Septrin for URI, is this right? Doesn't seem to be working

[liquidmelancholy]

I have 2 pigs, one of which, Lucy, was diagnosed with pneumonia in March, and since then seems to be surviving fine on 3 week long courses of Baytril (I ask for more each time she seems to be getting 'noisy' again.) But this morning, Hazel seems to have developed the same symptoms Lucy first had in March. I can't think that Lucy passed it on, as it's been a very long time. Hazel has been sneezing for a couple of months, but nothing that worried me.

But this morning, she did a MASSIVE sneeze and was then immediately making a congested, liquidy wheezy noise as she ate and sniffed the ground. I took her to the vet, and explained I was really worried about how to treat her, as she is intolerant to Baytil, which I discovered when she was prescribed it for recent UTI problems. The vet just said since she got on well with Septrin for the UTI, she would prescribe that for her breathing problems. Although she said she couldn't hear anything in Hazel's chest and that "she does seem to be breathing a bit heavily, but that's probably because she's stressed at being at the vets!" I have to say this vet (which we haven't seen before) seems very clueless. I expected her to suggest an x-ray, but I suppose as she couldn't hear anything in her chest she just put it down to "owner paranoia" or something...

So now she's on 0.7mls of Septrin twice a day for a week, but tonight she seems even worse than this morning, and is squeaking and almost panting as she's breathing and making those noises. Surely there's another antibiotic she could be prescribed other than Baytil which she can't have, or Septrin which I thought was mainly good for UTIs? And in the meantime what can I do? I'm going to take her back in a few days if she's not getting better, I'm not waiting a week if Septrin is going to be next to useless. I'm just worried she won't last tonight

 

[Pebble]

Hmmm...I think "summat's up" ..and therefore I would suggest you take her to a really cavy savy vet and get an X ray specifically to look for fluid in the lungs and outside the lungs/around the heart...

A vet can;t diagnose on "sneezing alone"....and they need to know what they are looking for (which many don;t through lack of experience unfortunately)

Your piggie may need a diuretic (furosemaide) to clear fluid IN the lungs before the antibiotic can work.

If it;s not a URI (or even Lower Respiratory Infection - LRI) she may have heart problems in which case diuretic plus heart meds should see her to a stable life.....

If it's an allergy ....exclusion practices will help you identify the cause and eliminate it from her current way of life


This is a very brief post because there are several possible issues..and not enough info to make a definitive diagnosis or point yoi in the right direction.......but, for what it's worth in my opinion your piggie definitely has an (as yet) undiagnosed clinical condition that needs diagnosing/treating properly and therefore the best way forwards is to go see a proper cavy savvy vet.......(armed with any info you may need that we can post here for you on the forum)

The most important thing therefore atm is to let us know where you are in the country so we can reccommend a piggiy savvy vet for a second opinion.....and then give you any relevant info...

HTH
x

 

[Wiebke]

For how long has your girl been on septrin? What bedding are they on and what hay are you using? Are you sure that is IS URI and not just hay or dust allergy?

Have you thought about giving children's sudafed decongestant 0.2ml up to twice daily? You can also ask your vet for bisolvon powder to help with any catarrhs. Your girl is on a pretty high dose for septrin already! If it is just an allergy or a cold, an antibiotic won't help.

 

[liquidmelancholy]

At the time I was really worried, Hazel had had just one dose of Septrin, but I was expecting some improvement, not getting worse. However, she does seem a little better now she's had 4 doses.

I've been through all this before with Lucy back in March, she had the diuretic to clear her lungs, x-rays etc. The vet told me that if she has a deep rooted infection in her lungs, there's not really anything they can do, because if you keep draining the lungs, they'll eventually just give up. All I'm doing with Lucy is getting repeat prescriptions of Baytril that last 3 weeks, and get more when she gets noisy. I don't know how long I can keep doing this, but whilst she's happy, I'll do it. I know she's probably on borrowed time.

But with Hazel, I'm just worried about her having seemingly caught the same bacteria in her lungs as Lucy, and because she can't have Baytril, I'm just questioning the effectiveness of Septrin.

I've always kept them on newspaper, with just shredded paper bedding on top and hay in one corner, I know not to put them anywhere near sawdust. I keep them indoors, in a spare room, so the only thing I can think of that caused Lucy's pneumonia in the first place is possibly dust? We had a new bathroom fitted in January which involved a lot of dust and "stuff" in the air, and their room is next door. I just didn't know this was a problem. Then Lucy fell ill in March. I had to put them in the conservatory for one day before Hazel had this massive sneeze and the noises started, as the loft was being done this time! Maybe she reacted badly to the temperature change? Although it wasn't that cold, and they were only in there for about 6 hours.

