Snaggletooth

I'd noticed late last week that Saké's face seemed a bit fatter than usual. Saturday night she was napping in a box with her head at just the right angle for me to glimpse what was going on - she had a really long bottom right incisor. We've noticed that as she's gotten older, her teeth don't line up quite as well as they used to. In this case the bottom incisor now was angling just enough to no longer get ground down by the incisor above it.

I figured she would have to wait until we could get her to the vet yesterday, but Dave had other ideas and pulled out a pair of nail clippers. Now, we both have read enough about malocclusion to know that you can trim a rat's tooth in a pinch but I didn't think that meant you actually should. Dave was pretty confident though and a few minutes later, after I finally managed to not only hold Saké still but also open her mouth, the tooth was snipped.

Saké after her trimming

We're keeping an eye on her, but so far she seems to be doing terrifically without that long, sharp tooth!

Sushi's Surgery Report

Sushi came home last night.  I was unprepared for how swollen her face would be.



We initially needed to give Sushi some quiet, confined time to rest, since she was still pretty groggy. We put her on the upper floor of the cage, so she could just curl up in the nest. Saké was less than thrilled to be locked downstairs, and occupied herself by burying the contents of her food dish in the litter tray. Sushi ate a bit of softened food (crushed lab blocks mixed with baby cereal) and then slept pretty hard for a while. Her ears and tail are a little pale, which combined with the swelling made her look a bit rough.


The surgery did not go exactly as expected. The right upper and lower incisors came out easily, but while the vet was pulling those the left teeth broke off just below the gum line. Dr. Nolan could have continued trying to get them extracted, but at the point Sushi had been under anesthetic for quite a while. It would not be quick for him to pull the teeth from under the gum line, not to mention that that would be more traumatic to her mouth than a regular extraction. So he decided to take the conservative route and saved those two teeth for a future day. While I had hoped that today would be an end to all of the annoyance and pain of malocclusion, I am glad he stopped for today when he did.

Dr. Nolan saved her teeth for us. I knew they would be long but I didn't expect them to be nearly the length of Sushi's head!

Her upper incisor broke in half and can be seen on the right and left above. The middle tooth is a single, intact lower incisor.

Sushi is on antibiotics (Ciprofloxacin) for the next ten days and pain medication (Meloxicam) for the next four days. I'm hopeful that we can keep the pain in check and that her mouth heals quickly so she can resume her normal diet.



I'm glad she's home.

Sushi's Teeth

This picture isn't very good, but it's important.

Do you see that large block Sushi is chewing on? It's monkey chow. Sushi can only eat monkey chow after she has her teeth trimmed, because otherwise it's too hard/big for her to break pieces off of. That picture was taken a few hours after Sushi's teeth were trimmed last week.

Her teeth trimming went well. She's at 238 grams. Her weight is pretty steady these days, and I don't expect we're going to see her get any bigger. She is ten months old.

We did receive amazing news from our vet. We've decided to go ahead with the surgery to pull all of Sushi's incisors. This is a drastic step but will overall improve her quality of life. Right now her upper incisors appear to be dying and her lower incisors are loose and wiggly, making eating difficult. Not to mention that she has to go under anesthetic once a month to get her incisors trimmed, something that is more dangerous each time.

Last month we received a quote for the surgery - $450-600, depending on how it goes. At Sushi's appointment last week though, our vet offered to do the surgery for cost. Essentially, we pay for her anesthesia and her medications and the clinic will cover the rest of the expenses. Why? Because they appreciate that we are willing to do the right thing for her, and have done everything we can for her up to this point.

That is amazing news. A huge thank you to everyone at Cedar Creek Veterinary Clinic and especially to Dr. Derek Nolan for helping us to get Sushi the care she needs. Her surgery will be next month.

Sushi's a pretty special rat.

An Update on Sushi's Teeth

When I took pictures of the girls and their bag of treats the other night, I also managed to get a couple of shots of Sushi's teeth. She is at four weeks and needs her teeth trimmed soon.

Sushi's Teeth

Sushi went to the vet last week for another teeth trimming. One of her front incisors has turned a funny pink color, and it looks likely that the tooth is dying. That isn't a good sign overall, but it does mean it might be easier to remove when they pull all of her incisors.

We are definitely going ahead with surgery, as soon as we have the $400-600 that it is going to take. Even though it is expensive, it will not only improve the quality of her life, but also remove the current risk she faces each month when she goes under anesthetic. Poor girl.

