Possible Renal Failure (Inc. Blood Results)

[WilfyPig]

Hi everyone,

I've been an avid reader of TGPF for a few years now and appreciate all your content so much! I really need to crowdsource some opinions/experiences regarding renal failure in piggies please as my pig Wilf (4yrs 8 months old) has been ill for the past month. Apologies in advance for the long post- I'll try and keep it to the pertinent points but I do have a months worth of weights, notes, poo counts, food measurements, drug doses etc., so can provide even more info if helpful.

Here is a brief rundown of what's happened:
23rd Oct 2023 - Wilf started to be very quiet and ate noticeably less, this was an overnight change in demeanour. Weight was 1150g which is normal for him.
26/10/23 - Appointment with exotics vet, palpation then ultrasound revealed one kidney was very slightly larger than average (although there is scarce data for guinea pigs). We started syringe feeding a thick Emeraid mix ~40ml a day to try and maintain weight. Giving metacam and emeprid to try and help.
02/11/23 - Last metacam dosage - he seemed fine afterwards and not showing obvious pain signs. Weight was 1000g.
06/11/23 - Last emeprid dosage - he started displaying signs of discomfort, being subdued and his poos became softer and misshapen after this. We resumed emeprid on 08/11.
09/11/23 - General anaesthetic, full tooth examination and blood sample taken. No signs of malocclusion - exotics vet used word "perfect" to describe his teeth!
His recovery from the GA took ~48 hours before he looked even slightly normal again. He lost use of his back limbs, couldn't eat for himself and could barely stay awake - which indicated to me he was having a very difficult time clearing the GA drugs from his system. We really thought he was going to die the day after his GA, so it was a really scary time for us.

Since then he has slowly dropped weight each day and is now at 875g despite 50+ml of very thick Emeraid or Oxbow critical care each day. He is still eating hay, veg (inc. some baby sweetcorn for weight gain and lower calcium veg), supplementary dry oats, drinking water and squeaking for veg in the mornings. He is acting almost normally if slightly lethargic, yet he is still gradually losing weight. We are now aiming for 60+mls a day top up feeding.

Blood results took almost 2 weeks to come back, but I have attached them here for people to see. He has high urea and creatinine which immediately leapt out at me as kidney issues. They also show that almost all of his biochem results are high, and he has high neutrophils. Our two exotics vets do not know where the infection is though. We have started him on 0.3ml Bactrim 48mg/ml (paediatric banana flavour) 2x daily for 10 days due to the neutrophil infection indicator which has helped perk him up even more. This is in combination with 0.5ml Emeprid 2x daily as well as Pro-C probiotics syringed with his critical care. He is currently not on metacam as he isn't showing signs of pain and vet is concerned it could be stressing his kidneys. Throughout all of this his poos have been fairly decent shape/consistency - just slightly too small compared to normal. I haven't seen any signs of blood in urine or squealing etc. when he urinates.

I suppose my questions are - has anyone else received blood results like this before? Does my judgement of infection and renal failure seem likely? If so, what kind of timelines have people experienced with their pigs before the inevitable goodbye?

My partner and I have been syringe feeding 4/5 times a day for a month now, which takes 30 - 45 mins each time, and we are completely exhausted (we both have full time jobs and other life commitments). I'm fraught with anxiety and cannot focus on anything else other than making sure Wilf is ok. He is doing all the things that show me he still wants to live (eating, drinking, squeaking, toileting normally and cleaning himself) so I am prepared to keep this up until he lets me know he doesn't want to carry on. The vet currently wants to see how he does on the antibiotics for a few days (today is the third day), which I am fine with, but we haven't had a serious kidney related discussion yet. I would really love to hear about other peoples experiences, particularly blood test results. Thank you in advance.


