We have had several seniors over the years, and when they reach the point of losing weight and slowing down, our vet has generally told us that nothing much can be done other than keeping the pig comfortable. That may be the case here, but I just want to make sure I'm not missing anything. After the last couple of losses of our older guys, I've lost some confidence in my vet's ability to be pro-active if she thinks it's "just age-related."
So...I will be asking for x-rays to look for arthritis and heart issues, possibly kidney function, teeth, but is there anything else we need to look for that could be going on with an 8-year old?
That's partly why I don't get tests run often. With my pigs, even if we were to get a diagnosis, what would I do with the results? How much extra time would treatment "buy" me? And how will it affect the quality of life?
Taking my pigs to the vet is usually pretty stressful. It's been my preference to not subject them to a whole lot of tests and procedures. Keeping them home, and pain free, with their favorites around them feel better. Even if that means they have a few less months than they would with a diagnosis and treatment.
I do think it's a personal thing though.
I suppose teeth could be an issue as well.
And it does make sense to ask what the test results are really going to get you. If you are unlikely to do anything differently as the result of the test, then maybe it's not worth the cost and discomfort just to get information.
X ray could give you some useful info. Assuming you are willing to give arthritis meds or heart meds if needed. Checking teeth is always good in pigs. I'm not sure if kidney function tests will be worth doing. It can't be easy to get blood samples and what can you really do about failing kidneys?
There is nothing wrong with just keeping an old fellow comfortable. Leonard really is pretty old!
- You can quote me
I will say this: an x-ray will show 1) possible heart enlargement and 2) arthritis. Sef, if your vet will do an x-ray without sedation, in my mind that is worth it. If and only if she will do an x-ray without sedation, that is, and only when it is not 7 deg. F out in the middle of a whiteout blizzard.
Our vet (the lovely and talented Dr. A.) would give me a prescription for a low dose of benazepril and carprofen (or Metacam) for potential heart enlargement and arthritis based solely on age and clinical sign. If your vet will do this, that IMO is the safest way to go. If your vet is not that open-minded, then try for an x-ray. Again, IMO only.
Past that in my experience there isn't much to do. Kidney weakness will only show up in bloodwork and as I understand it, it has to be pretty well advanced before it will show (Josephine is the expert here on that). Absolutely not worth it. Hydration is also good; try giving him some unflavored Pedialyte and see if he guzzles it. If he does, that's a good supplement/jumpstarter to regular water.
You can try giving subcues, but again in my experience only they fall into two distinct categories: one, doesn't bother the pig much and really benefits him, especially in the case of progressive kidney weakness, or two, stresses the pig so much the benefit isn't worth a fraction of the trouble and stress.
Try giving him Pedialyte or carrot juice first IMO.
Also look into a low, regular dose of Reglan (metoclopramide). We've had several seniors to benefit from this.
I wouldn't do anything invasive or stressful past this if he were our pig. Best would be if your vet would be willing to try benazepril and carprofen in low doses just based on clinical sign; they won't do any harm if not needed. But she may not be willing to do that. An x-ray is worth it IMO **if and only if** they won't manhandle him, sedate him, keep him in the back with four yapping dogs for 45 minutes, etc. etc. etc. You get the idea.
Also -- if the vet is good with teeth, I'd ask for a preliminary exam with otoscope. If she doesn't see anything that would warrant a more thorough exam under light sedation, then don't worry about his teeth. If she does, then go from there.
Caveat: a vet has to be pretty good with teeth to be able to do this accurately. Dr. A. is. She knows when to be able to tell "this looks okay" or "I'm not so sure, let's give him just a whiff of iso/sevo and take a closer look". Vets that are not that good with teeth will do an otoscope exam and say he's fine when there really are more problems there than the vet has seen preliminary evidence of.
Take a look at his incisors. Are they slanting, uneven, or V-shaped? Uneven incisors can (but not always) be an indicator of molar problems. There can be molar problems with no indication on the incisors, too, and sometimes (often, actually, in our case) older pigs get wonky incisors with no molar problems at all. But it is a good quick and dirty guesstimate method of whether there are dental problems or not -- albeit not as reliable with an older pig.
I think what we're dealing with is renal failure. Almost overnight I can feel his hip bones, and he's just not the bright-eyed, active pig that he was just a couple of weeks ago. Although the weight loss has been semi-gradual (at first, I chalked it up to running out of Kleenmama and having to substitute with Zupreem), I can tell he's losing muscle mass, now.
