Has anyone had experience of abdominal fluid being drained from a heart piggy?

[LucyP]

Hi all

Just wondering if anyone has had fluid drained from their piggy before and how it went?

We have a lovely girl called Dottie, who’s about 5 (unclear exactly as she’s a rescue). For at least a year she’s had a heart condition which is progressive and incurable. Since June 25 she’s been on frusol (currently 0.3ml three times a day) to help reduce fluid build up. Also vetmedin 0.2 x 2 per day to help her heart contract better and since March, the vets added caradlis, which contains another diuretic (spiro) and an ACE inhibitor.

Although her breathing is visibly effortful, she’s been otherwise doing well, eating and engaging. Happily takes her meds. Begs for food and etc. However her rocking style breathing has been getting a bit worse again over the last while. (BTW we’re keeping her cool so not heat related I don’t think).

We have a few exotic vets at the practice and they’re really good at working with us. In the past, one of the vets mentioned possibly draining fluid to make her more comfortable if it comes to it. Another vet wondered if it was kinder not to, as it could just come back again. That really stuck with me.

As it happens that was hypothetical as since she’s been on the meds her scans have shown only small amounts of fluid and ‘not enough to tap.’

But as she seems to be getting a bit worse, I’m considering asking for another appointment and a quick ‘look’ ultrasound to listen for fluid. If it’s not mostly about the fluid and her issues are more structural, there is nothing we can do I don’t think except maybe tweak the medicine to try to make her comfortable while we see out the end of her life.

But if the extra rocking is mostly fluid related, we may have to decide whether to try draining or not. I would value others opinions, so I wondered if anyone here had any experience of that?

Google/AI says how easy and helpful it is can depend on the location of the fluid and how easy it would be to reach. I don’t love the sound of the procedure and assuming she would be a sedation risk I wonder how feasible it would even be. But I want to get my head straight on it in case we’re asked to make a quick decision. I know the vets will have advice based on what they find and that will have a large bearing on what we decide but experience of others can be helpful knowledge in the mix.

Many thanks
Lucy

 

[Wiebke]

Hi all

Just wondering if anyone has had fluid drained from their piggy before and how it went?

We have a lovely girl called Dottie, who’s about 5 (unclear exactly as she’s a rescue). For at least a year she’s had a heart condition which is progressive and incurable. Since June 25 she’s been on frusol (currently 0.3ml three times a day) to help reduce fluid build up. Also vetmedin 0.2 x 2 per day to help her heart contract better and since March, the vets added caradlis, which contains another diuretic (spiro) and an ACE inhibitor.

Although her breathing is visibly effortful, she’s been otherwise doing well, eating and engaging. Happily takes her meds. Begs for food and etc. However her rocking style breathing has been getting a bit worse again over the last while. (BTW we’re keeping her cool so not heat related I don’t think).

We have a few exotic vets at the practice and they’re really good at working with us. In the past, one of the vets mentioned possibly draining fluid to make her more comfortable if it comes to it. Another vet wondered if it was kinder not to, as it could just come back again. That really stuck with me.

As it happens that was hypothetical as since she’s been on the meds her scans have shown only small amounts of fluid and ‘not enough to tap.’

But as she seems to be getting a bit worse, I’m considering asking for another appointment and a quick ‘look’ ultrasound to listen for fluid. If it’s not mostly about the fluid and her issues are more structural, there is nothing we can do I don’t think except maybe tweak the medicine to try to make her comfortable while we see out the end of her life.

But if the extra rocking is mostly fluid related, we may have to decide whether to try draining or not. I would value others opinions, so I wondered if anyone here had any experience of that?

Google/AI says how easy and helpful it is can depend on the location of the fluid and how easy it would be to reach. I don’t love the sound of the procedure and assuming she would be a sedation risk I wonder how feasible it would even be. But I want to get my head straight on it in case we’re asked to make a quick decision. I know the vets will have advice based on what they find and that will have a large bearing on what we decide but experience of others can be helpful knowledge in the mix.

Many thanks
Lucy

Hi

Personally, I have let my own piggy with water on the chest go after upping the diuretics wasn't doing the trick because the fluid will return if the diuretics are already maxed out and the heart is just no longer able to work properly.

