Case Study

CT – Bilateral otitis externa and mild left sided otitis media, wth moderate hydrocephalus internus in a 5 year old Holland Lop rabbit

This 5 year old MN Holland Lop rabbit presented with a history of hydrocephalus. Recently vestibular symptoms and nystagmis worsening. Longstanding history of weekly seizires – on Zonisamide and Keppra. Previous CT in 2012 showed hydrocephalus. Previous dental extractions die to malocclusion. R/O otitis media and worsening hydrocephalus.

DX

Bilateral otitis externa and mild left sided otitis media, wth moderate hydrocephalus internus

Image Interpretation

CT of the head, plain series – The left tympanic bulla contains a mild amount of gravity dependent soft tissue attenuating secretions. The bulla wall is within normal limits. Both ear canals are filled with uniformly soft tissue attenuating material.
The upper and lower incisor teeth have been removed or are missing. Remnants of the upper incisor tooth roots are seen.
Part of the premolar and molar teeth have been removed as well and present with impacted remnants of the tooth roots. The premolar and molar teeth present irregular length and angulation with variable longitudinal growth and step formation resulting in complex chronic malocclusion. Only mild retrograde elongation and apical periodontal widening is noted around the premolar and molar tooth roots.
There is moderate dilation of the ventricular system emphasizing the lateral ventricles consistent with a hydrocephalus internus of unknown origin.
Moderate generalized osteopenia is noted throughout the imaged bones as included.
Spondylosis deformans is noted within the deep cervical spine.

Outcome

There is a complex malocclusion with multiple missing teeth, impacted tooth root remnants and irregular longitudinal growth of the remaining molar teeth as well as generalized age-related osteopenia and degradative changes of the axial skeleton.