Urgent Need Advice!

[Adelle]

My 6.5 year old sow fudge is being treated for heart disease by a specialist as my usual vet couldnt help us.

She was put on 4mg frusemide, up to 3 times a day, but using cautiously as she has possible renal disease. I was told to cut it down to 2mg twice daily, but it was not enough- i had her stable on 2mg every 8 hours.

She was also put on fortekor, 0.5mg once a day.

She improved in herself, but after 4-5 days, her activity decreased. I was advised by the specialist to increase fortekor to 0.75mg once daily (but i split it into 2 doses).

There was no change, we are now at day 5 of the increase and her breathing is worse. Iv had to up her to 4mg frusemide and her sides are still bellowing in and out. Her breathing is bad considering the dose of frusemide shes getting.

Heres the biggest problem:
The specialist is on holiday for 3 weeks, hes not contactable, and my usual vet has admitted she cant help me with heart meds. I have contacted a vet recommended by @flintstones , and she is seeing me at 2.30pm.

She is thinking of adding in Vetmedin. Fudge has no heart murmour but a very fast heart rate.

Does anyone with piggy knowledge think this is a good idea? Or should i ask about something else? I am so worried right now. Trying to get one pig through surgery and now the other is really struggling.

Thank you.

@helen105281 @flintstones

 

[helen105281]

I still think the Fortekor dose is very low so it may be that you can increase that before considering Vetmedin. Take the article I sent you with you to the appointment as it goes through all the doses that are acceptable. Vetmedin can be added in, I have known of it being used quite a few times but not with my own pigs (yet). The article has the doses for that too I think. I know finding the right balance of heart med doses can be tricky.

 

[Adelle]

I still think the Fortekor dose is very low so it may be that you can increase that before considering Vetmedin. Take the article I sent you with you to the appointment as it goes through all the doses that are acceptable. Vetmedin can be added in, I have known of it being used quite a few times but not with my own pigs (yet). The article has the doses for that too I think. I know finding the right balance of heart med doses can be tricky.

Charging my phone fully before i go as i fully intend on showing that article- thank you. The article says 1.25mg fortekor should be the starting dose, I'm just worried if she ups that further as my specialist already said 0.75mg was higher than he'd like? And he has over 30 years experience. I just need someone to do something as i cant leave her like this, I'm just worried that whatever gets done isnt the right way to go and specialist doesnt like it- but i cant leave her till hes back. Its hard for me to trust a vet I'm only going to meet for the first time, she did tell me she has some experience but no where near as much as the specialist- so i feel stuck!

 

[helen105281]

The doses mentioned are based on an American Exotic Animal formulary by someone called Carpenter I think, the name is in the article, so maybe ask them to look there? if they go by the British Animal Formulary then the doses are likely to be lower. They could always discuss with my vets if needed www.letchworthvets.co.uk as they prescribed mine an eighth of a 5mg tablet twice a day.

 

[GPTV]

i gave my 8yr old Ellie heart meds - nelio (2.5mg tablets for cats) my vet put her on quarter of a tablet twice daily.
so her starting daily dose was 1.25mg in total. i'm not sure of the different strengths of nelio & fortekor though. although i believe they do the same job, just different names.
Ellie was between 900g -1kg at the end, but i'm sure i have read somewhere that its the heart as a pumping muscle that the dose is for & the weight of the piggy doesn't affect this.

please discuss with your vet. i had lots of wonderful information from helen105281 & it was some of this that made my vets consider trialling the nelio. as i had done my homework!i happened to have a different vet that day too who was open to suggestion& successful experiences of others.
i had however spent many weeks trying to get my usual vet to trial heart meds, i think with ellie her age & other health problems just the meds were started too late & i did lose her. i think she also had renal failure as she was drinking excessively too. (about half a bottle a day&not a leaky bottle)

Fudge is quite a bit younger & if she is starting on the heart meds quickly then she has a better chance of being sorted. hopefully its a case of tweaking her meds & maybe a different vet will be looking at your situation with a fresh set of eyes & help stabilize her.

good luck for the appt later.
definitely discuss the info helen provided.

