Keds Medical Thread - not eating on own

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maggieP

Post   » Sat Jul 18, 2020 1:48 pm


Hi, this is my first post here. Was looking to see if anyone has advice or experience with these symptoms for my six year old girl, Keds.

We went to the ER vet Monday evening and she was there overnight. She has only been nibbling a few veggies (bell pepper, cucumber, greens) since last weekend.
We are doing the following regimen:
  • Critical Care every 3-4 hours (trying to get around 40g dry CC a day)
  • Trimethoprim Sulfa - antibiotic - give 0.35ml by mouth twice a day for 30 days
  • Meloxicam - anti-inflammatory / pain medication - give 0.13ml by mouth twice a day for inflammation and
    pain
  • Gabapentin - pain reliever - 0.04 to 0.1ml every 8-12 hours if seems painful and the meloxicam is not
    enough. If makes too sleepy can give the lower dose; if seems more painful can give the higher dose, but it
    will just make her more sleepy
  • Cisapride - for GI motility to keep her stomach and intestines moving - 0.16ml twice a day
  • Probiotic - ProBios (last vet gave us this when we had antibiotics for a different GP)
Her best weight was about 975g back in June (closer to 1075 in prior months). Now she is down to about 835 in the mornings (gains a little more throughout the day, up to around 880g). Weight has been mostly stable since Tuesday.

Behaviors/symptoms:
  • Picks up a few bits of hay and throws it around but doesn't eat
  • Does eat a few soft veggies like greens/lettuces, bell peppers, some cucumber
  • Has a few moments of "freezing up" when doing feedings and possibly when urinating. Could this be a GI or stone issue?
  • Doesn't seem too much more lethargic compared to previously, though mostly stay in the same pigloo
  • Sometimes will eat a little of the CC on her own without having to do a syringe (but not enough)
  • Teeth grinding/clicking occasionally - sign of pain?
Vet didn't find anything yet and we are going back Monday. She did write this:
  • "There is some sludge in her bladder, and her bladder is thick which can be from chronic inflammation or a
    cancer. There is a possible chance she could have a stone not necessarily in her bladder, but in her urethra.
    There is also a possibility that the blood we are seeing is actually related to reproductive issues / a cancer or
    infection of the uterus / from some other ovarian disease."
  • "We will call with the results of the thyroid test and blood cells when it comes back in a few days."
  • Said it wasn't teeth or mites
  • I think she said she did ultrasound and wasn't able to see any stones
My main questions apart from any general advice are:
  • Anything we can do to get her wanting to eat on her own instead of just CC ?
  • What else should I ask the second vet on Monday? (we are seeing a different one than the ER doc). Xrays, ultrasounds, dental exam under anesthesia?
Thanks in advance for your help.

User avatar
maggieP

Post   » Sat Jul 18, 2020 1:57 pm


I forgot to add another symptom. She is self-barbering her hindquarters a lot, and scratching occasionally (not constantly like she would have mites though?). Some patches losing fur on one side as well.

bpatters
And got the T-shirt

Post   » Sat Jul 18, 2020 2:58 pm


I'd treat her for mites since she's scratching and has hair loss.

I'd also want a good dental exam -- side and top view x-rays, and a visual exam while she's under.

Did they x-ray to look for stones? They don't always show up on ultrasound.

Her interest in food is likely to decrease while she's on antibiotics, so you're probably looking at hand feeding for several days. Be sure to give her a probiotic (like Bene-Bac) 60-90 minutes after every dose of antibiotic.

Keep us posted on how she's doing.

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maggieP

Post   » Sat Jul 18, 2020 3:07 pm


Thanks, I’ll ask about the full dental and xrays. We haven’t done any xrays yet.

We have been doing the meds for 4 days now and not really seeing much change in appetite.

She also has some crusty/watery eyes. The teeth grinding and freezing up seemed like she was in pain?

We just finished some ProBios and I have BeneBac to start next. I’ll make sure to time it now, I wasn’t aware of that.

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Lynx
Celebrate!!!

Post   » Sat Jul 18, 2020 9:17 pm


Ditto on all bpatters' advice.

If she has crusty, watery eyes, she might need a different antibiotic.

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maggieP

Post   » Sat Jul 18, 2020 10:26 pm


Thanks. Keds seems a little on the up today. Her weight was 902g this evening, compared to low 800s (792 once) on Tuesday and Wednesday. She seems a bit more active and has more interest in veggies and a bit of a treat but no hay.

Is anesthesia required for any xrays, or just dental? High risk in that...?

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maggieP

Post   » Sun Jul 19, 2020 12:07 am


I think when she freezes up she may be straining to urinate. She also arches her back a little and does the teeth grinding. That’s probably indicative of a stone, right?

She also had a little blood in her urine Sunday/Monday but haven’t seen any since then.

She looks like she might be a little bloated, too, but that seems to come and go.

User avatar
Sef
I dissent.

Post   » Sun Jul 19, 2020 7:15 am


She could have more than one underlying issue. The reluctance to eat sounds dental related and I would want that checked out more thoroughly. Straining to urinate could very well be a stone, particularly if it's in the urethra. While complete blockage of the urethra is less common in females, it has been known to happen. I would keep a close eye on how much she seems to be urinating, and would want to make sure the vet gets some clear images of bladder and urinary tract.

