‘King’, a 2-year-old rescue gelding under the care of World Horse Welfare, was seen by our vet Kai for a persistent discharging tract at the base of his right ear. The issue was clearly bothering him, with frequent headshaking and signs of irritation observed by his carers.

A short course of antimicrobials gave only limited improvement, which raised suspicions that something more unusual was going on. Given the location and lack of response to treatment, a dentigerous cyst was high on the list – a congenital condition involving a tooth that has, quite simply, taken a wrong turn.

Figure 1 – The red circle highlights abnormal tooth structures in the skull near the ear base on the right side. The green circle highlights normal anatomy on the left side of the head.

King was admitted to our clinic for further investigation, including radiographs and an ultrasound of his head (figure 1). These confirmed our suspicions, revealing a large tooth-like structure lurking deep within his skull – definitely not where you would be expecting to find a tooth! This misplaced tooth leads to a discharge that tracks through the tissues and eventually drains at the base of the ear.

Figure 2 – Photos from during and immediately after surgery.

King underwent a lengthy general anaesthetic for surgical removal of the cyst and tooth (figure 2). In a surprising twist, not one but two rogue large teeth were discovered (figure 3). Our diplomat surgeon, Guy, carefully worked over several hours to remove both, all while navigating the many vital structures in the area and avoiding any damage to the nerves responsible for facial movement and ear function.

Figure 3 – The culprits following removal. A 3x2cm tooth and 5x6cm tooth.

We’re very pleased to report that King has since made an excellent recovery. His staples have been removed, he’s much more comfortable, and most importantly, he’s no longer hiding any unexpected dental surprises. We’re delighted to see him doing so well and wish him all the best in finding his much-deserved forever home!

If you have any concerns for your horse, please do not hesitate to contact the team. At least two of our Oakhill Equine Vets are on call 24/7, 365 days/year.