One Bite Deserves Another

D. E. Larsen, DVM

“Doc, I know it’s late, but Rex is hurt pretty bad,” Reese said into the phone.

“What’s going on with him, Reese?” I asked.

Reese was an old rancher. He still worked a few cows, but his son did most of the hard work now. Reese was a big man, big all over. And his features were rough. He shaved about once a week, and wrinkles seemed to soften a once stern face.

“I was working a few cows tonight,” Reese said. “Old Rex, if they don’t do what he wants, he gets sort of mean. Rex grabbed this old black cow by her heel, and she kicked at him pretty hard. Old Rex, he ain’t smart enough to let go. She broke his mouth up pretty good.”

“Okay, Reese,” I said. “I can meet you at the clinic in a few minutes.”

I could see that Rex had a significant injury to his mouth when they came through the door. His mouth hung open, and the right side of his muzzle drooped lower than it should.

Rex was one of my working dogs. He was mostly Australian Shepherd but darker in color than was typical for that breed. He also was a little more aggressive with the cows that most dogs.

“He really did it to himself this time,” Reese said.

I lifted Rex onto the exam table. I always marveled at the bodies of these working dogs. Some would be considered heavy if you just looked at their weight. But these dogs were solid muscle. And tough as nails. Rex did not act like his injury was bothering him at all.

I lifted his right lip, what a mess. He had a fracture of his maxilla, his upper jaw bone. He must have had a hold on the cow’s foot when she kicked. His canine tooth acted like a lever, and it produced a flap of bone that contained his canine tooth, two incisor teeth, and two premolars. The fracture line ran down the right-center on the roof of his mouth. 

“This is a mess,” I said. “But it is probably good that you brought Rex in tonight. I think I can fix it with a couple of pins and several wires. He is going to be uncomfortable for a couple of months.”

“Do you think he is going to lose any teeth?” Reese asked.

“All these teeth are still set in bone,” I said. “It is the bone that is broken. We might need a little luck here. But I think this will repair okay. The problem is I am going to have a couple of wires running across the roof of his mouth, and that is going to bother him.”

“How long will he have those wire?” Reese asked.

“Probably six to eight weeks,” I said. “Now that I think about it, I will probably wire between a couple of sets of teeth also. Sometimes when we do that, we will lose a tooth or two. But that won’t bother him.”

“He doesn’t have to smile for any pictures,” Reese said. “He won’t care as long as he can get back to work.”

“I think it is a good thing that you brought him in tonight,” I said. “With this wound open on the roof of his mouth, it would be a mess by morning.”

“Are you planning to fix it tonight, Doc?” Reese asked.

“I think that it is something I can do by myself,” I said. “And he will be far better off if it is repaired tonight. I would guess he will be ready to go home in the morning.”

With that, I showed Reese out the door after I had him hold Rex while I placed an IV catheter and started a bag of fluids on a slow drip. I got things set up in surgery and then gave Rex a dose of Pentathol via the IV.

The repair went pretty well. The slab of bone with the 5 teeth fit snuggly into place. I secured it with a couple of pins that ran through to the other side of the mouth and then placed tension band wires that ran across the roof of the mouth to hold the slab of bone securely in place.

That was all I needed. I did wire the teeth on each end of the slab to their neighboring teeth. And then, I covered all the sharp ends of the pins and wires with dental acrylic. Hopefully, the acrylic will last for the full eight weeks.

Rex went home the following morning, looking none the worse for wear. I checked him every couple of weeks. The repair held up well, and at eight weeks, his x-rays showed good healing. 

We sedated Rex and pulled the pins and wires. There were a couple of minor abrasions in his mouth, but nothing that would not heal well.

“I think you can probably start treating Rex like a dog again,” I said when Reese was in to pick up Rex.

“I think that he can’t wait to get back to work,” Reese said. “I bet he is thinking he is going to get back at that old black cow.”

“I don’t know,” I said. “Maybe we should put a muzzle on him for a couple of weeks. I’m not sure this repair will hold up to another bite like the last one.”

“We ain’t going to make no sissy out of Rex,” Reese said.

It was a long week later that Reese had Rex back in the clinic. He had landed a bite on the heel of that same old black cow, and sure enough, the same slab of maxillary bone was hanging loose.

“Looks like we need to do the same thing again,” I said. “But this time, we are going to extract both of those upper canine teeth. That way, when he bites, he won’t be able to hang on, and there won’t be a big lever to brake that jaw.”

“That sounds good, Doc,” Reese said. “Because we ain’t going to slow old Rex down.”

Rex healed well, once again, and didn’t seem to notice his missing canine teeth.

Photo by Ivan Vershinin from Pexels