Severe Hemorrhage Requiring Transfusion in Two Dogs Following Right Inferior Alveolar Artery Laceration Secondary to Severe Periodontitis

IF 1.6 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care Pub Date : 2026-10-18 Epub Date: 2026-09-07 DOI:10.1111/vec.70146

Harriet L. Pearce, Anais G. Allen-Deal, Ingrid Tundo, Johanna Wolf

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引用次数: 0

Abstract

Objective

To describe the presentation, management, and outcome of two dogs with severe hemorrhage after laceration of the inferior alveolar artery (IAA) caused by advanced periodontitis.

Series Summary

A 9-year-old neutered female Jack Russell Terrier (Case 1) and a 12-year-old intact female Bearded Collie (Case 2) were referred for further investigation of stomatorrhagia, melena, and hematemesis. Both cases were anemic (PCV 21% and 20%, respectively) on presentation, with Case 1 exhibiting signs of hemorrhagic shock. Profuse hemorrhage from the right mandibular quadrant originating at the first molar and severe periodontitis were identified on oral examination. Platelet count, activated partial thromboplastin time (aPTT), and prothrombin time (PT) were normal in both cases. Hyperfibrinolysis was identified in Case 1 on viscoelastic testing. Initial management included fluid resuscitation, tranexamic acid, and packed RBC transfusions (28 and 14 mL/kg for Cases 1 and 2, respectively). Both cases required anesthesia and surgical arteriolar ligation for hemostatic control. In both dogs, a laceration of the right IAA was identified, and dental extractions and ligation of the IAA were performed. Intraoperative dental radiographs confirmed periodontitis as the underlying cause for hemorrhage in Case 1; in Case 2, a preoperative computed tomography scan of the head was used. Surgery was curative for the oral hemorrhage in both cases; however, Case 1 died secondary to comorbidities.

New or Unique Information Provided

This is the first published report of severe anemia and hemorrhagic shock secondary to IAA hemorrhage due to advanced periodontitis in any species. This case series demonstrates that IAA erosion needs to be considered as a differential diagnosis for severe oral hemorrhage and should be recognized as a condition that may require emergency surgery in veterinary medicine.

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两只狗右下牙槽动脉撕裂伤继发于严重牙周炎后的严重出血需要输血。

目的：介绍2例晚期牙周炎引起的下牙槽动脉（IAA）撕裂后严重出血的临床表现、治疗和结果。病例1：一只9岁的绝育雌性杰克罗素梗犬（病例1）和一只12岁的完整雌性大胡子牧羊犬（病例2）被转介接受进一步的口出血、黑黑和吐血的调查。两例均为贫血（PCV分别为21%和20%），病例1表现出失血性休克的迹象。在口腔检查中发现右下颌象限起源于第一磨牙的大量出血和严重的牙周炎。血小板计数，活化部分凝血活素时间（aPTT），凝血酶原时间（PT）在两例均正常。在病例1的粘弹性测试中发现了高纤溶。最初的治疗包括液体复苏、氨甲环酸和红细胞填充输注（病例1和2分别为28和14 mL/kg）。这两个病例都需要麻醉和手术小动脉结扎止血控制。在两只狗中，发现了右侧IAA的撕裂，并进行了拔牙和结扎IAA。病例1术中牙科x线片证实牙周炎是出血的根本原因；在病例2中，术前使用头部计算机断层扫描。两例口腔出血均可手术治愈；然而，病例1死于合并症。提供新的或独特的信息：这是首次在任何物种中发表的由晚期牙周炎引起的IAA出血继发的严重贫血和失血性休克的报告。本病例系列表明，IAA糜烂需要被视为严重口腔出血的鉴别诊断，并应被认为是兽医学中可能需要紧急手术的一种情况。

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来源期刊

Journal of veterinary emergency and critical care 农林科学-兽医学

CiteScore

2.50

自引率

15.40%

发文量

121

审稿时长

18-36 weeks

期刊介绍： The Journal of Veterinary Emergency and Critical Care’s primary aim is to advance the international clinical standard of care for emergency/critical care patients of all species. The journal’s content is relevant to specialist and non-specialist veterinarians practicing emergency/critical care medicine. The journal achieves it aims by publishing descriptions of unique presentation or management; retrospective and prospective evaluations of prognosis, novel diagnosis, or therapy; translational basic science studies with clinical relevance; in depth reviews of pertinent topics; topical news and letters; and regular themed issues. The journal is the official publication of the Veterinary Emergency and Critical Care Society, the American College of Veterinary Emergency and Critical Care, the European Veterinary Emergency and Critical Care Society, and the European College of Veterinary Emergency and Critical Care. It is a bimonthly publication with international impact and adheres to currently accepted ethical standards.