Sushi at an earlier vet visit.

Teeth Update

Sushi's visit to the vet yesterday was pretty uneventful. She is at 245 grams, up from 221 grams 32 days ago. She's small but she's still growing slowly, and overall she looks pretty good.

Regardless of her teeth, she's adorable.

Back to the Vet

Sushi returns to the vet today to get her teeth trimmed. It's been 32 days since her last visit, which is the longest she's gone since we got her in December. I don't think she could make it much longer.

Upper incisors twist toward her left, lower incisors to her right.

A view of the upper incisors.

Such a sweet girl. I hate that she has to go through this so frequently.

Back to the Vet

Sushi has an appointment for her teeth again this afternoon. It has been four weeks since her last visit. It's easy to keep an eye on her upper incisors, since they turn and grow outside of her mouth now, but I worry about her bottom ones. They still angle into her right cheek and it's hard to keep tabs on how long they are. I'll be relieved after she gets them all trimmed today.

Sushi's upper incisors poking out of her mouth.

Teeth Trimming Pt. 3

Over the previous days, I have shared pictures of Sushi's most recent trip to the vet, where she had her teeth trimmed for malocclusion. Today we have the final part of the process, when Sushi slowly wakes up from the anesthesia.

Once Sushi's teeth are trimmed, it takes a few minutes for her to wake up.

I hate seeing her like this.

She's given a few seconds of pure oxygen before they remove the tube, which is supposed to help her exhale the anesthesia gas and wake up.

Not quite ready to open her eyes...

Gentle rubbing from the vet helps Sushi wake up.

Once she wakes up, it is as if someone flipped a switch and she is ready to go.

Wide awake but her legs are not working yet.

The tough part of Sushi waking up is that once she's awake, she is ready to move immediately, but her coordination is off. Shortly after the above picture was taken, she ran up the vet's arm, around to her back, and then just about fell to the ground before we could grab her. We have to contain her while she loses her sea legs and returns to normal.

Overall, we ended up spending less than twenty minutes at the vet and by the time Sushi was home, she was ready to eat and test out her newly shortened teeth.

Teeth Trimming Pt. 2

Yesterday I shared pictures of the first part of Sushi's teeth trimming process. Today I want to show what happens during the actual teeth trimming.

Once Sushi is asleep, she's taken out of the bell jar, but still needs to be given gas so she doesn't wake up too soon. The vet tried to use the tiny mask, but it was still too big.

Sushi could wear the mask as a hat!

Instead they ended up taking the tube off the mask and using that directly over her nose. Using only the tube also makes it easier to work on her teeth.

Malocclusion at its finest.

The above picture provides a good look at Sushi's teeth. You can see that there are two bottom teeth pointing to the side, and on the top there are also two teeth, even though it almost looks like just one. Her malocclusion is so severe that her teeth completely miss each other. Normally the top and bottom teeth line up and grind themselves down naturally. Sushi's teeth turn so quickly that they never touch. Unless they are trimmed, her bottom teeth grow into the inside of her right cheek and her top teeth grow into her left upper gums. There is only 3.5 weeks of growth in the above picture.

Rat teeth are similar to fingernails, in that they can be trimmed without pain, unless you get too close to the blood supply. Sushi's teeth are yellow and look disgusting, but they are actually completely healthy.

Beginning to trim the upper incisors.

The vet uses a diamond tipped saw to cut Sushi's teeth. According to one of Sushi's vets, the saw cuts through most teeth "like butter" but because of the strength of rat teeth, it does not cut quite as easily. Trimming the teeth takes a little bit of time and the vet has to be careful not to cut the teeth too short. The vet also has to be very careful not to cut the tongue, and the vet tech uses a cotton swab to keep the tongue out of the way.

With such a tiny patient, there isn't a lot of room to maneuver.

Once the top teeth are cut, there is more room to work on the bottom teeth.

The bottom teeth naturally aim straight at Sushi's cheek.

Near Sushi's foot is one of her just removed upper incisors.

Once the teeth are removed, the vet takes a few more moments to even them. Sometimes malocclusion can be helped by cutting the teeth at an angle, encouraging them to meet. Since Sushi's is so severe, it does not matter if the vet angles them or not. Instead they focus on getting them even and comfortable for her.

A slightly different blade is used to even the teeth.

In the end, her teeth look drastically different, guaranteeing Sushi a few more weeks of comfortable, pain-free life.

It's amazing that the removed teeth are nearly the length of Sushi's paws.

