Jan's Toothy Smile medical thread

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sef1268
Supporter in 2019

Post   » Sat Jun 29, 2019 4:08 pm


I'm a little confused. In fairly recent posts, you stated that you suspected a heart issue and you were annoyed that your then-vet wouldn't put Joy on a trial of heart meds. You apparently have a new vet (?) who is willing to try heart meds with her, but you now think it isn't her heart? Or am I not reading this correctly?

Flusapex is, I think, Furosemide. It's a diuretic. Recommended dose, according to Carpenter's Formulary, is 1-5mg/kg q 12-24h. You can work out the dose calculation yourself based on her weight and the suspension, as I don't understand what is meant by 100/10 mg/ml. Is it 100 mg/ml or 10 mg/ml? That's a big difference.

You don't mention what the other heart med is---possibly Lotensin or Vetmedin?

Zantac Syrup is Ranitidine, which, among other things, protects the stomach lining from ulceration. I assume it's being used to counter-balance the effects of long-term NSAID use (Metacam). You didn't mention the Metacam/Meloxicam dose, unless you mentioned it earlier, so I don't know if it's being given at higher levels or not. Generally speaking, it's never a good idea to use an NSAID for long periods of time and/or dose at the higher end of the scale. For the 1.5mg/ml strength Meloxicam, the recommended range for rodents is 0.1-0.3mg/kg.

As far as I know, it shouldn't matter if you dose the Zantac and Flusapex that closely together.

Metamide appears to be metoclopramide, which is medication used used for, among other things, gut motility. Based on that x-ray I posted for you, and seeing that large air pocket, my guess would be that the vet thought Joy needed something to help with that. Recommended dose is roughly .5mg/kg.

The Protexin product is, I assume, Fibreplex which is a probiotic. Probiotics are generally indicated whenever a guinea pig is put on an antibiotic, such as Baytril. Why was she put on Baytril, and how long has she been on it?


The best thing, in my view, would be for you to have a conversation with the new vet about all of these meds and whether or not any can be reduced or eliminated, based on what's currently going on with Joy.

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sef1268
Supporter in 2019

Post   » Sat Jun 29, 2019 5:06 pm


Sorry meant to say, "Generally speaking, it's never a good idea to use an NSAID for long periods of time and/or dose at the higher end of the scale without something to protect the stomach lining."

bpatters
And got the T-shirt

Post   » Sat Jun 29, 2019 9:03 pm


Haven't you been wanting heart meds for months?

Those meds all do different things. Zantac calms the lining of the digestive tract. Metomide also helps with the digestive tract. Meloxicam is an anti-inflammatory. Protexin is a probiotic. Baytril is an antibiotic to treat infection.

If you don't want to take your vet's recommendation, then discontinue the meds you don't think she needs.

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daisymay
Supporter 2016-2019

Post   » Sun Jun 30, 2019 6:03 am


Yes I wanted heart medication but NOT 2 of them! it seems over kill to me. She had X-rays done 2 months ago and it was thought she had a lung infection so was put on Baytril 0.2mls twice a day for 7 days. After 7 days there was NO change so was told to stay on it for lung infection and swollen paws.

The bottle says100X10mg/ml Flusapex drops 25mls. Give 0.8mls(just under 1ml. morning and night).

I thought it was Joy's heart due to the rapid breathing but when you go through they symptoms for heart the rapid breathing is the only symptom she has.

Before the heart medication she was eating and maintaining weight. I thought if she went onto heart medication and if she improved then we would know one way or the other. I did NOT know one side affect would be not eating. I understood if it was her heart she would improve, if not her heart she would stay the same.

I intend to ring the vet tomorrow and discuss it all with all, I just thought I would get ideas from GL that I could converse with her.

Meloxicam is 0.3mls once a day for her paws. Zantac syrup twice a day 0.2mls for the wind in her tummy. Protexin, once a day to protect tummy, Baytril 0.3mls twice a day but we have cut this to once a day and tomorrow will cut it out. A few days later will cut out Meloxicam.

Can I run a theory by you without criticism? Now I was thinking Joy etas her food, tummy goes rock hard, full of wind, this puts pressure on the respiratory system causing rapid breathing. Is this plausible?

The other heart med I don't know what it is till it comes back from chemist as vet sent it away to be compounded. All I know it is once a day.

To close yes I wanted heart meds to rule things out NOT to make things worse! Which I had no idea the heart meds would!

