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Holly - long term mouth issues

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Just to update on Holly, I've spoken to the vet again, and she wants to proceed cautiously, given that there has been some improvement. She wants to leave it for another 6 days (with the Lasix) before thinking about a heart medicine.
 
I'm feeling a little uneasy about all this, as my vet is so cautious about going so far off license without a definite diagnosis.

Holly has improved quite a lot with the diuretic, and her breathing has quitened right down. But she's only got slightly better - just slightly perkier and eating slightly more. Rightly or wrongly, I feel that it's time to take some risks, because she has been like this for ages, and she doesn't have great quality of life (although it certainly isn't at the PTS stage).

It was left that my vet will do some research and come back to me with a prescription for a heart medicine. I've already given her some information, so I'll see what she comes back with.

I really hope I don't end up regretting this. If it all goes wrong, I think I will have to come back to this post and hopefully get some comfort from it, that I did what I thought was right, and couldn't just leave Holly how she was.
 
Erm... it's a 2.5 mg tablet, to be cut into 4, and given twice a day, so... what's that? 0.625 mg twice a day.

Just noticed that the lump in her throat is back too (the one that Vedra drained the other week). :(
 
My little Holly monster got quite excited about her breakfast this morning (even though she has left loads), and actually did a little popcorn jump! How excited am I?! :)

Am going to give it a few days on the Fortekor, and then go back to the vets about this lump.
 
Thanks! :) Yes, I'm trying to reign in my excitement (given that she has left loads of veg, despite getting excited about it!), but baby steps eh? Whatever happens, it has to be worth a try. And if she doesn't improve, I'll feel like I've done everything that I can.

It's so interesting to hear about other piggies with heart issues.
 
Muffin has become a different pig on fortekor and furoseamide - had to print out guinea lynx adb get X rays done to convince my normal vet but they have been bowled over by the results. She is now being monitored by a specialist heart/exotics vet.

Muffin had cyanosed lips and ends of ears (ie should be pink but were slightly blue/grey in colour). She had also developed fluid in abdomen and fluid in lungs on X ray....she was also a "pancaked" pig - and very lethargic.

One week on F/F and she was back to her normal self....this was over a year ago and she is now 4 years old....and has been maintained on F/F once daily (1mg/kg fortekor and 2mg/kg furoseamide).

Her sister Crumpet died very suddenly and unexepectedly 2 years ago (i suspect from a heart attack - this was before I found a good vet).

Recently I have, on the instruction of the vet, upped her dose to twice a day....(.Muffin has additional complications of an unknown, non-bacterial chronic pneumonia as well as the heart problem...hence why she is still on furoseamide).

Heart meds for guineas over a couple of months should have no lasting effects so are deffo worth a trial if you suspect a heart problem.........according to my heart vet......several of my genetically-related guineas have had trials over the last year and are now off the meds with no ill effects.

Also, in many cases it is possible to wean them off the furoseamide diuretic after a time/once stabilised - (not possible in Muffin's case because of the additional complications of chronic pneumonia)

I grind up 4x2.5mg fortekor tablets (=10mg) plus 1 furoseamide (20mg) tablet in a pestle and mortar, add in 5 ml of water (=2mg/ml and 4mg/ml respectively) and give (body weight/2)ml from a syringe.


Good luck - hope the meds will sort her out.......
x
 
Hey Sarah, how is the lovely Holly doing now?

It took around two weeks for me to suddenly turn around and see that actually, lots of small and subtle changes had taken place but made a notable difference to Gwenny's condition. I have had to 'play around' with the dosage a lot with Gwenny though, started off on once daily but soon found that she needed 2x daily doses, as 24hrs was too long between doses for her. I too make a suspension to make altering the dosage easy.
 
I'm really in two minds what to do today, as Holly has gone downhill again in the last 36 hours or so... :{ She's only been on the Fortekor since Thursday evening, but she's still on the diuretic. I am finding that she's sleeping more and totally glazing over - she has no idea that I am there, and she doesn't want to eat etc. This had really improved.

I'm wondering whether to stop or reduce the Fortekor, or whether it is too early to tell. :{
 
I'd check with the vet Sarah but I'd be inclined to reduce the dose rather than withdraw it altogether. Your choice of course, but she does sound to have crashed a bit.
 
Thanks Laura. I also feel that there is a potassium loss element to her dips, to confuse even more. I've been giving her a little dried dandelion a day, and 0.1 ml Metatone. This morning I gave 0.3 ml Metatone. This afternoon she seems perkier - I just went in and she was scoffing at the dried food bowl.

I'm so confuuuuuuuuuused. :(
 
Just to update, I dithered a lot, but in then end gave the full dose of Fortekor, as she'd perked up on the higher dose of Metatone. She popcorned around her cage when fresh fleece went in (which is hilarious - something she used to do back in the time when the three piggies were on fleece - the other two used to look at her like she was a loony and be quite scared!). I wish I'd got a video!

Anyway, she's still not eating a great deal, but I've given her the same dose (0.3 ml) of Metatone today to see what happens.

Oh, one more thing that I've noticed is that her pee (or poos, not sure which) has a funny smell to it. Sort of like... cheese/butter! :{ I'm thinking it's a drug side effect.
 
Ok... rightly or wrongly I've decided not to give her the dose of Fortekor tonight and see how she is by the morning (then make another judgement call as to whether to give it). She has perked up gradually as the day has gone on again today, but really hasn't been on good form. Also, she has very squishy poos.

