Retrobulbar abscess in the dog: pain on opening the mouth
3-year-old Labrador that loves chewing sticks, with 2 days of right exophthalmos, third eyelid protrusion, chemosis, fever and severe pain when trying to open its mouth. Oral examination shows swelling of the mucosa behind the last right upper molar.
What is the most appropriate treatment?
chevron_right Show answer and explanation
A. Systemic corticosteroids at immunosuppressive doses for suspected myositis
The fever, acute unilateral onset and oral swelling point to an infectious process; immunosuppressing without drainage would worsen the abscess.
B. Enucleation to remove the source of infection
This is disproportionate: the eye itself is usually healthy and the condition responds well to drainage and antibiotics.
C. Topical antibiotic and lubricant, and recheck in a week
Topical treatment does not reach the orbit. Lubrication is useful to protect the exposed cornea, but it does not treat the cause.
D. Drainage under general anaesthesia through the oral mucosa behind the last upper molar, with systemic antibiotics and NSAIDs
Correct. The mucosa is incised and closed haemostatic forceps are advanced into the orbit (blunt dissection) to avoid damaging vessels and nerves. Submit samples for cytology and culture and protect the cornea with lubricant.
lightbulb Key takeaway
Pain on opening the mouth is the sign that distinguishes inflammatory orbital disease (abscess, cellulitis) from neoplasia, which is usually painless. Look for plant foreign bodies or sticks and dental disease; if there is no fluctuant collection, ultrasound or CT will guide you before draining.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.