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Specialist At A Loss, Uri, Heart Failure Or Something Else

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squeakysmallpaws

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Hi,

Just hoping for some help/advice/experience from anyone who has had this.

I have a 4 year old neutered boar. He was diagnosed with a grade 3 heart murmur when he was approx 6 months old. He's had it checked over the years but it actually started to improve and was down-graded (this was last health check - approx 12-18 months ago).

Manny presented with a hooting sound. He's always had this on and off over the years but this time he seemed lethargic, his eyes were crusty, he looked poorly, he was quiet and felt thinner, decreased appetite but still eating. I couldn't hear anything on his lungs (I have sethescope (sp?) at home) - nonetheless I took him to the vet on Tuesday evening.

Vet equally couldn't hear anything on his lung but could detect a rattle over all - it just didn't seem to be resonating from the lungs. So she said likely a Upper respiratory infection - i.e. upper airways/nose etc, infection probably hadn't spread to lungs so we weren't dealing with pneumonia. His temperature was a little on the low side. He had lost between 50-100g in weight. Weighing in at just over a kilo (usually he's around 1.1kg)

He had a baytril injection and put on 0.5mls once a day starting from Wednesday.

Wednesday evening I gave him the baytril, some metatone and some vitamin C along with a squirt of fibreplex. He was still quiet but his eyes looked brighter and he was still eating.

Today I took him out to give him some more fibreplex. He couldn't walk, it was like his front left leg kept giving out on him. He kept stumbling then laying down as if he wanted to sleep.

I took him straight back down the vets. We decided to treat for heart failure.

Vet gave:
  • Benazepril (Lotensin®) at 1 mg/kg orally every 12 hours.
  • Furosemide (Lasix®) at 2 - 5 mg/kg orally every 12 hours (for cardiogenic or pulmonary edema).
I gave these medicines at approx 6.30/7pm. His appetite had actually increased and he ate the meds in some green beans!

Had him out at 9pm to give the baytrill and he seems livelier. He isn't collapsing now when walking, he even resisted the baytril (last night he just sat there, didn't even move).

So - I'm just unsure. I can't imagine that within 2 maybe 2.5 hours the heart meds have worked that quickly - is that possible?

Clear he probably did have a URI as the crusty eyes have gone, his eyes seem brighter.

I'm just not really sure what I'm dealing with. He doesn't seem in pain. When I put him back in the cage after his baytril and put hay and dried food down he was straight to the bowl.

Overall he's not right though. I've wondered all sorts, could he have had a stroke and that's what caused the weird movement stumbling and honestly, I can only describe it as narcolepsy, almost like he was struggling to walk a few steps and was falling asleep instantly - but then 2 hours later he was moving about - I just can't quite fathom that could be the heart meds working that fast?

Or could it be he had an infection - maybe even spreading to his inner ear which was causing an imbalance and the baytril has started working?

Any thoughts or ideas? I'm pleased he looks better but I'm confused at the same time. It was the struggling to walk and then the extreme lethargy that I'm really struggling to work out.

Thanks,
Katherine
 

Wiebke

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I am very glad that your boy is still there and that he is doing fine!

Heart meds, when they work, work very quickly and have a dramatic effect. The fluid build-up from heart failure can happen in the chest cavity, not just in the lungs. the can of course well be that the lowered immune system from the heart issues has given well known opportunistic illness the chance to hit. But I doubt that you will ever know the exact truth.

I am tagging our member with experience in medication and in heart piggies for you. @Pebble @helen105281

I would recommend to step in with syringe feeding as soon as you notice a loss of appetite/weight loss, if only to top him up as much as necessary.
https://www.theguineapigforum.co.uk/threads/complete-syringe-feeding-guide.115359/
 

squeakysmallpaws

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thanks Wiebke - I'm monitoring how much he's eating. Tricky because I don't want to overdo the veggies when he's on the abs - better to have him eating loads and loads of hay, but he deffinietly is still eating for himself still. I've been sat in the C&C cage at meal times and hay feeding times if only to monitor the spark. Got some critical care on order - hoping it will have arrived tomorrow.