Wilf's Blood Results (high/low values are in bold)
BIOCHEMISTRY
Albumin 29 g/L ( 20 - 36 )
Total Protein 55 g/L ( 49 - 56 )
Total Bilirubin 1.77 umol/L
ALT 54 IU/L ( 0 - 54 )
Alkaline Phosphatase * 78 IU/L High ( 0 - 56 )
AST * 199 IU/L High ( 0 - 50 )
Creatine Kinase * 605 IU/L High ( 0 - 250 )
Urea * 19.7 mmol/L High ( 2.8-12.8 )
Creatinine * 231 umol/L High ( 36 - 210 )
Sodium * 125 mmol/l Low ( 140 - 150 )
Potassium *Above detectable limit*
*Overnight Sample*
Calcium * 3.35 mmol/L High ( 2.00-3.03 )
Ionised Calcium 0.69 mmol/l
Phosphorus * 7.90 mmol/L High ( 0.68-2.30 )
Cholesterol * 3.84 mmol/L High ( 0.59-1.79 )

HAEMATOLOGY

White Cell Count * 20.88 10^9/l High ( 3.6 - 9.0)
Haemoglobin 12.1 g/dl ( 10.6-16.2 )
Red Cell Count 4.81 10^12/L ( 4.29-6.79 )
PCV * 44.4 % High ( 32 - 42 )
MCV 92.4 fl
MCH 25.2 pg
MCHC 27.3 g/dL
RDW 12.3 % (2.4 - 27.3)
Platelets 252 10^9/L

WBC Differential

Neutrophils * 71% 14.82 10^9/l High ( 0.40- 4.3 )
Lymphocytes 26% 5.43 10^9/l ( 0.90-5.70 )
Monocytes 2% 0.4 10^9/l ( 0 - 1.7)
Eosinophils 1% 0.2 10^9/l ( 0 - 0.70 )

Film Comment No polychromasia within erythrocyte series. Moderate
neutrophilia noted. No toxic or macrophaging leucocytes
seen. Platelets appear normal on film.

 

[Bill & Ted]

I am sorry I can’t help but bumping your post

 

[Wiebke]

Hi everyone,

I've been an avid reader of TGPF for a few years now and appreciate all your content so much! I really need to crowdsource some opinions/experiences regarding renal failure in piggies please as my pig Wilf (4yrs 8 months old) has been ill for the past month. Apologies in advance for the long post- I'll try and keep it to the pertinent points but I do have a months worth of weights, notes, poo counts, food measurements, drug doses etc., so can provide even more info if helpful.

Here is a brief rundown of what's happened:
23rd Oct 2023 - Wilf started to be very quiet and ate noticeably less, this was an overnight change in demeanour. Weight was 1150g which is normal for him.
26/10/23 - Appointment with exotics vet, palpation then ultrasound revealed one kidney was very slightly larger than average (although there is scarce data for guinea pigs). We started syringe feeding a thick Emeraid mix ~40ml a day to try and maintain weight. Giving metacam and emeprid to try and help.
02/11/23 - Last metacam dosage - he seemed fine afterwards and not showing obvious pain signs. Weight was 1000g.
06/11/23 - Last emeprid dosage - he started displaying signs of discomfort, being subdued and his poos became softer and misshapen after this. We resumed emeprid on 08/11.
09/11/23 - General anaesthetic, full tooth examination and blood sample taken. No signs of malocclusion - exotics vet used word "perfect" to describe his teeth!
His recovery from the GA took ~48 hours before he looked even slightly normal again. He lost use of his back limbs, couldn't eat for himself and could barely stay awake - which indicated to me he was having a very difficult time clearing the GA drugs from his system. We really thought he was going to die the day after his GA, so it was a really scary time for us.

Since then he has slowly dropped weight each day and is now at 875g despite 50+ml of very thick Emeraid or Oxbow critical care each day. He is still eating hay, veg (inc. some baby sweetcorn for weight gain and lower calcium veg), supplementary dry oats, drinking water and squeaking for veg in the mornings. He is acting almost normally if slightly lethargic, yet he is still gradually losing weight. We are now aiming for 60+mls a day top up feeding.

