Heart Disease Medication

[Amysguineapigs]

Today Cookie went into the vets for a nasal flush and X ray due to a lot of snorting coming from his throat and nose. My vet suspects he has early signs of heart disease. So he is on Frusemide tablets, a quarter tablet crushed with 0.5 ml of water and then given 0.1 ml of the medicine. I just have a question though, the liquid which is left over can be used the next time he needs it? So where do I store it, in the fridge or not?
Thanks
Amy

 

[Wiebke]

Today Cookie went into the vets for a nasal flush and X ray due to a lot of snorting coming from his throat and nose. My vet suspects he has early signs of heart disease. So he is on Frusemide tablets, a quarter tablet crushed with 0.5 ml of water and then given 0.1 ml of the medicine. I just have a question though, the liquid which is left over can be used the next time he needs it? So where do I store it, in the fridge or not?
Thanks
Amy

Please store it in the fridge and only use on the next day (shake well before use!); ideally you should have been given enough to only use it on the day.
The concentration sounds too high for me; the one I had to give a suspected heart piggy was a lot lower. Have you checked your decimals?
@helen105281

 

[Amysguineapigs]

Please store it in the fridge and only use on the next day (shake well before use!); ideally you should have been given enough to only use it on the day.
The concentration sounds too high for me; the one I had to give a suspected heart piggy was a lot lower. Have you checked your decimals?
@helen105281

That's what has been written down by my vet or it says on the medication bottle crush a quarter of a tablet and mix with 5ml of water then give 1ml of the solution. just all a bit confusing!

 

[helen105281]

What mg is the tablet?

 

[Amysguineapigs]

What mg is the tablet?

20mg

 

[Adelle]

Hi! So you have a 20mg tablet, a quarter of which contains 5mg. Adding 0.5ml water makes a 10mg/ml solution (5mg in 0.5ml). Giving 0.1ml means you are giving 1mg- which is low end of the dosing range for frusemide but your vet obviously thinks this is all your piggy requires. The good thing with that is, if your piggy needs more diuretics then you have a good scope to work with. Anything up to 4mg is usually prescribed, more has been given in some cases but its suggested that higher than 4mg doesnt provide further relief, just poses a high risk to the kidneys.

I have a sow in heart failure. She requires 4mg frusemide every 8 hours, plus a 5mg of a different diuretic every 12 hours- her case is severe.

You arent the first to talk about frusemide being made up by crushing tablets which has made me think the type fudge is on isnt as popular as i thought.. Frusol liquid (or lasix solution) is liquid frusemide. Its a yellow syrup and is much easier and more accurate to dose. No need for crushing tabs etc. I have to do this with her fortekor and spironolactone as its the only form they come in, but the liquid frusemide is really handy. She goes through a whole 150ml bottle a month, so i just buy it that way. Its £40 for the bottle but she is on a massive amount x

 

[helen105281]

Thanks @Adelle, I would have had to get the OH to work it out for me.

Is your vet thinking of trialling an ACE inhibitor like Fortekor too?

 

[Amysguineapigs]

Hi! So you have a 20mg tablet, a quarter of which contains 5mg. Adding 0.5ml water makes a 10mg/ml solution (5mg in 0.5ml). Giving 0.1ml means you are giving 1mg- which is low end of the dosing range for frusemide but your vet obviously thinks this is all your piggy requires. The good thing with that is, if your piggy needs more diuretics then you have a good scope to work with. Anything up to 4mg is usually prescribed, more has been given in some cases but its suggested that higher than 4mg doesnt provide further relief, just poses a high risk to the kidneys.

I have a sow in heart failure. She requires 4mg frusemide every 8 hours, plus a 5mg of a different diuretic every 12 hours- her case is severe.

You arent the first to talk about frusemide being made up by crushing tablets which has made me think the type fudge is on isnt as popular as i thought.. Frusol liquid (or lasix solution) is liquid frusemide. Its a yellow syrup and is much easier and more accurate to dose. No need for crushing tabs etc. I have to do this with her fortekor and spironolactone as its the only form they come in, but the liquid frusemide is really handy. She goes through a whole 150ml bottle a month, so i just buy it that way. Its £40 for the bottle but she is on a massive amount x

My vet reckons Cookies is early stages but not 100%. His been snorting for months, and in the nasal flush a lot of mucus come out but she says he has no heart murmur or racing heart and hasn't lost weight, so maybe that's why he is on such a low dose. Got to see how he goes over the weekend and if the snorting doesn't return and he seems a bit brighter he will stay on the meds long term.
Thank you for your reply I'm going to read as much as I can on heart disease in guineas to get more knowledge on it

 

[Amysguineapigs]

Thanks @Adelle, I would have had to get the OH to work it out for me.

