Midnight's Medical Topic

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Lynx
Celebrate!!!

Post   » Sat Sep 11, 2021 9:39 am


Would you like me to add your test result image permanently to your topic for future readers?

Unsure if reviewing how to tell if your guinea pig is dehydrated but since you are interested in water intake, I will add it here anyway. I note you say your guinea pig seems to be drinking more water so dehydration should not be an issue.

Dehydration: From what I understand, tenting of the skin at the back of the neck can be an indication of dehydration. A well-hydrated guinea pig, the skin would return to normal fairly quickly if gently pinched upward. A dehydrated guinea pig, the skin might be slow to return to normal. Teardrop shaped poops might also be a sign of not drinking enough (also an indication of not eating enough). Concentrated urine could mean your guinea pig is not getting enough fluids.

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AviN4
Supporter in '21

Post   » Sat Sep 11, 2021 7:11 pm


Sure, I would appreciate if you added the test result image permanently. Thank you!

It doesn't seem like dehydration is an issue but to be sure I'll do the skin test tomorrow when I weigh him.

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Lynx
Celebrate!!!

Post   » Sat Sep 11, 2021 10:32 pm


Thanks! I resized it slightly so it would load a little quicker.

It is good to have a baseline for comparison.

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AviN4
Supporter in '21

Post   » Mon Sep 13, 2021 6:30 pm


I took Midnight to my usual vet (Dr Buchholz) today. It seems like Midnight is showing signs of age.

He reported a cataract in Midnight's left eye, which he found by shining a light in the eye with the room lights off.

He also took a full body x-ray and found:
  • Likely arthritis in rear legs.
  • A bladder stone.
He did not find anything wrong with Midnight's teeth in either a physical examination or on the x-rays. The x-rays were not specifically dental x-rays though.

Among the issues, he said he thinks abnormal eating caused by pain from arthritis is the most likely cause of the weight loss. However, I'm still confused about the change in behavior with regard to eating carrots.

For arthritis pain, he prescribed Metacam (0.25 mL of 0.5 mg/mL) per day to start with and asked me to check back with him on Thursday. He said next steps would be to increase the dose. (On this topic, I found the dosing and administration to be confusing. I hope I got it right.)

I didn't have time to ask many questions or get many answers about the bladder stone as we had already spent a lot of time discussing other issues. I'll ask on Thursday.

I'll share the x-ray image when I get a copy.

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Lynx
Celebrate!!!

Post   » Mon Sep 13, 2021 9:06 pm


There are a number of member described case studies of arthritis. Unfortunately, there is not uniformity in describing amounts of medication (the dosage should be in mg/kg, which is the most useful) but other descriptions may help you if you are into researching it. Is he stiff when he walks?
https://www.guinealynx.info/forums/viewtopic.php?t=34228

A recent topic, lots of potential issues, looked like teeth - and ultimately it was! Hay stuck in between the incisors, not visible, vet finally noticed it when food began rotting. This accounted for problems eating. Not yet known if all will resolve.

Sometimes diagnosing the cause of an illness can be quite complicated.

I'm sorry about the stone. Hoping it is small and can somehow be passed. Meanwhile, increasing fluids might help him pass it. I note he seems to be drinking more which perhaps could be adequate. Excess drinking can also be a sign of pain.

Guinea pigs can manage with cataracts. They can be associated with diabetes but not always. I am guessing age plays a large part.

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AviN4
Supporter in '21

Post   » Thu Sep 16, 2021 10:25 pm


Lynx, Thanks for the helpful reply. I'm still catching up, and have a whole bunch of reading to do on arthritis and bladder stones.

Midnight seems to walk fine, and frequently wanders around the cage. If he is experiencing pain while walking, he is not showing it. I've been giving him the Metacam anyway though.

I'm not sure if the bladder stone is small enough to pass. I'm including some x-rays below. Any idea what the prospects of a good outcome are without surgery? How seriously should I be considering preventative surgery? My vet is recommending against preventative surgery, and suggests euthanasia if the bladder stones reach his urethra and start causing him pain. His reasons:
  • It might remain asymptomatic and never reach his urethra. (How likely is this?)
  • My vet seems thinks Midnight is reaching the end of a life worth living. But I'm not so sure. He still seems like a happy little guy, and I'm not sure we've identified any confirmed issue that's destined to kill him or make him miserable.
  • My vet thinks with Midnight's pattern of weight loss and signs of age, the surgery could be risky.
  • The surgery would be expensive. My vet can't do it himself, but thinks it'll likely cost around $2,000 to $3,000 at the hospital he recommends (Red Bank Vet Hospital). Vet treatments in the NYC metro area are expensive. And if additional bladder stones continue to appear, this could become a bottomless money pit. I could shop around though, and maybe rent a car and drive to a lower cost area.
I'm not too concerned about the cataract. As long as he retains enough vision to find his way around his cage, I think he should be OK? And so far, it seems like it's just a mild cataract in one eye.

