Difference between revisions of "Oral Examination - Other Diagnostic Tests"
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==Blood Tests== | ==Blood Tests== | ||
| − | [[:Category:Blood Samples and Coagulation Tests|'''Biochemistry and Haematology''']] - Useful to identify any underlying problems | + | [[:Category:Blood Samples and Coagulation Tests|'''Biochemistry and Haematology''']] - Useful to identify any underlying problems eg. [[:Category:Kidney - Pathology|kidney disease]], [[DM|diabetes]]. May be useful to assess any underlying organ pathology as a contraindication for use of certain medications.<br><br> |
| − | In | + | In some predisposed breeds, a [[Coagulation Tests|clotting profile]] (or a buccal mucosal bleed time) may be advisable prior to certain procedures. For example oral oncological surgery or in some cases even a surgical extraction. |
<br><br> | <br><br> | ||
==Viral Tests== | ==Viral Tests== | ||
| Line 7: | Line 7: | ||
'''[[FIV]]/[[FeLV]]''' | '''[[FIV]]/[[FeLV]]''' | ||
| − | '''Viral isolation''' - [[:Category:Caliciviridae|Calici virus]] and [[:Category:Herpesviridae|Herpes virus]] have been implicated in certain oral conditions affecting cats chronic gingivostomatitis.<br><br> | + | '''Viral isolation''' - [[:Category:Caliciviridae|Calici virus]] and [[:Category:Herpesviridae|Herpes virus]] have been implicated in certain oral conditions affecting cats with chronic gingivostomatitis.<br><br> |
==Microbiology== | ==Microbiology== | ||
| − | [[Bacterial Disease - Laboratory Diagnosis#Bacterial Culture|Bacterial culture]] and sensitivity is not usually useful from samples taken in the mouth. Many of the pathogens are anaerobic and difficult to culture. There is also a large proportion of naturally occurring, | + | [[Bacterial Disease - Laboratory Diagnosis#Bacterial Culture|Bacterial culture]] and sensitivity is not usually useful from samples taken in the mouth. Many of the pathogens are anaerobic and difficult to culture. There is also a large proportion of naturally occurring, non-pathogenic bacteria and results are not always representative, therefore the majority of the information obtained is of little value. However in long term cases that are non-responsive to treatment, or in cases with an unusual presentation, culture should be considered.<br><br> |
==Cytology and Biopsy== | ==Cytology and Biopsy== | ||
| − | Any mass in the [[Oral Cavity Overview - Anatomy & Physiology|mouth]] should be biopsied. The mouth is the 4th most common site for [[:Category:Oral Cavity - Proliferative Pathology|tumours]]. Many tumours in the mouth do not exfoliate well, so cytology | + | Any mass in the [[Oral Cavity Overview - Anatomy & Physiology|mouth]] should be biopsied. The mouth is the 4th most common site for [[:Category:Oral Cavity - Proliferative Pathology|tumours]]. Many tumours in the mouth do not exfoliate well, so cytology is of limited benefit. |
The information you gain from the histopathologist is only as good as the sample you send. <br><br> | The information you gain from the histopathologist is only as good as the sample you send. <br><br> | ||
| − | The following steps should be followed in order to obtain a '''good | + | The following steps should be followed in order to obtain a '''good diagnostic sample''': |
*A full thickness wedge biopsy should be taken wherever possible | *A full thickness wedge biopsy should be taken wherever possible | ||
| − | *The biopsy should be of | + | *The biopsy should be of sufficient size |
*Take a deep biopsy, including underlying bone where indicated | *Take a deep biopsy, including underlying bone where indicated | ||
| − | *Avoid ulcerated / inflamed areas – this may compromise interpretation | + | *Avoid ulcerated/inflamed areas – this may compromise interpretation |
*Avoid tissue trauma or heating the tissue (rough tissue handling with rat-tooth forceps or cautery) | *Avoid tissue trauma or heating the tissue (rough tissue handling with rat-tooth forceps or cautery) | ||
*Where a mass is near any underlying bone, an [[:Category:Intra-Oral Radiography|intra-oral radiograph]] should be taken to assess bone involvement | *Where a mass is near any underlying bone, an [[:Category:Intra-Oral Radiography|intra-oral radiograph]] should be taken to assess bone involvement | ||
| Line 27: | Line 27: | ||
[[Category:Oral Examination]] | [[Category:Oral Examination]] | ||
[[Category:To Do - Dentistry Images]] | [[Category:To Do - Dentistry Images]] | ||
| − | [[Category:To Do - | + | [[Category:To Do - Mars Check]] |
Revision as of 08:02, 18 September 2013
Blood Tests
Biochemistry and Haematology - Useful to identify any underlying problems eg. kidney disease, diabetes. May be useful to assess any underlying organ pathology as a contraindication for use of certain medications.
In some predisposed breeds, a clotting profile (or a buccal mucosal bleed time) may be advisable prior to certain procedures. For example oral oncological surgery or in some cases even a surgical extraction.
Viral Tests
Viral isolation - Calici virus and Herpes virus have been implicated in certain oral conditions affecting cats with chronic gingivostomatitis.
Microbiology
Bacterial culture and sensitivity is not usually useful from samples taken in the mouth. Many of the pathogens are anaerobic and difficult to culture. There is also a large proportion of naturally occurring, non-pathogenic bacteria and results are not always representative, therefore the majority of the information obtained is of little value. However in long term cases that are non-responsive to treatment, or in cases with an unusual presentation, culture should be considered.
Cytology and Biopsy
Any mass in the mouth should be biopsied. The mouth is the 4th most common site for tumours. Many tumours in the mouth do not exfoliate well, so cytology is of limited benefit.
The information you gain from the histopathologist is only as good as the sample you send.
The following steps should be followed in order to obtain a good diagnostic sample:
- A full thickness wedge biopsy should be taken wherever possible
- The biopsy should be of sufficient size
- Take a deep biopsy, including underlying bone where indicated
- Avoid ulcerated/inflamed areas – this may compromise interpretation
- Avoid tissue trauma or heating the tissue (rough tissue handling with rat-tooth forceps or cautery)
- Where a mass is near any underlying bone, an intra-oral radiograph should be taken to assess bone involvement
- Send your sample to an experienced oral pathologist or one with a particular interest in oral pathology
- If the results don’t match the clinical picture, discuss this with the pathologist and re-biopsy if necessary
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