Is your vet thinking of trialling an ACE inhibitor like Fortekor too?

Sorry, what are they? Never had a Guinea with heart problems before!

 

[Adelle]

My vet reckons Cookies is early stages but not 100%. His been snorting for months, and in the nasal flush a lot of mucus come out but she says he has no heart murmur or racing heart and hasn't lost weight, so maybe that's why he is on such a low dose. Got to see how he goes over the weekend and if the snorting doesn't return and he seems a bit brighter he will stay on the meds long term.
Thank you for your reply I'm going to read as much as I can on heart disease in guineas to get more knowledge on it

What tests have been done to get a heart diagnosis? Mucous is normally more down to infection/inflammation.. The fluid that builds up in heart piggies is usually just liquid, which can come out the nose during a high build up, but it more runs and doesnt clog.

Fortekor (ACE inhibitors) are medications that try and improve/support the hearts function itself, whereas the diuretics deal with any fluid.

Has there been any xrays to look at the heart, and to see if theres any fluid in the lungs? Have antibiotics already been tried? I also wouldnt have thought a nasal flushing would be safe for a heart piggy, as increased breathing rate could make them susceptible to aspiration.

I'm sorry if this has already been covered elsewhere- i havent been around much lately.

Hope he stays breathing easy!

 

[Amysguineapigs]

She X rayed him and gave him a nasal flush thinking it could be a grass seed stuck or a polyps but couldn't find anything so she zoomed on his chest and skull and saw a bit of fluid on his lungs so she suspects it could be heart disease because of his age too. He had baytril twice in the past couple of months and it did nothing, would it be worth asking for a different type of antibiotic? When she did flush out his nose there was clear mucus from one nostril and not so clear in the other, he does have a runny nose now, and the snorting has come back already

 

[Adelle]

Okay so there was fluid in the lungs. I guess this could still point to infection but id imagine if it was, the antibiotics would have helped or if not, it would have gotten worse really quickly.

Your best bet is to have another vet check, explain hes still congested on the 1mg frusemide (how often?) and if they think he needs a higher dose, or if they will reconsider infection x

 

[helen105281]

I agree with Adelle, the vet could try a different antibiotic like Marbcoyl, Doxycycline or Zithromax?

 

[Amysguineapigs]

Okay so there was fluid in the lungs. I guess this could still point to infection but id imagine if it was, the antibiotics would have helped or if not, it would have gotten worse really quickly.

Your best bet is to have another vet check, explain hes still congested on the 1mg frusemide (how often?) and if they think he needs a higher dose, or if they will reconsider infection x

Yes, I would of thought baytril would work, if it is an infection surely it would of got so much worse by now as it's been going on for some time. The snorting isn't always constant either, I held him earlier and he was quiet until he starts eating or sniffing . She wants me to phone Monday for an update on him and he is on it twice a day. I'm meant to be on holiday Monday afternoon until Thursday but I'm reluctant to go as I'm worried about him

 

[Adelle]

Yes, I would of thought baytril would work, if it is an infection surely it would of got so much worse by now as it's been going on for some time. The snorting isn't always constant either, I held him earlier and he was quiet until he starts eating or sniffing . She wants me to phone Monday for an update on him and he is on it twice a day. I'm meant to be on holiday Monday afternoon until Thursday but I'm reluctant to go as I'm worried about him

Bless you it is hard! Under your vets instruction, he is able to have up to 4mg of frusemide 3 times a day- so you do have a good scope to work with there. You could call your vet and ask about it, they may advise you to try a higher dose and see if his snuffling settles.

Obviously dont do anything without instruction from your vet, but it is good that u have a large scope med wise to work with.

If his breathing worsens, or he deteriorates in any other way then getting him to the vet to discuss his meds would be a good shout.

It is hard at the beginning until you get them stable. Fudge was on 2mg every 12 hours to start with, but she was still snorty/snuffly. She then became worse with a large collection of fluid in her lungs. She was put on max dose frusemide, 4mg every 8 hours, for 4 days.. And that was 10 months ago! Anytime we tried to reduce it, the fluid built up again. Further down the line we added in a second diuretic too, which started at 5mg once a day, to 5mg every 16 hours. We are currently fluctuating between that and 12 hourly- as it is progressive.

However, the past few months have been steady and shes at the best shes ever been.

Dont lose hope, its just a matter of getting stable. By all means i dont think giving more diuretics than is needed is a good idea- but at the end of the day, breathing trumps everything else and whatever dose he needs to make him breathe clearly, is what he will need to have.

