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Oral Surgery

Oronasal Fistulas

This is a term used to describe a hole or communication between the oral cavity (mouth) and the sinuses. When you have such a fistula or hole it allows mucus from the sinus to drain into the mouth. It also allows liquids (saliva, water, etc.) from the mouth to go up into the sinuses (often seen as dripping or drainage from the dog’s nose).

Clinical Symptoms

Patients with oronasal fistulas may present with a variety of symptoms. The owner may notice sporadic or chronic sneezing. There may be a nasal discharge from one or both nostrils. Sometimes patients will present with no clinical signs indicating the importance of thorough examinations and periodic teeth cleanings.

Causes of Oronasal Fistulas

The most common cause of oronasal fistulas is from periodontal disease that has led to bone loss around the tooth resulting in fistula development. Other causes of oronasal fistulas include complications from past extractions, foreign-body penetration, bite wounds, neoplasia as well as Inherited or developmental clefts of the lip or palate.

Because periodontal disease is the most common cause for oronasal fistulas regular exams and teeth cleanings can’t be emphasized enough. Dachshunds are frequently affected. In these cases, bone loss is often present adjacent to the upper canine teeth.

Treatment

Treatment requires the extraction of the tooth where the fistula is located. Merely extracting the tooth will not lead to closure and healing, instead a hole will remain between the mouth and the sinuses if additional surgery is not performed to close the fistula. Again, to avoid the development of these lesions, early recognition and appropriate therapy is required.

After the tooth is extracted, a mucogingival (tissue) flap is created so that the defect can be covered so that the fistula will heal. The flap must be designed to allow maximal blood supply (tissue perfusion) to the defect that it is being created for, and must be sized so that the flap is tension-free- otherwise the flap will not heal. A skilled surgeon is required to ensure that the flap will heal.

Summary

There are many different causes of oronasal fistulas. The fistulas can occur in both dogs and cats. Symptoms of fistulas vary but most commonly include nasal drainage and or sneezing. Proper diagnosis and treatment if important. Oronasal fistulas should be treated because appropriate treatment can dramatically improve the quality of the patient’s life.

Dr. Bonnie Bloom

Dr. Bonnie Bloom, a Fellow of the Academy of Veterinary Dentistry, has completed a residency in veterinary dentistry and offers the newest and most innovative techniques for treatment of periodontal disease, tooth and jaw fractures, orthodontics and general dental care.


Dr. Ken Karger

Dr. Ken Karger, (human dentist) works with Dr. Bloom to contribute to our veterinary dental practice with the incorporation of advanced human dental techniques. He graduated from Baylor Dental College in 1983 with a Doctor of Dental Surgery degree. He has practiced dentistry in the metroplex for the past 28 years, winning 6 International Awards from the Academy of cosmetic Dentistry for Advanced cosmetic makeovers. He also enjoyed serving as the official dentist for ms. Texas for over a decade. Dr. Karger has lectured across the country in cosmetic dentistry and practice management, recently giving two lectures with Dr. Bloom to the Veterinary Dental Forum in Boston on dental materials advanced crown preparations.


Laura Roberts says...

I brought in a stray that had been hit by a car. The care was immediate and excellent. I was very impressed with the facility and quality of service. Thanks so much for the crate to transport him. It was very helpful!

Richard Jezek says...

High five kudos to Dr. Killman! She, with the help of the entire treating staff saved our TomTom’s life! Dr. Killman, Dr. Welch and Dr. Smith have renewed my faith in the caring veterinarian that we were looking for.

Brenda Rowland says...

Would like to thank the staff and doctors for the great care they gave our Tabby. The care given to Tabby was so kind and courteous. I am so grateful I chose I-20 Animal Medical Center.

Laura and Ricardo Grant & Nunook say...

Dr. Doherty and all of the vet techs that helped Nunook were so great. Words cannot convey how much we appreciate the great work everyone did for Nunook. He is our baby and he makes our family whole. Thank you for all that you do.

Marcia Marrow says...

Dr. Welch is amazing. She has a very calming nature, just what I needed when my Lhasa Apso was injured by a pit bull. She clearly explained everything in an understandable way. She also checked in with us (while we were there) to let us know what was going on. Thank you very much!

