cheilitis

[Toots33]

Hi,

My guinea pig has had cheilitus for about a month now. She was initially treated with Doxycycline which cleared up the crust on her nose but really upset her tummy. The crusts then appeared in the corners of her mouth so we took her back to the vet who prescribed Marbocyl (we asked for a different antibiotic due to the effects of the Doxycycline on her gut). This helped to get rid of the infection that had developed but didn’t really get rid of the crusts. We were then prescribed Silver Sulfadiazine which again hasn’t really helped. I’ve been back to the vet again today who seems at a loss. His suggestion today was to continue with the Silver Sulfadiazine (even) though it’s not helping with a comment about surgery if this doesn’t clear it up.

I was quite frustrated by this point so I asked about whether it could be fungal as the treatment so far has been bacterial. He said it doesn’t look fungal but they could do a culture if I could come back another day. I persisted as I live quite far away from the vet having chose a piggy savvy vet to go (the vet I usually see unfortunately called in sick today) and they took the sample today. I need to wait for the results.

Has anybody got any advice about how to treat Cheilitis as I feel like I’m getting nowhere at the minute and surgery seems like a bizarre suggestion. I am quite persistent when I see a vet as I’ve found over the years that you have to be with guinea pigs otherwise you don’t always get the right treatment.

 

[Roselina]

I deal with chelitis for humans (it’s usually the corners of the mouth ) - if it is diagnosed as chelitis for your piggie then it IS fungal not bacterial - an anti fungal ointment would get rid of it ( humans have darktarin ointment) - but there maybe lack of vit c issues so you may need to supplement that - I would find a specialist vet who can give you the correct treatment. Don’t let it carry it on - good luck
P.s chelitis NEVER needs surgery

 

[Piggies&buns]

Cheilitis can be bacterial or fungal.
Guinea Lynx :: Cheilitis

Are you feeding any acidic items or fruit? Acidic food items can cause cracks in the skin which allows in bacteria.

 

[Toots33]

Cheilitis can be bacterial or fungal.
Guinea Lynx :: Cheilitis

Are you feeding any acidic items or fruit? Acidic food items can cause cracks in the skin which allows in bacteria.

Thanks for your reply.

We don’t feed tomatoes or fruit. We’re careful with diet because we’ve got a guinea pig with IC.
The only wet foods that we feed are cucumber and bell peppers. We cut everything up into small pieces for her to try and avoid her mouth getting too wet when she’s eating. Do you know if cucumbers or peppers are too acidic?

 

[Claire W]

Cucumbers and peppers are fine to feed

 

[Piggies&buns]

 

[furryfriends (TEAS)]

Our piggy, Freddie, had a very severe case of Cheilitis. It was cured quickly and easily, using Itrafungol.

 

[Wiebke]

I would also recommend to try a course of itrafungol (a prescription-only oral systemic cat fungicide) as the next step as Candida can also cause cheilitis. Itragfungol has cleared up the only case of cheilitis I ever had in my own piggies.

There are rare cases where cheilitis is not responding to any treatment; it very much depends on what has got through the cracks in the lips.
Guinea Lynx :: Cheilitis

 

[Toots33]

Thank you everyone, the vet seems really reluctant to prescribe any fungal treatment but I’ll keep pushing for this and try a different vet if I need to.

 

[Wiebke]

Thank you everyone, the vet seems really reluctant to prescribe any fungal treatment but I’ll keep pushing for this and try a different vet if I need to.

Here is our recommended vets locator in case you need it. Vet Locator

Itrafungol is not cheap but it is safe for guinea pigs and has been in use against ringworm and candida infections in guinea pigs for the last decade with very good results. Unfortunately like so many medications, it is not licensed for guinea pigs (only a very few basic meds actually are). If you are seeing a general vet not all that familiar with guinea pigs you may struggle when it comes to unlicensed meds.

 

[Toots33]

Here is our recommended vets locator in case you need it. Vet Locator

Itrafungol is not cheap but it is safe for guinea pigs and has been in use against ringworm and candida infections in guinea pigs for the last decade with very good results. Unfortunately like so many medications, it is not licensed for guinea pigs (only a very few basic meds actually are). If you are seeing a general vet not all that familiar with guinea pigs you may struggle when it comes to unlicensed meds.

