Keds Medical Thread - not eating on own

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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.

User avatar
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.

User avatar
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.

User avatar
Lynx
Celebrate!!!

Post   » Tue Jul 28, 2020 9:51 pm


If there is any chance of a uterine infection, it seems a spay would be the best route (besides taking care of the ovarian cysts).

You will want to read up on surgery and after care to be prepared. These are useful articles.
http://www.guinealynx.info/surgery.html
http://www.guinealynx.info/postop.html

User avatar
maggieP

Post   » Tue Jul 28, 2020 9:57 pm


Thanks Lynx, I’ll review. Is it recommended to have a separated “hospital cage”/ quarantine area for here away from our other two GPs?

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Lynx
Celebrate!!!

Post   » Tue Jul 28, 2020 10:03 pm


Yes, a separate, smaller cage to limit running around which would interfere with proper healing of the incision. But you can put the cage real close by.

User avatar
maggieP

Post   » Thu Jul 30, 2020 11:44 pm


Keds doesn’t seem as miserable as she had been looking before the Tramadol. She walks around a fair bit and eats a bit of her favorite veggies. However the past couple days she has had a very wet chin and appears to be grooming/wiping her mouth a lot. She makes a yawning motion when she does this. She also seems a little less agreeable to the syringe feeding. Hoping the molar trim will help. Perhaps her teeth are getting overgrown due to the prolonged soft diet...?

User avatar
Sef
I dissent.

Post   » Fri Jul 31, 2020 6:44 am


Not sure. Hay generally does a good job if grinding down the teeth, assuming there is no misalignment.

User avatar
maggieP

Post   » Fri Aug 07, 2020 6:17 pm


She seems to be doing ok so far after surgery. We are at day 3 post-op. But her mouth issues and eating has not really improved. Trying to get a second vet that may have more experience with dental issues.

Is there a difference between a regular xray and a skull xray? The latter has more detail I assume? Vet basically said her molars look fine and didn’t know what the issue was. Would an abscess show up on xray? She only had a full body one apparently.

User avatar
Lynx
Celebrate!!!

Post   » Fri Aug 07, 2020 7:05 pm


Yes, an xray of the skull to evaluate dentition is different from a regular one. It provides more detail. Yes, a vet should be able to identify an abscess if it is present.

User avatar
maggieP

Post   » Fri Aug 07, 2020 9:53 pm


Here’s a picture of her top incisors. The left one was fractured somehow. She does seem to be favoring that side, tilting her head to the right when trying to grasp something.
Image

User avatar
Lynx
Celebrate!!!

Post   » Sat Aug 08, 2020 8:12 am


I cropped a closeup of your picture so we can see the teeth a little better (let me know if that is okay). Do you know if the small, discolored upper incisor has been broken more than once? Sometimes discoloration can indicate it will fall out again and may have been injured or infected.

Image

User avatar
Sef
I dissent.

Post   » Sat Aug 08, 2020 10:02 am


Agree. That tooth doesn't look too healthy.

The corresponding bottom incisor may need to be filed down a little to remove the sharp edge, since it's not able to grind down properly.

User avatar
maggieP

Post   » Sat Aug 08, 2020 1:38 pm


Thanks. I’m not sure. I only noticed it around two weeks ago. It almost looked like it was split down the vertical at one point. I think it’s growing back healthy near the gum but it’s hard to tell.

User avatar
Lynx
Celebrate!!!

Post   » Sat Aug 08, 2020 3:47 pm


If there was an injury or infection, sometimes a tooth will fall out more than once while it tries to grow in correctly.

User avatar
maggieP

Post   » Wed Aug 12, 2020 5:53 pm


Went to a second vet that is a bit closer to us to see if we could get some more eyes on her. We were supposed to see Dr. Sip (she is listed on your California vet page, but is no longer at Berkeley Dog & Cat but rather Groveway Vet Hospital in Castro Valley) but unfortunately she was out today so we saw Dr. Moffat who seemed pretty experienced. He seemed concerned about what he called 'lesions' on her back. I had thought these were normal incisions from her surgery, in addition to the main abdominal one. Is it normal to do additional incisions on the back for a spay? He was going to try and call Berkeley Dog & Cat (where we were going so far) to talk to them about it.

He mostly recommended the dental workout / molar trim under anesthesia, but seemed more concerned about the possible spurs than the earlier vet. I am a bit nervous about putting her under again so soon. He also wanted to do a small biopsy of the 'lesions'...? He said they seemed painful to her, possibly swollen, and did an antibiotic injection (doxycycline).

bpatters
And got the T-shirt

Post   » Wed Aug 12, 2020 6:16 pm


They could have done what is called a "flank spay," where they go in through the flanks and take just the ovaries out. But as far as I know, when they do that, they don't usually go in through the abdomen at all. However, I'm sure practices vary, and it could be that they just did the uterus through the abdomen and took the ovaries from the sides.

User avatar
maggieP

Post   » Wed Aug 12, 2020 6:27 pm


OK.. that's kind of what I thought but these are more on the 'top' of the back rather than the sides. Not sure if it's still the same thing. Would have expected this guy to know about that type of procedure though... seems strange

User avatar
Lynx
Celebrate!!!

Post   » Wed Aug 12, 2020 8:05 pm


Let us know what the clinic that did the spay has to say. If there is any infection, I hope it heals fine.

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