Specialist Some Thoughts Please - Ongoing I C And Now Lump

[JackJack1]

Whilst I will always be guided by my vet, I would like some thoughts on my current situation with my guinea pig Joe.

Joe is 5 and half now and been experiencing some problems with interstitial cystitis for the last few months. He has been scanned and no stones, but he cries when he wees. He is on Metacam and Cystophan. He has had a course of Baytril which he finished about 2 days ago. He is improving now and whilst his appetite was a bit depressed whilst on Baytril, which is quite normal, I know, this is starting to come back and is weight is on the up again and he is gaining back his weight. I have just come back from the vet and they have doubled his dose of Metacam so he is getting this morning and night now, which is fine, but whilst examining him the vet found a lump under his chin, which she thinks is an abscess. When she was examining him under his chin, he was not protesting at all and it did not seem to bother him. I am going back to see them again in a week's time to check on his progress with his cystitis. I have booked in to see one of the vets that are listed on the cavy savvy vets on this forum. The vet today seemed to think they would start him on Metronidazole for his abscess. I really do not know what to do for the best as I know that having fought his cystitis and on the road to recovery, however fragile at the moment, I do not want to be giving him even more antibiotic and causing more problems than he already has.

My question is, I feel I do not want to deal with something that does not seem to bother him at all. He is eating and drinking now, eating his pellets, hay, greens etc. I know if it is an abscess he is going to go through hell again to have it drained, go off his food, lose weight and possibly lose the fight altogether and lose him. At the moment apart from his cystitis, he is happy and eating and apart from the odd squeak when weeing, he seems perfectly normal. He did not struggle when his chin was examined and it does not seem to bother him at all.

What do you think and can you give me the benefit of any similar experiences you have had? I know older guinea pigs tend to develop a double chin when they get older - I had another like this and he lived to be 8 years before he passed away naturally.

 

[Wiebke]

Whilst I will always be guided by my vet, I would like some thoughts on my current situation with my guinea pig Joe.

Joe is 5 and half now and been experiencing some problems with interstitial cystitis for the last few months. He has been scanned and no stones, but he cries when he wees. He is on Metacam and Cystophan. He has had a course of Baytril which he finished about 2 days ago. He is improving now and whilst his appetite was a bit depressed whilst on Baytril, which is quite normal, I know, this is starting to come back and is weight is on the up again and he is gaining back his weight. I have just come back from the vet and they have doubled his dose of Metacam so he is getting this morning and night now, which is fine, but whilst examining him the vet found a lump under his chin, which she thinks is an abscess. When she was examining him under his chin, he was not protesting at all and it did not seem to bother him. I am going back to see them again in a week's time to check on his progress with his cystitis. I have booked in to see one of the vets that are listed on the cavy savvy vets on this forum. The vet today seemed to think they would start him on Metronidazole for his abscess. I really do not know what to do for the best as I know that having fought his cystitis and on the road to recovery, however fragile at the moment, I do not want to be giving him even more antibiotic and causing more problems than he already has.

My question is, I feel I do not want to deal with something that does not seem to bother him at all. He is eating and drinking now, eating his pellets, hay, greens etc. I know if it is an abscess he is going to go through hell again to have it drained, go off his food, lose weight and possibly lose the fight altogether and lose him. At the moment apart from his cystitis, he is happy and eating and apart from the odd squeak when weeing, he seems perfectly normal. He did not struggle when his chin was examined and it does not seem to bother him at all.

What do you think and can you give me the benefit of any similar experiences you have had? I know older guinea pigs tend to develop a double chin when they get older - I had another like this and he lived to be 8 years before he passed away naturally.

If it is an abscess, your vet has basically got three options:
- a course of a strong antibiotic if the abscess is still relatively small
- lancing and a course of a strong antibiotic to prevent a re-infection. You will also need to keep the abscess open by pulling of the scab 1-2 times daily (not very pleasant) so it the pus can be regularly drained and it can heal from the inside out. Otherwise there is a high risk of it coming back.
- removing the abscess in an operation

Unfortunately, an abscess won't go away on its own and it can blow up very quickly all of a sudden. I am ever so sorry for your run of bad luck.