It can be so frustrating. I had to sign a document when I registered with this vet giving my agreement that they could use unlicensed medication on the guinea pigs. My usual vet is normally really good and the vet I saw today is an exotic vet but he’s new to the practice and I haven’t really got a lot of confidence in his advice. I’ll have a look at the locator and find another vet I can go to if I don’t get anywhere. I don’t mind travelling further afield if I need to.

 

[Roselina]

Good luck Toots33 !

 

[Toots33]

Good luck Toots33 !

Thanks

 

[piggieminder]

Has anyone looked at his gums/front teeth. A dirty mouth (food debris stuck round teeth) can cause the fungal that causes chelitis. He would still need the fungal cream to clear his chelitis up but it can be hard to clear or can reoccur if the cause isn't sorted out.
Good luck, I hope you can find a vet who can help.

 

[Toots33]

Has anyone looked at his gums/front teeth. A dirty mouth (food debris stuck round teeth) can cause the fungal that causes chelitis. He would still need the fungal cream to clear his chelitis up but it can be hard to clear or can reoccur if the cause isn't sorted out.
Good luck, I hope you can find a vet who can help.

Thanks for your reply. Teeth and gums have been checked and I’ve been told her mouth is fine inside. I found a previous thread on here that recommended cleaning twice a day with hibiscrub to try and remove the crusts so we started that yesterday. Hopefully this will help to keep her mouth clean. I’m willing to try anything at the moment even if it’s to stop it from getting worse until we can access the right treatment for her.

 

[Toots33]

Just to update, I’ve got an appointment with a different vet tomorrow for a second opinion. In the interim we’ve been treating with a combination of Nystatin for yeast infection (recommended in a case study on Guinea Lynx) and the antibiotic cream prescribed by the vet. We’ve also been cleaning twice daily and removing the crusts when they have softened and we are able to as it’s quite painful for her. It does seem to be responding to the Nystatin but applying topically is quite stressful for her and us. I’m definitely going to push for intrafungal tomorrow and if they won’t prescribe, try an alternative vet practice.

 

[Claire W]

Just to update, I’ve got an appointment with a different vet tomorrow for a second opinion. In the interim we’ve been treating with a combination of Nystatin for yeast infection (recommended in a case study on Guinea Lynx) and the antibiotic cream prescribed by the vet. We’ve also been cleaning twice daily and removing the crusts when they have softened and we are able to as it’s quite painful for her. It does seem to be responding to the Nystatin but applying topically is quite stressful for her and us. I’m definitely going to push for intrafungal tomorrow and if they won’t prescribe, try an alternative vet practice.

I can’t comment on the treatment as I’ve never dealt with chelitis but good luck for your vet visit tomorrow

 

[Toots33]

It feels like such a long time ago since I posted this thread but I wanted to give an update.

It’s been a very long road for Luna and we had a real battle with our local vet who refused to prescribe itrafungal because in his view it is not suitable for guinea pigs as it can damage their kidneys and cause renal failure. He did not offer another treatment plan and we were left in limbo with no treatment but also no recommendation to put Luna to sleep.

We contacted the Cat & Rabbit clinic and took her to see Simon whose immediate treatment plan was to prescribe itrafungal. Unfortunately, as the condition had become quite chronic, the intrafungal on its own didn’t work because there was also infection present so subsequently, a combination of itrafungal and antibiotics was prescribed.

It is looking likely that despite the initial ringworm test being negative, Luna did/does have ringworm and the scratching of the face then caused what looked like cheilitus. We are not out of the woods yet and we’re still not sure whether Luna will fully recover from this however, she has made some positive progress, she seems happy, is maintaining her weight and has had no negative side effects from the itrafungal. We are back to see Simon for a review next week.

