barely eating x3 months, now impaction issues

platypus

Post   » Sat Jun 06, 2020 3:16 pm


[Edited - spaces added for readabity -Lynx]

i rescued males izzy & gilbert when they were 2 months old (the breeder only wanted the female & was gonna dump the males, ugh). we lost izzy a few months ago - bladder stone that completely blocked his urethra, urine backed up into the kidneys. we are still heartbroken. gilbert is 4.5 years old & lives alone but always near me. (our piggy rescue person is no longer rescuing so no buddy so far). in march he was fine one day, next morning hadn't eaten any of his hay. he'd gone from 1200 gm to 1140.

started sq fluids, critical care, metacam. saw our gr8 piggy-savvy vet, dr. n, of course diagnosis was g.i. stasis. teeth ok. added cisapride. it's been 3.5 months of syringe fdgs x2-4/day, wt. up & down. only eating small amt. of greens & pellets (kms) for the most part, not much hay. saw 2nd piggy-savvy vet dr. w (dr. n in isolation), teeth ok, thought may have jaw issues & suggested ct scan (minimum of a thousand bucks & general anesthesia, so no go for us). xray & labs are normal.

5 days ago gilbert didn't eat anything at all, dropped wt to 1111 gms. couldn't get app't for 2 days, finally saw 3rd piggy-experienced vet dr. s. dx - impaction. cleaned & flushed. better that night. but since then he's barely eaten anything, pretty much only italian parsley. not even pellets (dry or moist) or hay (dry or moist), i can't believe we're still on g.i. stasis protocol. his wt. is stable on 3-4 c.c. fdgs/day (with some mashed alfalfa pellets added).

back on cisapride since yesterday, has always been on metacam 0.4 cc x2/day (yeah, it's a high dose but it's also for his knees, all 3 vets prescribed it). televet visit with favorite vet dr. n yest., incisors are straight & even so no jaw problems, to continue regimen. all 3 vets say wt. at around 1140 gm is ok. these are my first 2 boars, didn't know about impaction issues or would have neutered them, have read everything on guinealynx available.

so here we are. 1) any suggestions to get him to eat? 2) what's the softest hay? he's got 3rd cut timmy (kms), oat, alfalfa (quality is awful). i know lack of hay is big factor for impaction issue & cannot cut down on greens right now. 3) when do i intervene with impaction?

if there's a light brown soft ball in sac, do i leave it? he's got one coupla times/day. normal poops are about 1/2 normal amt. in cage so he is pooping on his own but still has soft ball in sac, is on fleece. 4) if i do have to intervene with impaction, how do i do it? don't want to immerse his butt in water several times a day...? dr. n says to push from bottom up. it's frustrating not being able to be in room w/vet so one of them can show me what to do. 5) has anyone else had this issue with their piggy? i'm grateful for any help you can give gilbert & me

User avatar
Sef
I dissent.

Post   » Sat Jun 06, 2020 8:38 pm


It's hard to read your lengthy post because you don't have any breaks in the text (paragraphs) or proper capitalization.

The lump in his anal sac is an impaction, and it will need to be gently removed. Have you read the GL page on how to do that?
http://www.guinealynx.info/impaction.html

I wonder if he might do better with Metoclopramide instead of Cisapride. They're both motility drugs, but each works differently on the GI tract.

Are you hand feeding him?
http://www.guinealynx.info/handfeeding.html

User avatar
Lynx
RESIST

Post   » Sat Jun 06, 2020 8:59 pm


Ditto Sef. If you take the time to use proper capitalization and punctuation, it makes posts so much more readable. And a line of space between paragraphs helps a great deal.

Thanks!

platypus

Post   » Sat Jun 06, 2020 9:28 pm


Oh Lynx & Sef, I apologize for the long post. I don't capitalize as I have arthritis and it hurts to stretch my little fingers. And I just simply forgot to use paragraphs, I didn't expect my post to go so long. I think I'm still mourning my Izzy and get long-winded without realizing it, I will try to watch that

It's all right, no need to reply. I know you are volunteers and I have benefitted from your expertise in the past which is why i made a donation at the beginning of the year and guinealynx is my amazon charity. But my Gilbert's case is complicated and is too much of a burden on others. I will just keep doing what I've been doing, thank you for reading my post

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Sef
I dissent.

Post   » Sat Jun 06, 2020 10:33 pm


I'm really sorry about your loss. It hurts, I know.

Did you read my response about impaction and question about handfeeding and motility drugs?

Wheeker

Post   » Sun Jun 07, 2020 1:55 am


Is it really impaction or is it clumps of poo? I'm asking because what you describe sounds similar to what I've been going through the past few months with two of my pigs. First diagnosed with anaerobic bacterial infection and yeast back in February, cleared up with Azithromycin and Nystatin. Now it's baaacck and they're on meds for possible Coccidia. Back in February one of the first signs of trouble in my intact boar was him making clumps of poop, like they'd get sort of come out all at once in a soft mass. He never had diarrhea even though his cagemate did and he still hasn't. When he got better the first time the clumping stopped.