 

[JackJack1]

Thanks Wiebke for your thoughts- I appreciate it. The vet has suggested Metronidazole for the possible abscess. I know that quite a lot of people seem to say that Zithromax is really good, but when I suggested this as an option, they said that they use Metronidazole and that Zithromax can cause upset stomach in guinea pigs and they tend to tolerate Metronidazole better. It is all a bit worrying and upsetting. Joe is well loved and he will get the best care for him, but I want to make sure that whatever treatment option I take, it is the best for him. I think the lump is about a couple of cms, so quite large and wondered whether antibiotic on own would deal with it. I guess if we go down the lancing pathway, there is risk of the infection spreading into his general system, which would be serious. Not sure as head in a whirl at the moment with it all.
The operation is probably not an option at his age, as the risk would be too great he would not come out of the anaethetic.

Would they normally try antibiotics alone first before any other intervention?

 

[Wiebke]

Thanks Wiebke for your thoughts- I appreciate it. The vet has suggested Metronidazole for the possible abscess. I know that quite a lot of people seem to say that Zithromax is really good, but when I suggested this as an option, they said that they use Metronidazole and that Zithromax can cause upset stomach in guinea pigs and they tend to tolerate Metronidazole better. It is all a bit worrying and upsetting. Joe is well loved and he will get the best care for him, but I want to make sure that whatever treatment option I take, it is the best for him. I think the lump is about a couple of cms, so quite large and wondered whether antibiotic on own would deal with it. I guess if we go down the lancing pathway, there is risk of the infection spreading into his general system, which would be serious. Not sure as head in a whirl at the moment with it all.
The operation is probably not an option at his age, as the risk would be too great he would not come out of the anaethetic.

Would they normally try antibiotics alone first before any other intervention?

It depends on the size of the abscess and the amount of pus there is likely in it; yours sounds rather large already.
To be honest, zithromax is generally taken well, but your vet may have made a bad experience with it. At least he is opting for a strong AB, which is good.

I am tagging our abscess specialists for you: @MintyAndGarry (TEAS) @furryfriends (TEAS)

 

[JackJack1]

I really appreciate the support - thank you.

 

[MintyAndGarry (TEAS)]

As there was no real reaction when the lump was examined, it doesn't sound like an abscess.

Do you have a picture you could upload?

If it is an abscess, or a source of infection, then it would need to be lanced and drained, due to the size. This should not cause him any issues as it is removing some of the offending material. Abscesses generally respond best to Zithromax or Marbocyl.

 

[JackJack1]

Please see attached photos of under his chin. It looks as though he has a double chin.

 

[biscandmatt]

aw he's gorgeous!

i would wait to see the more cavy-savvy vet as starting more antibitoics when she only 'thinks' it's an abscess doesn't sound like the best thing to do. to me anyway.

if it is an abscess then i think the only option would be to treat straight away. usually draining it and giving strong antibiotics is the first treatment. if there is infection in there and nothing is done, it could well spread and cause even more issues.

he's having a run of bad luck at the moment isn't he. but he has you and he sounds like a tough little one. things tend to crop up when the body is busy fighting something else

see what the savvy vet says first and then see what you feel is right. with any lumps and bumps, our vet usually has a feel and depending on what he thinks it is, he will use a fine needle to aspirate and see what is there or what comes out! not sure if this is the case with suspected abscesses but it might be.

our vets regularly use zithromax and the majority of piggies and rabbits they use it for tolerate it very well they said. all mine who have ever had it have been fine on it. same with marbocyl. i know you can never say how an individual will react but generally they are well tolerated and with abscesses, you have to hit them hard with something strong enough. good luck x

 

[JackJack1]

aw he's gorgeous!

i would wait to see the more cavy-savvy vet as starting more antibitoics when she only 'thinks' it's an abscess doesn't sound like the best thing to do. to me anyway.

if it is an abscess then i think the only option would be to treat straight away. usually draining it and giving strong antibiotics is the first treatment. if there is infection in there and nothing is done, it could well spread and cause even more issues.

