Button's breathing

dribble

Post   » Wed Aug 14, 2019 1:53 am


I adopted Button in March and he's seen the vet three times for his labored breathing. It has never improved, even though his activity level has remained good all along.

He is housed on fleece blankets that are washed in hot water and no scented anything. I thought maybe it was a veggie allergy because he seemed to react to bell pepper, so that stopped but really it made no difference. I've gone through several boxes of KMS Hayloft timothy, orchard grass and oat hay and one Small Pet Select timothy hay. No difference.

After his first vet visit he got a round of Baytril that did not improve his breathing. His weight has remained mostly stable (100g up or down), but he always struggles to breathe and his right eye is sunken. I'm taking him to the vet again tomorrow morning and have a list of treatment suggestions I've gathered from this site. However, I know this vet will refuse all of them. I've asked them to anesthetize Button to scope his nose, but any request for heart treatment is going to be denied. I also doubt he will agree to nebulizing gentamycin or baytril/doxycycline, or doing pulsed antibiotics or furosemide.

I feel so heartsick for the months Button has struggled to take every single breath so I need ammo here, please. Can anyone cite more than anecdotal successes with the meds mentioned?

I'm afraid the links aren't viewable on the site and need to be downloaded. I'll figure out a better way tomorrow. Meanwhile... https://app.box.com/s/z2v0f9zwtyi1jcfo4uqkqvm6zjhp5qji

Video 3 is the best for hearing his breathing and seeing his sides move to get a breath.
https://app.box.com/s/uzsd5mjwto4v73ikde9muk7o8wtir10c

Video 4 is best for hearing him while he's eating. https://app.box.com/s/txbr5udcp2uydx852kfndcz428sbhpe9

Video 1 shows how hard his sides move when he breathes (the chattering is because I pointed a phone at him instead of giving him the veggies he expected). https://app.box.com/s/23fgv1ct8jock2eg55nj8ebid4wyj7s5

Video 2 shows his sunken eye. https://app.box.com/s/smmp2sol2egun640l1s9t8enyo3bb2sz

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sef1268
Supporter in 2019

Post   » Wed Aug 14, 2019 6:04 am


Do you have an exotics vet? I think Dr. Burgess is in your area, correct? If your current vet won't work with you to either diagnose or treat what's going on with him, it sounds like it's time for a new vet.

Dental issues/sinus and heart are the things I would want to definitively rule out, if it's not a URI. Sunken eye could be something going on with his teeth, although it can also be a sign of dehydration (but I'd generally expect it to be noticeable both eyes).

It sounds like you have already read about some of these issues on the GL Medical pages, but just in case:
http://www.guinealynx.info/heart.html
http://www.guinealynx.info/uri.html
http://www.guinealynx.info/teeth.html

Hopefully others will chime in on any other possibilities.

I'm sorry that you and Button are dealing with this.

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Lynx
RESIST

Post   » Wed Aug 14, 2019 8:43 am


He is an awfully cute guy! Has he ever had any xrays to look for misshapen/obstructed air passage ways or evidence of an enlarged heart? (the heart page does have some indication of what an enlarged heart might look like). An xray might explain the sunken eye.

Since two vets are listed on the heart page, perhaps your vet could consult with one of them if the xrays seem to indicate an enlarged heart? Do any of the vets you have available belong to VIN.com? They might be able to give other avenues to look at.

He does seem to have quite labored breathing. What is he like when sleeping? The same? Does he lack energy or show any of the other signs a heart could be an issue (there are a list of signs on the heart page sef linked to)?

dribble

Post   » Wed Aug 14, 2019 1:57 pm


Thank you both (Hi Lynx!),

It's Dr. Burgess I've been going to for decades now. He's a stubborn guy! Another excellent exotics vet, Dr. Surrency, has plans in the works to move her office closer to me so I'm really, really looking forward to having options. She is more open to trying new treatments, but her current location is prohibitively far away for me.

They did take an xray of his chest and didn't see anything noteworthy about his lungs or heart (this was in April, I think). He said at the time that they can't get a good film of a head because of the bone structure.