R. and B. Boone say...

The technical staff in the ICU is excellent and equally professional in providing the care, we feel, brought about Brandi’s recovery.

Don and Holly Michel say...

I20 is the greatest !! They gave us four extra years with our precious Yorkie, Cujo, and are helping us take care of our other precious Yorkie, Carrie, who is diabetic. They are deep in our hearts.

Alicia Patterson & Percy said...

I cannot thank you enough for everything the doctor and the rest of I-20 Animal Medical Center did to save my cat, Percy. Your care and compassion for my family during this emotional time was overwhelming.

Michelle & Greg Lacy say...

Greg and I could not be any more pleased with I20 Animal Medical Center for always being there for us when we need you most!

Yvonne Fiore says...

This was our first experience at I-20 Animal Medical Center. I was so impressed by Dr. Bloom, her real care, concern and understanding for my Cinnamon. My pets have been as loved as my children, thus, I expect excellent loving care and I and Cinnamon got this per Dr. Bloom and Jessica. Thank you!

Kristin Rush says...

The staff was wonderful and you can tell that they are real animal lovers. They were very thorough when checking out my dog and I didn’t feel at all like Jack was “just another dog”. They genuinely cared and explained everything very well. Loved them

Heather Matson says...

I have recommended I-20 to friends due to the compassionate and wonderful service we have received. Thank you for everything you have done for us. The doctors are wonderful as well as the techs and the rest of the staff. Thank you

Rhonda Holley says...

I have been to lots of vet clinics. Yours is the best in every way that I have ever seen! Thanks for restoring my faith in excellent veterinary care!

Matt Smoot says...

Dr. Bloom is wonderful! She put our mind at ease and alleviated all of our concerns about Spice’s surgery. We plan on using her for all of our pet’s needs in the future and will highly recommend her services to our friends and family! Thank you I-20 Animal Medical Center.

Staci Thomas says...

The service was amazing! I came in as a referral for a critical condition. I was extremely upset and concerned about my pet’s life. The staff quickly attended to us making efforts to stabilize Sebastian and provide me with a quiet and calm area. I really appreciated the service I received

Leah and Ron Bullard say...

We very much appreciate the skill and training you have and it was very evident in the procedures you performed on our dogs. Each of them had issues, some serious, and each of them are much better now, thanks to you and your staff.

Valerie Jordan says......

My family and I were so impressed by every contact we had with the staff. I have been to medical doctors for procedures and did not get such service. I have already called family members and recommended you guys, keep up the great work!

Maryann Livengood says....

The staff was extremely concerned and courteous- Dr. Stinson saved my cat's life! Also pricing extremely reasonable for a 24-hr care facility.

Paula Emmons says....

I-20 Animal Medical Center is amazing!! All the doctors, technicians and staff are the best. We had to take one of our dogs in for an emergency and everyone who helped us was great with our dog and with us. They encouraged us to call when we had to leave him and always answered and updated us on how he was doing through the nigh (even with many calls in a very short amount of time). The next morning Dr. Welch called and said that they had found something. She told us that Mikey was not going to make it and let us have hours to say goodbye. They answered all our questions and never once made us feel like we were imposing on her or her time. We have found a new clinic for all our dogs because of Dr. Welch and all the staff

Save A Mexican Mutt Rescue says...

I would like to thank the staff of I-20 for a great experience with one of our rescue dogs, Cuervo. Shortly after his rescue, we realized he had a broken canine tooth that would require a root canal. For sure we were not going to find a veterinary dentist in Mexico. So, I-20 Animal Medical Center came to the rescue! Dr. Bonnie Bloom and Dr. Ken Karger took great care of Cuervo upon our arrival. The staff at I-20 is always so friendly, professional, and socially in tune to rescue.

Jim and Kay Marshall say...

Excellent Care! I highly recommend you to our friends. Thanks to all the staff, especially Dr. Welch - we have a healthy dog once again. The love you and the girls showered on Rainey showed me how much you all love animals.

Janice Bunting with Tye says...

Our vet Dr. Litsey, referred us to you when Tye needed special boarding. We were very pleased with his care. We also really appreciated the staff's willingness to talk with us every time we called the ICU to check on him. It made it so much easier to be away from him. He came home a healthier and spunkier dog. Dr. Long was great with Tye and felt she took very good care to properly diagnose his condition and treatment.