he's having a run of bad luck at the moment isn't he. but he has you and he sounds like a tough little one. things tend to crop up when the body is busy fighting something else

see what the savvy vet says first and then see what you feel is right. with any lumps and bumps, our vet usually has a feel and depending on what he thinks it is, he will use a fine needle to aspirate and see what is there or what comes out! not sure if this is the case with suspected abscesses but it might be.

our vets regularly use zithromax and the majority of piggies and rabbits they use it for tolerate it very well they said. all mine who have ever had it have been fine on it. same with marbocyl. i know you can never say how an individual will react but generally they are well tolerated and with abscesses, you have to hit them hard with something strong enough. good luck x

Thanks for the thoughts. I hope he can recover from all this. He is getting on a bit now, so age is not on his side for any more health problems to challenge him. We are well known at the vet practice with our regular visits! I am sure you know with Mollie, that cystitis is a long term health problem once they get it, it tends to come back, even when you think you have beaten it for good.

I really appreciate your post and help.

 

[JackJack1]

As there was no real reaction when the lump was examined, it doesn't sound like an abscess.

Do you have a picture you could upload?

If it is an abscess, or a source of infection, then it would need to be lanced and drained, due to the size. This should not cause him any issues as it is removing some of the offending material. Abscesses generally respond best to Zithromax or Marbocyl.

If he did not react when he was examined under his chin and he is eating hard pellets, this does not sound to me as though it is a tooth abscess. What do you think? I have had an tooth abscess myself and I know that this not only puts you off eating, but also eating hard things which need chewing, so I am sure he would not want to chew hay or pellets if he had a tooth abscess. He is currently eating his Timothy hay which the vet recommended, with no problem and he is bright and alert in himself and out and about in his cage. If it was an abscess, would he not be feeling sorry for himself and retreating a bit?

 

[biscandmatt]

If he did not react when he was examined under his chin and he is eating hard pellets, this does not sound to me as though it is a tooth abscess. What do you think? I have had an tooth abscess myself and I know that this not only puts you off eating, but also eating hard things which need chewing, so I am sure he would not want to chew hay or pellets if he had a tooth abscess. He is currently eating his Timothy hay which the vet recommended, with no problem and he is bright and alert in himself and out and about in his cage. If it was an abscess, would he not be feeling sorry for himself and retreating a bit?

the metacam may be helping him feel more comfortable within himself and with any discomfort. he may not have reacted possibly because of this.

i will keep my fingers crossed that it isn't an abscess. x

 

[JackJack1]

the metacam may be helping him feel more comfortable within himself and with any discomfort. he may not have reacted possibly because of this.

i will keep my fingers crossed that it isn't an abscess. x

Thanks biscandmatt. I hope it is not an abscess too. The vet cannot think it is too serious though, as she sent me home, not having been given any treatment for it and said we are treating the cystitis first and to come back in a week.

 

[biscandmatt]

hi, wondered how things are going?

 

[JackJack1]

hi, wondered how things are going?

Hi biscandmatt - thanks for asking how things are going. Things are not going so well at the moment. We went to the vets 2 days ago and Joe is still squeaking when he wees, so the vet has put his Metacam on a higher dose twice per day and put him on Baytril for 2 weeks and told to carry on with the Cystophan. She said she does not think he has a stone, as she cannot feel anything. He had already been scanned a while ago, when he was going through a similar episode and he did not have a stone, just inflammation.

She examined his neck and he did not flinch or feel uncomfortable when she examined him, so she said that if it was an abscess, she would have expected him to be more uncomfortable, so given his age, his other conditions and the fact that she said that they tend to put a thick capsule around an abscess, so it may not bother him, she was inclined to leave it alone whilst treating his other condition, which did cause him pain. She said she was worried about an open wound not healing and causing him a lot more upset at the moment, so just to monitor it all.

She is a cavy savvy vet and listed on this website as one, so had every confidence in her. It is just so hard at the moment, listening to Joe obviously being so uncomfortable and I do not think the Metacam, even at the higher dose is controlling his pain. She did suggest Vetergesic, but do not want to go down the opiate painkiller route. Joe had this before and he was spaced out for days with only one dose, so if he was taking regular doses, not sure if his quality of life would be badly affected.