He has taken a look at Button's teeth while he's awake, with a light probe, and saw nothing. He's able to eat normally (or he would've lost a whole lot of weight by now), but I agree that teeth or a problem on the right side in that area could well be the problem.

Button is mostly quiet while sleeping and resting. Activity and eating make it much worse. His activity level is really good, as it should be for a young boar, and better than it should be for someone who can't breathe!

I didn't know about VIN.com and it looks really great. I expect Dr. Burgess is aware of it, but like I said: He's not open to alternative ideas.

I wrote a small novel on the back of the drop-off sheet this morning with all of the things I've read here that might help. It's so distressing to be nearly certain that he will veto all of them. I will say, I'm not going to settle for the "I don't know so we're not going to try anything" story this time. I need something! Not trying is not an option.


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Lynx
RESIST

Post   » Wed Aug 14, 2019 9:26 pm


I guess I would take the approach of asking for a list of what he thinks may be causing this. What the treatment for his theory would be and when one would know the theory was wrong because the treatment had no effect. Get him to acknowledge other theories. They can be less likely theories - but after his ideas have failed, one would think he could try to treat based on another theory.

pinta

Post   » Thu Aug 15, 2019 2:41 am


I'm thinking his eye isn't so much sunken but being overwhelmed by fluid. He has Pea Eye. I would have him on Lasix. If the Pea Eye disappears you'll know it's excess fluid building up. His breathing and sounds he makes and how you describe his activity level all say heart to me.

Do you know any humans on lasix? Same med for pigs.

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sef1268
Supporter in 2019

Post   » Thu Aug 15, 2019 6:19 am


Yes, I see the Pea Eye, now. I couldn't view the earlier videos, for some reason.
http://www.guinealynx.info/eyes.html#pea

Does he make that sound fairly consistently (other than when resting), or just occasionally?

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Lynx
RESIST

Post   » Thu Aug 15, 2019 7:49 am


Without additional signs of heart problems, still possible there is some sort of obstruction in his nasal passageway.

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sef1268
Supporter in 2019

Post   » Thu Aug 15, 2019 12:07 pm


That's kind of what I was thinking, Lynx. Heart is a definite possibility, but we did have a male a few years ago who had a narrow nasal passage and he very often made that same noise. He was otherwise very active, ate well, etc. Did not have pea eye, though, which could be another heart sign or totally unrelated.

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Lynx
RESIST

Post   » Thu Aug 15, 2019 8:55 pm


One remotely possible scenario would be an inhaled piece of hay, infection, inflammation, affecting the eye on that side.

dribble

Post   » Thu Aug 15, 2019 9:05 pm


I will never understand why Dr. Burgess refuses to believe anything is heart related. I guess I need illicit drugs to try to just prove to him that yes! It's heart-related!

Dr. Burgess did talk to me for over 20 minutes about possibilities. We've already tried Baytril and SMZ in the past with no change. At that time he basically did a doctor shrug. It was just after I'd spent thousands of dollars on three pigs who rapidly died after intensive attempts to save them. Maybe it was bad timing for Button that I didn't do a deep dive into my bank account to try anything for him. If he'd started acting different or lethargic or losing weight I'd have jumped on it. His change in breathing caused me to try again.

So... the doc thinks:

-- It is not teeth because he's not drooling, he is eating normally, he has no nasal discharge.
--He ruled out URI or something lodged in there because no sneezing, no lack of appetite, no running nose or weirdness in the eyes (except yes, the pea eye).
-- He doesn't have a scope that will look up the miniature nostrils of a guinea pig to see if there is a polyp in the passages and if he found one he doesn't have the tools to safely remove it.
-- He does not think it's heart or lungs.
-- We talked about getting an xray of his head, which requires sedation and tipping the pig on his back with his mouth wide open. He was concerned about that with a pig that's having trouble breathing.
--As opposed to the two previous times where he said it was in the nasal area, this time he absolutely heard it exactly at the larynx area, not above or below. He describe laryngeal paralysis in dogs and how they help them surgically but that it won't work with pigs. He said there's no straight shot to the larynx in pigs. It's an L-shaped entrance (long mouth that bends down to the larynx) so the easy way won't work. He said you can go in from the side, but it's risky. He also said they have scopes with the ability to clip tissue, like a potential polyp, but if it bleeds you can't stop it.
--He said if they did that and damaged the nerves the pig would not be able to close its larynx in order to swallow food and liquid.
--He said it's possible to do ultrasound for under $500 and that they have a mobile tech who is very good with small animals and would check on that for me.
--He said it would be great if the "cillin" family of drugs didn't kill guinea pigs but it does so it rules out stuff that might be just the thing.
--Button and my other pigs are already getting twice yearly bordatella shots so if it is that, there's not much that can be done.
--Cysts in the throat area are very rare.
--We talked about the various medicine families we could try (Baytril vs Gentamycin, etc.) and by then my eyes were glazing over and he was talking even faster than normal.

