Surgical Removal of Mandibular Abscess

Photos 1 and 2 - A Chamaeleo johnstoni was presented with the complaint of a swelling in its mouth that the owner believed was a temporal gland infection. Upon examination a large swelling was noticed on the left side of the mandible but not where the temporal gland should be. It was actually growing in the lower dental arcade and seemed to be an oral abscess.

Photo 3 - Upon examination of the oral cavity a large amount of green/yellow material was noticed in the area of the mass and a very foul odor was coming from it. Surgery was recommended to debride the area and obtain a sample for culture and sensitivity.

Photos 4 and 5 - The chameleon was anesthesized with 5% isoflurane and a good sample was obtained for culture. There was a lot of pus obtained and only some was used to be sent to the lab for analysis. It was of doughy consistency and very bad smelling.

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Photos 6 and 7 - After the area was cleaned and disinfected it looked much better and the underlying tissue still looked viable. The mandibular bone however was missing. Seems like the infection actually ate the bone and now the Johnston's chameleon had an incomplete mandible. This made things worse for the recovery.

Photo 8 - After the surgery was finished, the chameleon recovered quite quickly and started to move around the cage. The swelling in the lower jaw was still present but without any debris. Broad-spectrum antibiotics were started while waiting for culture results. It was advised to monitor the chameleon while he recovered to make sure he did not fracture his jaw completely.

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Photo 9 - After 3 days, the culture results showed a heavy growth of Klebsiella and Aeromonas which were both susceptible to Baytril (this was the antibiotic of choice used after the surgery). With this results the treatment was continued for 14 days and the chameleon seemed to be doing better every day. He ate normally and learned to chew only with his right side. What is even more important, the swelling on the mandible went down dramatically after the first 7 days of therapy.

Ivan Alfonso, DVM
On-Staff Exotic Veterinarian and Herpetoculturist