Hope you are advised soon on what the next step is x

 

[Amysguineapigs]

Bless you it is hard! Under your vets instruction, he is able to have up to 4mg of frusemide 3 times a day- so you do have a good scope to work with there. You could call your vet and ask about it, they may advise you to try a higher dose and see if his snuffling settles.

Obviously dont do anything without instruction from your vet, but it is good that you have a large scope med wise to work with.

If his breathing worsens, or he deteriorates in any other way then getting him to the vet to discuss his meds would be a good shout.

It is hard at the beginning until you get them stable. Fudge was on 2mg every 12 hours to start with, but she was still snorty/snuffly. She then became worse with a large collection of fluid in her lungs. She was put on max dose frusemide, 4mg every 8 hours, for 4 days.. And that was 10 months ago! Anytime we tried to reduce it, the fluid built up again. Further down the line we added in a second diuretic too, which started at 5mg once a day, to 5mg every 16 hours. We are currently fluctuating between that and 12 hourly- as it is progressive.

However, the past few months have been steady and shes at the best shes ever been.

Dont lose hope, its just a matter of getting stable. By all means i dont think giving more diuretics than is needed is a good idea- but at the end of the day, breathing trumps everything else and whatever dose he needs to make him breathe clearly, is what he will need to have.

Hope you are advised soon on what the next step is x

Thanks so much for your replies, feeling quite stressed over it due to holiday next week, still not sure whether to go! I just spoke to the nurse on the phone who contacted my vet for me as its her day off today. I mentioned increasing the dose or trying another antibiotic. The vet said to increase his dose to 0.2 ml with half a tablet and 1ml of water added then update on Monday. I'm a bit confused about the medication and whether I'm doing it right, I'm crushing half a tablet and mix 1ml of water then give him 0.2ml of the liquid? X

 

[Adelle]

Thanks so much for your replies, feeling quite stressed over it due to holiday next week, still not sure whether to go! I just spoke to the nurse on the phone who contacted my vet for me as its her day off today. I mentioned increasing the dose or trying another antibiotic. The vet said to increase his dose to 0.2 ml with half a tablet and 1ml of water added then update on Monday. I'm a bit confused about the medication and whether I'm doing it right, I'm crushing half a tablet and mix 1ml of water then give him 0.2ml of the liquid? X

Half a 20mg tablet is 10mg. Adding 1ml makes a 10mg/ml solution. Giving 0.2ml means you are giving him 2mg, which is double what youve given him previously.

Hopefully his breathing eases with the 2mg frusemide x

 

[Amysguineapigs]

Half a 20mg tablet is 10mg. Adding 1ml makes a 10mg/ml solution. Giving 0.2ml means you are giving him 2mg, which is double what youve given him previously.

Hopefully his breathing eases with the 2mg frusemide x

Thanks, I'm doing it right then, hopefully it will help him x

 

[Adelle]

Thanks, I'm doing it right then, hopefully it will help him x

If he does well and needs this long term, enquire about frusol liquid/lasix .. Is already made liquid frusemide. Its like a thin syrup with no solid matter or powder in it. Means hes getting the exact dose each time. My heart piggy loves the taste too x

 

[Guinea Slave]

I use the frusol liquid and its so much easier to administer and adjust depending on their condition. Definitely recommend it. I have had a lot of piggies use it over the years and have one on it now. I agree @Adelle, mine love the taste and will run off with the syringe if she can, just to ensure she has got every last drop!

 

[Amysguineapigs]

Thanks both, I will definitely keep it in mind if he needs it long term as these tablets are a bit of a pain!x

 

[Amysguineapigs]

Checked Cookie today and I haven't yet heard the snorting noise his been making, he looks tired and not 100% but still very keen for food and does the odd squeak and clucking noise. Poor little guy is arthritic too so I guess that can make him seem lethargic too

 

[Adelle]

Checked Cookie today and I haven't yet heard the snorting noise his been making, he looks tired and not 100% but still very keen for food and does the odd squeak and clucking noise. Poor little guy is arthritic too so I guess that can make him seem lethargic too

How is his hydration? Does his eyes look bright and moist as normal or do they seem smaller and sunken? Diuretics obviously make the body expell fluid so they can sometimes get a little dehydrated, but usually on the dose he is on they are able to hydrate themselves just with their usual fluid intake.
The extra diuretics shouldnt make him feel flat, if anything they should make him feel better if his breathings clearer. If you think hes dehydrated, give him some water via syringe, or some extra cucumber. If he perks up then you'll know thats what it is.

