# My dog has a oronasal fistula, anything to do until Monday?



## poorpuppy (Dec 21, 2012)

My dog had a dental where many teeth were extracted a couple of days ago. I looked in her mouth today to see how things are healing. I noticed what appears to be a oronasal fistula. A hole from her mouth to her nasal cavity. Is it common that a fistula develops a couple of days post extraction?

Of course this happens on Saturday. My vet is closed. I tried calling a bunch of vets and all of them are closed too. There is the emergency vet but I don't think it's an emergency per se. It's not like they will repair it. Of course I'm going to see my vet on Monday but is there anything I can do this weekend?

She's still on antibiotics and pain medication so that's covered.

Has anyone had a fistula repaired? How much does it cost. I spent $1000 this week for the dental/appt. I'll need to do some planning if it's that much to fix the hole.


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## Kayota (Aug 14, 2009)

Er... if it really is that she could easily aspirate food or water and get pneumonia and die, so I'd say it's an emergency. If my dog had a hole through the roof of their mouth I'd be freaking out... If you or a child had that you'd be rushing to the ER so why not your dog?


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## poorpuppy (Dec 21, 2012)

Kayota said:


> Er... if it really is that she could easily aspirate food or water and get pneumonia and die, so I'd say it's an emergency. If my dog had a hole through the roof of their mouth I'd be freaking out... If you or a child had that you'd be rushing to the ER so why not your dog?


She has what appears to be a oronasal fistula, not a esophageal fistula. Aspiration is a not something very likely with a oronasal fistula. The sinuses empty into your throat. Remember how some kids would blow milk out their nose? They do not lead directly to the lungs. That's why when you sniffle with a runny nose, you end up swallowing or spitting out the mucus, it doesn't go into your lungs. The most likely complication of a oronasal fistula is a sinus infection.

I've been reading up on it. If one forms in a dog with teeth, the first thing to do is to extract the teeth, wait for the gum to heal and then repair the hole. If it happens as a result of a tooth extraction, it's recommended to put the dog on antibiotics for about 2 weeks before repairing the hole. In most cases, it is not an emergency. I expect the vet on Monday to suggest that we extend her antibiotic treatment out to 2 weeks from 1 and then repair the hole.

I understand the freaking out. That's exactly what I felt this morning when I saw it. But everything I've found about it says that it is something that should be fixed for the comfort of the dog and to prevent chronic sinus infections. It is not a life threatening emergency. I doubt the emergency vet would even repair it for no other reason then it's not recommended so soon after an extraction.


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## [email protected] (Nov 18, 2013)

You are correct, Poorpuppy. Typically oronasal fistulas are repaired once the local infection has cleared, some of the tissue has healed, and some granulation (scar) tissue has had time to fill in. Some (smaller) ones will self-correct (fill in with granulation tissue on their own). Typically except with HUGE ones, you can't see up into the nasal cavity, rather they are detected by chronic nasal discharge, small amounts of food or debris reaching the nostrils, etc. Because they are located above (ahead of) the pharynx, having an oronasal fistula is not typically much of a risk for creating aspiration. So, talk to your vet, have it evaluated, and have it repaired at the appropriate time. Like so many things, this is one procedure where you would want to ask your vet very directly what their success rate is in fixing them, and possibly ask for a referral. Performing the surgical flaps that allow these to close correctly is not difficult, but it is often outside the range of training of the average vet. The rate of surgical failure if very high if you don't know exactly what you are doing. Good luck.


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## poorpuppy (Dec 21, 2012)

Thanks. I will definitely ask them their success rate in repairing fistulae. Offhand, I think I will have to take her to a specialty hospital. When my vet did the dental, they took out her upper canines. They were thinking about taking out one of her lowers as well but said the lower ones are difficult since the lower mandible is so thin. She said I should probably go see a dental specialist if it indeed needs to be removed. I appreciate their honest assessment of their capability. So I think they'll be upfront on the fistula repair as well.

I don't know if it goes all the way to her nasal cavity. She doesn't have any of the symptoms such as sneezing, coughing or snuff coming out her nose. It could be a cavity. Considering that what led to all this was her sneezing with blood on occasion. Thus the dental to deal with a possible abscess, it seems likely though. The hole looks too big to self heal. It's about the size of what the extraction site for her tooth would be except it's located further up on her gums right below where the bone starts.

I really appreciate the responses. I've gone from freaking out yesterday morning to just waiting for tomorrow to go to the vet.


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## poorpuppy (Dec 21, 2012)

Just to follow up in case anyone else has a similar problem someday. Saw the vet today. We are going with wait and see. It's way too soon to think about repairing it. Her gums haven't healed yet. Things haven't settled so there's no point to it.


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