tissue may inhibit the normal growth of the teeth and contribute to the formation of an odontoma. The tooth or teeth continue to grow, despite the injury, and begins to form a mass of hard bony appendage that over time grows up into the sinus cavity and eventually becomes part of the skull. One of the initial signs of odontoma is the appearance of short front teeth, or the disappearance of an incisor up to two years following tooth trauma. A tooth or both teeth may appear to be broken, or seem to be growing backwards and will look shorter than usual.
Odontoma is different than a malocclusion. It is important that Veterinarians and pet owners become familiar with this affliction because it is common with prairie dogs, and is often misdiagnosed because the first symptoms of Odontoma are usually a secondary infection in the sinuses. Most Odontoma cases can be linked to tooth trauma from plucking cage wires or from a fall, approximately two years after tooth trauma occurs. When a prairie dog falls, they land on their face. Although they are great at climbing, they have no depth perception because they have peripheral vision. Sometimes, during the capture of wild prairie dogs, especially if a grain vacuum is used to extract prairie dogs from their burrows at a very high rate of speed, permanent damage to their teeth and other bones occur if they survive at all.
Some of the clinical symptoms of Odontoma are not obvious early on, and in many cases, symptoms are not recognized until the Odontoma has reached later stages. A baseline digital radiograph of the sinus area is suggested with either the first Vet appointment or during spay/neuter surgery, because it offers a comparison should symptoms appear later on. The use of digital radiography allows for magnification to view the small areas in the skull of a prairie dog. The initial symptoms are usually a loss of appetite and a 'stuffy' nose, and it is common to observe frantic rubbing of the nose as though they're trying to remove a foreign object. I have found that antihistamines used for nasal congestion have a harsh affect on the intestinal health of the prairie dog and I do NOT recommend them. Since prairie dogs are nose breathers, a blocked sinus cavity forces them to learn to breathe with an open mouth. They are forced to learn to eat and drink unnaturally, and become distressed because it is a difficult adjustment for them. They often gasp and cough while eating or drinking, which can result in further discomfort from gastritis and bloating due to taking in excess air. Further complicating matters, missing or broken teeth will prohibit the prairie dog's ability to snip the hay that is necessary for the proper digestion that only occurs with a diet inclusive of long fiber. A proper diet is critical to the health and well-being of prairie dogs. GI stasis may result as a consequence of the lack of long fiber necessary for pushing food through their digestive track, and can be uncomfortable and often very painful. Fresh grass or wet strands of hay may be helpful in their diet and will help prevent GI upset on a short-term basis, but over time, will take a toll and cause the death of a prairie dog.
Pete [advanced Odontoma]
They may begin to isolate and withdraw, and do not understand what is happening to them. They want to retreat. Upon physical examination, the incisors may appear short, missing, crooked or broken, and if the teeth are abnormal and nasal symptoms are present, it may be an indication of Odontoma. With stress, exertion or excitability you may hear a 'honking' noise as they gasp for air, which resembles the sound of "croup" in human children. Their lack of appetite eventually begins to affect their weight. They must be syringe fed a nutritious blend of fiber, calories and liquid in order to sustain them. As the affliction advances, so does the nasal passage swelling. Commonly, one side of the nose will be congested and/or runny. You may observe either a total lack of interest in socializing, or an incessant need to be held. As the Odontoma progresses, the symptoms become more obvious and the prairie dog begins to literally suffocate because of the blocked airway.
The first step is to find a Veterinarian that is experienced and knowledgeable about Odontoma and prairie dogs. It is my wish that everyone who needs a caring, compassionate Vet for their pet prairie dog will find one, but as most of us know, they are few and far between. Fortunate are those of us who have found a caring Veterinarian who was willing to learn about the species. There are several wonderful Vets known across the U.S. (and beyond) who truly care about and are willing to help prairie dogs in need of medical care. Ideally, your Vet will ask you key questions, knowing that no one knows your pet like you do, and will want to learn more from you, and exchange information with other Vets. There are teaching hospitals throughout the United States that are available for consultations with other Veterinarians that would like to learn more about Odontoma. There are only a limited number of specialized dental Veterinarians and animal hospitals. Ideally, a CT scan or MRI are the best means of diagnosis, but due to the cost of such diagnostic testing, a digital radiograph is the preferred method of diagnosis. An injection of valium for sedation may be enough to get a clear radiograph, but if not, then isoflurane may be used. It is smooth and easy to control for all office procedures. Once a diagnosis is rendered, your Vet will discuss the options that are available to you and your pet, along with the medical, emotional and financial planning that will be inevitable.