At the moment, Joes is eating OK and although had lost about 130g at the start of all of this latest episode, then his weight is now fairly stable at 1030g, so he seems to be reasonably maintaining this lower weight for him. He is of course being spoilt with all his favourites and timothy hay to make sure he is eating.

How is Mollie doing?

 

[biscandmatt]

Hi biscandmatt - thanks for asking how things are going. Things are not going so well at the moment. We went to the vets 2 days ago and Joe is still squeaking when he wees, so the vet has put his Metacam on a higher dose twice per day and put him on Baytril for 2 weeks and told to carry on with the Cystophan. She said she does not think he has a stone, as she cannot feel anything. He had already been scanned a while ago, when he was going through a similar episode and he did not have a stone, just inflammation.

She examined his neck and he did not flinch or feel uncomfortable when she examined him, so she said that if it was an abscess, she would have expected him to be more uncomfortable, so given his age, his other conditions and the fact that she said that they tend to put a thick capsule around an abscess, so it may not bother him, she was inclined to leave it alone whilst treating his other condition, which did cause him pain. She said she was worried about an open wound not healing and causing him a lot more upset at the moment, so just to monitor it all.

She is a cavy savvy vet and listed on this website as one, so had every confidence in her. It is just so hard at the moment, listening to Joe obviously being so uncomfortable and I do not think the Metacam, even at the higher dose is controlling his pain. She did suggest Vetergesic, but do not want to go down the opiate painkiller route. Joe had this before and he was spaced out for days with only one dose, so if he was taking regular doses, not sure if his quality of life would be badly affected.

At the moment, Joes is eating OK and although had lost about 130g at the start of all of this latest episode, then his weight is now fairly stable at 1030g, so he seems to be reasonably maintaining this lower weight for him. He is of course being spoilt with all his favourites and timothy hay to make sure he is eating.

How is Mollie doing?

sorry to hear that things haven't been going so well. it's good his weight is staying stable, but i can see why you are worried about his discomfort and stronger pain relief, especially if he has reacted before. you could always discuss with the vet about perhaps giving it in a much lower amount first to see how he reacts and maybe build from there. most stronger pain killers do have the potential to cause that drowsy effect.

i will keep my fingers crossed that the higher metacam reduces the inflammation more and he becomes more comfortable from the discomfort. nice to hear he is still being spoilt. knowing they are loved and well cared for goes such a long way i think.

i posted nearly a week ago about mollie dropping a little weight and me having a niggling feeling that something hormonal may be going on... but happy to report that it looks like i over-panicked and she was just having a stronger season. something seems different about her lately, in a good way, and she hasn't made the groan noise in a while. i don't want to tempt fate but lets just say i am very hopeful she can reach the 7-10days very soon. please don't let me have tempted fate there!

i have recently done a galens garden order to top up on the timothy hay pellets so if you still want to try them with joe then let me know and i can send a sample of those for you x

 

[JackJack1]

Thanks for the support, it really helps when you are dealing with a difficult case like this, that does not seem to want to go away this time. I may be taking Joe back to the vet sooner as I think the higher dose of Metacam does not seem to be doing much for him and I am worried that he is still in pain. This is all very upsetting to see him going through a bad episode and despite all the drugs and care does not seem to be improving. I only hope that the Baytril does not make him go off his food as well and then we will have to cope with all that too.

 

[biscandmatt]

Thanks for the support, it really helps when you are dealing with a difficult case like this, that does not seem to want to go away this time. I may be taking Joe back to the vet sooner as I think the higher dose of Metacam does not seem to be doing much for him and I am worried that he is still in pain. This is all very upsetting to see him going through a bad episode and despite all the drugs and care does not seem to be improving. I only hope that the Baytril does not make him go off his food as well and then we will have to cope with all that too.

poor joe

if you think he's not doing aswell as he was then it could be sensitivity to the baytril. some piggies just don't do well with it. mention it to the vet and see if they think a different one may suit him better.

avipro plus is a good product to give an hour or two after the antibiotic. i use it at a pinch in 1ml water.

sending him lots of vibes and a hug for you too, sounds like you need it x

 

[JackJack1]

I have just had a telephone consult with the vet and told them Joe is not doing so well and now losing weight on the drug treatment given, including Baytril. He is booked in for another scan tomorrow, to find out once and for all what the problem is. The vet said that this will also tell us whether the bladder wall is thickened or if he has a stone, so we can have a definite diagnosis. Looking at the forum, there seems to be quite a lot of guinea pigs with bladder problems at the moment, so not alone.