I'm attaching some x-rays of Midnight from a vet visit in 2021-04-24 and the recent one on 2021-09-13, as well as the nearest points on his weight chart. It looks to me like the arthritis was present at both visits, but the bladder stone was present only in the second one. But the weight loss only began a month or so after the first visit. This makes me wonder if the bladder stone is somehow the cause of the weight loss. Also, looking again at his weight charts, I'm wondering if something else happened during his accident on 2021-04-24 (box fell on him) that started this weight loss trend.

Lynx, feel free to permanently upload these images or use them however else you'd like.


2021-04-24 X-rays and weight chart

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2021-09-13 X-rays and weight chart

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Originals:
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2021-04-24 X-rays and weight chart

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2021-09-13 X-rays and weight chart

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User avatar
Lynx
Celebrate!!!

Post   » Fri Sep 17, 2021 9:30 am


I am wondering if there are stones in the ureter. I have a few topics I was going to review later but you might want to look at this, which includes a couple xrays and a photo the vet sent her from the necropsy, showing the string of stones in the ureter:

https://www.guinealynx.info/forums/viewt ... &start=100

The xray you include with the visible stone and a string of ? is not as detailed as the xray on that topic, showing the individual stones.
I think his initial sign of illness was rapid weight loss :-(

I will add your xrays later (thanks!).

What I plan to review (you might want to look them over):

Looked to me like a string in the ureter, still think this most likely but supposedly not:
https://www.guinealynx.info/forums/viewt ... 0#p2270350

An xray on this post, similar to yours:
https://www.guinealynx.info/forums/viewt ... 0#p1735610

Sef's xrays of Zachary:
https://www.guinealynx.info/forums/viewt ... 8#p1220928

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AviN4
Supporter in '21

Post   » Fri Sep 17, 2021 1:43 pm


Thanks for sharing all that. I'm going to do my best to do a review this evening.

The front desk at The Center For Avian & Exotic Medicine in NYC said she can't give me any concrete numbers but that the surgical removal could cost $1,000 to $1,300, which is not nearly as bad as I thought. I think I'm willing to spend that if it makes medical sense.

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AviN4
Supporter in '21

Post   » Fri Sep 17, 2021 7:26 pm


Lynx, I just read through the links you share. Thanks, these were extremely helpful. Yes, Midnight's x-rays looks similar to the others diagnosed as having ureter stones, especially this one:

https://www.guinealynx.info/forums/view ... 0#p1735610

The weight loss pattern seems roughly consistent as well, though it's odd that Midnight has been losing weight more slowly than what I've seen described. The other symptoms seem less dire as well -- so far.

I see that if they are ureter stones, surgery will not be an option. All I could do is try to keep his weight up, make him as comfortable as possible, and bring him in to be euthanized when necessary.

Are there other tests that a vet can do to confirm where these stones are? It would help to know if I should still be considering surgery or if it's time to give up.

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Lynx
Celebrate!!!

Post   » Fri Sep 17, 2021 9:37 pm


I think a better xray might help. I had been looking at some anatomy pictures to try to visualize where everything is. All the sketches and pictures have the bladder being smaller. The two kidneys are under the spine. A thin tube (the ureter) attaches to the bladder, nearer the base of the bulb.

In some of the images I found, the individual small stones in the ureter are quite clear. Your xray does not quite have the clarity I would hope for to point out to your vet.

I have to take a neighbor to the airport early tomorrow (get up at 4:30) so I will come back to this topic later.

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AviN4
Supporter in '21

Post   » Fri Sep 17, 2021 9:56 pm


Hmm... do you think the x-ray needs to be redone or is it possible they just need to rescan it in higher quality? Or even easier, maybe just send me the original DICOM file? The images I received seem to be low resolution, low quality JPEGs. I'll email them to see if I can get something better.

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Lynx
Celebrate!!!

Post   » Sat Sep 18, 2021 9:35 am


Yes, that might help you evaluate whether or not it is worthwhile bring up the possibility of stones in the ureters. The DICOM file might still not be super big but hopefully would give more detail.

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