I am quite concerned this may be all connected to heart problems, especially with Lucy, who seems to be fine when she's on Baytril, but starts wheezing when off it after a short period of time. How could I raise this with the vets? Both have had x-rays (some months ago) and there's never been any mention of their hearts.

 

[Pebble]

You;ve raised a lot of issues I am familiar with, having been through this process myself last year..the nost important being wheezing on withdrawal of baytril...htis is VERY important...and unofrtunatey I have still not got a definitive diagnosis from my vet because we are all stumped ......However hopefully I an save you some of the hoops me and my pigs have had to jump through to reach where we are now (and also the financial cost).

Firstly is the fluid IN the lungs or AROUND the lungs - from what your vet says it appears the fluid is AROUND the lungs and therefore can only be alleveiated by draining via syringe. If it is IN the lungs, then furosamide can help and coupled with antibiotics can have a real effect if it is bacterial.

If baytril isn't working then switch to septrin for three weeks...or better still, try azithromycin. (We can provide info for your vet as this is not a standard piggie treatment)

If that doesn;t work you might be dealing with possibly chronic pneumonia from unknown (either viral or enviromental but NOT bacterial) cause....or a heart/kidney/lymphoma problem.

There's a lot to talk about in view of your observations to date ..suggest you P me your phone number (or I will PM you mine) as it would make more sense to talk through this on the phone rather than loads of posts on the forum


HTH
x

 

[mikulinek]

From experience, I can recommend Marbocyl as an alternative anti-biotic. I think Wiebke's sensible about thinknig about things other than bacterial infections and an allergy could explain things.

Best of luck

 

[TwoPiggies]

How is she doing?

I very recently lost a pig with these symptoms.....he managed a few months on baytril then septrin but we lost him 6 weeks ago. I think it was to do with his heart though but the vet wouldn't listen.

Could she have another xray?

 

[liquidmelancholy]

I should point out there are two pigs with these problems. I originally was talking about Hazel who just suddenly started making wheezy noises and sneezing. She was given 7 days of Septrin (due to finish tomorrow), and I was just wondering how effective it would be, as she'd had it before, but for cystitis. However, she seems to be ok now, but I'm going to give her 10 days of the Septrin I think, just to make sure. She seems quiet now.

The more worrying pig is Lucy, who has had this pneumonia/URI thing since March. Originally, the vet said there was fluid IN her lungs, so she was given an emergency diuretic and a course of Marbocyl. They said to not expect her to make it, as draining the lungs is a very strong procedure. She obviously did, but seems to get wheezy and noisy if she comes off antibiotics. She had week long courses of Marbocyl at the beginning, but I asked for something that would last longer (rather than keep coming in every week for antibiotics), so the vet suggested 3 week or 1 month long prescriptions of Baytril as it is kinder on the stomach for that length of time.

Her latest course is due to end in a week, so should I perhaps take her to the vet then and discuss possible heart issues? To see if I can get him to concentrate on the heart? I do feel she has "something" in her lungs though as well, despite giving antibiotics. Although if she did, would she still be functioning as normally as she is? When she first had all the fluid in her lungs she was lethergic and not eating properly (not surprising.)

So the first course of action would be to talk to the vet about getting an x-ray to look at the heart? But then if there appears to be no problem with the heart, ask to try a different antibiotic like you, Pebble, mentioned?

Pebble, I've got a lot going on at the moment, is it alright if we just continue to talk on here for now? Thanks for the offer, you can PM me your number for another time!

 

[Pebble]

Firstly can I have some clarification please about the last procedure Lucy had done that the vet described as harsh please?Giving an injectable diuretic subcutaneously to reduce the fluid IN the lungs by generating a metabolic reaction is NOT a strong procedure....there is a risk of deydration, but one injection ina a relatively healthy full weight pig is not an issue. However, inserting a needle under GA to physically drain/withdraw fluid from the cavity AROUND the lungs IS. Diuretics will not be very effective if there is a large amount of fluid surrounding the lungs and surgical intervention is necessary to relieve the pressure.

