Culture results came back with no growth. Basically, we're in a really good position right now since I've got a fairly healthy pig who simply needs to be one giant bladder stone lighter than he is right now.
The plan is for me to bring him in about an hour before we're ready to start. We'll do an exam then and give him his premeds and likely shave the site before we induce. Quick induction in the handy little induction chamber that my coworker put together and then a speedy cysto.
Standard procedure in my clinic is to monitor and record vitals every 5 minutes so we'll be doing at least that. I wish we had better/different equipment though, it's frustrating that we won't be able to have a SpO2 or even a doppler on him for monitoring as the ones we have simply won't fit him. It might end up being one of those fun surgeries where someone spend the entire time with a stethoscope on him unless I can come up with a way to make the doppler work for him. I'm working the evening shift so I'll be the one doing his post-op care which is comforting.
Timothy - weight loss
Timothy had his surgery on Tuesday and it all went smoothly. The stone was quite large and his bladder wall was thickened and inflamed. It's definitely good that it came out when it did, it should increase his comfort level drastically. I've sent off the stone to be analyzed but haven't received results yet.
I thought I'd post the anesthetic protocol as it worked quite well for him. He was pretty stressed when I first brought him in so we opted to sedate pretty quickly. He was at 1.113 kg and we used Ketamine - 20 mg/kg, midazolam 0.5 mg/kg, butorphanol - 0.5 mg/kg, glycopyrolate - 0.02 mg/kg in a cocktail for a total of 0.3 mls given SQ. Once he was sufficiently sedated we took a lateral abdominal xray to assess where the bladder stone was located (and that it hadn't miraculously passed on its own). We then administered 20mL of warm LRS SQ and induced using a mask and isoflurane.
My vet removed the stone and took a sterile swab for a culture and sensitivity on the lining of the bladder. She then flushed the bladder with warm saline and passed a catheter from the bladder through the urethra followed by further flushing. She closed with subcuticular sutures and tissue glue. Mid surgery we gave him metacam and baytril by SQ injection. We were very careful to maintain his body temperature during surgery and post-op. Post-op we also did a follow up xray to make sure that no uroliths remained.
For aftercare he's been on buprenorphine, metacam and baytril. The first two days I used the buprenorphine every 8 hours and then backed off to twice daily. The metacam and baytril were both SID. He began eating on his own that evening, although not enough to maintain his own body weight so I supplemented with CC. By Wednesday afternoon he was begging for veggies. He's still not eating quite enough to maintain his weight so I'm feeding ~30 mL of CC a day.
His culture came back today with no growth after 72 hours so we've stopped the baytril. I'm going to try backing off on the buprenorphine today as he seems a bit sedate. His incision looks fantastic and he's been very vocal in his demands for more veggies and fresh hay. Honestly, I think he's enjoying the extra pampering at this point.
Does anyone have advice on how best to taper off his pain meds? Or even when to start?
I thought I'd post the anesthetic protocol as it worked quite well for him. He was pretty stressed when I first brought him in so we opted to sedate pretty quickly. He was at 1.113 kg and we used Ketamine - 20 mg/kg, midazolam 0.5 mg/kg, butorphanol - 0.5 mg/kg, glycopyrolate - 0.02 mg/kg in a cocktail for a total of 0.3 mls given SQ. Once he was sufficiently sedated we took a lateral abdominal xray to assess where the bladder stone was located (and that it hadn't miraculously passed on its own). We then administered 20mL of warm LRS SQ and induced using a mask and isoflurane.
My vet removed the stone and took a sterile swab for a culture and sensitivity on the lining of the bladder. She then flushed the bladder with warm saline and passed a catheter from the bladder through the urethra followed by further flushing. She closed with subcuticular sutures and tissue glue. Mid surgery we gave him metacam and baytril by SQ injection. We were very careful to maintain his body temperature during surgery and post-op. Post-op we also did a follow up xray to make sure that no uroliths remained.
For aftercare he's been on buprenorphine, metacam and baytril. The first two days I used the buprenorphine every 8 hours and then backed off to twice daily. The metacam and baytril were both SID. He began eating on his own that evening, although not enough to maintain his own body weight so I supplemented with CC. By Wednesday afternoon he was begging for veggies. He's still not eating quite enough to maintain his weight so I'm feeding ~30 mL of CC a day.
His culture came back today with no growth after 72 hours so we've stopped the baytril. I'm going to try backing off on the buprenorphine today as he seems a bit sedate. His incision looks fantastic and he's been very vocal in his demands for more veggies and fresh hay. Honestly, I think he's enjoying the extra pampering at this point.
Does anyone have advice on how best to taper off his pain meds? Or even when to start?
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Talishan
- You can quote me
In my opinion and experience, right about now, in light of the fact that he's doing so well postop.
I've had good success tapering the opiate down while ramping the NSAID up, then ceasing the opiate, then tapering and eventually ceasing the NSAID. Visualize it sorta like two overlapping roller coaster humps, if that makes any sense at all.
I've had good success tapering the opiate down while ramping the NSAID up, then ceasing the opiate, then tapering and eventually ceasing the NSAID. Visualize it sorta like two overlapping roller coaster humps, if that makes any sense at all.
Cut off the buprenoprhine last night but kept the metacam. He does look a more alert today and maintained his body weight over the past twelve hours. I will be so very, very thankful if this keeps up. My poor vet has been a bit of wreck over this, something about working on a coworkers pet I think. It's odd because she does a lot of routine surgeries on rats and rabbits at the other clinic she works at, they do all of those surgeries for a local rescue.
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Lynx
- Celebrate!!!