Fingers & paws all crossed her for you all.
xx

 

[Adelle]

The doses mentioned are based on an American Exotic Animal formulary by someone called Carpenter I think, the name is in the article, so maybe ask them to look there? if they go by the British Animal Formulary then the doses are likely to be lower. They could always discuss with my vets if needed www.letchworthvets.co.uk as they prescribed mine an eighth of a 5mg tablet twice a day.

So thats 1.25mg split into two doses. This is what i mean- it seems to be standard for everywhere, just not for the specialist! Dose your pig still require frusemide regularly? Or just whn needed? As obviously the aim is for the heart meds is to help the heart function better therefore reduce or stop fluid building up in the chest.

 

[helen105281]

No, I have 7 heart pigs and only one still needs diuretic and it is very occasionally. I always have it at home in case though. The aim is to get the ACE inhibitor dose right so that they can be weaned off the diuretic. The article also mentions Co-enzyme Q10 which my heart pigs are also on and I believe has helped with the reducing the diuretic but that is something to consider a bit further down the line.

 

[GPTV]

So thats 1.25mg split into two doses. This is what i mean- it seems to be standard for everywhere, just not for the specialist! Dose your pig still require frusemide regularly? Or just whn needed? As obviously the aim is for the heart meds is to help the heart function better therefore reduce or stop fluid building up in the chest.

Ellie wasn't too chesty but was given it on an as & when needed basis. she was really only crackley chested about three times though for me to need to give frusimide- if thats any help?

xx

 

[Adelle]

Yup 1.25mg split during the day seems to be standard- i dont know why the specialist is going so low. My fudge may be younger, but she is also queried renal disease, but couldnt confirm with bloods due to the stress and her breathing. I was also saying heart to my vet for a couple months before i got sick of being ignored and went to alistar lawrie, the specialist.

I fear it may be too late for her too.

 

[GPTV]

Yup 1.25mg split during the day seems to be standard- i dont know why the specialist is going so low. My fudge may be younger, but she is also queried renal disease, but couldnt confirm with bloods due to the stress and her breathing. I was also saying heart to my vet for a couple months before i got sick of being ignored and went to alistar lawrie, the specialist.

I fear it may be too late for her too.

hopefully now she's started on the meds they will start kicking in , i guess a low dose is better than no dose.

good luck with the appt this afternoon. fingers crossed, what time is your appt?

xx

 

[Adelle]

i gave my 8yr old Ellie heart meds - nelio (2.5mg tablets for cats) my vet put her on quarter of a tablet twice daily.
so her starting daily dose was 1.25mg in total. i'm not sure of the different strengths of nelio & fortekor though. although i believe they do the same job, just different names.
Ellie was between 900g -1kg at the end, but i'm sure i have read somewhere that its the heart as a pumping muscle that the dose is for & the weight of the piggy doesn't affect this.

please discuss with your vet. i had lots of wonderful information from helen105281 & it was some of this that made my vets consider trialling the nelio. as i had done my homework!i happened to have a different vet that day too who was open to suggestion& successful experiences of others.
i had however spent many weeks trying to get my usual vet to trial heart meds, i think with ellie her age & other health problems just the meds were started too late & i did lose her. i think she also had renal failure as she was drinking excessively too. (about half a bottle a day&not a leaky bottle)

Fudge is quite a bit younger & if she is starting on the heart meds quickly then she has a better chance of being sorted. hopefully its a case of tweaking her meds & maybe a different vet will be looking at your situation with a fresh set of eyes & help stabilize her.

good luck for the appt later.
definitely discuss the info helen provided.

