Case Story: Rogal and a CT Scan…
Rogal is a 1.5-year-old male entire whippet that had acute onset pain on the right side of his jaw. Rogal seemed painful when eating or yawning, and even when his owner stroked him on the right side of his head.
Rogal had otherwise always been a very healthy boy! His physical examination was normal except for discomfort when opening his mouth and a mild fever. He was initially given a one-week course of anti-inflammatories but when there was no improvement further investigations were recommended.
Rogal had full pre-operative bloods and a computerized tomography scan (CT) of his head under general anaesthetic. Biopsies of his temporal muscles (the muscles on his head) were also taken under the same anaesthetic as an autoimmune condition causing masticatory muscle pain (masticatory muscle myositis, or MMM) was considered a possible explanation of his clinical signs. Rogal’s blood results were normal except for a mild inflammatory pattern. His head CT showed a focal fluid-filled swelling surrounding his right temporomandibular joint- this is the joint that allows the mouth to open and close comfortably. The findings of the CT were most consistent with a migrating foreign body with secondary abscess formation (or infection) and inflammation. Moreover, his right sided tympanic membrane (the membrane found between the outer ear canal and the middle ear) was ruptured so possibly the foreign object entered through his ear canal, though most foreign objects usually enter through the mouth.
Some foreign body abscesses respond to medical treatment alone with antibiotics and pain relief, while others require surgical intervention to drain and flush the abscess and try and remove the offending object. Rogal was started on a 10-day course of antibiotics and luckily improved almost immediately. Rogal finished his antibiotic course 4 weeks ago and has had no further recurrence of his clinical signs! We are happy to report that Rogal is doing well and remains pain free!