By the way, I added your post with a link to your post here in the Records forum:
https://www.guinealynx.info/records/viewtopic.php?t=153
https://www.guinealynx.info/records/viewtopic.php?t=153
Timothy and I are in northern town hell. The only vet that will see him is an hour and half away, that's not a big deal right now since we don't have snow yet. It'll be more of a hassle in the winter but I can still pull it off. Only problem is that the vet is not particularly good. He's just the *only* vet that will see Timothy. My next best options are 3 hours away (maybe a vet there) and 8 hours (a vet I used to work for).
Over two weeks he lost 150g putting him at 1kg as opposed to his healthy 1.15kg self. He is still eating just not enough. He's not eager to see his veggies but he will eventually eat them. Same deal for hay and pellets. I just got an order of orchard grass in that he seems a tiny bit more interested in but nowhere near normal. I've been supplementing with CC mixed with a bit of baby food to keep his interest up. He's been eating most of that with minimal syringe feeding from me. I think it's guinea pig crack.
The vet could not get blood from him nor a decent urine sample. The sample Timothy provided in the kennel had no blood, the occasional crystal and a normal USG. His teeth looked wonderful and the vet did actually have the correct equipment to get a good look. His x-ray machine was down and he's still waiting on parts. This is the northern hell part of the equation. The vet didn't seem to think he'd have more luck getting a blood sample at a later date, I think I may be the only person he's met who wanted bloodwork done on her guinea pig.
No palpable masses or guarding, lungs sound great, no eye discharge, no pained noises when eliminating and no murmur heard. Basically, we've got anorexia and the history of the occasional cough. I think I got complacent with typically hearing him cough while eating and I've now caught him coughing at other times. It's rare but it is happening. The good news is that this vet is willing to give me heart meds just in case, mostly because he has no idea what is happening. He'll be calling it in today to the one compounding pharmacy available since they're not open on Sundays nor was the vet. I just somehow managed to catch him in the office catching up on paperwork. I miss my old vet.
Over two weeks he lost 150g putting him at 1kg as opposed to his healthy 1.15kg self. He is still eating just not enough. He's not eager to see his veggies but he will eventually eat them. Same deal for hay and pellets. I just got an order of orchard grass in that he seems a tiny bit more interested in but nowhere near normal. I've been supplementing with CC mixed with a bit of baby food to keep his interest up. He's been eating most of that with minimal syringe feeding from me. I think it's guinea pig crack.
The vet could not get blood from him nor a decent urine sample. The sample Timothy provided in the kennel had no blood, the occasional crystal and a normal USG. His teeth looked wonderful and the vet did actually have the correct equipment to get a good look. His x-ray machine was down and he's still waiting on parts. This is the northern hell part of the equation. The vet didn't seem to think he'd have more luck getting a blood sample at a later date, I think I may be the only person he's met who wanted bloodwork done on her guinea pig.
No palpable masses or guarding, lungs sound great, no eye discharge, no pained noises when eliminating and no murmur heard. Basically, we've got anorexia and the history of the occasional cough. I think I got complacent with typically hearing him cough while eating and I've now caught him coughing at other times. It's rare but it is happening. The good news is that this vet is willing to give me heart meds just in case, mostly because he has no idea what is happening. He'll be calling it in today to the one compounding pharmacy available since they're not open on Sundays nor was the vet. I just somehow managed to catch him in the office catching up on paperwork. I miss my old vet.
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Talishan
- You can quote me
Very lucky you were able to catch him, and very nice of him to give you the heart med. I realize you're in no-access-hell but he does sound like a decent vet.
Having said that -- I still suspect teeth which means x-ray parts needed. Any idea when they will be in?
Without reading back, how old is Timothy?
The heart med alone may do the trick. Please keep us posted.
Having said that -- I still suspect teeth which means x-ray parts needed. Any idea when they will be in?
Without reading back, how old is Timothy?
The heart med alone may do the trick. Please keep us posted.
He's six now but, prior to this, still acted like a young pig. Less popcorning and zoomies but they did still happen.
The x-ray parts should be in today, I'm going to call once they open. They don't have dental x-rays nor does any clinic in the surrounding area that is willing to see guinea pigs. I'm disturbed that they just flat our refuse to see them, the idea of having an emergency terrifies me. True, the good ER clinic where I lived before was an hour away but they were GOOD and fully equipped for everything.
I missed the vet's call yesterday but he mentioned he was calling the script into the compounding pharmacy. I missed the pharmacy by about 5 minutes. This morning I'll figure out what we got and negotiate if need be.
The x-ray parts should be in today, I'm going to call once they open. They don't have dental x-rays nor does any clinic in the surrounding area that is willing to see guinea pigs. I'm disturbed that they just flat our refuse to see them, the idea of having an emergency terrifies me. True, the good ER clinic where I lived before was an hour away but they were GOOD and fully equipped for everything.
I missed the vet's call yesterday but he mentioned he was calling the script into the compounding pharmacy. I missed the pharmacy by about 5 minutes. This morning I'll figure out what we got and negotiate if need be.
We got a lateral and v/d of him but couldn't get any skull rads without sedation and the vet is nervous to try it. He's completely discounting any dental problems since, with the buccal separators, he couldn't see any spurs or impaired tongue movement or anything else that looked wrong. Whole pig shots looked good overall but he did have a bit of gas so we've added on simethicone. Well, it's more like I told the vet I was going to and he didn't object.
We started on the enalapril but I'd love some input on dosage. The reference the vet went with was 0.5 mg every other day for a roughly 1kg pig. I'm pretty sure that I did 0.25mg SID for Alfalfa but I can't find it in my records. Any thoughts?
We started on the enalapril but I'd love some input on dosage. The reference the vet went with was 0.5 mg every other day for a roughly 1kg pig. I'm pretty sure that I did 0.25mg SID for Alfalfa but I can't find it in my records. Any thoughts?
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