Surgical Management of Osteomyelitis and Dental Disease in a Bottlenose Dolphin (Tursiops truncatus) Using General Anesthesia
Dental disease has been reported both in wild and managed cetaceans.1-4 Management of these cases poses unique challenges due to limitations with providing adequate sedation and analgesia. Various protocols and techniques have been employed in an effort to improve dental care for cetaceans.2,5-8
This case report describes a 37-year-old male bottlenose dolphin with chronic dental disease affecting the maxillary and mandibular arcades bilaterally. Multiple dental procedures using benzodiazepine sedation and local or regional anesthesia have been performed over the past 30 years. Treatments have included numerous dental extractions, debridement of oral draining tracts, and periodic systemic antimicrobial therapy.
Recent serial skull radiographs revealed multiple subgingival tooth fragments, widening of pulp canals, periapical lysis, and evidence of progressive maxillary and mandibular osteomyelitis. The presence of persistent draining tracts yielding repeated positive cultures of Actinomyces sp. and Peptostreptococcus sp. also warranted more aggressive oral surgery. Due to the limitations and risks associated with performing dental care using only sedation and local analgesia, the decision was made to perform a series of oral surgery procedures under general anesthesia.9
Within the last eight months, two oral surgery procedures were successfully performed under general anesthesia. The anesthetic protocol used provided the ability to perform multiple dental extractions, tissue debridement, and the collection of samples for laboratory diagnostics. The application of mesenchymal stem cells and platelet-rich plasma (PRP) to surgical sites was also used.10
The authors are sincerely grateful to all the trainers, records office, and veterinary staff for their continued dedication to this animal's health care. Special thanks to Lieutenant Colonel Shannon Wallace and the U.S. Army Veterinary Corps for their dedicated service and support to the U.S. Navy's Marine Mammal Program. We also thank Sarah Sharp and Whitney Greene for their assistance with the clinical management and surgical preparation of this case.
* Presenting author
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