11.02.2014

Sneezing rabbit (skull rads)

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(Part of a discussion)

As for the skull radiographs: On the latero-lateral view the lower incisors are elongated (overgrown clinical crowns). Therefore the diagnosis normocclusion and normal dentition does not seem to be absolutely correct. If the incisors are overgrown, then the cheek teeth exhibit an intraoral elongation as well. This might be the consequence of lack of abrasive food or the consequence of an insufficient tooth wear (decreased use of the teeth). Looking at this radiograph we should take into consideration, that there appears to be some kind of a problem with the first upper cheek tooth (P2). The radiograph is very blurry on my screen, but I suspect an apical lysis of this tooth. Your latero-lateral view is slightly oblique (lower yellow arrow) and between the first and second left upper cheek tooth (P2 and P3) there is a lysis visible that might be tooth related (periodontitis?). If this is a right lateral view, than it should be an pathology affecting the first left maxillary premolar (P2). In addition to that, an dilated NLD is visible on the lateral view (yellow line) and both bullae tympanicae appear to be a little bit more radiodense than normal. Furthermore, the apex on one upper incisor is definitely pathologically changed. 

Summarized: it’s an indication for intraoral radiography (dental films and normal x-ray unit or flexible digital plates) in order to assess the upper incisors and both upper premolars (P2 and P3). Also recommendable might be a flushing of the NLD with a contrastmedium study of both ducts. So further diagnostic steps are needed. The owner gets this information and then he can decide where to go from here.  

Kind regards       Estella