He is a much loved and I really hope we can get him through this. He is 5 1/2 years old so I hope he will not need an operation at his age and we can manage it with medicines.

 

[biscandmatt]

I have just had a telephone consult with the vet and told them Joe is not doing so well and now losing weight on the drug treatment given, including Baytril. He is booked in for another scan tomorrow, to find out once and for all what the problem is. The vet said that this will also tell us whether the bladder wall is thickened or if he has a stone, so we can have a definite diagnosis. Looking at the forum, there seems to be quite a lot of guinea pigs with bladder problems at the moment, so not alone.

He is a much loved and I really hope we can get him through this. He is 5 1/2 years old so I hope he will not need an operation at his age and we can manage it with medicines.

best of luck for tomorrow. x

 

[JackJack1]

Thanks, I hope luck will be on Joe's side.

 

[biscandmatt]

Thanks, I hope luck will be on Joe's side.

will keep everything crossed for him x

 

[JackJack1]

Bad news at the vets today. Joe has a urethral stone. The options given to me are that we put him to sleep or make him face a big operation. The vet that would be doing this is cavy savvy and operates on small animals. She has done these type of operations before, which involves pushing the stone back into the bladder so it can be removed. He will need an overnight stay and aftercare from the small animal team. This is so upsetting, especially as he has a lump under his chin which they think is an abscess. We are not well off, but having faced a bill of £140 today for Xray, ultrasound and consultation, we are now facing a bigger bill of around £250 estimate and that is if all goes to plan and he does not have to stay in longer to recover. The vet has given me the weekend to think about what I want to do. He is on his painkillers.

I feel I need to give Joe every chance and even if we go for the operation, she said there is a chance they may not be able to move the stone, so he may end up being put to sleep anyway.

I am devastated and in tears!

 

[Wiebke]

Bad news at the vets today. Joe has a urethral stone. The options given to me are that we put him to sleep or make him face a big operation. The vet that would be doing this is cavy savvy and operates on small animals. She has done these type of operations before, which involves pushing the stone back into the bladder so it can be removed. He will need an overnight stay and aftercare from the small animal team. This is so upsetting, especially as he has a lump under his chin which they think is an abscess. We are not well off, but having faced a bill of £140 today for Xray, ultrasound and consultation, we are now facing a bigger bill of around £250 estimate and that is if all goes to plan and he does not have to stay in longer to recover. The vet has given me the weekend to think about what I want to do. He is on his painkillers.

I feel I need to give Joe every chance and even if we go for the operation, she said there is a chance they may not be able to move the stone, so he may end up being put to sleep anyway.

I am devastated and in tears!

BIG HUGS

I am ever so sorry that Joe has such cosmic bad luck; once you are into serious illness and operations, bills can mount up very quickly.
Unfortunately, it is very difficult to predict from an x-ray just exactly where a stone is located in the urethra and whether it could be got out easily or not. It is good that your vet has been honest with you. Take your time to think things through, so you can make a decision that you feel is right for both Joe and you, knowing that it may not be a straightforward operation and that you may be facing a recovery that may not be quite easy in view of the abscess/lump complication. At least you have got the time to think things through, emotionally, financially and in view of having time with Joe.

A diagnosis like that always comes as a punch to your guts and there is unfortunately never a good way of telling you. It takes time to simply take it in and digest it.

 

[JackJack1]

Thank you. We have decided that Joe will have his operation and we will find the money. We need to give him a chance.

 

[biscandmatt]

i just replied on your other thread but just wanted to send more hugs. x