Poor little mite has a lot to deal with bless her.
Firstly, before you go for anything invasive I'd request they find out how her kidneys are doing- this will be the thing that will affect your treatment plan the most with regards to what pain relief is safest to use and if an anaesthetic is wise. A cyst on the kidney could just be a benign cyst on the kidney (I actually have one on my own kidney!) or it could be a sign of kidney disease starting- this can make the kidneys cystic and small as they degenerate. Depending on the piggy they should be able to get some bloods consciously with the help of the nurse, and the results are usually fairly quick. The other option to check the kidneys in a way that won't cause her any distress is via the urine in a "urine protein creatinine ratio" test (UPC), but this isn't as accurate and more for monitoring changes.
If you find out her kidneys are functioning normally, you can then dose adequately with Metacam without worrying about her kidneys struggling too much, and you can then decide if having her spayed to remove those nasty ovaries is what she needs.
If her kidneys are starting to struggle, an anaesthetic of any kind wouldn't be recommended. In that instance, you'd be looking at a course of the chorulin (HCG) injections to try and shrink those ovarian cysts, or better yet get them to go away completely. This would make her feel so much more comfortable for the time she would have left (which would depend on how quickly the kidneys would Deteriorate). As for pain relief in the instance of struggling kidneys, tramadol is usually what's recommended. Metacam isn't great for kidneys that are already struggling, as it puts more pressure on them. But sometimes a balance of Metacam and tramadol can work well. My vet doses at 1mg (note Milligramme, not milliletres!) of tramadol drops twice a day as a low starting dose.. In my experience, it doesn't create the "out of it" effect you would expect.. It hasn't had any sedative effect on my sow whatsoever, but does help relieve pain.
Thank yo s
I currently have a 7 years 7 month old sow named fudge. She has been in heart failure for 16 months, has close kidney monitoring as her heart medication causes kidney damage, has arthritis in her hips and recently spine, and was diagnosed with an ovarian cyst last week! Her kidney levels have now started to rise slightly (tested by urine and not near failure levels as yet) but given this has only happened since her last kidney check 2 months previously, the kidneys are clearly massively more resilient than you'd expect in an elderly pig! She is on half dose of Metacam in the morning and a full dose at night for her arthritis, and is also on tramadol given at the same time. With this she is bright, agile and still manages to popcorn (albeit pathetically!). Due to being in heart failure, she can't have an anaesthetic under any circumstances.. So She had her first hormone injection last week for the ovarian cyst. 1 week later her cyst was gone and she was noticeably happier. She's just had her second injection Wednesday and she doesn't need a third.
Don't give up hope.. Weigh up the risks and find out where those kidneys are at before you make any decisions.. This will let you know if you should push for a more invasive, long term solution treatment plan or just manage medically to keep her comfortable. The latter isn't a death sentence either.. I've been doing it for 16 months and Fudge is still very much enjoying her life like the total legend she is.
I really hope you make some positive steps forward soon x
