Peanut's Medical Topic

jlynnnx

Post   » Fri Apr 01, 2022 11:35 am


I have a 2 year old female, Peanut, that I noticed had sudden hair loss on both flanks, I checked her all over, and there was also a bit of crust on her nipple. Tuesday I noticed she was breathing heavy, although no watery eyes or discharge from the nose, no excess sneezing or wheezing. She was still active and eating well. I took her to the vet on Tuesday, and she said she doesn't hear any crackling in the lungs. She wanted to treat for a potential URI before following up with an Xray to check for ovarian cysts or to see what else is going on. She said she did feel a lump/ possible cyst. She's also getting 5 days of Metacam.

Well it's now Friday, and after several doses of Baytril the breathing hasn't improved, I don't think it's worse though. Still no other signs of URI, I've had guinea pigs with a URI and they all showed other symptoms like discharge and sneezing. I called the vet and told her there weren't improvements and I'm waiting for a call back. I kind of wish I would've just got the X-ray when I was there. I also don't want to give Baytril if it's unnecessary.


I did read somewhere that if the cyst is large enough it can press on the diaphragm and make it harder to breathe? She has all the symptoms of ovarian cysts, so I'm wondering if that's possibly the case? My follow-up is in two weeks but I'll see what the vet says today. She wanted to fix the breathing before any possible surgery because it would be risky otherwise. But if the cyst is causing the heavy breathing then there isn't really a choice right? Now I'm really worried.

Talishan
You can quote me

Post   » Fri Apr 01, 2022 2:30 pm


The x-ray is a good idea. Ovarian cysts are soft tissue, so they don't show up well on x-ray (ultrasound is a better diagnostic), but what will show up is an enlarged heart.

Ask your vet to consider: 1) heart issues --

https://www.guinealynx.info/heart.html

And 2) hormone therapy for ovarian cysts (vs. surgery). A full ovariohysterectomy on a guinea pig is massively invasive surgery; it is extremely hard on them and aftercare can be extremely hard on you. Hormone therapy can be effective with much less wear and tear on the pig (and on you).

Is this vet cavy-knowledgeable?

Good luck and blessings to her and to you. Hopefully the vet calls you back today. Please keep us posted.

jlynnnx

Post   » Fri Apr 01, 2022 10:01 pm


Thanks for the reply. I've never had a pig with cysts, or heart issues (and I've had many) so this is all new to me. I don't see any other signs of heart issues- no hooting, her ears and feet are warm, but I know not to rule anything out right now.

She is a cavy savy exotics vet, I went to her once and she'll be my main vet now because my previous one moved. Unfortunately she didn't call me back today so I'll be calling asap on Monday. She didn't mention heart issues and she only mentioned surgery for the treatment for cysts. I would definitely prefer the less risky option so I'll be bringing up this info next time I see her. But piggy is still eating well and is active which I'm happy to see.

Talishan
You can quote me

Post   » Sat Apr 02, 2022 8:44 am


Eating and active is good. Weigh her regularly to make sure she's holding her weight.

Many otherwise very knowledgeable exotics vets aren't aware that guinea pigs can and do get heart problems. I'd just suggest she consider it. Not saying that's what it is, but a URI will usually respond pretty quickly to Baytril.

We've had only one ovariohysterectomy in our house. The piggy died an agonizing death. I will not consider another, at least not for cysts (cancer or pyometra might be a different story). We've had good success with hormone treatments, although they may need to be repeated.

X-ray should be helpful. Let us know what the vet says.

jlynnnx

Post   » Mon Apr 04, 2022 11:01 pm


I'm so sorry about your piggy, that sounds awful.

I was able to get her seen by the vet again today. She had an x-ray which did show abnormal fluid build-up indicating heart issues. She couldn't see any cysts from a quick ultrasound. She said this is a 'unique' case for her so I guess she doesn't have a lot of experience with it. She's going to consult a different top exotics vet and get her opinion about it. Piggy was given an injection of a diuretic there, and a prescription for Lasix 0.1 ml twice a day for 5 days, then reduce to once a day. (10 mg/ml) She said we can tweak the dosage depending on how she responds, but this seems a little low right?