We do sadly have to face the fact that guinea pigs are small animals with a much faster metabolism sooner than with most other pet species although we bond with them just as deeply. That issue is not getting any easier as time goes on and we are forced face more and more risky and invasive procedures. And the rising cost is very much becoming a major and legitimate aspect for many of us.

I have recently written this guide here in order to help members work out where they stand themselves in this very tricky and controversial field. It is something that you have work out for yourself with each piggy anew because each bond is different. You may answer certain questions differently for a younger piggy or for one who you not have very special bond with. It also depends on the nature of any further treatment etc.
But it can help you if you know where your heart lies so you can set your own parameters now and you feel better prepared and hopefully less conflicted when it comes to a discussion of where you want to draw the line in this specific case.
Operation, Terminal Care or Euthanasia? - Helpful Questions to Ask Ahead or in Hindsight

This is an area where is not necessarily a right or a wrong answer - unless there is a clear medical reason so there is not one clear answer. It has to be right for your indvidual case and for how much you are prepared to put your increasingly frailer piggy through. Vets are currently sadly under increasing pressure from the clinic owners to offer further (expensive) treatments so the question of how far your heart wants to take it yourself is something that can help you navigate it all.

You are however also always allowed to book a (payable) telephone consultation slot with your vet in order to ask any questions and doubts that have come up after an examination or that you want to ask but didn't get around to if you find it really difficult to come to a decision you OK with.

My thoughts are with you in this difficult time.

 

[Truffolo]

Thank you for raising this issue. Wishing you strength and comfort

 

[LucyP]

Thanks so much both. I think you make excellent points as ever Wiebke, and it's very helpful indeed to know what you did.

It reminds me of one of the mantras one of our vets has (interestingly she is a surgical vet so most of her week is spent doing surgery or teaching students in this), but she said (in relation to another dilema we had) 'Just because we can do something, doesn't always mean we should.' I wouldn't want to put Dottie through something invasive just for the sake of time; we promised to make her days as comfortable as possible, and that's a different matter isn't it. The only thing that made me pause was that I read or heard somewhere, that IF it's in an area easier to reach, and IF it goes well, it can give them months of comfort before it comes back. And then you would call it a day. But there are no guarantees of either of those things, so I think the vets would have to give me a really compelling reason to try it.

Maybe it's not fair to put her through the visit and an US either. But then if they found fluid we might consider upping the frusol, if they don't we could look at tweaking other meds. I know that would be a temporary measure.

We've been monitoring her resting respiratory rate each day and since the cardalis was added, her scores have improved slightly or at least stopped getting worse. Since she's been diagnosed they'd been 80-90 per minute and even some that crossed 100 (rare but scary). Since the cardalis, they've been solidly more in the 70-80 range incudign with some late 60's. I read yesterday online that if RRR is stable but effort looks worse, that is more likely a structural issue than a fluid one. But that was AI - which can be good for brainstorming but definitely makes mistakes - so I don't plan to trust any important decisions to it! But I wonder if there is any truth in that. Maybe something to ask the vet.

I just held her and I can't be sure if she's feeling a little bit fuller in the lower area, maybe kind of pear shaped, and I wonder where fluid in heart piggies normally shows up?

But thank you, I think the draining decision feels much more like a no than a yes right now unless we're given new information.

I am not hell bent on keeping her going forever of course and her needs come first. It's just confusing when she seems otherwise happy! It's hard to imagine thinking about PTS when she is begging at the bars etc and her face lights up for grass, but I know the time for PTS might well come. I just want to make her comfy as much as possible before that happens. It's always such a dilemma isn't it.

Thanks again.

 

[Viennese Furbabies]

It's always an incredibly hard decision, especially when they are still eating.
Sending hugs and healing vibes!

 

[LucyP]

Thank you!

 

[Mrs Tiggy Winkle]

Just sending along my support as I remember similar (having to consider PTS when said guinea was still begging for food and otherwise showing a strong zest for life) with some of my previous guineas.

 

[LucyP]

Thank you, it is hard isn't it. I suppose we will know when she's had enough and I would rather be slightly early than too late, if we can know that. In the meantime I need to decide whether it's in her interest to have a check up in case the meds could be changed.