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Real stories from our doctors: Suborbital Swelling Is Not Always Related to the Eye

Real stories from our doctors: Suborbital Swelling Is Not Always Related to the Eye

By Dan Massoff, DVM
Banfield Pet Hospital of Braintree

Other Health Issues Can Cause Swelling

Many times when a pet comes in with swelling near the eye, you might think the problem is related to the eye. Snoopy, a 4-year-old mixed breed dog, came in to us with a firm swelling just under his left eye. Otherwise he was acting normally according to his owner.

Possible diagnoses we considered were upper fourth premolar tooth abscess, facial abscess and cancer. Dental X-rays would have been ideal to determine the possible cause of the swelling but were declined by the owner. Snoopy was started on an antibiotic (clindamycin) and a pain medication (rimadyl), and a dental cleaning with the extraction of the tooth was scheduled for the following week.

When Snoopy came in for the dental, the swelling had subsided almost 90% confirming that there was an abscess of the fourth premolar tooth. With an infected tooth root, abscesses like these are likely to return after antibiotic therapy, so removal is necessary. Pre-anesthetic blood work was normal and the tooth was extracted using a gingival flap technique. Gingival flaps are commonly used in periodontal surgery to better expose roots of teeth, especially roots that are multiple and deep seated. The gum tissue is separated from the root of the teeth and folded back temporarily. Multiple roots are then sectioned with a drill and removed separately. The gum tissue is then closed with dissolvable sutures to close the hole.

Recovery went well and there were no complications. At-home care included offering only soft food for one week and a recheck of the mouth in two weeks. Oral antibiotics were continued after the surgery to reduce the chance for bacteria to enter the blood.

I’m happy to report that Snoopy is doing very well.