Dear Colleagues,

I would be grateful for your advice regarding this case, which involves a 14-year-old male English Springer Spaniel, Max.

I operated on Max in June to surgically excise two eyelid masses on the right eye and one subcutaneous mass above the right eye. The surgical masses healed satisfactorily, and the histopathological examination revealed that they were all benign.

Six days post op the owner commented that his teeth were chattering a lot, which appeared to be associated with tooth 404 catching on the upper lip.

An area of dermatitis has appeared on the lip at the site where the tooth tends to impinge upon it. Cytological examination of exudate from the damaged skin has only demonstrated an inflammatory reaction.

The site has been treated with both systemic antimicrobial and glucocorticoid and the same topically. However, the lesion has persisted, and the tooth is still a problem.

I would be interested to hear of anyone else having a similar experience.

I cannot see how the surgery would have affected the right upper lip unless there was some pressure on a nerve whilst the dog was on the operating table.

What treatments can you suggest? The owner is very adamant that she does not want him to have any further anaesthetics.

Once again, thank you for your help.

With best wishes,

David