There are many theories on the cause of Odontoma. Many prairie dog pet owners and Veterinarians have shared "theories" regarding the origination of Odontoma, but there is only one commonality: tooth trauma. Nothing written here is scientific fact, but rather a collective effort to share information with those, who like the rest of us, want to learn more.
Preventing tooth trauma is probably the best means of preventing odontoma in prairie dogs. Should tooth trauma occur, an anti-inflammatory should be given orally immediately, to minimize the swelling of the tissue, and digital radiography should be done immediately and then repeated in a month or two. Any changes can be easily noted with magnification.
Any time a prairie dog falls, has their teeth clipped, or repeatedly bites on a hard surface, their risk of the development of odontoma increases. In captivity, falls and biting cage wire are the leading cause of tooth trauma. Even though prairie dogs are great climbers, they have little or no depth perception and were designed to live on a flat prairie and travel in dirt tunnels. In their natural setting, trauma may occur as a prairie dog dives head first into a deep burrow to escape a predator and land on their face. To date, there is very little evidence that prairie dogs in the wild suffer from Odontoma (because they are known to dig down deep underground when they know that death is imminent), and skulls that have been found are generally found above ground. I believe that this affliction may also occur in their natural environment as well. It is my hope that one day biologists, dental experts and scientists will take a closer look at the cause of death in wild prairie dogs. If skeletal remains found in abandoned or deserted prairie dog towns, and well into the depths of the burrows could be closely examined and reported, we all might better understand this affliction and help all who suffer with Odontoma. Prairie dog lovers around the world want to see an end to Odontoma.
Below is a enlarged view of Fancy Girl's Odontoma growth post-mortem:
Continuously erupting (elodont) teeth, as in the case of prairie dog incisors, appear to be a relevant factor in Odontoma. Any healthy teeth in close proximity of the odontoma develop indentations or ridges from the impressions of the odontoma mass [see photo below of a trimmed, healthy tooth in close proximity of an odontoma]. The healthy tooth/teeth must be trimmed accordingly. Amazingly, this particular Odontoma [above] had not yet affected Fancy Girl's normal breathing capacity.
Is there a cure for Odontoma?
It is difficult enough to hear those dreaded words "your pet has Odontoma", but it is far worse to learn that there are very few options available, especially if the injury went untreated and symptoms show up two years later. Each option is painful for our beloved pets, and for us as well. With this horrible affliction, the prognosis is guarded and the pet owner is left to make a very difficult decision that they will have to live with. Some choose to go to great lengths and aggressively do whatever is medically possible to keep their loved ones around, no matter what the emotional, financial or physical cost. Others choose to keep their pet comfortable with supplements or treatments and continue with that regimen as long as quality of life exists. Eventually, a painstaking decision must be made to have their pet put to rest in a humane manner, with the assistance of a compassionate Veterinarian. Choosing to do nothing is not recommended.
Having several prairie dogs in my care that were afflicted with Odontoma, I have found a few simple treatments that provide comfort from symptoms associated with the disease. These options are very successful and those who are opposed to invasive surgery will be grateful for the results of this protocol. The administration of the following procedures will ease symptoms providing continued quality of life. Little Noses is an infant saline solution that I use daily. Keeping the nose clear is critical to their comfort level and ease of breathing. If the mucous hardens in the nasal canal, it becomes impacted and causes respiratory difficulty. I administer a couple of drops of the infant saline solution onto a cotton swab and pinch the excess liquid into a point, and gently insert the tip of the swab into the nasal passage with a twist. I then follow up with an infant nasal aspirator a couple of minutes later, and gently suction the mucous from each nostril. It generally takes three or four attempts on each nostril to successfully remove the mucous. They may protest initially, but quickly learn that this provides relief and actually look forward to your assistance. I have found this treatment to be the most effective method. Prescription Nasonex can also be used once or twice a week the same way (on a cotton swab) if the nasal tissue appears to be inflamed. These simple steps really do help.
