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Swollen glands under the cheeks on both right & left sides…

Swollen glands under the...

Swollen glands under the cheeks on both right & left sides and unable to open her mouth except for about 1/2 inch, can hardly even eat soft canned food.

Veterinarian's Assistant: I'll do all I can to help. What is the dog's name and age?

Penelope, 2 year old Dalmatian. She's had perfect health until now, she came from a show breeder and has excellent bloodlines.

Veterinarian's Assistant: How old is Penelope?

2 years old

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Penelope?

No, she's been very healthy until now. I tried to check for any foreign body in her mouth and for abscess teeth. She can't open her mouth and when I tried she was in pain. I always open her mouth to brush her teeth and give her dentals & scale her teeth periodically. I am a professional in the pet industry for 27 years and own a Grooming & Boarding Facility.

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Answered in 2 minutes by:
3/18/2018
Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18,172
Experience: Over 20 years of experience as a veterinarian.
Verified

Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

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I am very sorry to hear about Penelope's pain with trying to open her mouth and swollen glands below her jaws.

One reason for pain opening her mouth could be related to an abscess up behind her last upper molar, which you wouldn't be able to see. The pain is created by pressure on the area in front of the joint when the mouth is opened. Diagnosis is by aspirating the area to drain the abscess and treatment is oral antibiotics. An infection would make sense with swollen lymph nodes.

Once these dogs are sedated the mouth opens easily, they resist doing so when awake because it hurts.

Another possibility is a condition called masticatory myositis, which is inflammation of the muscles that are used to eat. This is an autoimmune condition (body attacks itself) and is diagnosed with blood testing of antibody levels or a muscle biopsy of the affected muscles. You may notice swelling or pain of these muscles on top of her head. If the condition is not treated the muscles will eventually atrophy leading to a loss of muscle and a very distinctive, skull-like appearance to the head. Treatment is immunosuppressive drugs like steroids. These dogs truly cannot open their mouths, the inflammation makes it impossible to do so even when under heavy sedation/anesthesia.

Another possibility is disease/inflammation in her temperomandibular joint. This is diagnosed with radiographs of the joint under anesthesia. Treatment may be surgery or anti-inflammatory drugs.

Other possibilities are infected tooth roots, a foreign body lodged in her mouth making it painful to open her mouth or a tumor in her mouth.

Finally if she seems to have rigid muscles everywhere, she seems to be very sensitive to sound, experiencing muscle tremors when exposed to loud noise, and her third eyelids are up, she may have tetanus. This is a spasm of the muscles in response to a toxin produced by a bacterium called Clostridium tetani, which can be found in the soil. Usually the pup has a small puncture wound that that the bacteria get injected in and over a week or two the bacteria produce the toxin which affects the muscles. These dogs can have seizures or lose the ability to breathe so if you suspect that she may have Tetanus I recommend an emergency visit.

In short your girl needs to see her veterinarian to figure out which condition is affecting her as treatment will vary depending upon the cause.

In the meantime don't force her jaw open and do continue to feed her a soft diet with water added so she can lick up food and to keep her hydrated.

It has been my pleasure to help you today, and I hope that I have earned my 5 star rating. Please remember to rate my service by selecting the 5 stars at the top of the screen (rating me now does not close your question). You are welcome to ask follow up questions about my response here until you are satisfied, simply use the reply box and let me know. Thank you!

Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18,172
Experience: Over 20 years of experience as a veterinarian.
Verified
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Customer reply replied 1 month ago
Thank you for your thorough response. You have been very helpful. I don't think its and abscess or infected tooth because I'm constantly brushing her teeth and scaling them also. She's young and her teeth look great. I am going to take her to the ER vet today, I just wanted an opinion and was afraid it could be Lymphoma because of the swollen glands. I'm glad to hear that there are several different possibilities, all of which are treatable. My 11 years old English Bulldog was just diagnosed with Eccrine gland cancer in her paw and had to have her front leg amputated .I couldn't take having another one of my babies go through cancer, it's so awful!!!! Thanks for your advice Dr. Kara ........5 stars :)

Lymphoma is always possible, even at her young age. But I would expect other lymph nodes to be enlarged, and I would not expect pain trying to open her mouth.

