- I dissent.
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.
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.
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.
You will want to read up on surgery and after care to be prepared. These are useful articles.
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.
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).
- And got the T-shirt