Dave and Pamela Reitzel say….

“Cutie was a stray. When I took Cutie to I-20 Animal they were concerned for her health, and made arrangements to see her the next day. I-20 Animal set me at ease about Cutie after her exam. Now knowing that she is and was in good hands, I-20 Animal will be where I will take both my pets. VERY IMPRESSED!!.”

Nancy Schultz says…

“The doctor called the next day to check on Sophie and was genuinely interested in how she was doing. Very well done”

James Jacobs says...

“Huge thanks to the staff and doctors for the excellent care that Sasha received. The explanations about her care and pricing were first class. Thank you once again”

J. Headland says...

I cannot say enough how great Dr. Stinson and the staff were with Dirk and explaining the procedures. We have found a "new" place that I feel confident will take care of and actually care about Dirk. I have and will continue to tell our firends, family and co-workers how much we love I-20 Animal Medical Center.

LaTonya Thomas says...

"Shasha get's excited every time we exit the freeway to come to the I-20 Animal Clinic. Everyone there is so friendly and concerned about my pet's well being. Thank you all for such outstanding service."

J. Beed says...

"I just wanted to say thanks for your help yesterday! Mr. Fluffers had a great time getting his shots and I actually think he wanted to go back instead of driving home! :) Lauren and Kimberly were great! I'm sure Mr. Fluffers hopes to see them when he gets his booster in a few weeks. Thanks again!"

Laura Roberts says...

I brought in a stray that had been hit by a car. The care was immediate and excellent. I was very impressed with the facility and quality of service. Thanks so much for the crate to transport him. It was very helpful!

Richard Jezek says...

High five kudos to Dr. Killman! She, with the help of the entire treating staff saved our TomTom’s life! Dr. Killman, Dr. Welch and Dr. Smith have renewed my faith in the caring veterinarian that we were looking for.

Brenda Rowland says...

Would like to thank the staff and doctors for the great care they gave our Tabby. The care given to Tabby was so kind and courteous. I am so grateful I chose I-20 Animal Medical Center.

Laura and Ricardo Grant & Nunook say...

Dr. Doherty and all of the vet techs that helped Nunook were so great. Words cannot convey how much we appreciate the great work everyone did for Nunook. He is our baby and he makes our family whole. Thank you for all that you do.

Marcia Marrow says...

Dr. Welch is amazing. She has a very calming nature, just what I needed when my Lhasa Apso was injured by a pit bull. She clearly explained everything in an understandable way. She also checked in with us (while we were there) to let us know what was going on. Thank you very much!

R. and B. Boone say...

The technical staff in the ICU is excellent and equally professional in providing the care, we feel, brought about Brandi’s recovery.

Don and Holly Michel say...

I20 is the greatest !! They gave us four extra years with our precious Yorkie, Cujo, and are helping us take care of our other precious Yorkie, Carrie, who is diabetic. They are deep in our hearts.

Alicia Patterson & Percy said...

I cannot thank you enough for everything the doctor and the rest of I-20 Animal Medical Center did to save my cat, Percy. Your care and compassion for my family during this emotional time was overwhelming.

Michelle & Greg Lacy say...

Greg and I could not be any more pleased with I20 Animal Medical Center for always being there for us when we need you most!

Yvonne Fiore says...

This was our first experience at I-20 Animal Medical Center. I was so impressed by Dr. Bloom, her real care, concern and understanding for my Cinnamon. My pets have been as loved as my children, thus, I expect excellent loving care and I and Cinnamon got this per Dr. Bloom and Jessica. Thank you!

Kristin Rush says...

The staff was wonderful and you can tell that they are real animal lovers. They were very thorough when checking out my dog and I didn’t feel at all like Jack was “just another dog”. They genuinely cared and explained everything very well. Loved them

Heather Matson says...

I have recommended I-20 to friends due to the compassionate and wonderful service we have received. Thank you for everything you have done for us. The doctors are wonderful as well as the techs and the rest of the staff. Thank you

Rhonda Holley says...

I have been to lots of vet clinics. Yours is the best in every way that I have ever seen! Thanks for restoring my faith in excellent veterinary care!