Another thing to check is his circulation- are his extremities warm and a good colour? Or are they cold and pale? I.e his nose/gums/ears/feet. If theyre cold and pale then his circulation could be poor which is making him feel flat. If that is the case then seeing the vet to discuss possible heart meds would be a good idea.

Obviously you know him best and if you cant pinpoint the problem then id give your vet a wee call x

 

[Amysguineapigs]

How is his hydration? Does his eyes look bright and moist as normal or do they seem smaller and sunken? Diuretics obviously make the body expell fluid so they can sometimes get a little dehydrated, but usually on the dose he is on they are able to hydrate themselves just with their usual fluid intake.
The extra diuretics shouldnt make him feel flat, if anything they should make him feel better if his breathings clearer. If you think hes dehydrated, give him some water via syringe, or some extra cucumber. If he perks up then you'll know thats what it is.

Another thing to check is his circulation- are his extremities warm and a good colour? Or are they cold and pale? I.e his nose/gums/ears/feet. If theyre cold and pale then his circulation could be poor which is making him feel flat. If that is the case then seeing the vet to discuss possible heart meds would be a good idea.

Obviously you know him best and if you cant pinpoint the problem then id give your vet a wee call x

Cookie has always had watery eyes, they've never looked normal so I could be analysing it too much. Between Cookie and his friend Teddy they get through almost a bottle of water per day, but I syringed him a bit of water in case. Just gave him cucumber and carrot and he is very keen for them, although he does leave a bit of veg and goes straight to his hay but the way he is behaving is the way his been for weeks. He has been snorting a bit tonight and sniffling with a runny nose but other than that his eating and not losing weight X

 

[Adelle]

Cookie has always had watery eyes, they've never looked normal so I could be analysing it too much. Between Cookie and his friend Teddy they get through almost a bottle of water per day, but I syringed him a bit of water in case. Just gave him cucumber and carrot and he is very keen for them, although he does leave a bit of veg and goes straight to his hay but the way he is behaving is the way his been for weeks. He has been snorting a bit tonight and sniffling with a runny nose but other than that his eating and not losing weight X

The fact he is easting and maintaining his weight is great. Keep monitering him and if u think hes better on the higher dose but still snuffly when his dose is nearly due, your vet may advise giving him it 3 times a day instead of 2, or even giving a slightly higher dose twice daily. Obviously you would need to discuss that with them first but i know you know that already :-)

Fudge has off days, some days she popcorns (as high as her arthritis allows!) and is generally noisy and looks brilliant. Other days she sleeps all day and takes longer to eat. Its just part and parcel of the disease but on the most part shes great now we have her stable. Its a rollercoaster but trying to find the right dose of meds for them is key. Remember, your vet is there to help so dont hesitate to discuss things if you are unsure. Its better to be safe than sorry as they say! X

 

[Amysguineapigs]

The fact he is easting and maintaining his weight is great. Keep monitering him and if you think hes better on the higher dose but still snuffly when his dose is nearly due, your vet may advise giving him it 3 times a day instead of 2, or even giving a slightly higher dose twice daily. Obviously you would need to discuss that with them first but i know you know that already :-)

Fudge has off days, some days she popcorns (as high as her arthritis allows!) and is generally noisy and looks brilliant. Other days she sleeps all day and takes longer to eat. Its just part and parcel of the disease but on the most part shes great now we have her stable. Its a rollercoaster but trying to find the right dose of meds for them is key. Remember, your vet is there to help so dont hesitate to discuss things if you are unsure. Its better to be safe than sorry as they say! X

I will do, I have noticed today he was snuffly before his next dose, so will take note when I hear him make the noises. My vet wants me to update her on Cookie on Monday morning before I'm meant to going on a three day break, so I shall see what she says then she is a very good vet and I know she's always there to help so that reassures me too I guess at the moment I feel guilty that Cookie is living with arthritis and now potential heart disease, do you ever feel this way? Most of the time he seems content but like you said it's off days. It is definitely a rollercoaster and quite stressful at times as I'm sure you know! How old is Fudge?x

 

[Adelle]

I will do, I have noticed today he was snuffly before his next dose, so will take note when I hear him make the noises. My vet wants me to update her on Cookie on Monday morning before I'm meant to going on a three day break, so I shall see what she says then she is a very good vet and I know she's always there to help so that reassures me too I guess at the moment I feel guilty that Cookie is living with arthritis and now potential heart disease, do you ever feel this way? Most of the time he seems content but like you said it's off days. It is definitely a rollercoaster and quite stressful at times as I'm sure you know! How old is Fudge?x

Fudge just turned 7 on wednesday :-) the pics of her with her birthday cake are on page 13 of her thread if u wanna see her lol
A Picture A Day..