SO... I went home with a nebulizer formula of baytril/albuterol/saline solution to use 2x daily along with metcam to try to reduce swelling. He said if Button shows signs of improvement in a couple of days it seems likely it's a stubborn infection that the chloramphenicol he prescribed may help. If he does not, it's structural and maybe the ultrasound person can shed more light on it.

What I expect is everyone here with different veterinarians will tell me: IT"S HEART. Uh huh.

Exotics veterinarians are really precious. Their suicide rate is one of the highest. They have incredible education debt, and far worse is the emotional toll of people. They go from an idiot who just doesn't care about their animal, to end of life euthanizations, to happy first check-ups. I'm not going to criticize my veterinarian when he's actually pretty awesome.

He's done amazing things for me and my pigs and his staff are superstars. I really, really wish there were published FACTS I could bring to him that say "This clearly indicates a heart problem" but I don't have anything.

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Lynx
RESIST

Post   » Thu Aug 15, 2019 9:19 pm


You are very thorough in your review. It sounds like you are convinced it is a heart issue.

You've read the heart page, no? There are specific tests that can be done to check for heart issues. Sounds like nothing was found via xray? I reference one article on heart problems in guinea pigs and provide published guidelines for at least one of the tests. I list the sources I used so you can find and reference them.
www.guinealynx.info/heart.html
X-rays and echocardiography can confirm a diagnosis of cardiac disease.

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sef1268
Supporter in 2019

Post   » Thu Aug 15, 2019 9:40 pm


Some of the more experienced guinea pig owners here can sometimes tell from an x-ray if they think the heart looks enlarged. If it's a clear enough image, someone here might be willing to offer an opinion. Any chance they'd send you the digital chest x-rays and you could post them here? There are quite a few good images on GL to compare it against.

Based on what you have described, though, and your vet's findings, I'm not 100% convinced that you're looking at a heart issue.

pinta

Post   » Fri Aug 16, 2019 1:33 am


When we first twigged onto heart issues occurring in pigs it was with a pig named Zag. She had Pea Eye in both eyes that my vet informed me were fat deposits. She had a URI that would go away with drugs and always come back. We had xrays taken by a specialist(this was decades ago) who was renowned in his field. He declared her to have walking pneumonia. He did say there was fluid in the lungs. On a hunch I asked my vet if we could try lasix just to get the fluid out. We did and surprise surprise, the pea eye disappeared, the walking pneumonia symptoms disappeared. That was our eureka moment. She had heart issues. My vet, flying by the seat of her pants as there was no reference material dealing with heart disease in pigs(there is now), extrapolated heart med doses from cat to pigs and Zag never had a recurring URI again.

In the many years that followed we discovered in most pigs, it's almost impossible to diagnose heart disease unless you kill the pig and take a look at the heart. We did find a trial of Fortekor (our by-the-seat-of-our-pants dose is higher than the med references but has proven to get better results) works as a dignostic tool. If the pig gains weight, gets more active, is more alert, has better muscle tone, or breathes better after a few doses of Fortekor, you can be pretty sure the problem is heart. For me, unexplained weight loss is enough reason to try Fortekor. There have been countless pigs who turned around completely and started gaining weight once on Fortekor.