If the heart meds can work that fast then hopefully we've nailed it! I just wasn't sure because the literature I was reading said 3-5 days, but like anything, sometimes abs can show a results in a couple of hours and other times it can take 48 hours - in all species depending on what's wrong etc.
 

helen105281

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I have a few heart pigs and they are all on the same medication as your boy, though only have the diuretic when needed. The Benazapril dose does seem high but I know they can have a high dose if needed but a lot of vets like to start on a lower introductory dose. My pigs are on a range of doses from 1.25mg to 1.75mg a day (split in 2). It is possible for the heart meds to work that quickly but I would think the diuretic has helped too. Some vets give a higher dose to start with of I think 10mg and then drop down to a maintenance dose. Let me know if you have any questions. I also give mine Co-Enzyme Q10 which over time can stop them needing diuretics very often. I think my biggest transformation on heart meds was Fuzzy and she improved drastically within 24 hours.
 

Pebble

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In brief:

Thank goodness your vet has "finally" decided to intervene and prescribe heart meds..
After all - Manny has a pre-existing diagnosed heart condition but until now it has not been addressed in terms of pharmacuetical intervention.

Dosages may be higher compared to other cases but it is necessary to "restore" your piggies bodily functions to a normal equilibrium. (and higher doses do not really have harmful effects over a short period)

Most important now is to provide necessary supportive care to enable him to recover - syringe feeding/gut motility/love and cuddles!

You've crossed the biggest hurdle in getting the presciprtion so hopefully it should all be plain sailing from now on.

Sending healing vibes and wishes of good luck to you and Manny

x
 

squeakysmallpaws

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Hello,

Thank you for all the responses. He's ok, better - but he's still walking funny. Not as bad as he was - but it's almost a limp.

I don't know why. I don't know what would be causing it. I've check his legs all over. He's not broken it, there are no lumps and he doesn't seem in pain when I touch it. I've checked for bumblefoot - and anything I can think of that could cause leg pain. But I can't see or feel anything.

Is it possible because he's been so tired he's sprained it, maybe gone over on it? It's deffinitely better than it was, yesterday he seemed completely unable to walk without collapsing and falling forward.

I only say this because I keep rats and I've dealt with a couple of sprains in rats before. There's nothing you can do for a sprain except to give a little metacam. You just have to wait for it to get better and it usually takes about 2-4 days. Sprains are a fairlyish common problem in rats because they are such daredevils and can be clumsy. I can't give Manny metacam because of his heart, but I'm not sure how common sprains in guinea pigs are either? Is it likely that he could have gone over on his foot perhaps because he's been poorly and tired?

I'm scratching my head. It's like he can't properly hold his weight on his front paws. I will try to get a video but it's hard because he's not moving around that much for me to see him walk fully.

I don't want to rush him back down the vets again, I want to keep him quiet and reduce the stress on him, but if it doesn't look better by tomorrow I will take him.

The only other thing is he seems slightly dazed - is this a common side effect to the heart meds? He's deffo got more 'get up and go about him' then he did, but he has a slightly dazed look in his eyes and then it's like he gets a jolt and comes out of it - he even head butted my hand away earlier - which he hasn't done the last couple of days.
 

helen105281

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It sounds like he is more feisty. I haven't noticed a dazed effect on heart meds before, it may be an idea to discuss the dose with your vet if you can. My Katie was on too high a dose and was not herself so we dropped it and now she charges about like a loony. I do know of pigs that are on higher than your boy though so that may not be it.

Why can't you give him Metacam because of his heart? did your vet tell you that? I have had heart pigs on Metacam before.
 

squeakysmallpaws

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It sounds like he is more feisty. I haven't noticed a dazed effect on heart meds before, it may be an idea to discuss the dose with your vet if you can. My Katie was on too high a dose and was not herself so we dropped it and now she charges about like a loony. I do know of pigs that are on higher than your boy though so that may not be it.

Why can't you give him Metacam because of his heart? did your vet tell you that? I have had heart pigs on Metacam before.
Hi Helen - Metacam is part of a drug called NSAIDS. Across all species from dogs, cats, rats, to humans - NSAIDS shouldn't be given where the patient has an underlying heart condition. For example, my Mum's dog had a sever heart murmur and the vet said he couldn't be given metacam, so it's not a species specific thing. I think the science is that because it works as an anti-inflammatory it does something to the dilation of blood vessels - so essentially it significantly increases the risk of kidney/liver complications if there's already an existing condition and/or can make a heart condition worse. That's my basic understanding.

You especially cannot give metacam with ACE inhibitators because it will interfer. So Manny absolutely cannot have it now.

For humans, if you take a look on the back of an ibuprofen packet the warning will read do not take if you suffer from a heart/liver or kidney problem. Ibuprofen also belong to the NSAIDS group.

