Hasumi

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victoria15

Post   » Sun Sep 04, 2022 5:48 am


I would like to ask for suggestion on next step to treat Hasumi (or Haachan), a 4 years old sow who lost her friend a month ago.

Symptoms
-Peeing: I noticed a blood on fleece for the first time in Mid Aug, 2022 (around 18th or 19th) . The amount of bleeding was not much since it did not go through the fleece... or maybe it did not go through because the deposit was a blend of blood and calcium. I have not spotted any blood since then. I am not sure if she had been or it was her first time bleeding because she used to live with a sow named Choco who naturally peed blood.
Image
The above image is taken a day after I noticed the blood.

-Weight Fluctuation: 1070g in fall 2021, 1150 in Jan 2022, 1070g in Aug 1, 2022, 1020g in mid Aug 2022 (at the time I noticed blood), back to the range of 1020 to 1050g for last 2 days.
- Vet visit on Aug 21st, urinalysis findings: It resulted in negative for White Blood Cells and bacteria. It tested positive for protein but said in the report that it could be considered false positive for herbivores. It tested positive for small amounts of Red Blood Cells but vet thinks it was contamination from cystocentesis. There was a marked amount of spherical/ovoid debris that is likely calcium/phosphate. The technician left the note that he/she does not look at pig pees so he/she want us to take that in mind. The vet checked her bladder by ultrasound but she did not find anything.
- Potential depression? – Haachan became very inactive for few days after Choco died. Although I was informed by guinealynx and other soource that guinea pigs are social, I am surprised how much impact Choco's death has left on Haa-chan. She is a bit more active now.

I isolated her 3 times in a smaller cage to observe if she shows any sign of pain when she pees or poops. Fortunately, she does not. I hope she is not hiding the pain. I am encouraging her to drink more by giving green leaf lettuce throughout the day.

She pees good amounts when she pees, but she does not pee as often compared to fall 2021. I remember she used to pee every 15 minutes, but she takes about 45-1 hr now. Could this be a sign of illness such as UTI? Would it be safe to give her bactrim just in case?

For now, I am giving her massage to encourage a physical movement of the bladder and calcium inside of it so she could pee out more often. Also, I stopped feeding her Sherwood pellet (timothy hay based one) which I started to feed just 5 days before I noticed the blood. I stopped parsley as well. I have not stopped Oxbow supplements (Vitamin C and Urinary support) but I am wondering if I should stop them.

Since she is not in pain, I am not sure if x-ray is necessary. Could piggies have stones but show no sign of pain? I spent $160 CAD for urinalysis and 2 x-ray would cost me around $360 CAD. I do not think cystocentesis was good method to get a urine sample if RBC result becomes useless, technician is unconfident in his/her analysis anyway and cost me extra $60 bucks. I am wondering what additional information I can get from x-ray. Would x-ray help diagnose early-stage cancer? I am not sure if I am missing out on other potentials. I kind of want to go back just to buy metacam for the future use. I still feel Choco would have survived if I could have given her the pain killer earlier. It takes forever to see a vet in my town.

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Lynx
Celebrate!!!

Post   » Sun Sep 04, 2022 12:29 pm


The vet checked her bladder by ultrasound but she did not find anything.
Sometimes an xray works better at identifying stones. These charges may be high. Do you have any other qualified, more reasonable veterinarians you could see?

Usually there are some signs of pain with stones - but not always. The reproductive tract can also be a source of blood. I would supplement her with some vitamin C. There are also test strips that would confirm the presence of blood in urine. Sometimes what a person sees is not blood, but porphyrins, which oxidize. Some foods can also change the color of the urine.

bpatters
And got the T-shirt

Post   » Sun Sep 04, 2022 12:31 pm


If that's the only blood you've noticed, I'd just wait to see if it happens again. While most sows do not bleed when in heat, occasionally you run across one who does. If this is the case with yours, if it happens again it will likely be an a roughly 14-16 day cycle. And if it is the case, and there's only a drop or two, then it's perfectly normal.

If it gets worse, or occurs more frequently, then of course you'd need more diagnostics. But if she were mine, I'd definitely wait to see if there's a pattern before proceeding.

victoria15

Post   » Sun Jan 22, 2023 1:06 am


Thank you so much for the advice at that time. The idea on purchasing test strips became very useful for checking the health condition of our senior dog as well.

Anyway, firstly, the good news is that Hasumi has not urinated blood since the last post.

However, two days ago, I noticed a lump underneath her right jaw. This morning at the vet's appointment, she was diagnosed with Cervical Lymphadenitis (CL) through physical examination. We did not take the sample out for the bacterial culturing. She was prescribed with Azithromycin (zithromax) and metacam. I asked her if CL is painful, and the Vet explained that it is likely and also, piggies do not tell us. I asked her how life-threatening her condition is right now and she said it is not life threatening immediately and the lump does not seem to rupture any time soon. Although Hasumi has lost the weight from 1030g to 970g, the vet said she still looks healthy and nourished.