While we were waiting for Sushi to wake up, the vet also trimmed her claws. I am pretty sure Saké will not be nearly as cooperative when we trim her's.

Tomorrow I will post some pictures of Sushi slowly waking up. While I hate seeing her under anesthesia, she is a remarkably adorable sleepy rat.

Teeth Trimming Pt. 1

We have a ton of great pictures from Sushi's visit to the vet yesterday and I will probably share them over the next few days. My hope is that if someone has a rat with severe malocclusion and finds this blog, these pictures will give them an idea of what to expect. We had no idea what was going to happen the first time Sushi's teeth were trimmed. Now I'm beginning to feel like a pro.

The worst part of the trip to the vet is waiting. I'm not sure if this is worse for Sushi or I.

Sushi hangs out in her carrier.

Actually, the worst part might be handing her over. She's so tiny compared to everything else in the room.

Immediately after this picture she tried to escape via my scarf.

Sushi was given a pretty thorough exam prior to getting knocked out. Watching the vet listen to her heart with a stethoscope was pretty comical, not to mention palpating her abdomen.

Sushi was less than cooperative for the exam.

Once it was time to knock her out, Sushi fell asleep pretty quickly.

First few seconds of gas.

Starting to slow down...

And she's out!

Tomorrow I will post pictures of the actual teeth trimming. In the meantime, if you are reading this and wondering just how severe Sushi's malocclusion is, this should give you a good idea:

This is only three and a half weeks of growth!

Teeth Trimming

One of the main questions we had for the vet at Sushi's initial appointment was what her quality of life would be if we managed her malocclusion. In other words, would having to spend her life dealing with such horrific teeth be stressful? Excluding any concerns regarding cost or convenience, was this something we could put her through in good conscience?

There are a couple of different options for trimming rat teeth. Their teeth are similar to fingernails, in that they have no feeling and can be trimmed easily, as long as you stay away from the blood supply. After a rat has had their teeth trimmed properly, they have no soreness and can eat and chew immediately. Because of this, it is possible to trim a rat's teeth yourself, assuming you have the right equipment and know what you are doing. One of the recommended trimmers is a guillotine-style nail clipper, which slips over the top of the tooth and then cuts it to the desired length.

Naturally, it's a bit more complicated for Sushi. Because her teeth bend almost immediately, we can't use the normal type of trimmer. There isn't any way to slip anything over the teeth to cut them. Anything used has to be like a saw and cut directly into the tooth itself. She's also a fraction of the size of a normal rat, meaning we have less room to work and maneuver.

When Sushi's teeth are trimmed by the vet, she is put under anesthetic. There are risks associated anytime someone is put out, but this allows the teeth trimming process to be very low stress for her. It also means that the vet can easily prop her mouth open and trim carefully, getting the teeth as short as possible.

Our vet uses a diamond tipped dental saw on Sushi. Rat teeth are remarkably strong (rats can generate about 10 lbs of pressure with a single bite), so anything used to cut them has to be powerful, and will still dull quickly. The entire process of trimming her teeth, from putting her out until she wakes back up, is about ten minutes. It isn't a complicated process but using anesthetic allows it to be relatively stress free for her.

That said, frequent use of anesthetic is also a danger. When Sushi first had her teeth trimmed, we hoped she could make it 4-6 weeks before the next trimming. Sadly, within three weeks her teeth were pushing up against her gums again and she began eating much less. Her second trimming was 19 days ago and her teeth are already closely approaching her gums again. At her current rate of growth, she is going to need her teeth trimmed every 21-24 days. Not only does that quickly become expensive, it also begs the question of how much is too much. Our vet is okay with putting her under every 3-4 weeks if needed but he is concerned about doing it more frequently than that.  Yet Sushi's teeth grow at a phenomenal rate.

One option we began discussing after her second vet appointment is the possibility of surgically removing all of her teeth. Elderly rats do fine on a modified diet once they lose their teeth, so it is reasonable to think Sushi would do the same as a youngster. However, because of how the bony plates in the mouth grow, Sushi isn't a candidate for surgery until she has stopped growing. So we still have at least another 6-8 months to get through before that is even a possibility. We're hoping that her teeth growth slows as she gets out of adolescence. All we can do at this point is keep a close eye on her and her teeth, and make sure she's eating.

We hope to get pictures of the entire trimming procedure the next time she goes to the vet. In the meantime, here is a picture of Sushi and Saké in their nest.

It's easy to see how much bigger Saké is when they curl up together.