Cameo—For the Life of a Horse
Published in modified form in "Equus"

We met Cameo when she was five years old, a tall, strong dappled grey mare. But her ribs were showing, her BCS (body condition score) only 4 at 1079 pounds, and her owner, Pat, had done her best to feed her well. The mare had been losing weight over the past two months. Pat asked for help.

Cameo had been kicked on the right side of her face one year before, near her facial crest, fracturing the bones of her upper jaw and displacing them to the inside. Her right eye had been crushed and later surgically removed. The mandible, the lower jaw was displaced three teeth to the left and her right temporomandibular joint, the TMJ, was destroyed. The jaws had healed that way.

Pat brought Cameo to our clinic barn in May of 2002, and we slowly introduced her to the stocks. She viewed them with great concern. We used gentle trailer-loading techniques to get her in, along with a bucket of concentrate.

We sedated Cameo with Dormosedan and Xylazine and gave her IV Bute. Jim blocked and treated her left TMJ to see if we could increase her jaw opening and relieve discomfort. At this point she could only chew left to right, the overgrown right upper cheek teeth locked when she tried to chew the other way. Jim couldn’t get a full mouth speculum in Cameo’s mouth. We could only use a wedge. We took a look inside.

Because of the misalignment of jaws the right maxilla, the upper jaw, overlapped the displaced right mandible much more than normal, creating a one-sided shear mouth and an abrupt angle to the occlusal surfaces that Cameo used to chew her food. There was severe overgrowth of the right cheek teeth with long, sharp points on the outside of the upper teeth and the inside of the lower. Cameo’s jaw only opened about 30% of normal and she had hooks on her right front upper premolar and her right last mandibular molar.

Cameo’s first dental work involved removing the right sided hooks, front and back, and reducing the points on the right maxillary arcade. Jim used a flattened “S-float” with carbide chips to reach as much of the lingual (inside) points on the right lower cheek teeth as possible. The work on the left arcades was nearly routine. The left lower incisors and right uppers were also overgrowing in a crooked line as Cameo tried to eat in one direction. Jim reduced the overgrowth about 1/8th inch and planned more in the future.

When Jim was done, Cameo could move her jaw both directions. We suggested starting the mare on senior feeds which would be easier to chew, and continued her on pasture and supplemental hay. We scheduled an appointment in the fall.

Pat brought Cameo in September and even risked the snow-covered roads in January in 2003. She went right in the stocks each time. Cameo’s teeth continued to overgrow on the upper right outer edge and the accentuated angle of her mastication (chewing) was wearing the outside edges of the lower right cheek teeth nearly to the gums. Her unopposed left lower incisors and right upper incisors continued to grow long. There was always work to do and little room to do it in. But Cameo now weighed 1128 pounds and her BCS had increased to 5.5.

Pat tried to manage Cameo’s weight with senior feed and hay, and they made it through winter and onto summer grass. Cameo’s teeth remained a challenge, the opening of her mouth a bigger problem all the time. We saw her every six months, using flattened hand floats to get between the jaws.

In the fall of 2004, Cameo had once again lost weight. She hadn’t maintained herself on pasture without supplemental feed and the inside of the right upper and outside of the lower right arcades were worn close to the gum line because of the acute angle of her chewing. Her jaw could only open 25% of normal and we had serious concerns about periodontal disease developing on the right. But Cameo made it through the winter once again, gaining weight and condition. We treated her in June.

In November of 2005, Jim was able to float the last 3 cheek teeth on the lower right much more effectively than ever before by using a rotary disk float instead of a rotary burr, despite Cameo’s very limited jaw opening. He once again removed her hooks and carefully leveled her mismatched incisors, removing about 1/8 inch of tooth where needed. He treated her left TMJ with triamcinolone. Two days later, Pat reported that Cameo was eating her feed with gusto, in much less time, and planning on putting on weight for the winter. We continued to treat her three or four times a year.

At Thanksgiving, 2009, Cameo was able to open her jaws sufficiently for Jim to float all the surfaces of her teeth, and we now only plan to see her once every 8 or 9 months. Cameo is the happiest hay burner that she has been for years.
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