Vimago HDVI Dental Zooey
Vimago™ 12 Case Types – Right Mandibular Severe Lysis | Canine | Other | 7 years | Spayed, Female | 23 kg
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A seven-year-old mix breed canine patient weighing 23kg presented for mandibular mass first noticed by the pet owner. The patient was eating and drinking well but was showing signs of discomfort with a quivering jaw. The DVM used their Vimago™ HDVI CT to perform a scan of the skull to gather more information.
CT findings and reports are provided by Peregrine Radiology.
Here is a link to the full radiology report.
Clinical Findings History & Clinical Signs Referral from REDACTED FOR PRIVACY. Evaluated 11/23/2020 for evaluation of mandibular mass first noted by owner ~11/16/2020, growing quickly according to owner. Mass description: mandibular pink raised gingival mass 1.5 cm and firm swelling on rostral mandible bilaterally from canine to canine. History of Prednisone administration at 10mg BID for ~48 hours prior to oncology referral. Pet eating/drinking well, showing no sign of discomfort other than quivering jaw more.
Current Medications
DENAMARIN TABLET 425MG 11/23/2020Please give 1 tablet by mouth every 24 hours. Give 30 minutes before food or other medications. Liver Protectant.
Buprenorphine suspension 0.5mg/ml 120 ml 11/23/2020Please give 0.5mls by mouth every 8-12 hours for pain. CAN CAUSE SEDATION.
Deramaxx Chew tab 75 mg 11/23/2020Please give 1/2 tablet every 24 hours for pain and inflammation. NSAID. DO NOT GIVE WITH STEROIDS. DO NOT STOP SUDDENLY.
Gabapentin Capsules 100 mg 11/23/2020Please give 1-2 capsules by mouth every 8-12 hours for pain. CAN CAUSE SEDATION. Drugs or Sedation Used Dexdom/Hydromorphone IM premed; propofol IV induction; sevo maintenance Number of Images Submitted 67.0mL Omnipaque 300ug/mL IV contrast
CT Report Findings Survey and post-i.v. contrast CT of the skull
Nasal Cavity: No fluid or mass seen. No turbinate lysis or deviation or lysis of the septum
Oral cavity: Mass: expansile mass associated with right rostral mandible; lesion is centered on tooth 404. Aggressive appearing , mandible lysis and spiculated periosteal proliferation. 2.5 cm long x 2 cm wide, gross margins limited by symphysis. Caudally extends into region of tooth 405
Dentition: normal appearing. No periodontal lysis is seen. No missing teeth seen
Orbital structures appear normal.
Frontal sinuses: Right side and left side air filled. No frontal bone lysis seen
Ventral nasal meatus: air filled
Nasopharynx: air filled
Nasal vault: No maxilla, nasal bone or hard palate lysis seen
Cribriform plate: no lysis seen
Brain: No evidence of aberrant meningeal contrast enhancement or deviation of the falx. Pituitary gland normal size (6.0 mm tall)
Tympanic Bullae: air filled and no bulla wall lysis or thickening seen. hyperostotic tympanic bone spicules (HTBS)
External ear canals: air filled and no wall thickening Temporomandibular joints (TMJ's) appear normal
Mandibular LN's: symmetrical normal shape and size (5.3 mm wide)
Medial retropharyngeal LN's: symmetrical normal shape and size (5.0 mm wide)
Conclusion
Oral mass: aggressive, right side, mandible; consider
neoplasia: SCC, melanoma, FSA
tooth based neoplasia (e.g., epulis)
periapical abscess thought less likely Recommendations incisional biopsy pending histology, 1 cm excisional margins would include tooth 304 and 406