Matt Smoot says...

Dr. Bloom is wonderful! She put our mind at ease and alleviated all of our concerns about Spice’s surgery. We plan on using her for all of our pet’s needs in the future and will highly recommend her services to our friends and family! Thank you I-20 Animal Medical Center.

Staci Thomas says...

The service was amazing! I came in as a referral for a critical condition. I was extremely upset and concerned about my pet’s life. The staff quickly attended to us making efforts to stabilize Sebastian and provide me with a quiet and calm area. I really appreciated the service I received

Leah and Ron Bullard say...

We very much appreciate the skill and training you have and it was very evident in the procedures you performed on our dogs. Each of them had issues, some serious, and each of them are much better now, thanks to you and your staff.

Valerie Jordan says......

My family and I were so impressed by every contact we had with the staff. I have been to medical doctors for procedures and did not get such service. I have already called family members and recommended you guys, keep up the great work!

Maryann Livengood says....

The staff was extremely concerned and courteous- Dr. Stinson saved my cat's life! Also pricing extremely reasonable for a 24-hr care facility.

Paula Emmons says....

I-20 Animal Medical Center is amazing!! All the doctors, technicians and staff are the best. We had to take one of our dogs in for an emergency and everyone who helped us was great with our dog and with us. They encouraged us to call when we had to leave him and always answered and updated us on how he was doing through the nigh (even with many calls in a very short amount of time). The next morning Dr. Welch called and said that they had found something. She told us that Mikey was not going to make it and let us have hours to say goodbye. They answered all our questions and never once made us feel like we were imposing on her or her time. We have found a new clinic for all our dogs because of Dr. Welch and all the staff

Save A Mexican Mutt Rescue says...

I would like to thank the staff of I-20 for a great experience with one of our rescue dogs, Cuervo. Shortly after his rescue, we realized he had a broken canine tooth that would require a root canal. For sure we were not going to find a veterinary dentist in Mexico. So, I-20 Animal Medical Center came to the rescue! Dr. Bonnie Bloom and Dr. Ken Karger took great care of Cuervo upon our arrival. The staff at I-20 is always so friendly, professional, and socially in tune to rescue.

Jim and Kay Marshall say...

Excellent Care! I highly recommend you to our friends. Thanks to all the staff, especially Dr. Welch - we have a healthy dog once again. The love you and the girls showered on Rainey showed me how much you all love animals.

Janice Bunting with Tye says...

Our vet Dr. Litsey, referred us to you when Tye needed special boarding. We were very pleased with his care. We also really appreciated the staff's willingness to talk with us every time we called the ICU to check on him. It made it so much easier to be away from him. He came home a healthier and spunkier dog. Dr. Long was great with Tye and felt she took very good care to properly diagnose his condition and treatment.

Dave and Pamela Reitzel say….

“Cutie was a stray. When I took Cutie to I-20 Animal they were concerned for her health, and made arrangements to see her the next day. I-20 Animal set me at ease about Cutie after her exam. Now knowing that she is and was in good hands, I-20 Animal will be where I will take both my pets. VERY IMPRESSED!!.”

Nancy Schultz says…

“The doctor called the next day to check on Sophie and was genuinely interested in how she was doing. Very well done”

James Jacobs says...

“Huge thanks to the staff and doctors for the excellent care that Sasha received. The explanations about her care and pricing were first class. Thank you once again”

J. Headland says...

I cannot say enough how great Dr. Stinson and the staff were with Dirk and explaining the procedures. We have found a "new" place that I feel confident will take care of and actually care about Dirk. I have and will continue to tell our firends, family and co-workers how much we love I-20 Animal Medical Center.

LaTonya Thomas says...

"Shasha get's excited every time we exit the freeway to come to the I-20 Animal Clinic. Everyone there is so friendly and concerned about my pet's well being. Thank you all for such outstanding service."

J. Beed says...

"I just wanted to say thanks for your help yesterday! Mr. Fluffers had a great time getting his shots and I actually think he wanted to go back instead of driving home! :) Lauren and Kimberly were great! I'm sure Mr. Fluffers hopes to see them when he gets his booster in a few weeks. Thanks again!"