Midnight's Medical Topic

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Talishan
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Post   » Fri Sep 24, 2021 10:21 pm


Ditto Lynx on the Critical Care 'meatballs'.

You can also try 'pellet stew'. Soften a small number of pellets in warm water, then mix with carrot baby food, squash baby food, or canned pumpkin. Put this on a small plate in a little mound or ridge. My husband drizzles carrot baby food over it for icing. 😊 Some of ours have loved this, and it has really helped them.

bpatters
And got the T-shirt

Post   » Fri Sep 24, 2021 10:43 pm


Lynx, can we put Talishan's response somewhere easily findable?

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Lynx
Celebrate!!!

Post   » Sat Sep 25, 2021 8:55 am


Perhaps a link to her post on the pain page?

I will give it some thought.

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AviN4
Supporter in '21

Post   » Sun Sep 26, 2021 8:48 pm


Talishan, Thanks so much for all the helpful advice and kind words!

I appreciate your explanation of the different kinds of pain medications. A few questions on this:
  1. It's good to know infant's Tylenol is an option. Is it safe to combine this with NSAIDs? I think it's safe in humans, so I'd guess so?
  2. To get the 1mg/kg Tylenol dosing, I presume that requires significant dilution? I see the normal dose for infants is 160mg.
  3. Does it make sense to give opiates long-term to a terminally ill guinea pig? Or is that more like to cope with short-term severe pain? Or to ride out a tough weekend until the vet's office opens (for surgery or euthanasia)?
  4. Are there cases where the pain appears to be only minor to moderate, but opiates are still the right tool? Perhaps because the NSAIDs just aren't working in the particular case?
  5. Is it difficult to get prescriptions for opiates for guinea pigs? I imagine they're likely a controlled substance, abusable by humans.
With regard to symptoms of stones reaching his urethra, yes, I'll be sure to keep an eye out. I'm not totally sure what I'd do in that case: on one hand, if there are still stones in his ureter, then I'd opt for euthanasia. On the other hand, if one stone has reached his urethra, then it's possible rest of the stones have moved to his bladder? And in that case an x-ray may be warranted. I suppose I should think it over and come up with a plan in advance.

Also, Lynx and Talishan, thanks for the helpful advice on diet supplements. I've been experimenting with a few of these strategies and will see if any of them seem to work. I'm also trying rolled oats. And I was also surprised to find that Midnight seems to like Oxbow "Garden Select" pellets. (Based on anecdotes on this forum, most guinea pigs seem to like the "Essentials" better.) We'll see if he continues eating it or if he gets bored. And I was finally able to place an order of 5lb of KMS pellets today. Hopefully between these calorie dense food options, he'll eat enough of something.

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Lynx
Celebrate!!!

Post   » Sun Sep 26, 2021 9:41 pm


The analgesics page has some guidance regarding mixing the various types of drugs. Some combinations are safe, others not so much.
https://www.guinealynx.info/analgesics.html

Talishan
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Post   » Sun Sep 26, 2021 11:41 pm


Ok. With apologies to Lynx, I'm going to break this out into multiple posts. (I'm on a phone and if it loses a great long post I will get extremely agitated. Just ask my husband. 😉)

1. Yes. Tylenol is an NSAID and NSAIDs can be mixed, although with some care. Imagine you took some Advil for sore muscles, and also some aspirin for a headache. Don't take tons of it, but you'd be ok.

2. The infants' Tylenol I have is 160 mg/5 ml. This is, thus, 32 mg/ml. (I hope you're pretty good with math. If you're not now, you're gonna be. 😁 All kidding aside, don't hesitate to post here and ask any calculations you make to be double-checked. Someone will confirm or correct.)

Let's assume Midnight is 1 kg. You will need 1/32, or .03 ml of the stuff in the bottle, or an eyelash more. Get a 1cc oral syringe (no needle) from the vet, or sometimes human pharmacies will sell you one, or just give you a few, if you explain you are caring for a small pet. It'll be a tiny tiny amount, but draw-able. First try just offering it to Midnight. Most of our pigs have loved the mild grape flavor they use, and have taken it straight from the syringe readily.