Have you tried running a fecal sample? Is that what you meant by "labs?" If you've got a vet with an in-house lab it's not too expensive.

Also you def shouldn't be feeding alfalfa to a pig his age--that could be the cause of his partner's stones. Try different cuts of Orchard, timothy, oat hay, or meadow. 3rd cut timothy is the softest timothy.

Does he show interest in food? My boar right now shows interest but won't eat more than a few bites.

Do you only feed mashed pellets? What kind? Make sure they're not over 8% calcium content without calcium carbonate. You should get a Critical Care powder. It'll be easier on your arthritis too rather than mashing stuff up.

You're right that it always could be jaw related. I had to handfeed a pig for months once while he was developing a tumor that went undetectable until he had basically almost wasted away and we had to put him down.

Sending happy wishes as I too hand-feed my pig!

bpatters
And got the T-shirt

Post   » Sun Jun 07, 2020 9:38 am


Did you mean .8% calcium content, Wheeker? Eight percent is way high. I always tried to limit my pigs to about.4% calcium if possible.

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Lynx
RESIST

Post   » Sun Jun 07, 2020 1:43 pm


It is possible the impaction issues are secondary to the not eating as much - likely not as many fluids and less food moving through the system - the slowing contributing to the impaction.

Has he had a general xray to check for stones? An xray of the skull to check for malocclusion? (which can develop if not eating as much). Are there any signs of pain? Pain on urination or pooping?

I am sorry he is having these issues.

Sometimes I feel like I have a disability - not being able to read large blocks of posts - and I completely pass over them. I went back and broke up your post into random paragraphs so I would be able to read it today.

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Sef
I dissent.

Post   » Sun Jun 07, 2020 5:57 pm


I have the same problem, Lynx. My eyes are quite bad at this point.

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Lynx
RESIST

Post   » Sun Jun 07, 2020 7:32 pm


For me it is something like a tracking issue. My mind just shuts down.

platypus

Post   » Sun Jun 07, 2020 10:01 pm


Sef - Yes, I had read the impaction info and have been following the guidelines. I'm especially glad that you told me that Gilbert was impacted, I didn't know what to look for and at what point i should remove the poop. You relieved my mind a lot, I was worried I would do the wrong thing

I've emailed my vet re: Metoclopramide

I've been handfeeding him since March, currently we're at x4/day since he's stopped eating on his own. I give him critical care and I add small amounts of alfalfa pellet mash when he drops his weight too much.

Lynx - I'm sure you're right that his impaction issues are related to his diet. Since you reminded me about fluids in his G.I. tract I have made his critical care more soupy. I try to get him to drink water via syringe

Both boys had full body xrays when Izzy died. That's how Izzy's fatal bladder stone was found, it was an ugly xray. Thankfully Gilbert was clear.

Gilbert also had his head xray in March. His teeth were fine but the vet (#2) said she couldn't tell about his jaw and he should get a CT scan. Two days ago when I had a televisit with our #1 vet Dr. N, he looked at Gilbert's front incisors and since they were straight and flat said that his jaws were fine. I did ask him in the email if he thought another xray was needed.

I haven't noticed any signs of pain but he's on metacam 0.4 cc twice/day so it's hard to tell.

Wheeker - The vet said he didn't need a fecal. His bloodwork didn't show an infection either. I'm sorry you are going through the infections with your piggies, hopefully this post finds them on the mend

I normally don't give Gilbert any alfalfa hay but at this point I'm desperate for him to eat so I'm trying anything I can think of. He's had 6 different types of hay, sigh.

Thanx for thinking of my poor hands...I use a coffee grinder for the alfalfa pellets but they do still come out kind of grainy.

So my questions now are:

1) Do you have any tricks to get Gilbert to eat more hay, greens or pellets? Chocolate syrup? haha, kidding of course

2) Any special techniques you've come up with to make the removal of the impactions safer? So I don't injure him or stretch out the muscles more than they already are?

3) Do you have a recommendation for where I can get hay that is soft? I don't know any companies besides KMS

4) Any other thoughts as to how I can better care for him?

So much gratitude for you all for helping me, for sharing your expertise. We might have issues with our eyes, hands & brains but our spritis are loving and we have tons of compassion for critters and other people. We rock!

User avatar
Lynx
RESIST

Post   » Sun Jun 07, 2020 11:49 pm


Some people soak their hay in water and serve it on a plate (removing uneaten hay in a couple hours or so since once wet, mold may grow). The soaked hay adds fluids and for some reason, they like to eat it that way. As for impactions, if you give your guinea pig a butt bath and soak his rear end in water, the water should soften any impaction, making it easier to remove.

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?

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?

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]

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