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Nasolacrimal Obstruction from Canine Tooth Root Abscess in a Cat
A D VA N C E S
val, nasolacrimal, neuro-ophthalmic, and uveal signs. In cats, pulpal exposure of the maxillary canine tooth leads to an apical periodontitis and may also cause external compression of the nasolacrimal duct lumen. Chronic involvement of the maxillary canine tooth in the cat may be misidentified as nasolacrimal signs or disease.
Objectives To report nasolacrimal obstruction caused by root abscess of the upper canine in a cat.
Case Report
NASOLACRIMAL OBSTRUCTION FROM CANINE TOOTH ROOT ABSCESS IN A CAT Background Excessive tearing and ocular discharge in cats may be the result of reflex hypersecretion, nasolacrimal pump failure, or nasolacrimal duct constriction or obstruction. Nasolacrimal obstructions may be intralumenal, intramural, or compressive extralumenal and can be categorized as congenital or acquired. Congenital abnormalities of the puncta, canaliculi, or nasolacrimal duct occur most frequently in young cats. Acquired nasolacrimal obstruction often occurs in the cat due to fibrosis and symblepharon of the nasolacrimal puncta following severe conjunctivitis. Other causes include dacryocystitis attributable to intralumenal foreign material, nasolacrimal inflammation or infection, and trauma to the nasolacrimal system. Inflammation, cysts, or neoplasia of adjacent periorbital or nasal tissue may also cause compressive extralumenal nasolacrimal duct obstruction. Ocular disease may occur in association with dental disease due to the proximity of the posterior maxillary teeth and the orbit. Ocular manifestation of dental disease include orbital, periorbital, conjuncti-
A 10-year-old, castrated male domestic short hair cat was presented with a history of chronic ocular discharge from the left eye. Ocular examination confirmed epiphora and mucopurulent discharge, but there were no apparent reasons for the ocular discharge. A cutaneous draining tract was not present in this case, and partial extralumenal nasolacrimal obstruction was observed via radiographs and unusual resistance to nasolacrimal duct irrigation. Nasolacrimal obstruction was suspected. The cat had swelling of the left side of the face, severe periodontal disease, and fractured upper left canine tooth with pulpal exposure. Dacryocystorhinography revealed narrowing of the nasolacrimal duct above the root of the fractured upper left canine tooth. Dental radiographs showed a severe periapical lucency at the apex of the upper left canine tooth. The fractured canine tooth was removed. Subsequently, the ocular discharge and facial swelling resolved and has not recurred in 2 years.
Author Conclusion Suspected root abscess resulted in extralumenal compression of the nasolacrimal duct in a cat. A thorough oral examination should be performed when nasolacrimal obstruction is evident.
Inclusions Three figures, 18 references.
Editor Annotation This report demonstrates the wide variety of ocular, periocular, and orbital diseases that can result in excessive tearing. Epiphora is excessive tearing as a result of lack of drainage of tears appropriately through the nasolacrimal system. Tear production is always independent from the production of aqueous humor, so tear
PAG E 7
PAG E 8
A D VA N C E S
test results and intraocular pressure measurements are not related. Patency and function of the nasolacrimal duct can be established if fluorescein dye passes from the tear film, down the nasolacrimal duct, and out the nose. In brachycephalic patients, be sure to look in their mouth for the presence of fluorescein dye, as many have accessory openings of the nasolacrimal duct into their mouth.
This case clearly demonstrates that proximity of the nasolacrimal system to many of the tooth roots in dogs, cats, and even exotic species. Dental disease in any of these species can results in blockage of the nasolacrimal system or orbital disease depending on the location of the affected tooth. A good oral examination and dental radiographs can be quite helpful in the diagnosis of periocular disease. In a young
animal, inflammatory or infectious disease is a more likely cause of periocular inflammation, while neoplasia is generally more common in an older animal. (REH) Anthony JMG, Sandmeyer LS and Laycock AR. Nasolacrimal obstruction caused by root abscess of the upper canine in a cat. Vet Ophthalmol 2010;13:106-109.
Journals Monitored • American Journal of Veterinary Research • Australian Veterinary Journal • Australian Veterinary Practitioner • Avian Diseases • British Veterinary Journal • Canadian Journal of Veterinary Research • Canadian Veterinary Journal • Journal of Avian Medicine and Surgery • Journal of the American Animal Hospital Association
• Journal of the American Veterinary Medical Association • Journal of Small Animal Practice • Journal of Small Exotic Animal Medicine • Journal of Veterinary Dentistry • Journal of Veterinary Emergency and Critical Care • Journal of Veterinary Internal Medicine • Journal of Veterinary Pharmacology and Therapeutics • Journal of Zoo and Wildlife Medicine • New Zealand Veterinary Journal
• Research in Veterinary Science • Veterinary and Comparative Orthopaedics and Traumatology • Veterinary Dermatology • Veterinary Immunology and Immunopathology • Veterinary Pathology • Veterinary Radiology & Ultrasound • Veterinary Record • Veterinary Research Communications • Veterinary Surgery ... and more than 20 others
val, nasolacrimal, neuro-ophthalmic, and uveal signs. In cats, pulpal exposure of the maxillary canine tooth leads to an apical periodontitis and may also cause external compression of the nasolacrimal duct lumen. Chronic involvement of the maxillary canine tooth in the cat may be misidentified as nasolacrimal signs or disease.
