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528
and plasma lactate concentrations of horses performing the tread-
mill and track exercise tests. This suggests that the horses did not
derive any effect of training during the experimental period. The
reason for the lack of difference is not clear, but it is possible that
the effects of air resistance, treadmill mechanics, draught forces
and surface conditions became less important when the total
amount of work increased.
Exercise performed on a horizontal treadmill with a low
draught resistance was significantly less demanding than exercise
on a race track. However, the difference in workload disappeared
when the draught resistance became heavier.
Acknowledgements. - This study was supported by grants from
Agria Insurance Company. The authors would like to thank Olav
Johnsen for driving the horses and Anita Bostrom, Bo Ericsson
and Karin Thulin for their technical assistance.
References
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BARREY, E., GALLOUX, P., VALETTE, J. P. & AUVINET, B. (1993a) Equine
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BARREY, E., LANDJERIT, B. & WOLTER, R. (1991) Equine Exercise Physiology 3.
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MERKENS, H. W. & BARNEVELD, A. (1994a) Veterinary Quarterly 16, S87
BUCHNER, H. H. F., SAVELBERG, H. H. C. M., SCHAMHARDT, H. C.,
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Suppl 17, 13
DANIELS, F., VANDERBIE, J. H. & WINSMANN, F. R. (1953) Natic QM
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Surgical treatment of a septic dentigerous cyst in a goat
C. C. Miller, B. A. Selcer, L. H. Williamson, E. A. Mahaffey
Veterinary Record (1997) 140, 528-530
A slowly growing lesion of the rostral mandible of a goat was
diagnosed to be a septic dentigerous cyst. The lesion was treat-
ed surgically to remove one displaced tooth and debride the
cystic cavity, and systemic antibiotic therapy was applied.
Thirty-four weeks later the goat was clinically and radio-
graphically improved and the problem had not recurred.
DENTIGEROUS cysts generally surround the crown of an
unerupted tooth, but may completely encompass a tooth and its
roots (Gardner and others 1976, Anderson and Harvey 1993,
Barker and others 1993). Radiographic examination may reveal a
unilocular or multilocular cystic lesion with a normal or mal-
formed tooth within the cyst (Gardner and others 1976, Lobprise
and Wiggs 1992). Dentigerous cysts can cause jaw enlargement,
extensive bone destruction and/or remodelling, and the resorption
of affected and/or adjacent tooth roots secondary to pressure
(Gardner and others 1976, Anderson and Harvey 1993).
C. C. Miller, DVM, PhD, 1080 Ramblewood Place, Watkinsville, Georgia
30677, USA
B. A. Selcer, DVM, Department of Anatomy and Radiology, L. H.
Williamson, DVM, MS, Department of Large Animal Medicine, E. A.
Mahaffey, DVM, PhD, Department of Pathology, College of Veterinary
Medicine, University of Georgia, Athens, Georgia 30602, USA
The Veterinary Record, May 17, 1997
FREDRICSON, I., DALIN, G., DREVEMO, S. & HJERTtN, G. (1975) Equine
Veterinary Journal 7, 91
FRISBERG, B. A. (1983) Medicine and Science in Sports and Exercise 15,
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GALLOUX, P., VALETTE, J. P., BARREY, E., AUVINET, B. & WOLTER, R.
(1993) Journal of Equine Veterinary Science 13, 417
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Persson, R. J Rose. Cambridge, Granta Editions. p 458
PERSSON, S. G. B., ESSEN-GUSTAVSSON, B. & LINDHOLM, A. (1991) Equine
Exercise Physiology 3. Eds S. G. B. Persson, A. Lindholm, L. B. Jeffcott. Davis,
ICEEP Publications. p 231
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PUGH, L. G. C. E. (1971) Journal of Physiology 213, 255
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PERSSON, S. (1995) Equine Exercise Physiology 4. Eds N. E. Robinson.
Newmarket, R & W Publications. p 191
SCHAMHARDT, H. C., VAN DEN BOGERT, A. J. & LAMMERTINK, J. L. M. A.
(1994) Proceedings of the 8th Biennial Conference, Canadian Society for
Biomechanics, Calgary, August 18-20, 1994. p 306
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(1995) Veterinary Record 137, 136
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Biomechanics 16, 517
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Eds J. R. Gillespie, N. E. Robinson. Davis, ICEEP Publications. p 206
The most common type of dentigerous cyst reported in domestic
animals is associated with the ear tooth of horses (Barker and oth-
ers 1993). Odontogenic dentigerous cysts have also been described
in dogs (Lobprise and Wiggs 1992), pigs and sheep (Anderson and
Harvey 1993). In sheep, dentigerous cysts are generally associated
with the mandibular incisors (Anderson and Harvey 1993).
This report describes the clinical and radiographic appearance
of a dentigerous cyst of the rostral hemimandible in a goat, a
species that, to the authors' knowledge, has not previously been
reported to be susceptible to this condition. The surgical and med-
ical management of the case is also described.
Case history
A 35 kg three-year-old Nubian wether was examined for swelling
of the left rostral hemimandible. The swelling had been detected
two months earlier and had slowly increased in size. The enlarge-
ment did not affect the goat's ability to eat or drink. There was no
history of trauma to the affected area. The wether was housed with
four other pet goats on a 6 acre Bermuda grass pasture.
Clinical examination
Abnormalities were limited to the mandible and oral cavity.
The face of the goat was asymmetrical owing to the presence of a
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The Veterinary Record, May 17,1997 529

