Keds Medical Thread - not eating on own

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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.

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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...

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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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Sef
I dissent.

Post   » Tue Jul 21, 2020 6:18 pm


Carpenter's Exotic Formulary, 5th Edition, lists a range for Meloxicam of 0.1-0.3 mg/kg q24h for guinea pigs (listed in the Rodent section).

Katherine Quesenberry's Ferrets, Rabbits, and Rodents lists Gabapentin at 3-5 mg/kg q12-24h for guinea pigs.

Same reference (Quesenberry) lists Tramadol at 5-10 mg/kg q12-24 for guinea pigs.

I'm not saying that pain meds shouldn't be adjusted up or down to provide adequate pain relief. It's definitely a sliding scale, and there are situations in which a higher dose may be appropriate. What I'm saying, though, is that you have to balance pain management with zonking the pig out too much or causing slowed GI/gastric issues. NSAIDs in particular (which Meloxicam is) can be particularly hard on the kidneys, and care needs to be given to keep the guinea pig well hydrated. All of these pain meds combined with antibiotics can be a double-whammy.

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maggieP

Post   » Thu Jul 23, 2020 11:22 pm


Finally got some responses (via email, even though they said they would call me yesterday.. sigh)...

I mentioned the Formulary references but doc said she usually does 0.5 mg/kg for meloxicam and would even consider going higher. Keds doesn't seem overly lethargic right now so I think the meds are OK right now. Possible UTI and stones (plus the blood in the urine - which I haven't seen since) were the reasons from the ER vet for the 30 day antibiotic but current doc said she would be OK dropping that since we're not seeing improvement.

For the xrays - "The radiograph images mainly confirmed GI stasis, or slowing of the GI tract. This can be the main issue, though is often caused by another disease process. In Keds' case, likely ovarian disease and associated discomfort, and possible contributing dental disease, or other cause." "The radiograph images also supported mild dental disease seen on exam, with no major underlying issues in the jaw or skull."

They are suggested either a more comprehensive ultrasound (was quoted ~$600), or go right to "a surgical explore and spay procedure with a teeth trim under anesthesia". She believes ovarian cysts is the real issue, though I just am not so sure..

No new behaviors though she does seem a little more alert/active with the addition of the Tramadol. She still is eating soft veggies (greens/lettuces, bell pepper, cucumber). Today I saw her by the food bowls and she picked up a pellet but it fell out of her mouth. To me that feels like it would indicate teeth problems, but maybe she is just in a lot of pain and doesn't want to put energy into chewing hard things?

Any suggestions or new advice? Ultrasound, spay, or something else? They also offered CT scan as an option but recommended prioritizing the ultrasound. Budget is not too much of a concern but I don't want to just throw money at all kinds of various options either.

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Lynx
Celebrate!!!

Post   » Fri Jul 24, 2020 8:33 am


If there are spurs on her teeth, they can injure the tissue and cause pain. I think an oral exam would show any dental spurs. Dental disease seems like an overly broad diagnosis. I think having specifics would be helpful.

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maggieP

Post   » Tue Jul 28, 2020 9:39 pm


We had the ultrasound today and found ovarian cysts on both sides, and some evidence of uterine issue as well (can’t remember what term was used).

Teeth were checked again and Keds does have a bit of malocclusion but molars looked OK.

The spay is still the top recommendation as well as a better dental check and possible molar trim once under anesthesia if needed. I was researching the hormone injections (hCG, Cystorelin) but vet says they have not used these and there is limited information about their effectiveness. But she is willing to try that route if we prefer. Given the eating issues have been going on for over two weeks now, I am inclined to agree with her advice and go with the OVH.

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