Objectives To report nasolacrimal obstruction caused by root abscess of the upper canine in a cat.
Case Report
NASOLACRIMAL OBSTRUCTION FROM CANINE TOOTH ROOT ABSCESS IN A CAT Background Excessive tearing and ocular discharge in cats may be the result of reflex hypersecretion, nasolacrimal pump failure, or nasolacrimal duct constriction or obstruction. Nasolacrimal obstructions may be intralumenal, intramural, or compressive extralumenal and can be categorized as congenital or acquired. Congenital abnormalities of the puncta, canaliculi, or nasolacrimal duct occur most frequently in young cats. Acquired nasolacrimal obstruction often occurs in the cat due to fibrosis and symblepharon of the nasolacrimal puncta following severe conjunctivitis. Other causes include dacryocystitis attributable to intralumenal foreign material, nasolacrimal inflammation or infection, and trauma to the nasolacrimal system. Inflammation, cysts, or neoplasia of adjacent periorbital or nasal tissue may also cause compressive extralumenal nasolacrimal duct obstruction. Ocular disease may occur in association with dental disease due to the proximity of the posterior maxillary teeth and the orbit. Ocular manifestation of dental disease include orbital, periorbital, conjuncti-
A 10-year-old, castrated male domestic short hair cat was presented with a history of chronic ocular discharge from the left eye. Ocular examination confirmed epiphora and mucopurulent discharge, but there were no apparent reasons for the ocular discharge. A cutaneous draining tract was not present in this case, and partial extralumenal nasolacrimal obstruction was observed via radiographs and unusual resistance to nasolacrimal duct irrigation. Nasolacrimal obstruction was suspected. The cat had swelling of the left side of the face, severe periodontal disease, and fractured upper left canine tooth with pulpal exposure. Dacryocystorhinography revealed narrowing of the nasolacrimal duct above the root of the fractured upper left canine tooth. Dental radiographs showed a severe periapical lucency at the apex of the upper left canine tooth. The fractured canine tooth was removed. Subsequently, the ocular discharge and facial swelling resolved and has not recurred in 2 years.
Author Conclusion Suspected root abscess resulted in extralumenal compression of the nasolacrimal duct in a cat. A thorough oral examination should be performed when nasolacrimal obstruction is evident.
Inclusions Three figures, 18 references.
Editor Annotation This report demonstrates the wide variety of ocular, periocular, and orbital diseases that can result in excessive tearing. Epiphora is excessive tearing as a result of lack of drainage of tears appropriately through the nasolacrimal system. Tear production is always independent from the production of aqueous humor, so tear
PAG E 7
PAG E 8
A D VA N C E S
test results and intraocular pressure measurements are not related. Patency and function of the nasolacrimal duct can be established if fluorescein dye passes from the tear film, down the nasolacrimal duct, and out the nose. In brachycephalic patients, be sure to look in their mouth for the presence of fluorescein dye, as many have accessory openings of the nasolacrimal duct into their mouth.
This case clearly demonstrates that proximity of the nasolacrimal system to many of the tooth roots in dogs, cats, and even exotic species. Dental disease in any of these species can results in blockage of the nasolacrimal system or orbital disease depending on the location of the affected tooth. A good oral examination and dental radiographs can be quite helpful in the diagnosis of periocular disease. In a young
animal, inflammatory or infectious disease is a more likely cause of periocular inflammation, while neoplasia is generally more common in an older animal. (REH) Anthony JMG, Sandmeyer LS and Laycock AR. Nasolacrimal obstruction caused by root abscess of the upper canine in a cat. Vet Ophthalmol 2010;13:106-109.
Journals Monitored • American Journal of Veterinary Research • Australian Veterinary Journal • Australian Veterinary Practitioner • Avian Diseases • British Veterinary Journal • Canadian Journal of Veterinary Research • Canadian Veterinary Journal • Journal of Avian Medicine and Surgery • Journal of the American Animal Hospital Association
• Journal of the American Veterinary Medical Association • Journal of Small Animal Practice • Journal of Small Exotic Animal Medicine • Journal of Veterinary Dentistry • Journal of Veterinary Emergency and Critical Care • Journal of Veterinary Internal Medicine • Journal of Veterinary Pharmacology and Therapeutics • Journal of Zoo and Wildlife Medicine • New Zealand Veterinary Journal
• Research in Veterinary Science • Veterinary and Comparative Orthopaedics and Traumatology • Veterinary Dermatology • Veterinary Immunology and Immunopathology • Veterinary Pathology • Veterinary Radiology & Ultrasound • Veterinary Record • Veterinary Research Communications • Veterinary Surgery ... and more than 20 others