Fingers & paws all crossed her for you all.
xx

Ellie wasn't too chesty but was given it on an as & when needed basis. she was really only crackley chested about three times though for me to need to give frusimide- if thats any help?

xx

hopefully now she's started on the meds they will start kicking in , i guess a low dose is better than no dose.

good luck with the appt this afternoon. fingers crossed, what time is your appt?

xx

Do you mean chesty as in raspy breathing? And was huffing and puffing with heaving sides still evident ? Fudge has only been raspy/hooting twice, but i dont let it get to that anymore. Her sides are heaving regularly- thats with frusemide every single day. Its when they get stronger heaves and shes rocking back n forth with it that i up it.

My appointments in an hour- hopefully we have a plan after that.

Thank you all for your help, its really appreciated.
Xx

 

[biscandmatt]

sorry i can't offer any advice but wanted to wish you good luck for your appointment x

 

[gizzy]

Hi there.,What sort of tests wete used to detemin a heart condition? a pigs heart beat incredabaly fast and can be anyting from 250 to 350 beats per min
l would be catiuos with Frusemide , it has all sorts of side efects , incuuding shortness of breath , tiedness, and an increased heart beat

 

[GPTV]

Do you mean chesty as in raspy breathing? And was huffing and puffing with heaving sides still evident ? Fudge has only been raspy/hooting twice, but i dont let it get to that anymore. Her sides are heaving regularly- thats with frusemide every single day. Its when they get stronger heaves and shes rocking back n forth with it that i up it.

My appointments in an hour- hopefully we have a plan after that.

Thank you all for your help, its really appreciated.
Xx

yes sounded like water in her lungs/chest or crackley & horrible, made me short of breath just listening to her
she was quite a heavy breather anyway but yes her sides were quite noticeably heaving in & out, perhaps its the low dose of forteker & not the fruseimide is to blame in her case?.

hopefully your appt went well?
xx

 

[Adelle]

No, I have 7 heart pigs and only one still needs diuretic and it is very occasionally. I always have it at home in case though. The aim is to get the ACE inhibitor dose right so that they can be weaned off the diuretic. The article also mentions Co-enzyme Q10 which my heart pigs are also on and I believe has helped with the reducing the diuretic but that is something to consider a bit further down the line.

sorry i can't offer any advice but wanted to wish you good luck for your appointment x

Hi there.,What sort of tests wete used to detemin a heart condition? a pigs heart beat incredabaly fast and can be anyting from 250 to 350 beats per min
l would be catiuos with Frusemide , it has all sorts of side efects , incuuding shortness of breath , tiedness, and an increased heart beat

yes sounded like water in her lungs/chest or crackley & horrible, made me short of breath just listening to her
she was quite a heavy breather anyway but yes her sides were quite noticeably heaving in & out, perhaps its the low dose of forteker & not the fruseimide is to blame in her case?.

hopefully your appt went well?
xx

Appointment was productive, she read the article and has opted with puttin her on 1.25mg fortekor split over 2 doses. If no improvement at all by the end of the week we might be looking at vetmedin. I hope it works, she had 4mg frusemide last night at 1am and another at 9am, with impaired kidneys this is a big risk, but i couldnt leave her struggling for breath. She coped with the car journey and slept on the way home whilst she had some nose strokes from her mum.

Now for another question! Do yous give the fortekor tabs into the mouth or do u dissolve them then syringe? My fortekor at the moment is made up in a solution which i syringe but it doesnt dissolve fully- so even shaking the bottle fully before drawing it up isnt really accurate with how much fortekor shes getting.