If the moment she comes off antibiotics the respiratory porblems come back it sounds like she either has heart problems or (more likely) chronic pneumonia....either way there could be fluid in the lungs and a twice daily dose of diuretic (furosemaide) *** help keep the respiratory issues at bay. Injections of the drug are not necessary unless there is a lot of fluid and a "kick start" is needed....which is what it sounds like Lucy had last time....but unless you keep up the diruetic, all that will happen is the fluid comes back

Most often tablets (normally 20mg) are prescribed - they are tiny and the easiest way to administer is to grind one 20mg tablet in 5ml water and administer (body weight in kg/2) ml - but you can also get the oral suspension frussol.
The maintenance dose for furosemide is 2mg/kg twice daily. If the fluid is down to heart issues then fortekor (1mg/kg) twice daily will help stabilise the condition and hopefully the diuretic can then be withdrawn over time as fortekor also hleps reduce the lfuid - however your piggie would need to be on fortekor for the rest of her life. (Muffin is still doing well one year on....and without a good Xray to show the fluid, my first vet would not have accepted a diagnosis of heart condition because her heart sounded fine with the stethoscope)

But be warned - it's quite difficult to get a decent X ray showing fluid ...let alone heart enlargement. Muffin's fluid was obvious - (well she also had oedema/swelling in her paws and he pink ears/lips were tinged blue) .....but several of my other pigs had unclear/fuzzy X rays and were considered only "possible fluid" - however the vet was prepared to "go with" for all of them as they were related to Muffin. Over time (and following post moretm results from a few piggies) we realised that Muffin the heart pig was actually a one-off and the rest were suffering from either lymphoma or some type of chronic pneumoia but of non-bacterial origin. So we stopped the fortekor but keep up with the furosemide for the rest of them that have wheezy lungs or are showing heavy breathing from the flanks/abdomen.....

If the fluid is due to chronic pneumonia - I would firstly consider the diuretic together with another antibiotic. Baytril long term caused gut stasis in one of my gunea pigs so I would prefer to opt for septrin over 3-4 weeks. Alternatively a couple of injections of long acting oxytetracycline would eradiacte any infection (including any due to mycoplasma which is not killed by baytril or septrin). It could be (although unlikely) a fungal infection, in which case itrafungol or griseofulvin would be given (this would be a long shot) - but the two other causes of chronic pneumonia are viral (no cure - just manage the symptoms) and chemical exposure (eg bleach, fumes, volatile resins)...in which case furoseamide is your best bet with a careful eye on possible secondary bacterial infection developing and thus anitbioitics being required.

Bottom line is that it sounds to me like your piggie needs a daily oral diuretic to stabilise the respiratory issues first rathe rthan an antibioitic - and provided an X ray can be done without GA and the vet is able to interpret what they see properly, then you can work your way through the antibioitics/antifungals.....or consider fortekor


if you would like either myself or my vets to speak to your vet before/after your next visit to add weight to your concerns then please let me know.

I note you are in Essex - I am up your way every wednesday for the next few weeks. So if at any time you feel you would like to get a second opinion from my vet practice who are cardiac/utrasound/exotics specialists and have worked with me this last year regarding all my piggies problems (including performing PM;s on all my piggies who have gone to The Bridge) then perhaps we can organise something.

By the way - for the benefit of the forum who are following this thread.....whilst I appreciate piggies might develop allergies -and I too addressed all the usual things like changing bedding etc...the PM results on ALL my piggies (4 to date) showed no histological evidence of any kind of allergic reactions to hay/wood shavings or other allergen - and no evidence of fungal exposure. Both of these conditions would show up from a PM as certain types of cells would be present in the lung samples....they weren;t....


HTH - let us know how you get on

x

 

[liquidmelancholy]

Pebble thank you SO much for the information! I am going to try and make an apppointment with a vet that is good with small animals at my vets, and if she's not in this week, I'll wait til next week when another vet who seems more guinea-friendly is back in.

The only thing I'm concerned about after asking for an x-ray is that won't the vet be a bit put out by me basically telling him what I think the problem is, and what medication she should be taking? I really don't think they freely stock anything other than Marbocyl, Septrin and Baytril.. in all the years I've kept pets they've never given me anything else! I just feel a bit rude sort of "telling the vet how to do his job", if you know what I mean.

However, if the vet is unwilling or is unable to prescribe any of the meds you mentioned, I think I'd just have to change vets and see if they are anymore flexible etc.

So basically you are saying that if an x-ray shows fluid in/around the lungs AND an enlarged heart, Lucy will need treatment for both. If she just has the fluid in/around the lungs, but the heart looks normal, then the diagnosis is chronic pneumonia, and treat with the diuretic furosemide in conjunction with an antibiotic such as Septrin?

If chronic pneumonia is the problem, what is the prognosis if, as you say, you cannot cure the illness just control the symptoms? Can you keep giving the diuretic every day for the rest of her life? Because you said that if don't keep up with a diuretic the fluid will just come back.

Maybe I should bring you to my vets too, and try and make the points if they won't listen!

 

[Caviesgalore (EPGPR)]

Sorry to hear you are still having problems.

