Osteomyelitis in Dogs

If your dog is having trouble eating or drinking, has a large growth on the face or mouth, or has very bad breath, you may be dealing with a case of osteomyelitis of the jawbone. It is important to get this seen by a veterinary professional right away because it is an extremely painful condition and could result in permanent damage to the bone or it can spread to other parts of the body, such as the brain. If you think your dog has osteomyelitis, you should call your veterinarian and set an appointment.

Osteomyelitis of the jaw is the inflammation of the jawbone (mandible or maxilla). This type of inflammation is most often caused by bacterial or fungal infection. It can also be caused by injury (bite or puncture wound), dental disease or infection, and decreased blood flow to the area. In addition, osteomyelitis can be considered acute or chronic. The osteomyelitis may be considered acute or chronic, depending on how long the infection has been allowed to continue. Acute osteomyelitis shows symptoms right away while the chronic form is slow to form with the symptoms showing up over several months. However, the infection is progressive and the acute stage turns into the chronic form of osteomyelitis of the jaw.

The symptoms of osteomyelitis can be acute or chronic. The acute form shows symptoms right away, but the chronic form is more gradual and hard to diagnose. However, the most common signs of either acute or chronic osteomyelitis include:

• Fever
• Pain and swelling of the mouth
• Lesions filled with blood or pus
• Dropping food from mouth
• Inability to eat or drink
• Lack of appetite
• Depression
• Weakness
• Pawing at mouth
• Whining
• Extreme lethargy

 Types

• Acute
• Chronic
• Bacterial (Brucella canis, Escherichia coli, Pasteurella, Proteus, Pseudomonas, Staphylococcus, Streptococcus)
• Fungal (Aspergillus, Blastomyces dermatitidis, Coccidioides immitis, Cryptococcus neoformans, Histoplasma capsulatum)

Osteomyelitis can be caused by many different bacteria, including

• Brucella canis
• Escherichia coli
• Pasteurella
• Proteus
• Pseudomonas
• Staphylococcus
• Streptococcus

There are also several different fungal diseases that can cause osteomyelitis of the jaw, but they are based on where you live.

• Aspergillus
• Blastomyces dermatitidis (southeastern USA
• Coccidioides immitis (southwestern USA)
• Cryptococcus neoformans
• Histoplasma capsulatum (central USA)

Other factors that can contribute to osteomyelitis are:

• Injury
• Dental problems (abscess)
• Bone necrosis

The veterinarian will need all the information about your pet’s condition, in detail. For example, tell her when you first noticed a problem, what symptoms you have noticed, and if your dog has been behaving abnormally. Bring your dog’s medical and shot records, if possible, and let the veterinarian know if you have given your pet any kind of medication. Some drugs can mask symptoms and make it more difficult to determine the diagnosis. The physical examination will be performed next, which will likely include heart and respiration rate, blood pressure, height, weight, body temperature, skin and coat condition, reflexes, pupil reaction time, breath sounds, and a comprehensive oral examination. The veterinarian will then use a very thin needle to collect some tissue from the area for microscopic evaluation and biopsy.

Diagnostic tests include a urinalysis, bacterial and fungal cultures, complete metabolic panel (CMP), blood count, biochemical analysis, and a packed cell volume (PCV). Other tests needed include radiography (x-rays) and possibly an ultrasound or MRI for a more detailed view. CT scans are also great tools for giving the veterinarian a three dimensional (3D) view of the jawbone.

Treatment depends on the cause of the osteomyelitis, but it usually includes medication, surgery, and observation.

Medication

The first step to recovery is intravenous (IV) antibiotics or antifungals, depending on the organism involved. Oral and topical antibiotics are also necessary in most situations.

Surgery

The veterinarian will flush the wound or infected area with saline, removing any necrotic or infected tissue and any debris. Draining the wound and grafting the bones involved comes next. The veterinarian will probably leave a tube inserted for drainage until the infection is cleared up. Aggressive antibiotic therapy using oral, intravenous, and topical is essential to recovery. Keeping the area clean is also extremely important.

Observation

The veterinarian will probably keep your dog in the hospital under sedation for 36-72 hours to let the jaw heal and will use a feeding tube to supply nourishment during the healing process.

In some cases, the infection is hard to get rid of and your dog may have to have future surgeries and extensive treatment. If the infection refuses to go away, removal of the bone may be the only choice.