She also gave me Trimethoprim Sulfamethoxazole in case she does have some other infection going on. Also about the patchy hair loss she has all over- the vet didn't really have a clear answer. There's no skin conditions that could be causing it. Could the heart issues cause it due to her body being under stress?

I'm going to be reading posts about it on here to learn more info. I believe the Lasix is a life-long treatment? The vet said we may have to switch to different heart meds eventually. Will she need another X-ray to see if the fluid is cleared or is that unnecessary if she's breathing better? I'm hoping by tomorrow with another dose or two it will have improved. Luckily throughout all this her appetite hasn't been affected and she isn't acting lethargic.

Talishan
You can quote me

Post   » Fri Apr 08, 2022 6:51 pm


Lasix is a pretty strong med. I think your vet is being wise in starting at a fairly low dose and seeing how she responds. I wouldn't necessarily get another x-ray to check for progress; I'd go on her breathing. I'm gonna bet this will help.

Lasix is a diuretic, thus it should help clear the fluid seen on x-ray. It isn't a heart med per se; it helps clear the fluid that accumulates from weakened heart function. There are other meds, like benazepril and pimobendan, that support the heart's function more directly. It sounds like your vet is willing to consider these and if so, she may not need the Lasix permanently -- or she may. Heart treatment and medication is a tweaking-and-balancing act, but it works. We've had pigs that have done well for years on heart meds.

I have no great insight on her hairloss, though. Could it possibly be something as simple as a hide box or part of her cage she constantly brushes up against?

Continuing best wishes to her and to you. You're doing the right things.

jlynnnx

Post   » Fri Apr 08, 2022 11:15 pm


Thank you for the well wishes. Unfortunately, the Lasix hasn't helped with the breathing yet. I think it would've by now after four days? So I'm guessing she definitely needs a heart med and/or increase the dose. I called the vets yesterday and we scheduled a time where she would call me to discuss getting another prescription, but she never called me back... Very frustrating. I have another appt with her already scheduled for next Friday but I would like to discuss with her before then. She's still eating well/active so I'm not too worried but I would really like to get her breathing normally.

I'll bring up the Benazepril and Vetmedin, I read through the heart pig posts and it makes me hopeful she'll be fine once I'm able to get her on the right meds. The hair loss is a mystery- no hideys or anything to cause it, she's on fleece bedding, and her cage-mate doesn't have any hair loss.

User avatar
Lynx
Celebrate!!!

Post   » Fri Apr 08, 2022 11:23 pm


I wish you success sorting this out.

p.s. I removed the quotes from your posts. In a running conversation where you are responding to the person who just posted, they are not needed.

Talishan
You can quote me

Post   » Fri Apr 15, 2022 1:26 am


Do you ever see her cagemate gently chewing on her hair/sides?

This is called barbering and some pigs do this. Could be an alternative explanation for the hairloss.

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Lynx
Celebrate!!!

Post   » Fri Apr 15, 2022 8:07 am


More info on barbering and other causes of hair loss here:
https://www.guinealynx.info/hairloss.html

jlynnnx

Post   » Fri Apr 22, 2022 10:30 am


I don't think I've seen her self-barbering or her cagemate doing it to her, beyond the normal biting themselves to get rid of an itch for example.

I'm not sure about my vet if she's going about things the best way, I hope you guys can give me some guidance. Peanut's breathing is still heavy so I took her back last week, and she had another X-ray and ultrasound which showed a slight improvement with fluid buildup with just the Lasix. We've upped the Lasix to 0.3 2x/ day.

I started her on Enalapril two days ago, 0.2 ml a day (2 mg/ml in 15 ml suspension). My vet has been following up to see how she's doing, and before I even received the Enalapril (had to be shipped to me from a compounding pharmacy), she called and she was saying how she spoke with her several other vets to get their opinion on Peanut's case because she doesn't have a lot of experience with heart pigs. She said how she wasn't optimistic that the ACE inhibitor would help and the next step would be to take her to another exotic's vet she referred me to who would be able to sedate her and manually drain the fluid around her heart.