Blood results took almost 2 weeks to come back, but I have attached them here for people to see. He has high urea and creatinine which immediately leapt out at me as kidney issues. They also show that almost all of his biochem results are high, and he has high neutrophils. Our two exotics vets do not know where the infection is though. We have started him on 0.3ml Bactrim 48mg/ml (paediatric banana flavour) 2x daily for 10 days due to the neutrophil infection indicator which has helped perk him up even more. This is in combination with 0.5ml Emeprid 2x daily as well as Pro-C probiotics syringed with his critical care. He is currently not on metacam as he isn't showing signs of pain and vet is concerned it could be stressing his kidneys. Throughout all of this his poos have been fairly decent shape/consistency - just slightly too small compared to normal. I haven't seen any signs of blood in urine or squealing etc. when he urinates.

I suppose my questions are - has anyone else received blood results like this before? Does my judgement of infection and renal failure seem likely? If so, what kind of timelines have people experienced with their pigs before the inevitable goodbye?

My partner and I have been syringe feeding 4/5 times a day for a month now, which takes 30 - 45 mins each time, and we are completely exhausted (we both have full time jobs and other life commitments). I'm fraught with anxiety and cannot focus on anything else other than making sure Wilf is ok. He is doing all the things that show me he still wants to live (eating, drinking, squeaking, toileting normally and cleaning himself) so I am prepared to keep this up until he lets me know he doesn't want to carry on. The vet currently wants to see how he does on the antibiotics for a few days (today is the third day), which I am fine with, but we haven't had a serious kidney related discussion yet. I would really love to hear about other peoples experiences, particularly blood test results. Thank you in advance.


Wilf's Blood Results (high/low values are in bold)
BIOCHEMISTRY
Albumin 29 g/L ( 20 - 36 )
Total Protein 55 g/L ( 49 - 56 )
Total Bilirubin 1.77 umol/L
ALT 54 IU/L ( 0 - 54 )
Alkaline Phosphatase * 78 IU/L High ( 0 - 56 )
AST * 199 IU/L High ( 0 - 50 )
Creatine Kinase * 605 IU/L High ( 0 - 250 )
Urea * 19.7 mmol/L High ( 2.8-12.8 )
Creatinine * 231 umol/L High ( 36 - 210 )
Sodium * 125 mmol/l Low ( 140 - 150 )
Potassium *Above detectable limit*
*Overnight Sample*
Calcium * 3.35 mmol/L High ( 2.00-3.03 )
Ionised Calcium 0.69 mmol/l
Phosphorus * 7.90 mmol/L High ( 0.68-2.30 )
Cholesterol * 3.84 mmol/L High ( 0.59-1.79 )

HAEMATOLOGY

White Cell Count * 20.88 10^9/l High ( 3.6 - 9.0)
Haemoglobin 12.1 g/dl ( 10.6-16.2 )
Red Cell Count 4.81 10^12/L ( 4.29-6.79 )
PCV * 44.4 % High ( 32 - 42 )
MCV 92.4 fl
MCH 25.2 pg
MCHC 27.3 g/dL
RDW 12.3 % (2.4 - 27.3)
Platelets 252 10^9/L

WBC Differential

Neutrophils * 71% 14.82 10^9/l High ( 0.40- 4.3 )
Lymphocytes 26% 5.43 10^9/l ( 0.90-5.70 )
Monocytes 2% 0.4 10^9/l ( 0 - 1.7)
Eosinophils 1% 0.2 10^9/l ( 0 - 0.70 )

Film Comment No polychromasia within erythrocyte series. Moderate
neutrophilia noted. No toxic or macrophaging leucocytes
seen. Platelets appear normal on film.

Hi and welcome

I am very sorry. Kidney failure in older guinea pigs is not at all uncommon. Unfortunately, there is nothing that can be done outside of some very expensive medication that may or may not bring rather short term relief, which I am sure that your vet has likely either mentioned or already ruled out ;( .

Please accept that we are an owners and not a medical forum. We concentrate on practical and moral support during treatment.

I wish I had better news but I haven't.

 

[WilfyPig]

Hi there,

Thank you for your responses. Apologies for all the medical jargon. Gathering all the info possible is just a method for me to cope really.