FIG 1: The wether's mandibular incisors. The central and second
pairs of incisors were permanent teeth. The third and fourth left
incisors were deciduous teeth that were almost vestigial in appearance
and not in wear
5 cm, firm, non-movable, ovoid swelling of the left ventrolateral
rostral hemimandible. The central and second pairs of permanent
incisors were present and the second left incisor was loose. The
right third incisor was a permanent incisor, but the left third
incisor was deciduous. Both fourth incisors were deciduous
(Fig 1). The mucosal surface over the mass appeared to be nor-
mal.
The goat was sedated with xylazine (Rompun; Haver) (0.11
mg/kg intravenously) and a biopsy of the mass was attempted. A
fluid-filled cavity was invaded when only mild pressure was
applied to the biopsy instrument. A sample of the gelatinous,
dark-brown fluid within the cavity was collected aseptically for
aerobic and anaerobic bacterial culturing and cytological analysis.
No further attempts to biopsy the mass were made to avoid dam-
aging the mandible. The fluid contained very few nucleated cells
and numerous pleomorphic bacterial rods.
placed incisor could not be located. The cyst lining and all abnor-
mal bone were removed by gentle curettage. The cyst was flushed
with 500 ml of a 1 per cent povidone iodine solution in saline
(Betadine solution; Purdue Frederick). The lesion was left open to
drain. Sodium ampicillin (Marsam Pharmaceuticals) was adminis-
tered subcutaneously at 1 g twice daily for three days. The owner
was instructed to flush the cyst with 100 ml 1 per cent povidone
iodine in saline twice daily and to keep the incision site clean.
Because tumours such as ameloblastomas and squamous cell
carcinomas have been found to develop within dentigerous cysts
(Gardner and others 1976, Anderson and Harvey 1993), the
excised tissues were examined histopathologically. No evidence
of neoplasia was observed. The connective tissue surrounding the
tooth examined was infiltrated by neutrophils, macrophages and
fibroblasts. Organisms cultured from the initial aspirate included
Actinomyces pyogenes, Bacteroides species and a third organism
that was not identified; it was suspected to be another
Actinomyces species, because it was a Gram-positive, non-spore-
forming rod. All three organisms were sensitive to ampicillin.
Four days after surgery the owner reported that the goat had no
difficulty eating or drinking, and that there had been only minimal
discharge from the surgical site. The incision was clean and the
surrounding tissues were well vascularised. The cavity was
flushed with 0.9 per cent saline and the owner was advised to con-
tinue flushing with 0.9 per cent saline twice daily for five days. In
the light of the bacteriological results, sodium ampicillin was
administered as before for a further 10 days. Fourteen days after
the surgery, healthy granulation tissue had completely covered the
surgical site.
Thirty-four weeks after the surgery the goat's face was no
longer asymmetrical. The left third and fourth deciduous incisors

Radiography
Lateral, dorsoventral, and intra-oral radiographs were taken
(Fig 2). A smoothly marginated, expansile, unilocular, radiolucent
lesion was identified which extended to the level of the mandibu-
lar symphysis on the rostral left hemimandible. The cortical bone
surrounding the mass was thin but intact. One displaced tooth
with a poorly defined root was located caudoventrally within the
lesion. The roots of the left first and second incisors were blunted
and possibly located within the lesion. Two small deciduous teeth
were visible adjacent to the second left incisor. An unerupted per-
manent incisor was displaced laterally within the mass rostrally. A
tentative diagnosis of a septic dentigerous cyst was made on the
basis of the clinical, cytological and radiographic findings.