I don't understand why she's rushing to that type of procedure before I even started her on the heart med? She was only on Lasix and from what I know most heart pigs need both a diuretic and an ACE inhibitor to get better. I've also never read about a heart pig needing the fluid manually drained like that? Is she jumping to that conclusion because the Lasix by itself hasn't helped?

She wants to see her again this Monday for another X-ray and ultrasound to see how much the Enalapril has cleared the fluid and discuss what we should do next. I'm not sure how I feel about her not even giving the Enalapril a chance to work, unless she's just letting me know ahead of time. I would think we just need time to give the meds the chance to do their job, because the fluid doesn't always clear overnight especially if it's possibly been built up for a while?

In the heart pigs reference page, at the bottom there's a similar case of a pig (below) who didn't respond to Lasix alone but after 5 weeks on both meds was much improved and breathing better. Should I print it out to show her?



Dilated Cardiomyopathy and Congestive Heart Failure in a Guinea Pig
Jennifer Mosier Franklin, DVM and David Sanchez-Migallon Guzman, Lic en Vet, MRCVS treated a one year old male guinea pig that they diagnosed with DCM and CHF. An article describing treatment appeared in Exotic DVM.

PATIENT: A 952 gram well cared for skinny living in a large cage with a companion.

SIGNS: less active and had labored breathing, especially when exhaling.

DIAGNOSTICS (X-ray): X-rays showed "a loss of cardiac silhouette, an increased interstitial pattern throughout all lung fields and suspected pericardial effusion [excess fluid in the pericardium, the sac surrounding the heart]."

TREATMENT: The guinea pig was put on Terramycin (ophthalmic ointment) for the persistent right eye discharge (this had been going on for some time) and Baytril. Go Up

NINE DAYS LATER: the pig was down to 909 grams and had mild diarrhea.

A careful examination with a stethoscope revealed slight crackling in one lung.

DIAGNOSTICS (echocardiogram #1): Following an echocardiogram to evaluate heart function, the guinea pig was diagnosed with right-sided congestive heart failure (CHF).

"The echocardiogram revealed pericardial effusion and a paradoxical septal motion; hepatic vessels were also distended."

TREATMENT: given lasix (1 mg/kg PO q12h) Go Up

TWO DAYS LATER: the guinea pig was down to 862 grams.

DIAGNOSTICS (echocardiogram #2): Tufts University School of Veterinary Medicine (TUSVM) performed a second echocardiogram (with no anesthesia) resulting in a diagnosis of dilated cardiomyopathy (DCM) and CHF.

TREATMENT: The furosemide dosage was increased to 5 mg/kg PO q12h, and treatment with enalapril was started (0.3 mg/kg PO q12h). Go Up

ONE WEEK LATER: the guinea pig, now down to 787 grams, is still having difficulty breathing (flared nostrils, extended neck, abdominal movement from labored breathing) and both lungs crackled. Eye discharge thick, white and pasty. Owner stated that the guinea pig's behavior had not changed during the preceding week.

The guinea pig has now lost almost 6 ounces.

DIAGNOSTICS (echocardiogram #3): A third echocardiogram was performed. "Pericardial effusion and left atrial enlargement were still present on the echocardiogram, but the heart function had improved based on an increase in the LVSF% from 12.5% to 28.3% "

TREATMENT: Furosemide and enalapril continued at the same dosages. The owners (who had moved out of state) noted after 5 weeks of treatment, the guinea pig was doing well and his breathing was nearly back to normal.

User avatar
Lynx
Celebrate!!!

Post   » Fri Apr 22, 2022 9:59 pm


That was one of the few article done on guinea pigs at the time I worked up that page. If you read between the lines, I was really upset with all the weight loss this guinea pig was experiencing.

You might want to track down the original article (not my summary of it) and give that to her instead. I'm sure it is foot noted.

And I rather agree with you that it looks like she's jumping the gun on not letting the medications work.

Not having any personal experience with guinea pigs that had heart issues, I am relying primarily on the research I did and contributions that were made to the page.

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