As far as talking to your vet about possible conditions etc., I know it can be very difficult, some (not all I hasten to add!) are so pompous and don't take kindly to any suggestions from joe bloggs public, however, just keep telling yourself you have your piggies interests at heart. I am very lucky, my vet knows I use TGPF and GL for medical info. and she will often look things up with me!

If you are worried about making suggestions why not print out Pebbles post and just explain how dreadfully worried you are about your piggies and you have asked other piggy people if they have ever had similar issues. If you can get the vet to think the revised treatment was his idea you will be on to a winner in my experience! Try to "suggest" rather than "tell" and you should be ok. Keeping everything crossed for you, keep us posted.

 

[Pebble]

So basically you are saying that if an x-ray shows fluid in/around the lungs AND an enlarged heart, Lucy will need treatment for both.
Yes

If she just has the fluid in/around the lungs, but the heart looks normal, then the diagnosis is chronic pneumonia,
The diganosis is NOT chronic pneumonia - it is just acute pneumonia
and treat with the diuretic furosemide in conjunction with an antibiotic such as Septrin?Yes

If chronic pneumonia is the problem, what is the prognosis if, as you say, you cannot cure the illness just control the symptoms? Can you keep giving the diuretic every day for the rest of her life? Because you said that if don't keep up with a diuretic the fluid will just come back.

Maybe I should bring you to my vets too, and try and make the points if they won't listen!

I think the suggestion that you print out my posts and take to your vet is a good one so there is no misunderstanding.....it takes time, trial and error to sort out a definitive diganosis with any animal and it is esepcially difficult in pigies as you cant subject them to the same tests that we can do for other animals.

The first thing to consider is more antibioitic together with a diuretic.....preferably septrin as if baytril doesn;t work it is unlikely that marbocyl will either (the two are related chemicals). The antibioitic should be given for 2-3 weeks in order to try and eliminate a stubborn bacterial infection.....and if septrin doesn;t work it may also be worth trying a couple of injectable doses of [*]long acting[/*] oxytetracycline as this kills Mycoplasma (which the others don;t).

You could also try a microbial culture and antibiotic sensitivity testing of a throat swab to rule out ay micrbial cause - but this can;t be done unless you piggie has been off antibioitics for at least 5 days so is a bit risky at the moment..I wold go with another round of antibioitics and then see if the symptoms come back when the course has finished. That would then be the time to do a microbial culture.

Are your piggeis in contact with any domestic or wild rats/rabbits/mice?

If the vet is willing to perform an X ray at this time, it may help speed up any diagnostic process.... An X ray will hopefully show whether there is fluid and whereabout it is. It may or may not show if there is an enlarged heart. Just because the heart may look and sound normal doesn;t mean there isn't a heart problem....indications are bluish tinge to lips/ears, swollen front paws, squishy abdomen, hooting noise, noisy gugrly git with lots of air in it on X ray

If the antibioitics don;t work, the culture is negative and the X ray doesn;t show much i would still then try the heart meds....if they don;t work then you might be nearing a possible chrnic pneumonia situation - in which case diuretic shouldve given dily to reduce the congestion in the lungs.

However allergies should also not be ruled out. If you use fleece - it could be the washing powder. Some hay/straw can cause allergies and also some wood shavings......try bedding them on newspaper and timothy hay for a bit.....

Good luck with the vet......I ma happy to talk to them over the phone if needs be or give them my own vets telephone number

HTH
x

 

[liquidmelancholy]

I think that's a good way to go Caviesgalore, I'll try and be as subtle as possible, but if he can't or won't try the treatments then I may just have to take my pigs elsewhere!

Pebbles - my pigs only share a house with my dog and he is scared of them, so never goes near them! They have always lived on newspaper with hay on top. I am convinced Lucy got ill as a result of our bathroom being done next door to where they live in the spare room. There was lots of dust created, and goodness knows what chemicals/paints etc were used. I did keep their door shut the whole time, but I can't think of anything that makes more sense in terms of timing, we had the work done in Jan, and Lucy got ill in March.

I'm going to take both pigs in and ask for x-rays, because even though Hazel seems to be better after starting making strange noises after sneezing that day, she does still sneeze, and I want to make sure to catch any problems with both of them.

I am going to the vets tomorrow afternoon, and I am expecting them to keep them in overnight to do the x-rays as their appointment is quite late, and then I'll collect them on Wednesday morning. I'm just worried that if they find any fluid in either of their lungs that they'll just go ahead and do that lung draining procedure that was done last time. I guess I just need to really state the treatment I want to try i.e. the daily diuretic and antibiotic during my appointment with the vet, and make sure he won't do anything else before I come back in for the results.

What should I do if he says that they simply don't stock any/or some of the meds that we've spoken about?