Treatment
It was decided to remove the displaced teeth, debride the cystic
cavity, and provide a route for drainage and irrigation. The goat
was sedated with diazepam (Elkins-Sinn) (0-5 mg/kg, intravenous-
ly) and general anaesthesia was induced with ketamine hydrochlo-
ride (Ketaset; Bristol Veterinary Products) (11 mg/kg, intramuscu-
larly). The skin over the left rostral hemimandible was prepared for
aseptic surgery, and the incision site was anaesthetised by infiltrat-
ing the skin and subcutaneous tissues with 5 ml 2 per cent lido- FIG 2: Initial radiographs of the mandibular lesion. a) Lateral radio-
caine hydrochloride (Elkins-Sinn). A 3 x 2 cm elliptical incision graph of the rostral mandible. A large, lytic, expansile bony lesion is
was made through the skin and subcutaneous tissues at the most visible extending from the intermandibular space to the level of the
roots of the incisors. The affected cortical bone is thin but intact.
ventral aspect of the cyst. The mandibular bone was exposed and a There is a displaced tooth in the caudoventral aspect of the lesion and
3/16" Michel trephine was used to enter the cystic cavity. an unerupted incisor is visible dorsorostrally. b) Dorsoventral radio-
Rongeurs were carefully used to remove the cortical bone to the graph of the rostral region of the skull. Two displaced teeth are visible
within the expansile bony lesion involving the left hemimandible. The
length and width of the skin incision. The cavity of the cyst was roots of these teeth and those of the left second incisor are blunted.
explored, and one tooth was located and extracted. The second dis- Two small deciduous teeth (left incisors 3 and 4) are visible
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530
FIG 3: Mandibular radiographs taken 34 weeks after surgery. a)
Lateral radiograph of the rostral mandible. The lesion is less lytic and
new bone is visible within the previously cystic area. The caudoventral
displaced tooth has been removed. A displaced dorsorostral incisor is
still evident. b) Intra-oral ventrodorsal view of the rostral mandible.
The cyst is smaller, appears less expansile and shows evidence of new
bone production. The caudal displaced tooth has been removed. An
unerupted incisor is evident. Two small deciduous teeth (left incisors 3
and 4) are still present
were still present, though not in wear. Radiographs (Fig 3)
revealed that the lesion was smaller and that there was a non-
expansile, less radiolucent lesion at the site of the previous cyst.
The cortical margins of the mandible were thin and new bone pro-
duction was evident within the medullary portion of the mandible.
The rostrally unerupted permanent incisor was still present, but
the tooth previously visible at the caudoventral aspect of the
lesion was absent.
Discussion
Differential diagnoses for mandibular lesions in ruminants
include tooth-root abscesses, osteodystrophia fibrosa, Actinomyces
bovis infection (Smith and Sherman 1994a), fractures, osteomyeli-
tis (Smith and Sherman 1994b), periostitis, odontogenic cysts (pri-
mordial, dentigerous, periodontal or gingival; Anderson and
Harvey 1993), non-odontogenic cysts (simple bone cysts or
aneurysmal bone cysts; Blackwell and others 1985, Purdy 1985,
Lamb and Schelling 1989, Jackman and Baxter 1992), odonto-
The Veterinary Record, May 17, 1997
genic tumours (osteoma, ameloblastoma, odontoma or ame-
oloblastic odontoma; Steinberg and George 1989, Chalmers and
Shacklady 1991, Barker and others 1993), and non-odontogenic
tumours (osteolytic lymphosarcoma, fibrosarcoma, ossifying
fibroma, osteosarcoma, squamous cell carcinoma or adenocarci-
noma; de Silva and others 1985, Craig and others 1986, Palmer
1993, Smith and Sherman 1994a, b). The gross and radio-graphic
appearance of the lesion can assist in formulating a diagnosis. In
this goat, a dentigerous cyst was suspected because of the insidi-
ous onset of the clinical signs, the unilateral nature of the lesion
and the radiographic appearance of a cystic bone lesion containing
teeth.
The treatment of dentigerous cysts depends on the size and
location of the lesion. If possible, it is preferable to excise the
entire cyst (Anderson and Harvey 1993). As an alternative, marsu-
pialisation allows the lesion to be debrided and provides a route
for drainage and irrigation. In the event of a septic lesion, specific
systemic antibiotics should be administered. In this case, it is pos-
sible that the bacterial organisms had invaded the cyst via the
abnormal gingival tissues adjacent to the loose incisors.
Cancellous bone grafts can be used for their osteoinductive prop-
erties to fill the cystic cavity after it has been debrided (Purdy
1985, Jackman and Baxter 1992). A bone graft was not undertak-
en in this case, owing to financial constraints and because the
surgery was performed under field conditions, but the lesion
resolved without the side effects. It was unfortunate that only one
unerupted incisor was located for extraction. If the remaining per-
manent incisor resumes its eruption, additional mandibular prob-
lems may arise. However, 17 months after the surgery, no abnor-
malities had been observed.
Dentigerous cysts are generally lined by stratified squamous
epithelium, and inflammatory cell infiltrates are sometimes pre-
sent (Gardner and others 1976). In this case, an epithelial lining
was not identified, though inflammatory cells were present.
However, only small sections of the lesion could be examined, as
a result of the surgical approach. Excisional biopsy might have
been preferable to incisional biopsy, to obtain a complete histo-
logical examination, but it was not possible without mutilating the
jaw, owing to the location and size of the lesion.
The authors are unaware of any previous description of a
dentigerous cyst in a goat. The onset of the condition in this case
may have been related to the eruption of the third permanent
incisors, which normally occurs at approximately three years of
age in goats. Although the incidence of dentigerous cysts in goats
is unknown, this case provides evidence that they can arise spon-
taneously and must be included on the list of differential diag-
noses when evaluating mandibular lesions in goats.
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Surgical treatment of a septic dentigerous

cyst in a goat
C. C. Miller, B. A. Selcer, L. H. Williamson and E. A. Mahaffey

Veterinary Record 1997 140: 528-530

doi: 10.1136/vr.140.20.528

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