Hasumi is prescribed with 30mg/kg/day Zithromax, but according to Merck Vet Manual, the range is from 15-30mg/kg so I am planning to reduce the dosage a bit https://www.merckvetmanual.com/multimed ... uinea-pigs. I found an article that guinea pigs (weighing only 300g) that were administered with 38.54 mg/kg of AZM on the first day and 19.27 mg/kg from day 2-5 damaged their cardiac function. However, I am not sure how legitimate the finding are since pigs are way too young in the first place https://www.biorxiv.org/content/10.1101 ... 1.full.pdf.

I am studying CL from one of your threads: https://www.guinealynx.info/forums/viewt ... 439#160439 but I still still confused on the treatment. Is it better to rupture the un-ruptured abscess first and then give antibiotics? Is it okay to treat with antibiotics without draining the pus?

Thank you.

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Lynx
Celebrate!!!

Post   » Sun Jan 22, 2023 12:31 pm


I cannot answer with authority - but believe your vet would have considered draining and flushing the lump if it looked really big and/or ready to burst.

You might want to read:
https://www.guinealynx.info/antibiotic_advice.html

I believe this antibiotic can cause problems for some guinea pigs so watching for inappetence or diarrhea is important.

victoria15

Post   » Mon Jan 23, 2023 6:24 pm


I gave half the recommended dose two nights ago (ie. 15mg/kg, not 30mg/kg) and she looked sick in the following morning. I found few irregular shape poops (smaller) and she has lost her weight by 15 g. I stopped since the initial dose and good news is that she regained her weight, but her appetite and behaviour has changed (not moving as much). She used to jump out of the bed when she heard me opening the oxbow supplement bag, but now, she stays in her snuggle sac. Her poop is not back to the healthy shape yet. I stopped metacam as well but I might re-introduce once her poop is back to shape. I ordered bene bac probiotics to help her recovery.

She is a super cautious and nervous guinea pig and I do not feel like she can come back from anesthesia. I see a lot of Youtube videos where the rescuers lance the lump when pigs are awake. I hope that could be one of the options. I might look for a second opinion. I think the abscess under her chin is around 3 cm in diameter, so it is not small, but not huge like the ones on Youtube.

Anyway, thank you for your reply because the support keeps us stay strong.

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Lynx
Celebrate!!!

Post   » Mon Jan 23, 2023 11:49 pm


An experienced veterinary surgical team can manage anesthesia properly Generally inhalant anesthetics are used. Years ago, it might have been an anesthetic that depressed the whole system but I don't think it is done that way now.

I would think for lancing a lump, at least a local anesthetic would be used to control pain. Managing pain is extremely important for recovery from surgery.

victoria15

Post   » Tue Jan 24, 2023 7:00 am


Thank you for the information of local anesthetic. I hope that could be the option once she recovers.
Quick question, have you heard of metacam causing the bloat?

Hasumi might be bloated from either the metacam or the antibiotics. I called the clinic 5 minutes before the closure, and the front kindly booked me in for the first thing in the morning. Hasumi has been lethargic since she was medicated but it just never came to my mind that she is bloating. Fortunately enough, she could be encouraged to eat hays and green lettuce. I started to force feed her tonight. She does not poop as much, but I was able to encourage by touching where her grease glands are. I do not know why, but she pooped non-stop when I shampooed her grease gland (when she was healthy) so I used that trick. I do not feel like stomach massaging is helping her without the bloating medication. Since metacam could be the cause of bloating, I am hesitant to give her right now. I suspect that Zithromax is the cause. I wish I just gave one med so I could at least rule out the other.

Expectation at tmr's appointment,
1. X-ray to rule out that she is not suffering from true blockage in the gastrointestinal tract
2. There seem to be few options for med, so I am a bit overwhelmed to learn all of them overnight when i know I cannot miss the job tomorrow... I process payroll.

I am leaving the note below for myself:

- Reglan / metaclopromide - works on the upper GI to move stalled fecal material through the GI.
- Metronidazole (10–40 mg/kg/day, PO https://www.merckvetmanual.com/multimed ... uinea-pigs) - If yeast overgrowth is the cause, Metronidazole stops the yeast growing to excess because it is an antifungal.
---> Side Effect of Zithromax is that it causes yeast overgrowth, so this may be a good choice for Hasumi's case. However, the sources mostly refer to vaginal yeast infections in human
- simethicone - some say yes, some say no.... not sure...

Other notes:
https://www.guinealynx.info/motility.html#top
https://www.guinealynx.info/forums/viewt ... 015#355015

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Lynx
Celebrate!!!