My vet still hasn’t specifically diagnosed renal failure yet given that there are signs of infection, so we haven’t spoken about kidney specific palliative care, but Wilf does seem to be declining each day compared to his usual healthy/happy behaviours. My gut feeling is that I need to start thinking about whether all of this is fair on him. I’ve read the excellent guide on here about euthanasia which has been of great help.

I just feel awful and guilty to be considering it when he still has some of his old self still visible.

 

[Wiebke]

Hi there,

Thank you for your responses. Apologies for all the medical jargon. Gathering all the info possible is just a method for me to cope really.

My vet still hasn’t specifically diagnosed renal failure yet given that there are signs of infection, so we haven’t spoken about kidney specific palliative care, but Wilf does seem to be declining each day compared to his usual healthy/happy behaviours. My gut feeling is that I need to start thinking about whether all of this is fair on him. I’ve read the excellent guide on here about euthanasia which has been of great help.

I just feel awful and guilty to be considering it when he still has some of his old self still visible.

HUGS

Keep an open mind but concentrate on quality of life and creating one memorable enrichment activity for the two of you to share together for a little diary; it doesn't have to be earth shattering, just a sharing of joy and pleasure in many possible forms. This helps you to make the best of this time and fill it with happy memories and not just with your fears, whatever the outcome.
Enrichment Ideas for Guinea Pigs

Right now you are quite obviously not anywhere close to terminal care but it is good to be aware of and to also be aware of that your own grieving process has been triggered. Hence the emotions; your reaction is totally normal and a testament to your love and strong sense of responsibility.

 

[Suki&Indie]

Hi there,

Thank you for your responses. Apologies for all the medical jargon. Gathering all the info possible is just a method for me to cope really.

My vet still hasn’t specifically diagnosed renal failure yet given that there are signs of infection, so we haven’t spoken about kidney specific palliative care, but Wilf does seem to be declining each day compared to his usual healthy/happy behaviours. My gut feeling is that I need to start thinking about whether all of this is fair on him. I’ve read the excellent guide on here about euthanasia which has been of great help.

I just feel awful and guilty to be considering it when he still has some of his old self still visible.

Hi sorry for the late response I’m a bit of a night owl.
I didn’t manage to get blood results from my girl (sadly she was too far gone that my vet couldn’t get enough blood from her to do a test) however I was in a very similar situation - losing weight despite feeding etc. I noticed her going downhill in April and she was put to sleep in September, however we made the decision to have her on metacam the whole time as she was showing clear signs of pain - this may have quickened the renal failure so it may not be the most accurate timeline for renal failure.
We also used Bactrim when she seemed to go further downhill and it really helped her. I am a vet student so my vet kindly gave me the equipment to perform subcutaneous fluid therapy - I’m not sure if it slowed the progression but I think it gave her a lot of relief from thirst.
Feeding the critical care is the main thing you can do to help your piggy. Towards the end my girl (who used to be very eager for her critical care) began to refuse it. I also noticed the metacam didn’t ease her pain as much and on the day we put her to sleep she was passing very bloody urine
I apologise that my post is quite sad but I hope some of this info has helped and if you have any more questions please ask away.

 

[WilfyPig]

HUGS

Keep an open mind but concentrate on quality of life and creating one memorable enrichment activity for the two of you to share together for a little diary; it doesn't have to be earth shattering, just a sharing of joy and pleasure in many possible forms. This helps you to make the best of this time and fill it with happy memories and not just with your fears, whatever the outcome.
Enrichment Ideas for Guinea Pigs

Right now you are quite obviously not anywhere close to terminal care but it is good to be aware of and to also be aware of that your own grieving process has been triggered. Hence the emotions; your reaction is totally normal and a testament to your love and strong sense of responsibility.

Those are all really lovely ideas, thank you. Makes me happy knowing that Wilf experiences lots of those things regularly! E.g. no cardboard boxes or paper bags can leave our kitchen until they have had a full piggo inspection (nibbled and peed in).