I haven't spoken to the vet but, to be honest, I'm sure she would say to do as I am.
 
Thanks for updating Sarah. If she does well on the Fortekor and Metatone, I see no reason not to give both on an ongoing basis....(does anyone else - Pebble?)

Is she still on the Lasix? The drugs likely explain the change in urine, make sure she does stay well hydrated.
 
Firstly - glazed eyes/lethargy:
Both drugs are needed initially to help stabilise the heart and reduce the fluid that has accumulated. After a period of time the diuretic (furoseamide) can be with withdrawn gradually but it is the fortekor that needs to be given regularly. Fortekor in itself should not cause a piggie to glaze over or crash...it is more likely to be dehydration, not enough fortekor or an underlying infection.

How laboured is her breathing at the moment? Can you see whether her lips/ends of ears are cyanosed (blue) or pink...or is she a dark-skinned piggy in those areas?

What doses of fortekor and furoseamide are you giving her atm and how frequently?

If you are worried about potassium - try giving some dioralyte as this will also help rehydrate her.

Next - Smelly wee can be firstly as Laura says an element of dehydration owing to the furoseamide diuretic. Also when fortekor is first given it can also increase urination as it starts to act on reducing salt and water uptake by the kidneys in order to reduce the strain on the heart until the body balances itself again. Secondly some fortkeor will be excreted by the kidneys and it is quite a smelly drug anyway when made up in water for oral dosing (and you may see some sediment in the urine). Thirdly however the changes in urinary pattern may have encouraged an infection to start so if there is no improvement or the smell gets worse it may be worth getting a sterile urine sample analysed by the vet and possibly a course of anitbiotics.....especially as she seems a bit lethargic

As for the squishy poos - Muffins poos are fine - I can;t remember if there was an intial reaction when she first started the fortekor - I don;t think so but it wouldn;t surprise me to learn piggie poos are slightly squishy for a few days as I know some dogs can;t tolerate fortekor and can get upset tummies. I have noticed that the fortekor suspension goes off quite quickly and can become really whiffy even when kept in the fridge. Therefore I always make up a fresh batch every 72 hours.
It could however actually be the metatone that is causing the poo problem - might be worth reducing the dose to 0.2ml and giving it after she has had some food? Also you might want to try fibreplex for a couple of days to help re-stablise the gut flora and firm up the poos.

Bottom line is therefore it is the fortekor not the furosamide that should be continued long term for heart pigs and IF this is the medication that is upsetting her tummy then I would discuss with the vet a staged withdrawal of fortekor and replacement with an alternative drug.....but you need to rule out metatone as the cause first.

HTH
x
 
Thanks for both replies. I will reply properly to all the details soon, as I'm struggling to make sense of anything at the moment (migraine plus a cold! rolleyes), but just to update at the moment that with two missed doses of Fortekor (last night and this morning) she has perked up and eaten a bit more. :{ I'm wondering if she has been on too high a dose.

Current prescribed doses are:
Fortekor - quarter of a tablet twice a day
Frusol (which she now has instead of Lasix, as it's a liquid solution and easier): 0.3 ml twice a day

Her breathing sounds absolutely fine now (to me, but hasn't been listened to with stethoscope yet).

Sorry for not answering everything else yet - will do when my brain returns! :red
 
AAARGH no edit. I just wanted to add that she's drinking a fair bit for herself (she has a bowl and a bottle), but I'm also regularly giving her syringes of water, as she sees them as a treat. Whether she's drinking enough, I can't say, but she's certainly getting plenty.
 
pelicano said:
Current prescribed doses are:
Fortekor - quarter of a tablet twice a day

Is this a 2.5mg tablet? If so it means she is getting 0.625mg twice daily. The normal dose should be 1mg/kg twice daily so assuming she weighs approx 1kg, this is a smaller than normal dose and ore suitable for a piggie weighing 625g


Frusol (which she now has instead of Lasix, as it's a liquid solution and easier): 0.3 ml twice a day


Again what concentration is the frussol. I was given frussol of concentration 20mg/5ml = 4mg/ml. The normal dose is 2mg/kg so again, assuming Holly weighs approx 1kg she would need 0.5ml....the dose she has been given is again for a piggie weighing approx 625g

Her breathing sounds absolutely fine now (to me, but hasn't been listened to with stethoscope yet).

Sorry for not answering everything else yet - will do when my brain returns! :red
Click to expand...

Breathing sounds do improve quickly - but you need to watch how laboured it is - ie how deeply her lower flanks are moving as this is an indication she she is breathing from deep in the abdomen rather than the chest because there is still a lot of fluid affecting lung function.

Muffin the heart pig spends a lot of time just lying around and eating....and she sleeps more soundly and more often....

Let me know how much Holly weighs and the meds dosages and I'll calculate the doses for you to discuss with your vet.

x
 
So sorry I never updated on here. Have been feeling really rough myself. Although I was in two minds about Holly, and about to take her back to the vets to discuss her meds, her throat lump etc, she was on good form, doing more eating for herself, popcorning about a bit, etc. Basically, she seemed a happy pig.

She was on good form last night and had obviously eaten fairly well during the night, but at some point she had a heart attack. We found her slumped and gasping about an hour ago, then about two minutes later, she died. 8... I really hope she didn't suffer, but I would imagine it was mercifully brief.
 
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