I had a skinny with weight loss after my vet retired. Because I wasn't sure what other issues a skinny might have that would cause weight loss, I tracked down a very pig savvy vet who was doing a shift at the SPCA. He's the type of vet who wants a clear diagnosis. Took advantage off all the diagnostics the SPCA hospital had available. The only thing we couldn't do was get blood as the skinny was so tiny. Absolutely nothing seemed amiss. I asked if we could try a trial of fortekor and the vet reluctantly agreed. But his dose was 1/3 the dose I was used to. No changes after 3 days. I upped the dose to what I was used to and within 24 hours she started gaining weight. I emailed the vet, told him what I'd done. I think he may have change his dosing. Her turnaround was rapid and lasted.

Willie came to us sounding like a freight train at the age or 2 months. Since he wasn't dying we ruled out a URI. My vet(before we realised how common heart disease is in pigs) thought it must be asthma. When he was two we finally tried him on heat meds. The asthma symptoms disappeared.

My vet confirmed heart disease in all our pigs on heart meds via necropsy. So we know although there was no "official" diagnosis, heart was the issue and it's incredibly common.

I think a trial of Fortekor would be safer for Buttons than Chloramphenicol which is a big gun in ABs and can often totally eff up the gut. Basically if he had a bacterial infection it should be gone by now(with the ABs he's been on) or he would be dead. This is important to note. Infections like URIs kill pigs rapidly if the AB doesn't work. If the pig has a URI for months, it ain't a URI.

By the way there is a 'cillin pigs can take via injection - Duplocillin(sp?). Dr. Legendre uses this frequently in his pig dental patients. I've had a pig on it for 2 weeks with no ill effects whatsoever. Shocked the hell out of my regular vet when she heard the dose and the med!

All of the stuff your vet wants to try is expensive or invasive. A trial of Fortekor is neither. If Fortekor doesn't make any difference, then it's time to try the pricier diagnostics. I know a vet wrote something on the heart thread for people to print off for vets who refuse to consider heart but I suspect your vet wants something in a textbook. I also suspect he has no interest in consulting with other vets....

Coincidentally I had a pig in heart failure this morning. I had just finished subcuing her fluids for a sludgy bladder when she went into death spasms. Lost all her muscle tone. Fortunately the oxygen was already out for another pig who didn't make it. I slapped the oxygen on her snout and when she started breathing again, listened to her chest and one side was sticky. Dosed out oral Lasix(10mg). She was too weak to take it orally so I called the vet and asked them to prepare a 10mg injectable lasix dose for me to grab. Told them it would be too much stress for her to bring her in and she was connected to oxygen. Had a slight argument with the receptionist about preparing drug doses over the phone but worked it out. Left the pig in the basket inside a plastic bag with the oxygen hose by her snout and dashed to the vet. My pig vet wasn't in so the dog and cat vet followed my instructions and gave me a syringe with 5 doses of Lasix. When I got back, Princess(came with that name) was still upright and breathing. Seemed more stable than when I left. Injected the lasix and in 30 minutes she was able to take her heart meds orally by syringe. Upping her Fortekor dose by 1/3 daily. Now she's outside munching grass with the rest of the herd. I will give her another dose of lasix tonight.

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sef1268
Supporter in 2019

Post   » Fri Aug 16, 2019 6:58 am


That's quite amazing, Pinta. My experience with heart issues is limited to one male that we had a few years ago who presented with the 'classic' signs of heart trouble, and I believe he was put on Benazepril and Lasix. It seemed to help for a while, but then he crashed and that was the end. I don't know if the doses were too low or too high (our vet had never treated heart problems in a guinea pig before, but was at least willing to give it a try), or if maybe the problem wasn't his heart to begin with, but it has not a good experience.

We also had a male who made a very similar sound as the one being made by Button, but our vet was able to get a good enough look up his nose to see that he had a badly constricted nasal passage that she felt was something he was born with. He didn't make the sound constantly, but it did worsen when he would eat. It didn't seem to affect his activity, appetite, etc., and he appeared to be otherwise healthy.

You (Pinta) have obviously dealt with this much more than many/most here, though, and what you're suggesting seems reasonable. The question is...how to persuade Dr. Burgess to give the meds a trial run-?

