Approximately 80% of pets have some form of dental disease by age three. Dental health issues that are not corrected can escalate into major problems affecting the entire body as your pet ages. Oronasal fistulas are one such problem. 

What is an oronasal fistula?

An oronasal fistula is a tract between the oral cavity and the respiratory tract openingessentially a hole connecting the mouth and nose that can lead to numerous problems in pets. Food, water, and saliva travel from the mouth to the nasal passages, irritating the respiratory tract. A pet with an oronasal fistula may show the following signs:

  • Excessive sneezing
  • Nasal discharge
  • Sneezing out food
  • Respiratory tract inflammation
  • Chronic infections of the nasal passages

An open pathway between the mouth and nasal passages causes your pet significant discomfort, especially if she develops chronic infections. She may not want to eat or drink, since food and water travel to the nose. Food and hair may also get stuck in the fistula and cause irritation. We recommend immediate closure of oronasal fistulas.

What causes oronasal fistulas in pets?

Oronasal fistulas are most commonly seen in dachshunds, but they can affect any dog or cat breed. Dental disease weakens the bone surrounding the pet’s teeth, including the upper incisors, canines, and premolars, and can cause a gap to form between the mouth and respiratory tract. Oronasal fistulas are commonly associated with upper canine teeth, but also occur in the upper incisor region.

Periodontal disease is the most common cause of this type of fistula. If dental disease progresses to a severe stage, bone loss causes infection-filled pockets to form. When bone loss and infection are evident, extraction is usually necessary to remove the source of pain and the bacteria. If the large, long-rooted canine tooth needs extraction, an oronasal fistula can result if so much bone has been lost that the channel between the mouth and nasal passages is exposed.

Oronasal fistulas can also be caused by:

  • Trauma, such as during a dog fight
  • Tooth extraction
  • Cancer
  • Penetration by a foreign object
  • Cleft palate

How are pets’ oronasal fistulas treated?

Prompt treatment provides the best prognosis for an oronasal fistula. Older, chronic fistulas are difficult to repair and never fully heal on their own.

Once we diagnose an oronasal fistula in your pet’s mouth, we formulate a treatment plan. If this is a chronic issue, your pet may have a respiratory infection due to food particles she has inhaled, and a course of antibiotics will be necessary before the repair. If not, we will close the fistula, an intensive surgical procedure that requires general anesthesia. Once we safely anesthetize your pet, we evaluate the fistula’s depth, clean out any debris, and search for healthy gum tissue. We close an oronasal fistula with a mucogingival flap, a piece of gum tissue we suture over the fistula. This can be a challenge, especially in severely diseased mouths that lack healthy gum tissue.

After the procedure, you have the challenging task of preventing your pet from chewing on anything hard, such as dry food, treats, or toys, for two to three weeks to allow the gingival flap to heal over the fistula.

How can oronasal fistulas in pets be prevented?

Top-notch dental care is the best prevention of an oronasal fistula forming in your pet’s mouth. Excellent oral hygiene wards off bone loss and infection that can weaken periodontal support structures. Good dental health also keeps your pet’s entire body healthy, since oral bacteria like to cling to heart valves and travel in the bloodstream, infecting organs and major body systems. Preserve your pet’s oral health the following ways:

  • Brush teeth regularly
  • Offer dental chews and treats
  • Invest in a water or food additive proven to reduce plaque formation
  • Schedule routine dental cleanings and examinations

Call our clinic to schedule an evaluation if you think your pet may have a fistula or other dental issues that may be causing discomfort.