Blood in the urine could be secondary UTI, which is not uncommon with stones.

Weight loss is to be expected if she's not eating enough, plus some degree of weight loss naturally occurs as they age. A loss of muscle mass where the hip bones become very pronounced could be indicative of renal failure which is also not uncommon in older pigs, but can also be caused or worsened by stones in the urinary tract.

User avatar
maggieP

Post   » Tue Jul 21, 2020 2:32 am


We had xrays taken today but takes up to 48 hours to get the results back. Blood tests didn’t show anything obvious (slightly low red / high white, normal thryoid).

Hoping for some kind of actual diagnosis.. She seems to be declining and has periods of lethargy/tired/pain and then perks up a little again. Ate quite a lot of veggies this morning (pain meds kicking in?). We were also prescribed Tramadol in addition to the existing meds.

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maggieP

Post   » Tue Jul 21, 2020 2:34 am


Weight is more or less stable (830-870 up to 900 throughout the day) but she feels very gaunt, vet said so as well but has a soft belly, not bloat.

User avatar
Sef
I dissent.

Post   » Tue Jul 21, 2020 3:09 am


I am surprised to hear that it takes 48 hours to know the results of an x-ray. Normally, the vet can look at it right away. Is this vet not very experienced with guinea pigs? If not, dental images I can see wanting to send to a vet with more teeth experience, but a bladder stone is fairly obvious on images.

I'm also a little surprised that she was put on an antibiotic for 30 days, particularly if there are no obvious signs of infection. Most guinea pigs tolerate Bactrim fairly well, but do watch for further lack of appetite.

I would also comment that the Meloxicam is a fairly high dose (twice a day) at her weight if it is the standard 1.5 mg/ml stuff. Do you know if it is? Do make sure she stays well hydrated. NSAIDs are hard on the kidneys, and if she does have renal issues, it could worsen the problem. Dry, sunken eyes, sometimes with eye crust, can be a sign of dehydration.

Tramadol is another pain med. Do be aware that it can be a little sedating as well. It is sometimes a balancing act when it comes to managing pain vs. zonking them out.

User avatar
maggieP

Post   » Tue Jul 21, 2020 12:25 pm


Thanks Sef. The clinic/hospital has been seeing our guinea pigs for awhile and seems well-versed in exotics, but I don’t know much about these two specifically. Our usual vet has been on medical leave for awhile and I don’t know when or if he’ll return.

The ER doctor who prescribed most of the meds seems to have a lot of experience in rabbits, based on my cursory Google search. Yesterday’s seems younger and I didn’t find that much info.

I have no clue about the xrays. I asked about dental but they didn’t do any gas so I don’t think it’s a full dental workup? She said the bald patch (doesn’t seem to be hairloss but rather barbering/scratching?) would be right near the ovary on that side. Only a “cursory ultrasound” was done so far and they want $600+ for a full one. This seemed like a lot since I don’t feel putting her through a surgery is a good idea.

I am trying to get some unflavored Pedialyte down her a few times a day per reading this very helpful forum.

User avatar
maggieP

Post   » Tue Jul 21, 2020 12:30 pm


The Meloxicam is 3 mg/mL

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maggieP

Post   » Tue Jul 21, 2020 12:56 pm


Just today/yesterday she started tilting her head to the side occasionally when chewing/swallowing. Another indication of dental?

Vet also said incisors were slightly uneven.

User avatar
Sef
I dissent.

Post   » Tue Jul 21, 2020 2:24 pm


Could be. Are you sure about the Meloxicam? I'm only familiar with it as either 1.5 mg/ml or 0.5 mg/ml, with the 1.5 mg/ml strength being the most common here in the US.

Tilting her head to the side if it's only when she eats could very well be dental. Uneven incisors are very often a sign that there's an issue with the back teeth that's causing uneven wear--unless an incisor has been broken and is growing back that way.

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maggieP

Post   » Tue Jul 21, 2020 2:34 pm


Yes, that's what the bottle and web portal say...
Image

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maggieP

Post   » Tue Jul 21, 2020 3:08 pm


She looks pretty miserable today and even if they do more imaging I'm not sure what treatments would be very effective at this point. I'm not sure what else to do. We could try another vet I guess...

User avatar
Sef
I dissent.

Post   » Tue Jul 21, 2020 4:31 pm


You really need to know the results of those x-rays. It feels like they are throwing a lot of meds at her, some of which may be making her feel worse. Can you follow up with the vet and advise that she's not doing any better, and that you want to see if there's any way to speed up getting those images back in order to see what's going on? I'd also mention that you don't know if the meds are helping or hurting---or if it could be the combination. Both the Meloxicam and Gabapentin doses still look high to me.

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maggieP

Post   » Tue Jul 21, 2020 4:55 pm


OK, I'll try to get ahold of them and ask.

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maggieP

Post   » Tue Jul 21, 2020 4:55 pm


Do you have any references I could read and possibly send them about the Meloxicam dosage?

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