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Specialist Recovery after splenectomy - help needed, please!

paul1

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Hi,

I am the owner of a guinea pig aged 5 1/2 old. On may 16th he needed open abdominal surgery for splenectomy and removal of a very large chist or tumor.
I'm trying to follow the vet's recommendation the best I can but I am worried and I hope I can get some advice or reasurance from you guys.
Becasue the vet clinic has no overnight, he was released on 16th evening with recommendation to keep warm and re-hospitalized on 17th until in the evening. He had low temperature post surgery, but when he was finally released on 17th evening, the temperature was all right.
Now, after 72 hours, he still won't walk. He is able to move his head and legs, but wont support his weight. The surgery was quite extensive, with a very large incision (I think over 5 cm or even 10cm).
He's been on emeraid since 17th (ate 13 x 1ml syringes in the morning and then again about the same in the evening when we took him from the clinic) but generally we could not really give him the full recommended 15, four times a day.
Initially, on 17th evening he accepted food easily (about 15-17 x 1ml syringes) but in the end he refused swallowing and some was going out, so we started weighting him before and after.
He have been able to pee, and yesterday (18th) as well as today (19th, up to 3 pm) he had stool but very small and just a few pieces. We have been visiting the vet clinic for treatment on 18 (two times, morning and evening) and 19 (once, at noon) and they gave him subcutaneus metoclopramide, ranitidine and meloxicam. He had narcotic and slow-release antibiotic during surgery but no antibiotic afterwards.
His weight is about 900 g.
On 17th he was fed 13 syringes in the morning, additionally in the hospital and in the evening he ate 17 syringes.
On 18th he ate about 40/45 ml emeraid (in four meals, 15, 5 or 10, 15, 5) with no additional water but the vet hydrated him with 20 ml special solution, subcutaneous.
The morning meal was ok, but the next we had to force them on him and some of the food he would spit out and not swallow.
Out of 17 syringes, by weighting, he would het about 15 grams (some is spilled out).
Today morning he ate 17 syringes emeraid (17 ml) + 2 ml water, and gained from 896 to 910.
Today at 3 pm he ate 17 syringes emeraid, no extra warter, weight from 894 to 910. Up to this hour he pooped about 10 small little stools pieces, all day.
Since this moment, he did not pooped or peeded up to this evening (19th) at 10 pm. So 7 hours no pee or poop.
Because he was refusing food lately, we gave him at about 8 pm this evening a different brand, which is supposed to help transit and appetite, hoping he would like it better:
https://www.amazon. . . . co.uk/d/Pet-Health-Supplies/Alfavet-Rodicare-Instant-170-Pack/B007H9J6MK
He only ate 4 ml + 1 extra ml water (from 908 to 913).
I notice from after the previous feed (910g) to the start of this one (908g) his weight has not changed much.
So in total, today, he ate about 35 grams of syringe feeding (up to 10pm).

Sorry for the very long text but I want to give as much detail as I can. The vet clinic is open only day time so in the evening or night is hard to get advice. Other clinics we have in reach refuse to give advice on guinea pigs, 'cos they lack expretise.

So the main problems are:
1. today since 3pm to 10 pm he had no stool and no pee (and his weight was 910 after previous meal, 908 before the one at 10pm and 913 after); at noon we visited the vet and this was really stressful (3 subcutaneus injections) but he did poo there and afterwards during the 3 pm meal
2. after 72 hours since surgery, he wont walk; he can move his head and legs; the front legs seem to be swollen a little and for the last hours he kept them under his head and he is no longer raising the head so often;
3. initially he was silent after surgery but since yesterday evening, he is squeak a little when being petted. it does not seem to be out of disconfort so we thought it must be good.
4. yesterday and today up to 3pm he was interested in various leaves (eg. carrot tops), carrots, hay and ate small quantities; but since today 3pm he refused any of those.

Now (> 10pm) we should try to give him a last meal for today, we are switching back to emeraid but since he did not poo or peee at all in 7 hours we are afraid and don't know what to do. Any vet we asked until now about the little pig's status said it is vital to feed him and that there's nothing else we can do.

just a quick update, right now he did pee a little and we weighted him again before starting feeding - 904 g (quite a difference from the previous 913).

Please, any advice or opinion would be useful!
Thank you.
 
Hi!