Simon has restored my faith in vets and even though it can be a six hour round trip, I wouldn’t hesitate to take my guinea pigs there for more complex health problems. It was so upsetting to experience a vet who was neither recommending treatment or euthanasia to a guinea pig that was clearly in significant pain. Making the decision to put Luna to sleep would have and still will be our last resort but we recognise that it has to be a consideration if she is not responding to treatment and has no quality of life.

We have dealt with a variety of different health issues with our guinea pigs over the years but the skin condition has been one of the hardest things to deal with. We hope that Luna can make a full recovery but whatever happens, we know that we have been able to give her a period of time of being happy and in less pain.

 

[furryfriends (TEAS)]

It feels like such a long time ago since I posted this thread but I wanted to give an update.

It’s been a very long road for Luna and we had a real battle with our local vet who refused to prescribe itrafungal because in his view it is not suitable for guinea pigs as it can damage their kidneys and cause renal failure. He did not offer another treatment plan and we were left in limbo with no treatment but also no recommendation to put Luna to sleep.

We contacted the Cat & Rabbit clinic and took her to see Simon whose immediate treatment plan was to prescribe itrafungal. Unfortunately, as the condition had become quite chronic, the intrafungal on its own didn’t work because there was also infection present so subsequently, a combination of itrafungal and antibiotics was prescribed.

It is looking likely that despite the initial ringworm test being negative, Luna did/does have ringworm and the scratching of the face then caused what looked like cheilitus. We are not out of the woods yet and we’re still not sure whether Luna will fully recover from this however, she has made some positive progress, she seems happy, is maintaining her weight and has had no negative side effects from the itrafungal. We are back to see Simon for a review next week.

Simon has restored my faith in vets and even though it can be a six hour round trip, I wouldn’t hesitate to take my guinea pigs there for more complex health problems. It was so upsetting to experience a vet who was neither recommending treatment or euthanasia to a guinea pig that was clearly in significant pain. Making the decision to put Luna to sleep would have and still will be our last resort but we recognise that it has to be a consideration if she is not responding to treatment and has no quality of life.

We have dealt with a variety of different health issues with our guinea pigs over the years but the skin condition has been one of the hardest things to deal with. We hope that Luna can make a full recovery but whatever happens, we know that we have been able to give her a period of time of being happy and in less pain.

I'd totally lost all faith in vets until the day I first met Simon. So glad Luna is making some progress and hopefully she will eventually make a full recovery. I have so many piggies here at TEAS, where other vets had given up on them or were saying euthanasia was the only option! They are all happy piggies, living very good lives, thanks to Simon and Kim Maddock!

 

[Roselina]

That’s great news for Luna - I really hope she recovers fully. It does seem that most vets have no understanding of guinea pigs and will often not know what to do. Debbie at TEAS is so knowledge as are many forum owners . Kim and Simon are heroes !

 

[Kate Williams]

Hi,

My guinea pig has had cheilitus for about a month now. She was initially treated with Doxycycline which cleared up the crust on her nose but really upset her tummy. The crusts then appeared in the corners of her mouth so we took her back to the vet who prescribed Marbocyl (we asked for a different antibiotic due to the effects of the Doxycycline on her gut). This helped to get rid of the infection that had developed but didn’t really get rid of the crusts. We were then prescribed Silver Sulfadiazine which again hasn’t really helped. I’ve been back to the vet again today who seems at a loss. His suggestion today was to continue with the Silver Sulfadiazine (even) though it’s not helping with a comment about surgery if this doesn’t clear it up.

I was quite frustrated by this point so I asked about whether it could be fungal as the treatment so far has been bacterial. He said it doesn’t look fungal but they could do a culture if I could come back another day. I persisted as I live quite far away from the vet having chose a piggy savvy vet to go (the vet I usually see unfortunately called in sick today) and they took the sample today. I need to wait for the results.

Has anybody got any advice about how to treat Cheilitis as I feel like I’m getting nowhere at the minute and surgery seems like a bizarre suggestion. I am quite persistent when I see a vet as I’ve found over the years that you have to be with guinea pigs otherwise you don’t always get the right treatment.

