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A trip to the dentist is bad enough at the best of times – but when you’re only 8 inches from head to toe and weigh just 500 grams, everything is a big deal.

Pygmy slow loris Charlie is probably the first of his species ever to have a hemimandibulectomy. The word is almost as long as Charlie, but if you break it down you find the meaning – hemi mandibul ectomy - the removal of one side of his lower jaw.

It all started in September 2017, when Charlie, who lives at Paignton Zoo Environmental Park in Devon, needed a dental check-up. Initially he was seen by the Zoo’s in-house vets, because he had what seemed to be a simple abscess. It turned out to be much worse than initially thought, so help and advice was sought from veterinary dental specialist Matthew Oxford. 

Over the next few months, Matthew performed three surgeries on Charlie. Matthew is one of only a handful of veterinary dentists in the UK; based in the New Forest, he provides a referral veterinary dentistry and oral surgery service at places including South Devon Referrals, in Kingskerswell.

Paignton Zoo Veterinary Associate Christa van Wessem: “Charlie was put on long-term antibiotics and pain relief and given liquid food, which he loved and ate very well with the sutures in place. After the first surgery, we really did not want him to chew at all, as it might break down the sutures and inhibit wound healing.”

But Charlie suffered a setback. In November he had to return to South Devon Referrals after a breakdown of the wound from the first surgery. Radiographs showed that the jaw bone had been damaged by the infection and it was decided to perform the hemimandibulectomy, removing part of his infected lower jaw.

Christa: “As far as I know, a hemimandibulectomy has never been performed on a pygmy slow loris, or indeed any primate, though it is fairly commonly performed on dogs and sometimes cats.”

Charlie was a small animal who presented his carers with big problems. Christa explained the issues: “The space you have to work in is tiny – it requires small instruments, steady hands and magnifying glasses. Anaesthetic maintenance and monitoring was difficult, too. His mouth is very small and doesn’t open very wide - the smallest of movements with the instruments was huge in that confined space. The first bit of bone we removed was no bigger than one centimetre. Also, the bone was brittle from the infection.”

In December came more bad news. During a routine check, the experts saw some problems with the healing process and a CT scan revealed that the remaining piece of the mandible was also severely affected and had to be removed. Christa again: “The third surgery was by far the most challenging, as it was far back in the mouth, surrounded by very sensitive tissues, nerves and lots of blood vessels. It is difficult enough in a cat, let alone something that’s ten times smaller than a cat!”


There were good reasons for the hard work and dedication: Charlie is important for the future of his species. Paignton Zoo Senior Head Keeper of Mammals Rob Rouse: “He has bred before, including twins last year, and we hope his mate Edna is pregnant again. He is ranked as the sixth most important male in the European Endangered species Program and we have recommendations to breed him in the future. It’s vital his bloodline continues as part of this carefully-managed international zoo breeding programme.”


Christa: “He has been a real trooper through all of this. He’s never lost his appetite – no matter what we did with him, he never stopped eating, which is a great sign! After the second surgery he started eating soft, cooked veg right away. Since the final operation he has been doing really well and is now back onto his normal food – crunchy uncooked veg and bugs. When we saw him eat a locust without much issue we knew he was going to be OK!”


Poor old Charlie has had dental work before, including extractions. Dental issues used to be common in this species in zoos because of their diet. Paignton Zoo stopped feeding sugary fruit developed for human consumption and the vets now see far fewer issues.


“We hope this case could help other animals in the future. Knowing that it is technically possible and that he is coping really well now, is very good news indeed.”


Many weeks on and Christa is delighted with his progress. “Hs mouth and face look amazing. There are still a few sutures in his mouth, but there’s no sign of inflammation, swelling or infection. The gums have healed beautifully and there are no issues at all by the look of it. His blood results are all normal, too. If you didn’t know he was missing half of his lower jaw, you wouldn’t guess from looking at him.”


Charlie and Edna have now been reunited and Edna is expecting.

 

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