Please continue to syringe feed. A piggy that is totally off its food needs between 40-90 ml in 24 hours or as close as your come to keep the guts going. Ideally you feed every two hours during the day and about every 3 during the night.
Ranitidine/zantac is a gut stimulant, and so is metoclopramide. Meloxicam/metacam is the common analgesic for guinea pigs.
Please also offer as much water by syringe as he will take.
When syringe feeding, please never give more than he can hold in his mouth (depending on age and strength between 0.1 ml with guinea pigs that struggle to swallow and 0.5 ml for fairly fit adult piggies. Wait until it has all gone down to prevent it from going down the wrong way, up the nose or coming back out again. It is not a quick job, especially not with a very will piggy.

You may find the tips in these guides here helpful:
Tips For Post-operative Care
Complete Syringe Feeding Guide
Weight - Monitoring and Management

The good news is that the weight seems to be pretty stable when you consider that a full bladder is about 10g heavier than an empty one and a piggy can weight 30-50g more after their dinner than before.

I am also linking in some medically more experienced members into your guide:
@Jaycey @helen105281 @furryfriends (TEAS) @Abi_nurse
 
Thank you Wiebke. We hope we are on the right track.
One more update for this evening (from 10 to 11:15 pm local time). He ate 13 syringes x 1ml emeraid + 1 syringe (1ml) water. Weight post feeding 917g (+1 for the extra ml water, did not weight again).
The total for today is 51 ml emeraid + 4 ml alfavet rodicare instant + 2 ml extra water. (the green alfavet paste we prepared quite diluted, it contains soy fiber and protein, other green fibers and vitamin suplements; it is supposed to help in bloating and innapetence and stimulate transit)
Yes, the syringes we gave in 2-3 steps (0.3 or 0.5 ml each).
He responds to petting, "talks to us" but almost inaudible; when we hold it he likes to cuddle near our colarbone under our chin.
We did a little gentle massage on side of abdomen (we can't on the middle 'cos that's the big cut covered in someting silver). The incision looks very nice with no sign of infection or bleeding.
Still, no poop since 3 pm (10 hours). Hopefully in the morning. He slips on a towel in his cage, with hay and some treats around. Should we worry?
Since he is not moving he won't be able to drink water during night. As per your advice, should we still feed him during night - or at least give water by syringe? Or at 6 am should be fine (that's a 6-7 hour non-feeding break)?
Thank you again!
 
Thank you Wiebke. We hope we are on the right track.
One more update for this evening (from 10 to 11:15 pm local time). He ate 13 syringes x 1ml emeraid + 1 syringe (1ml) water. Weight post feeding 917g (+1 for the extra ml water, did not weight again).
The total for today is 55 ml emeraid + 2 ml extra water. (the green alfavet paste we prepared quite diluted)
Yes, the syringes we gave in 2-3 steps (0.3 or 0.5 ml each).
He responds to petting, "talks to us" but almost inaudible; when we hold it he likes to cuddle near our colarbone under our chin.
We did a little gentle massage on side of abdomen (we can't on the middle 'cos that's the big cut covered in someting silver). The incision looks very nice with no sign of infection or bleeding.
Still, no poop since 3 pm (10 hours). Hopefully in the morning. He slips on a towel in his cage, with hay and some treats around. Should we worry?
Since he is not moving he won't be able to drink water during night. As per your advice, should we still feed him during night - or at least give water by syringe? Or at 6 am should be fine (that's a 6-7 hour non-feeding break)?
Thank you again!

I would recommend to get up at least once during the night for as long as a piggy is not eating and drinking on their own - and I know from my own experiences how draining it is.
The poo output reflects what has gone in 1-2 days before depending on how quick or sluggish the bowel is. Please change the are he is in once daily if he is not moving around much and give his bum end a gentle wipe with baby warm water as he may struggle to clean himself.

All the best!
 
I would recommend to get up at least once during the night for as long as a piggy is not eating and drinking on their own
All the best!
Thank you again, I will do that.

Yes, the towel is clean, freshly washed and we also used absorbant pads.
Thanks for all your other recommendations.

All the best to you!
 
Wiebke has given some very sound advice.

With cases like this where pig have had big surgeries they can really be touch and go and some of them can literally take a week or two to really get on their feet. Is he moving any more now? Does he have any companions who would encourage him to eat and move.