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Lynx
RESIST

Post   » Fri Aug 16, 2019 9:45 am


Super summary of some of your experiences, Pinta! Would you like me to copy your post to the Records forum where it will be more easily findable?
http://www.guinealynx.info/records/viewforum.php?f=2

I do think one of the issues surrounding treatment for heart problems is that as non-medical people (many of us), we do not have a good background for the many different diagnoses relating to heart. CHF (chronic heart failure) is only one of them. Also dilated cardiomyopathy.

I have a link on the heart page to the Long Beach animal hospital and it includes mention of treating a guinea pig for heart issues too. And goes into great detail on other pages concerning how the diagnoses is made.
https://www.lbah.com/canine/heart-disease/

At the bottom of the page are links to:
  • Vascular Anatomy & Physiology
  • Heart Anatomy & Physiology
  • Causes and Symptoms of Heart Disease
  • How We Diagnose Heart Disease
  • Cardiac Diseases and Treatments
The discussion of cardiomyopathy is particularly interesting.
https://www.lbah.com/canine/heart-diseases-and-their-treatment/

There are several causes. One cat case cited mentions a large blood clot blocking blood flow to the rear legs, resulting in paralyzed back legs and a cooler temperature to the extremities.

dribble

Post   » Fri Aug 16, 2019 12:47 pm


Oooh, good info from everyone, thank you. Lynx, I'll read those pages. sef1268, man that does sound similar to my pig.

Pinta, holy cow. Most of us cannot be present in our pigs' lives very much with work and stuff, so your pigs are very lucky that you have the ability to see changes much more immediately than most of us and especially lucky that you know what to do!

Dr. Burgess said at our appointment that if the nebulizing didn't help (which it has not) that going to Chloramphenicol wasn't going to help anyway, so I've left a message there for the staff to ask him for Enalapril or whatever ACE inhibitor he prefers. I'll beg/plead/coerce him into letting me get a prescription. I wanted to say "Don't make me go to the black market for this!"

pinta

Post   » Fri Aug 16, 2019 4:33 pm


Sure, Lynx, go ahead.

I once asked my vet if I had that syndrome for "inventing illnesses" in my pigs. She said I was just very observant. I suspect a lot of sudden deaths with no known cause are heart related. Unfortunately most people don't realize something is brewing until the pig is too far gone. They are prey animals. They will hide their symptoms until they can no longer hide them and by then it is too late. My vet was commiserating with me a couple of a weeks ago about his frustration when people bring in their pigs too late. Sad for the owner. Frustrating for the vet.

Because our pigs free range thru the kitchen and living room I can tell when someone's activity level is low. We put Princess (already on heart meds) on Cartrophen when she stopped coming into the living room to check out the "magic" basket. Once on the arthritis med she was back in action. Because we toss the veggies onto the floor in the kitchen we can tell when a pig is too slow getting to the food or hanging back. Sometimes it's as simple as arthritis which can be diagnosed by the vet. Sometimes you have to check the weight chart going back a few months to find a gradual trend downwards. Then you start putting the pieces together(if a vet visit finds nothing) until you find a likely reason for the weight loss. Because most of my rescued pigs are seniors heart is the problem 9 out of 10 times. Princess is over 6 years.

Weigh pigs weekly. This is the first defense against illness. The pig we lost had just had her weekly weighing and had lost 5 ounces. I did the triage but she didn't snap back like other pigs had done. Only a slight improvement. Took her in to the vet who agreed it was most likely heart as everything else was checking out. Despite all she died in her sleep in the oxygen tent the next day. This vet charges for necropsies so I can't afford to get one done so it could have been a tumour that couldn't be palpated or an unrecoverable heart episode. Poor Alice is still in the fridge as we have discovered hostas planted over pigs do really well. Taking time to get the hole deep enough for the hosta and the pig. Might have to move Alice to the freezer....

pinta

Post   » Fri Aug 16, 2019 4:40 pm


PS - Dribble - When you have a herd of seniors a portable oxygen tank is your best friend. We always have two tanks so we are never screwed by a tank running out. Oxygen lasts forever. My friends are so used to the sight of the oxygen tank leaning against the couch they just ask "which pig"?

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