barely eating x3 months, now impaction issues

platypus

Post   » Wed Jun 17, 2020 9:42 am


Gilbert continues to lose weight. He was 1190 gms in March. At the beginning of this month he was 1111 gms, now he is down to 1072 gm.

I am handfeeding him x4/day, I mix up about 3/4 tablespoon of the powdered critical care + 1/3 tablespoon of ground alfalfa pellets with water and he will eat most of that, he does drool some out. Lately he is drooling more out. It takes him at least an hour to eat one feeding.

He may nibble on hay or greens but doesn't eat a significant amount. I have offered him alfalfa, orchard grass (KMS & Small Pet Select), 1st & 2nd cut timothy (Small Pet Select), oat hay x2 brands, 3rd cut timothy (KMS but hard & stiff) and a couple of others. I've wet some. I tried giving him just the leaves of the alfalfa. He will nibble on a new hay but then won't eat more

He has impaction issues which I remove every day. It's mostly clumped together "normal" poops now

Yesterday I noticed tiny dried up, very light yellow mucus under his nose. His breathing is normal

Had video visit with his main vet yesterday. He said watch him a day or 2, if he lost more weight try metoclopramide. Because his breathing was fine and there wasn't much mucus, he didn't think he needed antibiotics right now. He did not want to start both because then wouldn't know the effect of either. And side effects?

I don't know why he did not recommend starting the metoclopramide right now, The vet is off until Friday. He did leave a prescription in Gilbert's medical chart for both metroclopramide & tms so I can start if Gilbert does poorly in the next day or two.

He said there are no appetite stimulants for piggies. He said that probiotics don't really work for piggies

If Gilbert gets down to 1030 gms. then he needs a workup under anesthesia: head xrays, good look at teeth, bloodwork, chest xray (for possible heart problems),

On top of this my dog got sick yesterday too. I'm so stressed that I am not thinking straight. My Gilbert is fading away before my eyes.

I'm going to start metoclopramide today, I probably should have started yesterday even though the vet didn't recommend it, right? If I start this, should i keep him on the cisapride?

I don't have another piggy to get poop, is there a probiotic that you know is effective?

I guess the metacam works for joint & muscle pain, not for any G.I. pain. I didn't know that. Is there something else for his pain which I'm sure something must hurt?

I am afraid of the stress of putting him through the recommended workup. His main vet has the skills to do it, but I'm not sure if the other vets do also or if they have the staff & equipment.

What should I do? Do you think I should get a workup now or wait to see if he gets to 1030 gms?

Should I add more ground alfalfa to his handfeeding? I'm worried that he won't get the proper nutrition if he eats less critical care because he's eating more ground alfalfa. Anything else I can do to stop him losing more weight?

I am beside myself. Thank you for helping us

User avatar
Sef
I dissent.

Post   » Wed Jun 17, 2020 12:32 pm


"He said there are no appetite stimulants for piggies. He said that probiotics don't really work for piggies"

I would respectfully disagree. B vitamins can be helpful in jump-starting appetite in some cases. I have generally given it subcutaneously, but it can be given orally as well. It might be worth asking about.

Probiotics can't hurt and there is plenty of anecdotal evidence to suggest that it can be beneficial. I use an acidophilus product called Garden Acidophilus by Nature's Life. It can be sprinkled on lettuce and apparently has a very palatable veggie/carrot taste.

Based on our few seniors who had chronic impaction issues, I do think it can make a guinea pig feel generally unwell and can affect appetite. Hopefully if you can get the gut moving more efficiently, the impactions will decrease and he will start to feel better.

It sounds like you're doing a good job with handfeeding, although I will add that I've had the best luck with it when it has been slightly thicker and warmed for a few seconds in the microwave. Some people prefer to make it more watery; I've had pigs reluctant to eat it that way. You can always syringe plain water in-between syringes of CC. A product that has been beneficial to several of our pigs has been unflavored Pedialyte. I can't remember if I have already suggested it to you.

On the Metoclopramide, you can use in tandem with Cisapride. What strength were you given? What was the vet's recommended dose?

EDIT: Per one veterinarian Sef has consulted with, Metoclopramide (Reglan) and Cisapride used together can cause potentially serious complications in some situations. Use only as directed and under the strict supervision of a knowledgeable exotics veterinarian.

See also: Motility Medications

platypus

Post   » Wed Jun 17, 2020 1:52 pm


The vets can't know everything, thankfully you are here!

Metoclopramide - 5mg/ml give 0.1cc twice/day x7 days

Also on hold: Bactrim 48mg/ml, give 0.5cc twice/day x10 days

Do I give the metoclopramide and cisapride at the same feeding or alternate them?

I will have to give the probiotic orally in his critical care. Is is just a sprinkle? How often do you give it?

My vet is off for 3 days so i can't ask him about the B vitamins. You said I can give it orally - do you have a suggestion of what to buy? How much to give?

He lost another 15 gms today, down to 1057 gm

Thank you, Sef

User avatar
Sef
I dissent.

Post   » Wed Jun 17, 2020 2:14 pm


That's a reasonable, low dose on the Metoclopramide based on his weight. How often and in what amount are you giving the Cisapride? I'd be inclined to give them at the same time, but do watch for any signs of bloating or gastric upset. **Generally speaking,** Metoclopramide tends to be very well tolerated. And again, that's a fairly low dose.

I think it's also reasonable that your vet gave you an antibiotic to have on-hand in case he develops any other signs of a URI, although Bactrim may not be as effective for something like that vs. Baytril. Better tolerated, though, and I can see why the decision was made to go with something less harsh on the gut.