Most dogs with pain opening their mouth due to an infection/abscess have pretty normal to great looking teeth. The infection is usually due to a puncture wound from chewing on something and sometimes having a splinter break off and get lodged deep in the gums back by the last molar.

I'm so sorry to hear about your Bulldog, that is tough! Hopefully this is a simple infection and they can quickly get things under control.

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Customer reply replied 1 month ago
You have been a great source of knowledge & treatment information. I’m very glad that I tried “ Just Answer”.com
Have a great Sunday Afternoon ��

Thanks very much for your kind words, enjoy the rest of your weekend!

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Customer reply replied 1 month ago
Sorry, one last question. Do you think I should take her to the ER vet today or can it wait till tomorrow to see her regular vet?
Customer reply replied 1 month ago
She does not seem to be in pain and has been acting normal, that’s why didn’t notice sooner.

If she seems stable you can take her to her usual veterinarian tomorrow. Since she's eaten today they wouldn't be able to safely sedate her today anyway. No food after 7pm tonight, and pick up her water in the morning so she can safely be sedated tomorrow.

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Customer reply replied 1 month ago
Ok that’s what I thought also. Thank you for your good advice. Have a great day !

You too!

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Customer reply replied 1 month ago
My Vet took blood sample but it won’t be back for 7-10 days, but I think it will be longer because it always is. She believes that it’s MMM also but didn’t want to start her on prednisones because it will make the test read a false results. I didn’t think about it at the time, but the blood was taken prior to any prescription being given. She gave me an oral anabiotic but I told her it would be a waste of money because I knew I could not get it down Penelope‘s throat. They gave her an injectable anabiotic instead that will last 10 days just in case it is an infection she said. I feel 100% in my heart that it is MMM. I believe that her condition is getting worse as she can now barely open her mouth at all. She will not eat any dog food of any kind. I can get her to eat very small amounts of tiny cut up pieces of chicken, and a little bit of cottage cheese. I’m afraid this dog is going to become dehydrated and anorexic in The time it takes to get the results back.Could you give me your opinion on what the harm would have been to go ahead and start her on the prednisone? Everything I’m reading says that the prognosis depends on whether it was called at the early stages or in the chronic phase. I told my vet that I believed it started almost 2 weeks ago so this would be the third week and by the time the blood test is back it will be a month. I think that is way too long to go without treatment. What is your opinion & do you think I should persist that she be started on the prednisone? Sorry to bother you this late but I’ve been sitting on my kitchen floor for hours trying to get her to eat it’s really got me worried. Thank you

No worries on bothering me, I was up chatting with other pet owners.

This is a tough one, because should any more testing need to be done (like a muscle biopsy) then the steroids would interfere with diagnosis.

But most of the time when we have a patient in the sort of condition your poor girl is in we start steroids, because as you are seeing waiting for test results isn't in our patient's best interest. It really is a judgement call. But if she was sedated and they were unable to open her mouth, then I would start steroid now if she were my patient.

They could try placing a nasoesophageal or nasogastric feeding tube too, that would allow you to by pass her mouth and feed her a high calorie gruel as a support measure while waiting on test results and for the steroids to start working.

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Customer reply replied 1 month ago
OK thank you so much. I’m going to call the vet tomorrow and talk to her more about it. It’s so difficult to watch a dog that was so healthy all of a sudden be going through this. She just turned two years old and her parents were from excellent champion bloodlines The breeder test her dogs for everything under the sun predator breeding. She’s very upset about this diagnosis and none of Penelope‘s relatives have ever went through this either. Thank you for answering me and giving me your opinion. Have a good night

You are very welcome, please let me know how things go for her.

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