 

[WilfyPig]

Hi sorry for the late response I’m a bit of a night owl.
I didn’t manage to get blood results from my girl (sadly she was too far gone that my vet couldn’t get enough blood from her to do a test) however I was in a very similar situation - losing weight despite feeding etc. I noticed her going downhill in April and she was put to sleep in September, however we made the decision to have her on metacam the whole time as she was showing clear signs of pain - this may have quickened the renal failure so it may not be the most accurate timeline for renal failure.
We also used Bactrim when she seemed to go further downhill and it really helped her. I am a vet student so my vet kindly gave me the equipment to perform subcutaneous fluid therapy - I’m not sure if it slowed the progression but I think it gave her a lot of relief from thirst.
Feeding the critical care is the main thing you can do to help your piggy. Towards the end my girl (who used to be very eager for her critical care) began to refuse it. I also noticed the metacam didn’t ease her pain as much and on the day we put her to sleep she was passing very bloody urine
I apologise that my post is quite sad but I hope some of this info has helped and if you have any more questions please ask away.

Hi there, thank you so much for sharing your experience. I’m so sorry about your piggy, it sounds like it was a tough few months. I hope you are ok.

Did you syringe feed for the whole time between April and Sept? We’ve been syringing critical care ~5 times a day for just over a month now which takes 30-60 mins each time. Wilf is getting more annoyed with the syringe as each day passes now and is wriggling to get away more (although perhaps a sign the Bactrim is helping and he’s feeling a bit stronger?!) I’m barely able to do my full time job alongside, let alone general life admin. It’s all a bit much.

He has been eating some hay throughout the day so I don’t know whether I should try and ease off to see if he will start increasing the amount of hay he’s eating? He’s been hovering around 880-900g this week with no big drops in weight, just this continued gradual decline. However trial and error with the syringe feeds is a scary prospect given how much weight he’s lost already.

 

[Wiebke]

Hi there, thank you so much for sharing your experience. I’m so sorry about your piggy, it sounds like it was a tough few months. I hope you are ok.

Did you syringe feed for the whole time between April and Sept? We’ve been syringing critical care ~5 times a day for just over a month now which takes 30-60 mins each time. Wilf is getting more annoyed with the syringe as each day passes now and is wriggling to get away more (although perhaps a sign the Bactrim is helping and he’s feeling a bit stronger?!) I’m barely able to do my full time job alongside, let alone general life admin. It’s all a bit much.

He has been eating some hay throughout the day so I don’t know whether I should try and ease off to see if he will start increasing the amount of hay he’s eating? He’s been hovering around 880-900g this week with no big drops in weight, just this continued gradual decline. However trial and error with the syringe feeds is a scary prospect given how much weight he’s lost already.

You monitor your syringe feeding and any transition phases with your kitchen scales by weighing every morning when the daily weight swing is at its lowest for best day to day comparison. Unlike the poos, the scales are giving you instant feedback so you can adjust the level of feeding support for the coming 24 hours accordingly.
Only start reducing your feeding if the weight has gone up at least 50g (i.e. more than the daily weight swing) on the same level of feeding support. You cannot judge the hay intake by watching a piggy nibbling on a little hay; that is a potentially fatal mistake that too many owners sadly make. But it is always good to see that their appetite is not totally gone!
In the transition phase it can help to start a session with some syringe feed, then solids as much as are going in and then topping up with more feed. That gets the most food in and also gives you a much better idea of just how much he is actually eating or whether he is just nibbling.

All About Syringe Feeding and Medicating Guinea Pigs with Videos and Pictures

 

[Suki&Indie]

Hi there, thank you so much for sharing your experience. I’m so sorry about your piggy, it sounds like it was a tough few months. I hope you are ok.

Did you syringe feed for the whole time between April and Sept? We’ve been syringing critical care ~5 times a day for just over a month now which takes 30-60 mins each time. Wilf is getting more annoyed with the syringe as each day passes now and is wriggling to get away more (although perhaps a sign the Bactrim is helping and he’s feeling a bit stronger?!) I’m barely able to do my full time job alongside, let alone general life admin. It’s all a bit much.