Thank you so much for all your help, dont know how i ever managed without this forum xx

 

[GPTV]

i think @helen105281 does hers in water & doses it that way, but with so many she needs an easy way of doing them all.

i found that Ellie took hers more easily if i broke the tablet into quarters (her correct full dosage each session), put the quarter on a saucer & dripped a small quantity of water onto the tablet, this would soak into the tablet & it would break down like a soggy weetabix type paste, i then sucked the paste into a 1ml syringe (with end cut off & rubber stopper removed).
& gave her the paste. this seemed to go better than my mixing crushed tablet with water attempt... most of which ended up on the floor, down my arm, down ellies chest, over the towel or nearly up ellies nose one time when she moved a bit quick
the water seemed to be really bitty & i wasn't sure how much she actually got in her mouth.

i found the paste stressed her out less as it went in her mouth in 2 or 3 goes & not loads like before. it was more accurate for me to measure too.

sounds like the appointment went well, hopefully you will see an improvement soon

good luck

xx

 

[helen105281]

That's brilliant news and am so pleased she read the article. I do mix mine in water but everyone does it differently really and you need to do what works best for you. As I have so many heart pigs on slightly different doses the mixing in water works best for us.

 

[gizzy]

She sounds like a good vet !
Re tables , l find it depends on how relaxed and willing the pig is to
take meds .
a relaxed pig will often take tablets that are brocken into 4 peices ,
with little fuss . this way all of the tablet is dijested without any spillage

if the pig is reluctant, then mix with water and draw up into the 1ml syring
then push the nosal into a piece of pigs faveate veg, this will trick them into
thinking he is getting a treat

 

[Adelle]

i think @helen105281 does hers in water & doses it that way, but with so many she needs an easy way of doing them all.

i found that Ellie took hers more easily if i broke the tablet into quarters (her correct full dosage each session), put the quarter on a saucer & dripped a small quantity of water onto the tablet, this would soak into the tablet & it would break down like a soggy weetabix type paste, i then sucked the paste into a 1ml syringe (with end cut off & rubber stopper removed).
& gave her the paste. this seemed to go better than my mixing crushed tablet with water attempt... most of which ended up on the floor, down my arm, down ellies chest, over the towel or nearly up ellies nose one time when she moved a bit quick
the water seemed to be really bitty & i wasn't sure how much she actually got in her mouth.

i found the paste stressed her out less as it went in her mouth in 2 or 3 goes & not loads like before. it was more accurate for me to measure too.

sounds like the appointment went well, hopefully you will see an improvement soon

good luck

xx

That's brilliant news and am so pleased she read the article. I do mix mine in water but everyone does it differently really and you need to do what works best for you. As I have so many heart pigs on slightly different doses the mixing in water works best for us.

She sounds like a good vet !
Re tables , l find it depends on how relaxed and willing the pig is to
take meds .
a relaxed pig will often take tablets that are brocken into 4 peices ,
with little fuss . this way all of the tablet is dijested without any spillage

if the pig is reluctant, then mix with water and draw up into the 1ml syring
then push the nosal into a piece of pigs faveate veg, this will trick them into
thinking he is getting a treat

I think il try the paste idea- that way i can see exactly how much shes getting instead of a fortnights worth in water that all settles at the bottom! Think that was a bit of a silly idea from the vet, but he was the only one willing to listen to me so i am grateful. She had 3 mg frusemide at 5 and then due her 2nd dose of fortekor at 9. Shes no longer fluffed up and breathing easier, eating pellets and hay and grooming her cagemate. I'll maybe stick to the 3mg at her last dose at 1am- as everytime i think i can lower it, the breathing badly starts again. Will reasses frusemide in the morning.

Thanks again everyone xx

 

[Adelle]

So Fudge has been on Fortekor now for 23 days, and the higher dose of 1.25mg daily for 10 days. She perked up for the first few days on higher dose, like she did everytime it was increased, but then soon went back to no change. We are currently on 4mg frusemide every 8 hours and this is starting to not even cut it. She is breathing very noisily tonight/wet sounding which she hasnt done since first diagnosed a month ago.

I am taking her back to the vet i used 10 days ago, as the specialist still isnt contactable for another week. She suggested last time we try vetmedin if unsuccesful with fortekor.