You can absolutely mix the probiotic with CC. Don't heat it with the probiotic, though. If memory serves, that can kill off the 'good' bacteria. Someone else can chime in if I'm off-base.

How does he seem otherwise?

EDIT: Per one veterinarian Sef has consulted with, Metoclopramide (Reglan) and Cisapride used together can cause potentially serious complications in some situations. Use only as directed and under the strict supervision of a knowledgeable exotics veterinarian.

See also: Motility Medications

platypus

Post   » Wed Jun 17, 2020 2:53 pm


Sef - I apologize, I just read the impaction article again and it gave the dose of the B vitamins. You can tell my brain isn't working very well right now...

Do you have a brand of B vitamins you can recommend?

I'm having no luck finding the Garden Acidophilus locally, guess I'll have to go with Amazon but was hoping to start it today

His cisapride is 10mg/ml, he gets 0.06cc twice/day

Partway through his handfeeding he usually starts headbutting when the syringe comes near. I do have to be firm but he often will drool out the critical care. Otherwise when he's in his cage he mostly sits there.

User avatar
Sef
I dissent.

Post   » Wed Jun 17, 2020 4:02 pm


If he's drooling it back out, you might not be pushing the syringe back far enough. It needs to go past the front teeth towards the back teeth, and at an angle. See if doing that helps any.

I don't really have a recommendation on the B vitamins off the top of my head, but let me look at my notes tonight and see if I can find anything. I imagine that any plain, liquid B complex without any sweeteners will work. The stuff I used in the past was red (injectible, but I'll see if it can be used orally).

Without scrolling back, is he still on a .4cc dose of Metacam? That's once a day, right? I also disagree that it won't help with GI pain. Most sources that I've seen on the subject of bloat and GI issues recommend Metacam to help with pain. I'm a little uncomfortable that he's on such a high dose for his weight, but that's your vet's call.

platypus

Post   » Wed Jun 17, 2020 5:17 pm


Yes, he is still on the metacam 0.4 cc and he gets it twice/day. The vet who prescribed it (vet #2) wanted the high dose in case he had jaw joint issues to hopefully get him to eat on his own. Vet #1 usually uses the normal dose but said it can go up from there. I tried to wean him (went to 0.35 cc twice/day) but then he had a huge weight drop, I don't know if that was related to the lower dose or was just a coincidence.

I'm glad that you think it helps with the GI pain. I've used it before on bunnies with stasis, I was surprised to hear vet #1 say that yesterday. The vet has health issues and he doesn't seem as sharp as he was before, but I don't know...

If Gilbert is doing vigorous headbutting to avoid the syringe, should i force him? I'm afraid he'll aspirate, but then again he desperately needs the

Would you do the workup at this point?

User avatar
Sef
I dissent.

Post   » Wed Jun 17, 2020 5:58 pm


If he's losing weight and not eating well on his own, then yes -- you will need to force feed him. Just go slowly with it and, like I said, push the syringe at an angle towards his cheek and back teeth. That helps avoid aspiration. Also try warming it up if you aren't already, and experiment with the consistency. Again, I've had better luck with a slightly thicker formula. He doesn't feel like eating, but it's not just a matter of keeping his weight up: his gut needs food moving through it, especially since he's on an NSAID and motility drugs.

**If it were me,** I'd be inclined to try bumping the Metacam a little and see how it goes. Owners have used higher amounts without any problem, but I do wonder if stomach irritation from it could be playing into his lack of appetite.

[edit - see Sef's clarification on the next page - Lynx]

User avatar
Lynx
Celebrate!!!

Post   » Wed Jun 17, 2020 8:42 pm


Look over this page that describes firmly pinning the head so it cannot be turned. It may be easier to get food and drugs in if a more gentle method does not work. One more relaxed method with more cooperative pets involves putting the guinea pig on a counter in the crook of your arm and offering food by syringe that way.
https://www.guinealynx.info/tips.html

User avatar
Sef
I dissent.

Post   » Wed Jun 17, 2020 8:43 pm


Also, just to clarify when I wrote, "**If it were me,** I'd be inclined to try bumping the Metacam a little and see how it goes," I meant bumping the amount of Metacam down---not up.

User avatar
Lynx
Celebrate!!!

Post   » Wed Jun 17, 2020 9:01 pm


Valium (aka Diazepam) has been recommended in veterinary literature as an appetite stimulant.

Since probiotics generally do not have any negative side effects and may help, many people use them.
https://www.guinealynx.info/probiotics.html

platypus

Post   » Fri Jun 19, 2020 2:52 pm


Gilbert is down to 1038 gms today. When he was eating on his own he hovered around 1200 gm

He is eating a bit better with thicker critical care, thanx Sef. I added pumpkin, it was someone's suggestion on this board.

Yesterday he started metoclopramide 0.5mg twice/day. Is also still on Cisapride 0.6cc twice/day

I handfed him hay (also another poster), he chews & chews but the hay doesn't go into his mouth unless i gently push on the ends. What does that mean?

We have an app't on Monday for anesthesia. Will look at his teeth, do 4 views of head xray, possible chest xray for heart, bloodwork (not sure what yet, I'm waiting for vet to call me for pre-op questions/instructions

Is there anything else you would want done while he's under anesthesia?

I can't find the probiotic Sef uses, Amazon delivery is July 2, would like to start it asap if possible. Any other brands for probiotics?

Also, any ideas for which brand of vitamin b-complex to get? I'm finding a lot have sugar in them, some have essential oils. Btw, the vet said she doesn't "believe" in vit. b. Sigh

We are having problems with the vets here, it's like they are too burned out to care like they used to. So having you all to help Gilbert & me is so valuable

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