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Head Tilt?!

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Guinea-pigGaga

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Posting on behalf of a relative, whose guinea pig has developed a head tilt!

However, the guinea pig in question, has been examined by a cavy-savvy veterinarian who found no evidence of mites, and/or an ear infection!

Nevertheless, the veterinarian has prescribed Baytril, and Metacam. . . But believes that the cause could be neurological, possibly the result of a stroke!

Any suggestions would be greatly appreciated!
 
If it is a stroke then the next 48 hours are crucial, hopefully the Metacam will help. I would say keeping them eating, hydrated and pooing is the most important thing.

I have had a couple of pigs have small TIAs which they got through ok on Metacam and supportive feeding. When my Phoebe had an ear infection she had the worst head tilt I have seen and was treated with Baytril which worked very quickly despite my protests that I wanted Zithromax.
 
Thank you for you reply, @helen105281!

The guinea pig in question, continues to eat, and drink, and behave relatively normally! Although, you can tell that the guinea pig is not 'happy'!

However, I understand that the veterinarian prescribed Baytril, to ensure that the cause of the head tilt is not an infection, thus confirming the cause to be neurological. . . In which case, euthanasia will be considered!
 
Another possible cause is a brain parasite, E. caniculi, which is more commonly found in rabbits, but can affect guineas too. Might be worth asking your vet about it. I really hope it is just an infection!
 
Yes that is definitely something to consider (I knew there was something I had forgotten), treatment is usually with a product like Panacur for about a month.
 
I haven't had a guinea pig with a head tilt but my rabbit has just recovered from a very bad head tilt! He was put on antibiotics, anti inflametry and medication for parasites! It was a very long process and took a lot of time but he is now fully back to normal (apart from a croaked ear) We still don't know what caused the tilt all I would say is make sure the guinea pig can drink as I had give mine water by hand! And also don't lose hope Sandys got worse before it got better!
 
Thank you for your reply, @Elwickcavies!

Unfortunately, I am familiar with E.Cuniculi. . . Therefore, I did advise my relative to discuss E.Cuniculi treatment with the veterinarian - I understand that the veterinarian felt that E.Cunculi was an unlikely suspect. . . Although, I do not see the harm in treating the guinea pig for E.Cuniculi - I understand that treatment is relatively safe, and should not cause the guinea pig any issues etc. . .

@Loverolo Pleased to hear that Sandy has recovered from his recent head tilt - A 'croaked ear' simply adds character!
 
Update: Regrettably, while some improvement was seen, once the antibiotics, and anti-inflammatory medication was stopped, the guinea pig began to revert back to its former condition - The head tilt has returned, and appears to be somewhat worse!

However, as there was an improvement, I would imagine that we are dealing with an infection?!

Therefore, I am thinking that the guinea pig should be treated with a different antibiotic - Zithromax, perhaps?!
 
It's definitely worth asking about Zithromax, I have had great results with it, though not for a head tilt. If the vet can't get hold of it, I was able to get it from the chemist with a veterinary prescription.
 
It's difficult to say really but it does look that way. It may even be a good idea to continue the original antibiotics and anti-inflammatories for a longer period.
 
The return of the condition once antibiotics and anti-inflamms are stopped is "likely" to indicate the cause is an infection..(although whether viral, bacterial or parasitic cannot be determined so therefore antibiotics may not necessarily eradicate any causative organism and it could be the improvement was solely down to the anti-inflammatory)

So I think more importantly it indicates what this head tilt probably isn't
(ie a stroke with lasting damage and a PTS prognosis can now be eliminated)
Therefore it is reasonable to assume that both the vets and your friend will want to continue to treat the piggie.

It's frustrating for all concerned that this appears to be an inner ear issue/infection which is not accessible for culture. Had the vet found evidence of an external/middle ear infection (which normally presents with pus and sometimes an associated ruptured ear-drum) - this would have made it possible to perform a culture/sensitivity test from a swab to identify the organism and (assuming its a bacterium) the most appropriate antibiotic to use and sort the problem.

For info: Every head tilt/ear infection presentation in my pigs has started in the outer ear/eardrum and been shown (bar one) by culture of pus to be a multi-drug-resistant bacterial pseudomonas that has been resistant to all the usual piggie antibiotics including azithromycin......the only way we could treat my pigs was with gentamycin injections (which are nephrotoxic and should not be given to pigs with renal impairment) and gentamycin ear drops. One of my pigs with this infection developed a transient head tilt that resolved on treatment, another has had a permanent head-tilt from the age of 3 (and is now coming up to 7years old!). I say this because I want to caution you all re: thinking that azithromycin will definitely be effective. I have also now had a dental abcess pig that on culture had an azithormycin-resistant streptococcus that was sensitive to baytril

Baytril is actually one of the best abx for bacterial inner ear infection because of its ability to penetrate tissues so I think if I were your friend, I would initially want to continue with that and metacam for another two weeks. Firstly however I would seek another vet exam to see if there are any signs/pus in the outer ear developing that might be able to be cultured before putting the pig back on abx. I'd also ask for another inspection for ear mites .....as ear mites can be quite difficult to diagnose. (the "bar one" of my pigs with head tilt/circling actually had ear mites but no bacterial infection)

I do sympathise with your friend as there are many different permutations and combinations going forwards in terms of cause/treatment (and I also think E caniculi cannot be ruled out) but any vet worth their salt will only want to treat "one condition/cause" at a time because often, a definitive diagnosis and appropriate treatment, is only achieved by a lengthy process of elimination.

Please do keep us updated.
 
UPDATE:

As my relative's guinea pig has not improved, I am encouraging my relative to consider an X-ray, and swabs - I am convinced that the guinea pig has a sinus infection!
 
UPDATE: My relative made the difficult decision to have their guinea pig euthanised!

Therefore, this thread can be closed!
 
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