Splenectomy (spleen removal) is a big surgery but not an uncommon one especially in dogs. There isn't anything extra special with these ops to monitor). I am slightly confused on what medications he is on apart from syringe feeding at the moment. Could you clarify? What oral medications and dosages is he on?

x
 
Thank you Abi,
He's been on medication since 16th evening when the surgery was done, until 19th at noon. In the clinic, during surgery or after, he had:
buprenorifne
meloxicame
medetomidine + ketamine
Isoflurane + O2
surgical procedures - exploratory laparoscopy and splenectomy
haemostatic resorbable sponge Gelaspon (he had some bleeding on liver - right lobe- due to adherence of spleen)
ringer lactate solution intravenous CRI (not sure what's CRI)
glucose 5% bolus iv
metoclopramide
arnetine
trimethoprim/sulfamethoxazole
antisedan
On 16 and 17 he received treatment in the vet clinic.
On 18 and 19 - post release home treatment was only metoclopramide, ranitidine and meloxicame (three syringes, subcutaneous). No antibiotic since according to the doctor, the one during surgery or post-op was enough (sustained release). This treatment was done two times on 18th and only 1 time on 19 (at noon).
Currently (since 19 evening, or 72 hours post surgery) there is no treatment recommended (I was wondering about pain - could this be the cause for lethargy?).

He moves his head left right and up when interested in something. On 18th evening and 19th morning he was more active and ate a little bit of treats (one very small piece of carrot slice, some carrot top leaves, a little leaf of parsley). Since 19th afternoon and evening he was no longer interested in treats and he's been more lethargic. He is able to move, but doesn't want to, apparently. His fore arms, he keeps them under his head, and head rested on them (back legs extended). A little later on 19th evening, he got a little more active with the head but he refused any treat. He is able to look around and raise head but other than that, he seems very tired and doesn't move.

No other companions, but we visit often and pet him, talk to him, plus we need to take him out of the cage for feeding. Yet, from 9 to 13 pm he is alone (but I have someone who could visit him but not really force feed him).

Thank you again!
 
Update:
1 ml rodicare instant paste and 1 ml water ate 3 am. Massaged abdomen sides from up to down.
At 6 am still no poop since 3 pm previous day (15 hours).
 
Thank you furryfriends. Indeed almost 4 days after surgery he doesn't walk. Can move legs though. This morning we hospitalized him in the vet clinic, he still hadn't pooed as of 10 am. Still letargic but constient
 
Vet said he was bloated. He managed to poop 2 pieces (he is hospitalized and under treatment)
 
This evening we got our piggy from the vet clinic, they said he was stable, and that the bloating problem was solved, but the moment we left the clinic he died. Hydrating solution (administered subcutaneous) was dripping from his back. They said this was normal. He had a last active moment when we saw him there, like a last try to stay alive. I suspect they gave him something to look more active when we pick him up. He died from cardiac arrest, so they said.
 
I'm so sorry you have lost your boy! :hug:

You clearly did everything you could for him to help him get better. At five and a half years, he was a reasonable age for a piggy, I wonder if perhaps the surgery and anaesthetic etc were all just too much for him.

Popcorn free over the Rainbow Bridge, little one xx
 
Oh I am terribly sorry you have lost him x sending big hugs to you, you couldn’t have done any more :hug:
sleep tight little man x 🌈
 
i am very sorry for your loss. I suspect as others have suggested that the surgery was a bit too much for his body to take on. Cardiac arrest simply means the heart stopping, so not a reason for death.

Thoughts are with you.
Abi
 
Thanks everybody. I think he was actually dead while we were still in the clinic, while discussing with the doctors, including discussing next day's appointment (we were planing to bring him back to stay hospitalized, for better s/c treatment including hydration, opioid). It is strange how they suddenly wanted us to get the piggy back in to our transport cage, and they were somehow acting strange (the two doctors), strange that we found him in the cage with head not at the door (who puts the piggy with the bottom at the cage's door?), so many suspect details... We are so sad and so disappointed by these vets, although the surgery itself might have been a success (if 4 days survival in stable/lowering condition was a success). After his last moves, he felt on a side. We were still in the clinic. While we were walking the stair to exit the clinic, my wife noticed something was not right. He was soft as water balloon, no muscle tone. We immediately returned (within 10 seconds) and they took it away in a different room, we were not allowed there. After 20 minutes they get out, letting us know he was dead. I am not even sure they tried to resuscitate him.

Thank you all for your good thoughts.
 
I'm so sorry! Those vets must of had zero experience in knowing how to actually love and take care of a guinea pig.
 
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