Post   » Tue Jan 24, 2023 10:10 am


I am going to guess that a yeast overgrowth (if a possible issue) would take a while to develop. Guessing this is not an immediate cause of bloating you may see.

The local anesthetic would be given for the procedure instead of an inhalant anesthetic. An inhalant anesthetic would have the benefit of calming her during the procedure. I mentioned it as a possible option but for a surgical procedure it is likely an inhalant would be better. You would need to consult with your vet.

I take it you have read the info on bloat?
https://www.guinealynx.info/emergency.html#bloat

User avatar
Sef
I dissent.

Post   » Tue Jan 24, 2023 11:32 pm


My bet would be on the antibiotic as the possible culprit for her stomach upset. Remind me, though: How much Metacam are you giving her and how often, and what is the strength of the suspension and Hasumi's current weight?

victoria15

Post   » Wed Jan 25, 2023 11:05 am


Good morning,

Sef is correct. The Vet said that she is not bloated and stomach is not as full as she would like her to be. However, the antibiotics would be her only option for now. The vet said she does not want to touch (surgery) her now considering where it is growing. Hasumi needs to be sedated to take the sample out of her pus. For the vet, the least aggressive way would be the antibiotic and that is the step she would like to go with. She thinks Zithromax is the best option for Hasumi. According to the vet, she felt more firm ones but hasumi's softer, so she said there still is a hope that it could be tackled by the Antibiotics. I gave and stopped 0.75mg/kg/day, but she told me to keep it at 1.25mg/kg/day once (do not split into two; ie= 0.65mg/kg twice a day). I remember in day two, her ears were red and her heart was racing. I am not sure if she could tolerate 1.67x dosage ever day for next few days. The vet told me to try for 2-3 days and see if the abscess gets smaller. I showed bene bac but the vet prefers guinea pigs to eat their own feces.

Hasumi recovered a bit from the antibiotic since she has been off for 4 - 5 days now. She weighs 20g less from where she started. She weights usually around 1030-1070g (has been over 1100 g in the past) and weighs 950g today. I measured her abscess (it was hard) but I think it is about 4 cm.

I am leaning towards trying for one or two days again, but at the same time, I feel like I will be poisoning her to death before the abscess kills her.

victoria15

Post   » Wed Jan 25, 2023 11:19 am


I forgot to mention about metacam:

The vet said that Hasumi does not seem to be in pain (Hasumi's chill when touching the lump), so we could stop the metacam and focus on antibiotics. I gave her 0.2ml OF 1.5mg/mL.

User avatar
Lynx
Celebrate!!!

Post   » Wed Jan 25, 2023 11:58 am


Other signs of pain you might look for (other than only judging pain by sensitivity of the lump):
https://www.guinealynx.info/pain.html

victoria15

Post   » Sat Jan 28, 2023 2:00 pm


Just an update: I switched the clinic because I did not like the idea of keeping zithromax regardless of few obvious side effects that I saw.
Overall: Hasumi is on baytril instead of zithromax, and she is reacting better to it. Not sure about the efficacy yet.

I could not go in person to new clinic due to my job but my mother kindly brought Hasumi to the clinic on my behalf and the vet let me join the appointment via phone call. I sent the clinic of a long list of questions and she went through all of them. New vet's opinion: Baytril is more common and less harsh than Zithromax. If Hasumi cannot tolerate zithromax, then we should switch the antibiotics. It is not worth the side effects that wrote out because it is important for guinea pigs to eat continuously. Hasumi should be as stress-free as possible, so the vet does not suggest force feeding and probiotics at this point as Hasumi has not lost tons of weight. Once pigs start loosing the weight, they can loose very fast and live for 2-3 days. Hasumi should be on metacam as the lump would be painful.

The vet also said that she would not do surgery as well because the swelling is big and, as the previous vet explained, there are so many important parts (vein etc) along where the lump is. If I understood correctly, it seems like the swelling around the lump is big and not the lump itself. According to my mother, the vet said that the lump is smaller than what she heard (or read). She suggested giving baytril for a long term.

Hasumi is on Day 2.5 of baytril treatment and she is doing better than zithromax. The feces changed and she lost about 20-30g, but her mood is much better than zithromax. I have not heard her voice for days, but I heard her happy noise a bit when her cage was cleaned yesterday. I have not started the metacam treatment. I did not want to second guess which med gives the negative effects when she does not react well to them. If she seems to tolerate baytril relatively well for 3 days, I will introduce metacam. Choco, the one that passed away, had diaharrea after 3 days of baytril treatment.

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Lynx
Celebrate!!!

Post   » Sat Jan 28, 2023 7:10 pm


...it is important for guinea pigs to eat continuously... So important!

Any antibiotic can have side effects so you will continue to monitor for issues, I am sure.

Has there been any change in the size of the lump while she's gotten antibiotics?

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