Ella is our Pet of the Month for April 2025. She’s an 11-year-old spayed female Springer Spaniel. Last summer she was seen for a routine wellness exam, and because of her age, we opted to check some baseline blood and urine samples. When the results came back, Ella had a significant increase in total white blood cells which suggested an infection somewhere. This was unexpected and unusual as we didn’t have any indication of her not feeling well, nor any outward signs of wounds. We had blood work from the previous year to use as a comparison so we knew this was not just normal variation.
White blood cells are part of the immune system and help to fight off infections. There is a range of ‘normal’ and values can fluctuate for a variety of reasons. However, in Ella’s case, the increase was more than typical variation. Since Ella was feeling fine, we opted to start with checking a urine culture & sensitivity to ensure that she didn’t have a urinary tract infection. In older patients, sometimes the infection ends up affecting the kidneys, but her kidney values were fine. The urine culture showed no growth of bacteria and the sample was well concentrated with no signs of abnormal cells. We needed to look further for the cause of the leukocytosis and neutrophilia.
We decided to admit Ella to the hospital for baseline radiographs of both her chest and abdomen, and to check an ECG to evaluate heart function. We hoped to get a better idea of what was happening internally. Since the radiograph positioning would necessitate sedation, we planned to proceed with a dental cleaning and assessment if the initial results of her testing was normal.
As can be common for older dogs, the radiographs, she had some old-age related changes in the lungs, evidence of osteoarthritis in her left elbow and a mild increase in the size of her spleen, thought to be related with the sedation drugs. An ECG showed a normal electrical tracing of her heart and there was no murmur or arrhythmia heard.
Ella was fully anesthetized so that we could get photos of the teeth, take full-mouth radiographs and chart the teeth for pocketing and/or damaged teeth. Surprisingly, we discovered that she had abscesses at the roots of both of the largest upper back teeth – #108 and #208.
The photos above show the right and left side of Ella’s mouth after the teeth were cleaned and polished. Compare these pictures to what we found when we took the dental radiographs and charted her teeth by checking with a probe beneath the gum line.
Normally the gingival depth is about 2-3mm. On the specific teeth the probe penetrated to a depth of 8-9mm, which you can see on the radiographs is all the way to the tip of the tooth root. These are 3-rooted teeth and are commonly damaged or broken when dogs chew on hard objects like rock, antlers and bones. The abscessed teeth were causing the increase in Ella’s white blood cell count. She also had infection of a smaller premolar on the upper right side, where there was loss of bone and exposure of the roots. Visually, when looking at each of these teeth they appeared normal; it was the probing and the radiographs that helped us with the diagnosis. Without the change on her bloodwork, we likely would not have known about the infected teeth until Ella was quite painful and showing obvious symptoms. Tooth root abscesses frequently cause facial swelling as the infection progresses.
The photo shows the probe on the inside aspect of the upper tooth – both right and left sides. The associated radiograph shows the pocket of infection we found, and on the left side the dental probe shows how deep the pocket of infection is – all the way to the tip of the roots.
The photo shows the second upper right premolar and associated radiograph. Tooth #106 looked fairly normal until we did the charting and probing. Bone loss underneath the gum line caused exposure of the roots as evidenced by the probe going all the way through; the tooth was extracted.
Due to time constraints, Ella’s age, and the additional anesthesia time required to extract these teeth, we elected to have her come back for the extractions. She recovered fine from the anesthesia and went home with antibiotics. A week and half later Ella returned for the extraction procedure.
Both upper carnassial teeth, #108 and #208 were extracted along with the second premolar #106. When we removed the upper large teeth, we found pieces of plant material in the pockets. The owner later told us that Ella loves to chew on the bamboo in their yard. Apparently in her enthusiasm she got some of the bamboo trapped below the gumline. This is similar to people getting popcorn hulls stuck between their teeth or under the gums. Dental floss helps us, but unfortunately for dogs, the trapped material leads to abscessed teeth.
Here’s a picture of one of the bamboo fragments we found in up in the tooth abscess pocket. Here’s Ella (on the right) and George (her younger compatriot) enjoying the outdoors.
Following tooth extractions, beyond pain meds, pets should be on soft foods while the gums are healing. They need to avoid hard food and chew toys for several weeks which can sometimes be the hardest part. Once the gums are completely healed, pets do great even if they are missing a few teeth. They have no problems eating and they generally don’t mind that they have a gap in their mouths!
We are happy to report that Ella is doing great, the extraction sites have healed well and the bamboo is no longer accessible.
~ by Dr. Robin Riedinger ~