My worry is she is being treated for the wrong thing. She hasnt had any xrays etc as she wasnt fit enough for the stress and she was treated based on her symptoms, which worked (at first). Although i know the alternative to heart disease is probably something nasty like a tumour in the chest.

Not feeling very good at the moment. Any advice would be appreciated.

@helen105281 @GPTV @flintstones

 

[helen105281]

Would they do a conscious x-ray? To get a proper diagnosis?

I would not remove the Fortekor yet. It would need to be phased out if you did anyway. I think Vetmedin can be a good addition to Fortekor but not instead of.

 

[gizzy]

An x ray is only as good as the tecnition interpreting it , and a lot depends on the qualerty
of the plate used,
anilog is nowere near as clear as a digital plate !

radiogtaphy is a trade (for want of a better word)
so if your vet is well practised in reading

and of the pig is sqwerming then that will also degrade the picture

 

[Adelle]

Would they do a conscious x-ray? To get a proper diagnosis?

I would not remove the Fortekor yet. It would need to be phased out if you did anyway. I think Vetmedin can be a good addition to Fortekor but not instead of.

Calling them at 8.30am to try and get speaking to the vet i want to see. I will ask for a conscious xray as sedating her would put her life in danger and that really isnt worth it.

Just hope they can fit us in, they are a busy practice.

I'm not as clued up on heart piggies as a few folk on here are- some of you could give some vets a run for their money! So when i know the vet isnt HUGELY confident either- it makes me worry constantly about her treatment.

If only the specialist didnt have to take a holiday!

 

[gizzy]

perhaps you could ask you vet to let a pig savy spesialst vet to read the plat

 

[flintstones]

Would the vet be able to Xray without GA it maybe worthwhile if she can. Although the heart may not be noticeable if there is a lot of fluid.

@helen105281 I'm sure has mentioned vetmedin before. I haven't had any heart pig's myself.

My only thought was is infection possible or has it already been ruled out?

 

[gizzy]

My vet x rays without ga when nessesary
he uses sand bags
he builds a wall with a space in the center to put the
pig in , though it is only any good for shots from the top.

though he dos not like doing it as it means holding the pig
till the last second before the shot and this is a lot of messing
round

 

[helen105281]

Calling them at 8.30am to try and get speaking to the vet i want to see. I will ask for a conscious xray as sedating her would put her life in danger and that really isnt worth it.

Just hope they can fit us in, they are a busy practice.

I'm not as clued up on heart piggies as a few folk on here are- some of you could give some vets a run for their money! So when i know the vet isnt HUGELY confident either- it makes me worry constantly about her treatment.

If only the specialist didnt have to take a holiday!

Take the article with you as I think it goes through the different diagnostics. It may even be that she needs her meds tweaking further, I have known of heart pigs on much higher doses than mine are on. An xray will at least show how much fluid there is.

Flintstones has mentioned an infection, I know there is a lot of information on your other threads, but did the vet rule out Pneumonia?

 

[helen105281]

My vet x rays without ga when nessesary
he uses sand bags
he builds a wall with a space in the center to put the
pig in , though it is only any good for shots from the top.

though he dos not like doing it as it means holding the pig
till the last second before the shot and this is a lot of messing
round

When I had my first heart pig Nigel he was the first pig my vets had done a conscious xray on and they used masking tape and loosely taped his legs to the table.

 

[Adelle]

The vet i was wanting to speak to isn't in until 1.30pm on a thursday, so any hope of having her in for an xray is gone. I will still speak to her when she calls and see what she thinks. But realistically it will be tomorrow.

She hasnt had any antibiotics no, and her lungs sound perfectly clear even when gurgling as its in the chest cavity the fluid is gathering.

This is why she needs xrayed i think, too many maybes. Thank you all

 

[Poppy'sMum]

I'm sorry I can't advise anything as you already have the experts on here helping you, but just to say my thoughts are with you & sending healing vibes for your little girl xx