Veterinary Oral Pathology

Oral biopsies, teeth, and jaw resections are read by Dr. Eric Snook, DVM, PhD, DACVP, a board-certified veterinary pathologist with a particular focus on oral pathology. We work with veterinary dental specialists and general practitioners nationwide, and most soft tissue oral biopsies are reported within 1 to 2 business days of arrival.

At a glance

  • Read by: Eric Snook, DVM, PhD, DACVP
  • Standard oral evaluations: soft tissue oral biopsies, reported within 1 to 2 business days of receipt
  • Complex oral evaluations: teeth, bone, and jaw resections, usually 24 to 48 hours longer because of decalcification
  • Submit: through the Vetopathy portal, with discounted FedEx or UPS labels
  • Ship to: Vetopathy, 11700 Commonwealth Dr., Ste. 200, Louisville, KY 40299
  • Fee schedule: email info@vetopathy.com
  • Contracts: none

Standard and complex oral specimens

The deciding question for an oral specimen is simple: does it contain bone or a tooth?

Standard oral evaluation

Soft tissue oral biopsies with no bone or teeth.

  • Gingival and oral mucosal masses
  • Lip, tongue, and palate lesions
  • Incisional and excisional soft tissue biopsies
  • Up to four samples of the same suspected condition, such as several biopsies for generalized gingivostomatitis, are evaluated together as one case

Turnaround: 1 to 2 business days from receipt.

Complex oral evaluation

Any oral specimen that contains bone or a tooth.

  • Tooth evaluations, including a single tooth
  • Mandibulectomy and maxillectomy specimens
  • Biopsies that include bone, such as deep incisional biopsies of bone-invasive lesions

Turnaround: usually 24 to 48 hours longer than a standard evaluation.

Why it takes longer: bone and teeth must be decalcified before they can be sectioned, which takes additional reagents and technician time. Jaw resections also need careful trimming so the sections show the lesion and the soft tissue and bone margins. Complex evaluations have their own category on the fee schedule.

Why oral lesions deserve a focused read

The mouth produces a small set of lesions that look alike under the microscope but behave very differently. Canine acanthomatous ameloblastoma and papillary squamous cell carcinoma can resemble each other closely. Reactive lesions can mimic neoplasia, and amelanotic melanoma can be mistaken for other tumors. Getting these distinctions right changes the prognosis and the next steps for the patient, so they get careful attention on every oral case.

Lesions we commonly see

  • Canine acanthomatous ameloblastoma
  • Peripheral odontogenic fibroma
  • Squamous cell carcinoma, including canine papillary SCC and feline oral SCC
  • Oral melanoma, including amelanotic melanoma
  • Reactive and inflammatory lesions, such as pyogenic granuloma and gingival hyperplasia
  • Less common odontogenic and bone tumors

What your report includes

  • A clear diagnosis either disease or morphologic
  • Margin evaluation on excisional biopsies and jaw resections, including bone margins on complex specimens.
  • Prognostic information when it applies, such as mitotic count for oral melanoma.
  • A clinical comment written for the clinician who has to make the next decision, correlated with dental radiographs, CT images and clinical photos and fully referenced when appropriate.
  • Immunohistochemistry when needed, for example Melan-A and PNL2 to confirm amelanotic melanoma (must be ordered separately from the original biopsy submission).

Working with veterinary dentists

Dental and oral surgery practices are some of our closest collaborators. You can call or email Dr. Snook to talk through a case before surgery, after a report, or when the histology and the clinical picture do not match.

"As a veterinary dentist, oral pathology accuracy and efficiency is essential to what I do. Vetopathy and Dr. Snook have exceeded all of my expectations." Katy Burton, DVM, DAVDC, East Tennessee Veterinary Dentistry

"I highly recommend Dr. Eric Snook, DVM, PhD, DACVP for veterinary oral pathology." Daniel T. Carmichael, DVM, DAVDC, West Islip, NY

Submitting oral specimens

  1. Fix in 10% neutral-buffered formalin at roughly 10 parts formalin to 1 part tissue. Jaw resections need a container large enough for the formalin to surround the whole specimen.
  2. Identify the location by tooth number using the modified Triadan system, and note which side is rostral and which is caudal.
  3. Mark the margins you care about with ink or a suture tag, and describe them in the submission.
  4. Submit anything with bone or a tooth as a complex evaluation, even a single tooth.
  5. Upload dental radiographs, CT images, and clinical photos in the portal. They help with interpretation, especially for bone-invasive lesions.
  6. List your differentials so the report can address them directly.

Common questions

Do you work with veterinary dental specialists?

Yes. Dental and oral surgery practices across the country send their oral biopsies and jaw resections to Vetopathy.

Is my oral biopsy standard or complex?

If it contains bone or a tooth, it is a complex evaluation. Soft tissue oral biopsies with no bone or teeth are standard evaluations.

How long does a mandibulectomy or maxillectomy take?

Usually 24 to 48 hours longer than a soft tissue biopsy, because the bone must be decalcified before it can be sectioned. Teeth are handled the same way.

Can you review an oral biopsy read by another lab?

Yes. Send the tissue blocks or slides and the previous report for an independent second opinion.

Should I send dental radiographs?

Yes. Radiographs and CT images help with interpretation, especially for lesions that involve bone. Upload them with the submission in the portal.

How do I get started?

Click "Submit a Sample" to create an account, then email info@vetopathy.com for the fee schedule and submission guidelines.

Related reading

Questions about a case?

Call or text 513-204-9345, or email info@vetopathy.com.