If you're vet has prescribed metacam while your guinea pig was on heart meds I'd seriously question that. On other hand if the vet has prescribed metacam and the GP has an underlying heart condition that is receiving no treatment he/she may well have just taken a risk based approached e.g how long will the animal be taking it etc, in some cases potentially the benefits outweigh the risks - but you should have been advised about this by your vet when he wrote the presciption/administered the meds. Generally it's best avoided and another pain relief prescribed which is not part of the NSAID group. Moreover, the metacam leaflet actually reads at the top: Do not use in dogs suffering from cardiac disorders - I have that in my hand as I type. Metacam is only licensed for dogs and cats - I have the dog one here, so the information says dogs but of course vets prescribing this to other animals, well those animals aren't exempt from the warning. So I'd be questioning why your vet has prescribed it.

There's lots of information available on the internet about metacam and heart issues and the warning is contained on the label of these NSAIDs.

Hope that helps answer your question :-)

I have another question - how do syringe the heart meds? I have it in tablet form and I'm crushing the powder, then mixing with water. What I found today was - alot of the powdered medicine got stuck at the bottom of the syringe. Manny has wised up to the meds in his greens, so wondered how I'm best administering this?
 

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Hi, I have no advice concerning the heart conditions but 2 of my girls have a nutracys capsule each day. I found- like you that mixing with water wasn't that good so what I do now is mix the powder into a little bit of fruit baby food, normally something with banana. It tends to be a little bit thicker. then scrape it off the spoon into a 2ml syringe then into a 1ml syringe. I've also done this when I have had to give steroid tablets to a pig with breathing problems.
 

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At 4 years old it's possible he may be developing arthriitis in his shoulders....I have piggies with this. The increase in fluid from the heart issues can put more stress on the joints and it could be painful for him.

It might be worth looking at an alternative pain relief such as buprecare or tramadol since your vet doesn;t wish to prescribe metacam/NSAID's. These are opiate based and, whilst "theorteically" can slow down gut motility, I have not experienced this in any of my pigs. If a pig has reduced food intake because they are poorly, my vet will consider precribing gut motility meds (cisparide and zantac) which would in any case counteract any effects of the painkiller.

HTH
xx
 

squeakysmallpaws

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At 4 years old it's possible he may be developing arthriitis in his shoulders....I have piggies with this. The increase in fluid from the heart issues can put more stress on the joints and it could be painful for him.

It might be worth looking at an alternative pain relief such as buprecare or tramadol since your vet doesn;t wish to prescribe metacam/NSAID's. These are opiate based and, whilst "theorteically" can slow down gut motility, I have not experienced this in any of my pigs. If a pig has reduced food intake because they are poorly, my vet will consider precribing gut motility meds (cisparide and zantac) which would in any case counteract any effects of the painkiller.

HTH
xx

That's good advice thank you.

Tonight he started with runny poo - urghhhhh! So I'm going to have to stop the abs. I'm giving the fibreplex 3 times a day but it's not doing enough.

Manny's been on the abs for 4 days but the symptoms of the URI stopped within 24 hours of starting the abs, so I think we're safe to stop them. Fingers crossed!
 

squeakysmallpaws

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Just been to check on him and actually he's having a good moment. He was really kicking up a fuss about having his fibreplex (obviously this is good and bad - bad because it's that much harder to give him his medicine, but good that he's got some fighting spirit and spark back).

Once he managed to wriggle free and I set him down his walking was much better and he trotted off. Last few days when I've set him down he's just stayed there.

His bum bum looks clean and I can't see anymore watery poo. I put more fresh hay down and he was having a nibble, i.e not going at it like you'd expect but there's interest and he was slowly munching it down. I'm pleased his tummy upset today hasn't completely putting him off eating for himself!
 

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Got my fingers crossed that things continue improving for you! X
 

squeakysmallpaws

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Just an update, his poo has firmed back up today. I'm getting tiny tiny little pellets now but I put some kale down earlier and he was much more enthusiastic about eating.
 

squeakysmallpaws

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Just another update Manny is doing marvellously well. He's up and about properly, walking properly, eating with gusto and all poo's are back to normality. :yahoo:
 

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That's good to hear - don;t overdo the kalw atm...try other veggies especially natural forage such as grass, dandelions, herbs (basil/coriannder/dill/parsley and a bit of mint) - has less effect on the gut!
x
 
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