The use of an oral steroid once or twice a week, (more frequently initially with a flare-up) such as (flavored) Prednilisone, is helpful in minimizing the inflammation of tissue around the odontoma and helps to increase their appetite. Some pet owners have found that injectable, long-acting steroids may prove to be beneficial in allowing easier breathing for their prairie dog, but I have seen better results with oral steroids. Taking the PD into a hot steamy bathroom with the shower running for 5 - 10 minutes helps in emergency situations. An oxygen (tent) for breathing treatments at home can bring added relief. Some Vets have prescribed nebulized Albuterol to bring some relief to a swollen bronchial passage. Oral Baytril may be administered for secondary (respiratory) infections that are often associated with the inflamed nasal passage. Due to the horrible taste of Baytril, ask your Vet to mix it with a flavoring or send you to a formulary for a special "flavor" mix for your pet. Any time *antibiotics are used, it is critical that the prairie dog is kept hydrated and that the flora in the intestinal tract is maintained. Benebac does not have adequate gut replacement, so please talk to your Vet about Probiocin to aid in maintaining a healthy digestive system following a regimen of antibiotics. Typically, a single dose of Probiocin following an antibiotic regimen is recommended.
Extraction of Odontoma is an option, but only if performed early on. Extraction is highly invasive and very painful for the prairie dog, but as the odontoma becomes part of the skull, the removal of such a large mass is not possible without shearing the tooth during extraction. In humans, extraction of an odontoma is not as difficult for two reasons: the spacing involved is larger, and the teeth do not continuously grow. The limited space and minute body parts make this a very invasive procedure on a prairie dog. If it is performed early enough, it can be successful, and months can be added to their life, but a specialized diet and regular dental checks are crucial to the health and well being of the prairie dog. Specialized diet, as mentioned earlier, is imperative and requires creative means of assisting the prairie dog with long fiber intake to prevent GI stasis.
An option in later stages of Odontoma is a Tracheostomy Surgical Procedure. This procedure has been around for years, and is also very painful, where an air "bypass" or better known as a "blow hole" or "shunt" is surgically placed in the sinus cavity. This procedure requires a serious commitment in the weekly care and cleaning of the area. This procedure requires intensive care and specialized dietary needs for the remainder of your pet's life. At best, if either of these procedures are successful, the prairie dog may gain an additional year of life; and on a rare occasion, a few additional years, as long as the specialized required diet is maintained.
It's best to adopt an educated approach to this affliction, because of the possibility that you may have to face a diagnosis with your beloved pet prairie dog one day. Knowing in advance about prevention, symptoms, treatment and prognosis, will aid in the preparation of, and aid in the decision making process without the intense emotion and sense of urgency that overwhelms a PD pet owner when confronted with a diagnosis of Odontoma. Most pet owners that have gone through with the surgeries concur that it may prolong their life for a little while, if they do survive, but that the quality of life never returns to the way it was before Odontoma. Remember, there may not be a CURE, but I believe that early detection and prevention of tooth trauma may be a big part of the solution.
In summation, whether we choose to fight with all of our being to keep our precious family members with us longer and make them comfortable until the quality of life diminishes; or opt for surgery; the prognosis is the same. Ultimately, the decision we make regarding this affliction must be one that we can live with.
What kind of diet is recommended for prairie dogs with Odontoma?
A normal diet can be followed as long as they have their upper and lower incisors. For those who are missing their snipping teeth, I have found a diet that provides adequate nutrition that includes daily supplemental syringe feedings (warmed) of a mixture of pureed sweet potatoes, peas and Oxbow Animal Health's apple/banana flavored Critical Care (contains fiber, an appetite stimulant, and additional nutrients). Ideally, a 35 cc syringe full once a day will provide adequate nutrition. I always provide a bowl of Oxbow Essentials Adult Rabbit food and Oxbow Essentials Healthy Handfuls (sold as Hamster & Gerbil diet). Hay and grass must be snipped into tiny pieces for those who are missing front incisors (snipping teeth) and even better if pureed to prevent choking. It is imperative to make necessary provisions if they are unable to eat the way they are accustomed to eating in order to maintain a healthy intestinal tract. Timothy hay cubes (crushed), Quaker Old Fashioned oats, dandelions (in season) and raw pecans are good choices for treats for those who require additional calories. Since they are able to chew with back teeth, raw corn (never dried), small pieces of red delicious apple, a blueberry, peas, veggie yogurt drops (sold for rabbits), raw green beans or Edamame.
Don't forget to say your prayer-ee dog prayers!