Talishan
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Post   » Sun Sep 26, 2021 11:52 pm


3. Yes. To all three. A mild narcotic like Tramadol can be used long term. The stronger ones can too, but they are more for the acute, emergent needs you mention.

4. Yes. Again, especially a mildish one like Tramadol.

In my experience (and I am not a vet, RN or medical professional of any kind), NSAIDs seem to work on a threshold basis, while narcotics/opiates work more linearly. That is, for an NSAID to do any good the dose has to get above a certain level, then it works. The narcotics seem to work more on a sliding scale; give a little more or less, get a little more or less result. They are more tweak-able.

Talishan
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Post   » Mon Sep 27, 2021 12:03 am


You will need an accurate weight for Midnight, for all of this.

5. This will depend on how willing and comfortable your vet(s) are in working with these meds. Some vets won't like using even mild narcotics, but good, cavy-knowledgeable vets know how important pain management is.

The drug classifications are the same (afaik) for human and veterinary meds (they're the same molecules), but the distribution and regulatory chains are separate. Your vet should NOT have to go through all the hoop-jumping and scrutiny to give Midnight Tramadol or buprenorphine that a human doctor would to give you Vicodin.

Talishan
You can quote me

Post   » Mon Sep 27, 2021 12:23 am


If it were my pig, and I saw blood in the cage, with whimpering and hunching while peeing or defecating, I would get an x-ray ASAP. If he were screaming -- and I do mean screaming, there is no mistaking this -- ER vet. IMMEDIATELY.

He may do just fine having one or more bladder stones removed from his bladder. If his kidneys continue to make them, and they continue down the ureter(s) into the bladder -- multiple surgeries are not quite so successful. They're hard on the pig AND on the vet. Scar tissue forms upon healing, making subsequent surgeries difficult for the vet to perform, much less multiple recoveries for the pig.

Ideally the stones will stay in his bladder, and he will feel fine to partly-crappy if they shift around; then when they resettle he'll be fine again. He can live well like this for quite a while. If they shift they may cause some bleeding; that's when I'd want an x-ray to see what they're doing.

If one blocks his urethra, you WILL know.

Midnight is the only pig I have ever known or heard of that would touch the Garden Select. Oxbow should pay you. 😁

Talishan
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Post   » Mon Sep 27, 2021 12:42 am


Finally -- there are other pain management options out there, though less frequently used in my experience in a case like this. Steroids (prednisone, prednisolone) are second to none for reducing swelling and inflammation; they can also be very effective in slowing tumor growth or even reducing them. They CANNOT be used in conjunction with NSAIDs. There is a more-than-additive effect on GI irritation that can really damage the GI tract. They CAN be combined with narcotics.

Butorphanol (brand name Torbugesic) is an older narcotic that isn't used as frequently because it doesn't stay in the animal's system as long as buprenorphine. If Midnight has some difficulty with buprenorphine (if it comes to that), you can ask about it; it will require more frequent dosing. It completely, peacefully zonks them out for about five hours; then they wake up and eat everything in sight. No, not Twinkies and afaik it has no weed in it. Afaik. 😉 We had one pig actually gain weight on it. Just like humans, different pigs respond differently to different meds and a good vet will work with Midnight and you to get the best regimen.

This thread is very long, but take a look at how barley water and Tramadol helped this pig (lemme see if I can find it, to follow):
Last edited by Talishan on Mon Sep 27, 2021 12:52 am, edited 1 time in total.

Talishan
You can quote me

Post   » Mon Sep 27, 2021 12:48 am


https://www.guinealynx.info/forums/viewt ... =2&t=62698

Continuing best wishes to Midnight, Moon and you. Please keep us posted on how he's doing.

Also, feel free to show your vet this thread. My medical knowledge is becoming dated and if anything I've written is flat-out wrong, I want to be corrected.

Talishan
You can quote me

Post   » Mon Sep 27, 2021 1:52 am


Actually, that goes for the current med pros and experienced owners here, too. Again, my med experience is getting dated. If GL members know of newer meds, procedures and treatments I'm not mentioning, or if something I've written is wrong, please don't hesitate to say so!

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