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daisymay
Supporter 2016-2019

Post   » Sun Jun 30, 2019 6:32 am


I found this on Google Flusapex Drops 10mg contains frusemide, a diuretic medication that is used to treat oedema (water retention and swelling) in cats and dogs, to reduce fluid build-up and swelling. ... Flusapex Drops 10mg are used to treat oedema (water retention and swelling),

Used for dogs and cats NOT guinea pigs and for fluid retention and swelling. what the hell are these vets thinking??????????????

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sef1268
Supporter in 2019

Post   » Sun Jun 30, 2019 7:59 am


Many veterinary drugs that are prescribed for guinea pigs are prescribed "off label" -- that is, the drug is primarily formulated and prescribed for dogs and cats, but can be safely used in rodents and rabbits as well, but usually at a different dosage range that the manufacturer doesn't necessarily endorse. If you do a forum search on GL, you'll find many guinea pig owners who have been given Flusapex/Frusemide/Furosemide over the years to treat CHF. In cases where there is edema, it can be a very effective drug to help reduce fluid build-up and thus increase the efficiency of the heart.

Joy is on a lot of different medications, though, and it's hard to predict how multiple drugs will interact or the cumulative effect they can have on things like appetite. Whereas Joy may normally tolerate the diuretic without any problem, she's on Baytril, which is notoriously hard on the gut, and what to me seems like a fairly high dose of Metacam -- assuming 1.5mg/ml suspension and basing it on a weight of 1kg. 0.3cc's is actually 3x the recommended *standard* dose for that weight and suspension. Obviously the dose can be raised if a lower dose doesn't cut pain, but as with any NSAID it can greatly upset the stomach after a period of time. I know this firsthand, because I pop NSAIDs on a fairly regular basis myself for migraine.

It might be worth waiting until she's off some of the other meds before starting her on the heart meds, but again -- I would discuss this with the new vet first.

Talishan
You can quote me

Post   » Sun Jun 30, 2019 9:14 am


Ditto all the advice you have received. All I'd add is that furosemide/frusemide is a powerful, effective med that can be harsh. Try giving her a lower dose, and make sure she continues to drink normally while on it. It's a loop diuretic that is meant to help clear excess fluid from the system, but which can thus also cause dehydration. Using it is a balancing act. Many times once a heart med like benazepril is added in, furosemide can be reduced; that is, once you get the compounded med she may no longer need the furosemide or as much of it.

Zantac (or any antacid in my experience) can slow the GI. In herbivores this can cause problems; again it's a balancing act. No medication is perfect; they all have side effects and it's a case of mitigating the side effects (or working with them) to get the needed effect.

I agree with discussing all of these meds thoroughly with the vet.

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Lynx
RESIST

Post   » Sun Jun 30, 2019 9:18 am


Note, furosemide is not a heart med in the way you are thinking. It is indeed a diuretic.

Find out what other medication she is being given.

Read over www.guinealynx.info/heart.html

Furosemide frequently is given along with the actual heart med.

Furosemide "is used to treat fluid retention (edema) in people with congestive heart failure, liver disease, or a kidney disorder such as nephrotic syndrome. Lasix is also used to treat high blood pressure (hypertension)."
https://www.drugs.com/lasix.html

bpatters
And got the T-shirt

Post   » Sun Jun 30, 2019 9:24 am


And just to add, almost nobody or no animal gets by with only one heart med. Every one I know, including me, is on at least two, and sometimes three or four. It's a difficult balancing act to find the ones that work and tweak the dosage, and the dosage frequently needs to be tweaked to keep things on an even keel.

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daisymay
Supporter 2016-2019

Post   » Sun Jun 30, 2019 10:16 am


If you hear a scream it is me kicking myself as I know only too well what it is like to juggle medication.
make sure she continues to drink normally while on it.
Joy drinks no water.
Zantac (or any antacid in my experience) can slow the GI. In herbivores this can cause problems; again it's a balancing act.
Jan had x-rays on her abdomen back in 2017-2016 and I am using this as an example her tummy was 20% wind 80%. Carol said I am sorry she won't make Christmas(this was November). Jan lived for another 12-24 months.She sent copy of X-rays to Dr Vella who suggested the Zantac. Because joy was/is Jan's sister Joy was just put on it when after eating her tummy would become rock hard. I have tried many times to lower dose or cut out the Zantac. Everytime both would stop eating and pooping.

Meloxicam should have read point 0.3mls, cat version 0.5 strength. She is on this for as like Jan her sister Joy is biting her toes like they are really itchy.

I have decided to cut out the Baytril as Carol said she thought Joy had lung infection it has been 8 weeks now no improvement. If all goes well will try and cut out or lower dose of Meloxicam. I plan to ring new vet tomorrow. When I get the compound med I will start that first and see how she goes on that.
Thanks for replies and much needed advice, sef1268,bpatters, Talishan and Lynx. Just proves no matter how long you have these critters you are always learning.