He has been eating some hay throughout the day so I don’t know whether I should try and ease off to see if he will start increasing the amount of hay he’s eating? He’s been hovering around 880-900g this week with no big drops in weight, just this continued gradual decline. However trial and error with the syringe feeds is a scary prospect given how much weight he’s lost already.

Hiya our girl ate some hay and pellets but we did supplement with critical care for the full time between April and September. I was very lucky that my mum and sister were happy to help so we could take it in shifts - it is seriously exhausting. We found out she liked her critical care very thin (lots of water) with sherwoods “appetite restore” powder mixed in for flavour (I think mashed banana or baby food is also popular to try entice them) it becomes a lot easier to feed them if they’re getting something super tasty. We did try leaving some in a bowl in her cage but she didn’t eat any so had to stick to syringe feeding the whole time.

 

[WilfyPig]

Thank you both for your replies. Apologies for radio silence - long story but life is quite tough at the moment and there seem to be no spare minutes. @Suki&Indie the full time syringing for 5/6 months sounds incredibly difficult - I'm so glad you had support throughout!

Wilf has been on Bactrim for 7 days now but we are continuing on to 10 days with the vets recommendation. We've been keeping up the syringe feeding but his weight has gradually dropped down to 860g now, so not a precipitous drop, but still this steady decline. This indicates he is eating even less hay now so we are going to try and increase the syringe feed to over 60ml each day.

I'm trying to spend time with him outside of the feeding sessions so he doesn't just associate us with having a syringe put in his mouth. He is becoming more lethargic and wants to lie in his cosies/boxes/house most of the day now. I do wonder whether the 6 weeks of syringing has made him a bit depressed, and if I should try and let him have a "normal morning" to give him a chance to eat more hay? Do you think if he's constantly stuffed with critical care then maybe it's putting him off eating by himself?

The usual routine before he was ill was that he'd have some veg in the kitchen with me while I had breakfast, then we'd both go to my office (I work from home) so I worked and he munched hay/napped all morning.

 

[Wiebke]

Thank you both for your replies. Apologies for radio silence - long story but life is quite tough at the moment and there seem to be no spare minutes. @Suki&Indie the full time syringing for 5/6 months sounds incredibly difficult - I'm so glad you had support throughout!

Wilf has been on Bactrim for 7 days now but we are continuing on to 10 days with the vets recommendation. We've been keeping up the syringe feeding but his weight has gradually dropped down to 860g now, so not a precipitous drop, but still this steady decline. This indicates he is eating even less hay now so we are going to try and increase the syringe feed to over 60ml each day.

I'm trying to spend time with him outside of the feeding sessions so he doesn't just associate us with having a syringe put in his mouth. He is becoming more lethargic and wants to lie in his cosies/boxes/house most of the day now. I do wonder whether the 6 weeks of syringing has made him a bit depressed, and if I should try and let him have a "normal morning" to give him a chance to eat more hay? Do you think if he's constantly stuffed with critical care then maybe it's putting him off eating by himself?

The usual routine before he was ill was that he'd have some veg in the kitchen with me while I had breakfast, then we'd both go to my office (I work from home) so I worked and he munched hay/napped all morning.

Hi

Please never make the mistake of withdrawing support feed from a guinea pig losing weight. They will not eat more hay, just lose more weight more quickly. Rodents are very different from cats and dogs in that they are not predators whose system is laid out for an irregular food intake where enticing them can work. For rodents, eating means living. They will never stop eating voluntarily. If they are no longer eating much hay, then there is an outside cause for it. Unless you can remove that cause, the loss of appetite will not simply revert.

If your boy continues to lose weight then it is because his kidney problems keep progressing and you need to up the feed as much as you can or draw the line if you feel that you have reached your own limit. Also accept that baytril in its own right can be appetite suppressing or killing as it does impact on the digestive gut bacteria as well.

There are sadly no easy choices left now. You are right out by the rock and the hard place without any cushions provided. This really is sadly the sharp end you come up against as a loving owner every now and then.

I am very sorry for the bad news. Unfortunately, you won't get your old routine back just by trying to force it back.

HUGS