Fudge wasnt right for a few months before they finally diagnosed her- they kept dismissing my claims until she went into respiratory distress, her lungs where brimming with fluid. Because it took such high doses of diuretics to stabilise her, i was told her heart failure was advanced and that she wouldnt live long enough to find a heart med dose that would help her, and even if she did, the high doses of diuretics would put her into kidney failure and kill her (she was also suspected kidney disease). I took her to a specialist that got her on fortekor and frusemide. She became unstable several times and i almost let her go twice, but i didnt feel it was her time. She has been on meds for a good 9/10 months with an extra diuretic added in further down the line- and shes doing amazingly well. Shes happy, shes the same weight, she popcorns, she sticks up for herself, she enjoys life to the full. She is a little boney over the hips as shes lost muscle from the arthritis- but she still gets about and her joints are much better than they where.. Shes been on oxbow science Senior hay tablets for 3 months which have helped alot. She also on vegan glucosamine for her joints now but thats only been the last month. If she has a bad hip day she gets a little metacam.

i posted this around 4 months into fudges battle- The Picture Says A Thousand Words..
I struggled with wether i was being fair to her.. I nearly let her go twice but something made me change her mind each time. She let me know.

I've always said, the minute she gives up, or goes into respiratory distress, or loses interest in eating or being her usual happy self- i wont let her suffer. I let her be my guide, your boy will do the same x

 

[Amysguineapigs]

Fudge just turned 7 on wednesday :-) the pics of her with her birthday cake are on page 13 of her thread if you wanna see her lol
A Picture A Day..

Fudge wasnt right for a few months before they finally diagnosed her- they kept dismissing my claims until she went into respiratory distress, her lungs where brimming with fluid. Because it took such high doses of diuretics to stabilise her, i was told her heart failure was advanced and that she wouldnt live long enough to find a heart med dose that would help her, and even if she did, the high doses of diuretics would put her into kidney failure and kill her (she was also suspected kidney disease). I took her to a specialist that got her on fortekor and frusemide. She became unstable several times and i almost let her go twice, but i didnt feel it was her time. She has been on meds for a good 9/10 months with an extra diuretic added in further down the line- and shes doing amazingly well. Shes happy, shes the same weight, she popcorns, she sticks up for herself, she enjoys life to the full. She is a little boney over the hips as shes lost muscle from the arthritis- but she still gets about and her joints are much better than they where.. Shes been on oxbow science Senior hay tablets for 3 months which have helped alot. She also on vegan glucosamine for her joints now but thats only been the last month. If she has a bad hip day she gets a little metacam.

i posted this around 4 months into fudges battle- The Picture Says A Thousand Words..
I struggled with wether i was being fair to her.. I nearly let her go twice but something made me change her mind each time. She let me know.

I've always said, the minute she gives up, or goes into respiratory distress, or loses interest in eating or being her usual happy self- i wont let her suffer. I let her be my guide, your boy will do the same x

She's so cute and pretty, doesn't look 7 at all, I can see how well you look after her Sounds like you had a very stressful time, I'm glad you've found the correct doseage of meds for her now and she is doing well, it's amazing how well she is doing, tough piggie! Cookie had a suspected fractured leg last year, costing me £165 in emergency vet bills! He had an X Ray which showed a bad sprain and arthritis in his leg joints, the ball of his feet and ankles are usually quite swollen, some days more than others, which is why I think some days his active some not, I've noticed his much better in warmer whether rather than damp and wet. I always have metacam in the house for emergency if I feel his in pain or limping. I would love to help his joints by using a natural method. I think my vet mentioned vegan glucosamine, is it any good? Where do you get it from?

Yes I think when it comes to pets us as owners know when the time is right, just got to use our gut instincts. I feel the majority of the days Cookie is happy, just old age takes its toll sometimes. He is five next month X

 

[Amysguineapigs]

Update on Cookie...
Checked him for a while this morning as I'm away until Thursday now. He looks a bit brighter, one eye seems to look brighter than the other but he has always had very runny not so healthy looking eyes since I've had him, all been checked out and the vet doesn't know what's wrong with them. His snorting has reduced and have barely heard a snort from him in two days! So hopefully the heart medication is working, looks like it is heart disease after all so it's amazing how my vet has found it on such early stages as he doesn't have heart murmur or anything like that. So fingers crossed he is stable and were on the right track! X