Published in modified form in "Equus"
The first time we saw Missy, a 21 year old chestnut Quarter Horse mare, she was standing in knee deep grass with a 6 month old colt, a pasture
surprise. Her ribs and hip bones protruded and she had a body condition, BCS, score of 3.5. It was mid September, 2002, and as
veterinarians, we were concerned about the mare’s overall health going into winter. Dr. Jim Latham, my husband and partner, examined
her mouth. Missy had angled teeth in her lower jaw, and the opposing teeth were long and overgrown. She could barely chew. We made a
plan; Missy’s colt was weaned and her caretaker began feeding her senior concentrate slowly, increasing the amount each week. The
mare and colt were dewormed and we advised a complete dental procedure as soon as Missy had gained a little weight and her owner
okayed the procedure.
At the end of September, her owner brought Missy to our clinic. I pulled blood samples to send to the lab and we carefully gave Missy
a combination of intravenous sedatives and pain relievers before inserting the full mouth speculum in her mouth and setting her head in
the dental halter.
Missy’s 309 and 409 (first lower molars in the Triadan numbering system) were canted medially and her second lower molars (310, 410) were
canted laterally. She had a “wave mouth” and buccal (cheek) lacerations from her misplaced teeth and sharp points on others. Jim told Missy’s
owner to expect food to pack between these teeth, with eventual periodontal disease and abscessation. We advised that Missy stay on senior feed
with frequent dental examination. Jim carefully reduced the wave and floated sharp points with power dental tools. Missy had a slight “frown”
and Jim removed about 1/8 inch from the outer edges of her upper incisors to allow more lateral excursion in each direction of the jaw.
The lab work showed chronic inflammation in the liver, and slightly elevated fibrinogen, a protein confirming inflammation inside the body.
Malnutrition, GI disease and bile duct scarring were in our differential. Missy was not well, but we gave her time to eat with her newly
conformed teeth. In two months time, Missy had had gained weight and made it through the winter.
We saw Missy again in the spring of 2004. Once again, she was existing out on lush, irrigated pasture, but losing weight. A dental was again
advised but her owner worked out of town and times were tight. We didn’t see her until the spring of 2005. Her BCS had dropped to 2.5 and
her coat was patchy and ragged. Jim could feel loose teeth and holes where teeth were missing in her jaw. She had a rancid odor to her mouth
and she could not chew hay. We could almost see her wince as she tried.
We discussed Missy’s quality of life and considered compassionate euthanasia for this 24 year old mare, but Missy’s owner finally decided to
try one more dental procedure.
Missy had lost the inside half of tooth 308 and all of 310 and 311 (left lower molars) and Dr. Jim Latham performed extractions on 309 and 409 and
410 (right lowers). Her upper cheek teeth were all intact and overgrown and were carefully reduced. Jim prescribed oral antibiotics and an oral
flush for 30 days post dentistry.
Missy was maintained on significant amounts of senior feed (worked slowly up to 12 pounds daily until she regained weight to BCS of 5.5, with
whatever good quality grass and hay that she wanted to gum. The senior concentrate was then gradually tapered as she continued to improve.
Missy gained 60 pounds in 1 month post extractions and chewed grass and hay comfortably with her few remaining teeth. A few months later,
going into winter, she had packed on a few extra pounds. Her BCS was 7!