I have had a case of a boar with cheilitis within 2 weeks of getting him from a rescue. It was quite severe around the lips and nose. I found after some research that Nizarol cream available online, clears this up within 10-14 days. It is related to the anti-fungal Nystatin a POM used by vets to treat fungal infections & systemic mycosis. I used it also on a piggy with a fungal nasal strip and that cleared up in 10 days.

 

[Toots33]

Just another update on Luna. We had a follow up appointment with Simon on Wednesday and we’re at the point of throwing the kitchen sink at Luna’s problem before making a final decision on what to do. We have agreed at least another month of treatment and then a final review. I’ve had some really interesting discussions with Simon and Chrissie from Gorgeous Guineas who’ve both said they’ve never seen anything like Luna’s skin condition in all of their years of experience.

Simon has increased the dose of itrafungal to the maximum dose for Luna’s weight as she’s had no side effects from the lower dose (she’s only tiny so he didn’t want to dose too high initially). He also gave her an injection for mites as Luna’s condition is presenting symptoms that would fit the ringworm/fungal criteria but also the mite criteria as well. We are also dipping and spot treating with imaverol (her cage mate is being dipped too) along with disinfecting with f10. She is prescribed antibiotics to deal with any bacterial infection due to her scratching the sores and metacam/tramadol for the inflammation and pain depending on the severity of it.

We do seem to have seen an improvement over the last 2 days and we can finally see Luna’s nostrils again which kept blocking over due to the crusts. She is maintaining her weight without the need for recovery food, is drinking, lively and we have seen her popcorning. The challenge is knowing whether the increase in itrafungal or the mite treatment is causing the improvement.

I thought it may be helpful to share some pictures of how Luna’s skin condition has changed over time. Everyday it seems to present differently and has definitely not been a text book case.



The final picture is yesterday. The crusts are still clearly present but the nostrils that have been tiny and almost covered for weeks are finally visible again.



This is Luna happily eating and drinking last night. She’s so dark, it’s really hard to take a picture that she stands out in.

 

[VickiA]

Crikey, she sounds like a real challenge in terms of treatment. Good that you have such an experienced vet and that she is showing some signs of improvement.

 

[Toots33]

Crikey, she sounds like a real challenge in terms of treatment. Good that you have such an experienced vet and that she is showing some signs of improvement.

It’s been so stressful, we’ve been trying to treat this since it started at the end of March. I do wonder if our previous vet had prescribed itrafungal in the very beginning, it may have been easier to treat but I guess we’ll never know really. We just have to keep going and hope for the best.

 

[Toots33]

Just a quick update on Luna. The picture on the left was taken on Monday and the one on the right was taken last night. We’ve seen such a drastic improvement over the past week and she doesn’t seem to be in pain any more. We’re so glad we went to see Simon as I don’t think Luna would still be here if we hadn’t.

 

[Roselina]

Wow that is amazing ! I’m so pleased Luna is doing so well and looking so beautiful ! Luna’s story provides so much info for us all ! Thank you

 

[furryfriends (TEAS)]

Just a quick update on Luna. The picture on the left was taken on Monday and the one on the right was taken last night. We’ve seen such a drastic improvement over the past week and she doesn’t seem to be in pain any more. We’re so glad we went to see Simon as I don’t think Luna would still be here if we hadn’t. View attachment 157745

Fantastic news! Simon is amazing and must've saved the lives of so many piggies, over the years!

 

[Roselina]

Simon is a guinea piggie Hero ( and Kim too)

 

[Toots33]

A final update from Luna. You can see that the scabs and white fungal looking skin have now all gone and she’s much better. Following Simon’s advice, we’re continuing the itrafungal and antibiotics until they run out to be on the safe side. He was also kind enough to send us mite treament to inject ourselves (with guidance) so that she can have the full course without us having to do the very long trip to Northampton. Her weight has increased to 730g which is the most she’s ever weighed and she’s no longer in pain.

This is the best Christmas present we could have asked for. We’ve got our fingers crossed that she continues to be ok when we stop the medication but it feels like we’re finally coming to the end of a very long journey .

 

[furryfriends (TEAS)]

Great news!