Fate brought me to Karma...

I was into my fourth day lazing on Maderas beach just north of San Juan Del Sur on the Pacific coast of Nicaragua - I had tried and mostly failed at surfing and had decided that sunbathing, reading books and drinking beer was easier!

Maderas beach

Karma - Sylvia's Labrador

In my beachside backpackers most of the others were doing the same but there were some long term residents there as well including Sylvia - a French Fashion Designer

Sylvia's Creations

I bought a couple of things from Sylvia and we got talking about her dog Karma - a huge black Labrador I mentioned I was a vet and soon I was having a look at the sore leg she sprained on the beach - no problem there but the dentist in me spotted other bigger issues - 2 slab fractured carnassial teeth with apical abscesses
This was a problem that needed attention - veterinary dentistry is in it's infancy here - specialised equipment is needed to do this complicated extraction - I wasn't hopeful but I knew I could improvise!

Karma and Sylvia on the beach shuttle to San Juan

Karma arrived on the Saturday morning on the beach shuttle from Maderas and Sylvia transferred her to a Trike to take her to the vets

On the trike going to the vets

 Karma's vet Fernando Lopez-Ponce in San Juan - he was happy to do the anaesthesia while I extracted the teeth - however he had very few dental instruments - no drill or elevators/luxators!

My equipment

Karma premeded

Once there I gathered together my instruments and materials. The carnassial tooth has to be surgically extracted - a flap needs to be raised and the tooth cut into 3 parts (it has 3 roots)
As before there was no inhalational anaethesia - she was premeded with ACP, a catheter placed and GA was maintained with Valium and Ketamine to effect
We tubed her and packed her throat - we were ready to go!
The drilling was done by a conventional DIY drill and bit - cooled by sprayed on water - compared to an air driven drill it took ages but got the job done

Left Carnassial - note swelling above muco-gingival line indicating apical involvement

Tooth sectioned

The 3 portions of each tooth were extracted - in each tooth the abscess was in the caudal root - the extraction sites was closed with vicryl

Post extraction - site closed with vicryl

Right carnassial - probe indicated pulp exposure - note fistula above M-G line

The caudal roots of both teeth - note the apical granulomas

Karma recovering in her trike

Antibiotic and NSAID cover had been started pre-op the day before and would continue for 5 days Then began a very long recovery period - because of the length of the surgery and all the Val-Ket top-ups (she had 18ml of the mix over the 1.5 hours) she wasn't able to walk on to the returning beach shuttle at 4 o'clock San Juan was really busy that night but luckily Sylvia found somewhere she and Karma could sleep.

Next day she had recovered and was able to go back to Maderas beach where she likes to play in the surf!

Back on the beach where she belongs!