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daisymay
Supporter 2016-2019

Post   » Mon Jul 01, 2019 6:00 am


New vet has now refused to see Joy saying she is way over her head. So now back to square one. For now Joy is still not eating but will do so if fed by hand. Any suggestions much appreciated. Thanks every one.

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daisymay
Supporter 2016-2019

Post   » Mon Jul 01, 2019 6:28 am


New vet refuses to see Joy, says too hard. Referral place also refuses so again got NO vet. Won't give up! Joy not eating only if hand feed her the leaves. keep you posted. slowly losing weight-5-20grams a day.

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sef1268
Supporter in 2019

Post   » Mon Jul 01, 2019 8:31 pm


Joy drinks no water.
How is that possible?

How long was she on the Flusapex? In looking back at what you wrote, 0.8ml's seems like a fairly high dose to me (based on Furosemide range for rodents of 1-5mg/kg at a strength of 10mg/ml). If Joy wasn't kept adequately hydrated, the diuretic could have caused dehydration and/or messed with her electrolyte balance and she lost her appetite. If that's the case, unflavored Pedialyte might be useful. Symptoms of dehydration can include dry, crusty and sunken eyes; reduced appetite; dark urine; small and/or hard poops.

The only other advice I can give at this point, is to suggest that you do the best you can with the resources you have, and accept the fact that there may not be any clear/easy answers to what's going on with Joy or how to fix it (assuming any of it is fixable). She's a 6 1/2 year old guinea pig who has been shuttled from vet to vet with the repeated stress of travel, diagnostics and medications. I know you want answers and solutions, as we all do when our pets are ill, but sometimes there are limits to what we or our vet can do. Unfortunately, this is sometimes the reality of pet ownership.

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daisymay
Supporter 2016-2019

Post   » Tue Jul 02, 2019 5:27 am


Joy bad health wise so went onto the med, stopped eating, lost weight. 3 days later she has picked up, gaining weight eating etc. Feeling all happy. Went to vet- fluid in lungs and heart irregular beat. Just can't win. Keep you posted.

Joy drinks no water.
All our girls have water bottles but none drink from them. I presume they get fluid from their food especially cucumber, rockmelon etc.

How long was she on the Flusapex?
Two days-4 doses. Have lowered dose to 0.2mls and will see how she tolerates it. 0.8mls was suggested by exotic vet. Her weight is 780-830grams.
Thanks for the reply sef1268.

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daisymay
Supporter 2016-2019

Post   » Tue Jul 02, 2019 5:44 am


Forgot to mention for last year or two she is being hand fed Critical Care so thinking maybe that is enough water?

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daisymay
Supporter 2016-2019

Post   » Thu Jul 04, 2019 5:31 am


The second drug will be ready tomorrow. It has been compounded into liquid form. It is for BP and kidneys. She gets 1ml a day which is suppose to equal 2mg. Will know more tomorrow. Keep you posted. Back on other medication, affecting appetite a little.

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daisymay
Supporter 2016-2019

Post   » Mon Jul 08, 2019 6:49 am


How long being on Benazepril before I see any improvement if any? Joy is on 0.2mg once a day and have seen no improvement after 6 doses. I don't want to up the dose incase she stops eating. Any advise welcome as this is all new to me. Thanks in advance! She goes to vet next week for review.

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sef1268
Supporter in 2019

Post   » Mon Jul 08, 2019 8:44 pm


What symptom was the heart med supposed to address? The rapid breathing?

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daisymay
Supporter 2016-2019

Post   » Tue Jul 09, 2019 3:25 am


What symptom was the heart med supposed to address? The rapid breathing?

Yes and the irregular heart beat.

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daisymay
Supporter 2016-2019

Post   » Thu Jul 18, 2019 3:01 am


Just got back from the vet as Joy has been on heart meds and shown no improvement after 2 weeks. Benazepril 1ml equals 2mg/ml once a day Flusapex 0.2mls twice a day If higher she stops eating. Poops have become mushy even though on Protexin.
So vet said to cut out the Benazepril and try Doxycycline incase not heart but infection.Joy was normal March 2019 but in April 2019 she got teeth filed(gas only) and got put in with Jay.
She is NO longer with Jay but she can still see her, Jaffa and Jill but it is like she is scared of them and would rather be with us as if we were guinea pigs.
The vet as usual had no idea but did say Joy's heart was beating so fast she couldn't get a reading.
Any suggestions appreciated. Thanks in advance for any replies. If this doesn't work she wants to do bloods which we refuse to do!!!!!

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