He's also very dry and rough-looking.I've been pushing Pedialyte, which he guzzles like crazy, canned pumpkin and plenty of wet veggies. Want to be careful, though, not to cause diarrhea. Subcue tonight didn't go all that well, and I only managed to get about 15cc's of Ringers into him before he managed to yank out the butterfly and send fluids flying everywhere.
We have a vet appt. tentatively scheduled for Thursday afternoon, but at this point, unless something changes, I'm leaning towards just continuing what I'm doing and trying to keep him as comfortable as I can for whatever amount of time he has with us.
Love this little old guy. It's going to be a rough loss.
- You can quote me
Sef -- how fast is the subcue being absorbed? If it's being absorbed like a normal bolus, that's one thing. If it vanishes *poof* like you poured water on a bone-dry sponge, that's advanced kidney problems. Our Toby, a/k/a Fearless Fuzzball, was like that toward the end of his life.
Give him as much Pedialyte as he wants. The tiny amount of glucose in it has never bothered any of our pigs. You can put it in his water bottle, or put a mix of it and water in his bottle also. If he likes the Pedialyte he will like that and it will make a big difference to him.
Caveat: there are no preservatives in Pedialyte and it is therefore a mold factory. Bottles need to be flushed out and refilled twice a day, and completely changed out, washed with soap and a very mild bleach solution every 48 hours. Bottle will only last 48 hours in the fridge, but if he really likes it you'll use it all in that time.
Try again with the subcue. Don't push more than 15 or 20 cc's at one time anyway (and warm the fluids first). Ideally this would be done two or even three times a day (as opposed to one of 40 or 50 cc's). That wasn't doable for us. Do the best you can.
If you have any Metacam, give him a low dose (if he is not on any other medications?) and just see if it helps him. If he is generally stiff and achy, an NSAID should help him feel better in general. Looking most at quality of life here.
Looked at the Evansville weather forecast for Thursday. High of 17 deg. F. I wouldn't take him out in that. MHO only.
The fluids absorbed instantly. I was surprised by that. Had hoped to get a full 20cc's in him (that's as much as I usually try to push at a time, anyway), but he pulled it out once and it dripped, and then pulled it out a second time and I lost a good 5 cc's out of that. He kicked and screamed...not a good scene. I'll try again tonight, though. He didn't want quite as much Pedialyte this morning, but then again he got a ton of veggies yesterday, the canned pumpkin, lost count on the cc's of Pedialyte, and whatever Ringers managed to go in.If it's being absorbed like a normal bolus, that's one thing. If it vanishes *poof* like you poured water on a bone-dry sponge, that's advanced kidney problems.
He also wiped out both the KMS pellets and the Zupreem that I put in his bowl at bedtime (which was over and above what he got for supper).
He's very stiff, and moving around much, or even being jostled when I pick him up in his cuddle cup, seems uncomfortable. I gave him .5cc's of Metacam this morning -- I'm almost out. Hoping Dr. M might give me a refill if I call today and plead my case. I agree that getting him out in this weather is not a good idea; I'm not even sure, at this point, that taking him in makes sense regardless.
This really sucks. :(
I have had numerous pigs come and go, but there are always the "special" ones that worm their way into your heart more than others. Losing them is a different story, and harder.
I hope that what to do will be clear for you, and that the two of you have good quality time right up till then end, whenever that comes.
I spoke with our vet this morning, and cancelled our appointment for tomorrow. She agreed with me that there's really nothing she can do for him, and it wouldn't be worth the stress on him and his body to put him through an exam; said we're already doing everything she would have advised us to do.
She is going to provide me with some fresh Metcam and said to let her know if we need anything, especially if we need her help when 'the time' comes. I really appreciated that.
All those piggies you've cared for in their twilight years - I'm sure they're watching over you and the other lucky piggies. And when the time comes for the next one to transition home, they'll be there, helping both of you.
Least that's how I like to think of it. . .
- You can quote me
Sef -- see if your vet will give you a small amount of buprenorphine. The standard liquid (0.3 mg/mL I think **but check this**) can be used in tiny, tiny amounts (0.01 -- 0.04 mL), given transdermally by gently smushing the syringe against the inside of the mouth, at the buccal cheek pad. Anything swallowed becomes oral administration, which works too.
I am NOT repeat NOT advocating home euthanasia or anything even close. I am NOT advocating using more than specified in Carpenter's. I am saying that if Leonard becomes weak enough, this can really help him relax, zone out, and feel less discomfort. That can be the case if he passes at home, or if you decide the best thing is to take him in and help him over.
Lynx -- I'll ask Dr. A. about the otoscope tutorial. The last time we needed a pic of something, the senior tech came in with her iPhone and snapped one, so I'm not sure about available technology but it's worth an ask.