Violet's medical thread

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Talishan
You can quote me

Post   » Fri Jan 15, 2016 2:43 am


What a feisty pig! Good for her!

Not so much for you, though. ;-) She is not the first pig on GL to rip a drain and/or sutures out, but still, I can imagine how you felt. !!!

Are you still flushing the area and if so, are you getting pus from it?

Does she go back for a recheck and if so, when?

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Zaphy

Post   » Fri Jan 15, 2016 5:23 am


Update: Nothing terrible happened today for once!

Yeah... when it happened it may have been one of the scariest moments of my life. I'm just glad it wasn't worse, holy cow! And on the plus side, since the drain came out and the incision opened, flushing it has been quite a bit easier! Nice big target to aim at now :)

So yes, I am still flushing the area, heh. I'm not using the sides of the drains as often as I'm mainly going through the front now. One of the sides went and closed up pretty solidly, and it looks pretty clean from the outside so I'm not worrying about it too much, just making sure to hit that side of the inside from the front in case there's anything hanging out behind that nice clean scab that I can't see. I am still getting pus (and there is still a noticeable odor as well)- I've been taking photos a lot, partly because I like to see the progress the wound is making and partly to help me see if I've missed any stuff that should be coming out. So hey, why don't I just show you! They're all from today. The last one (there's a chunk of pus/dead tissue material on the cloth you can see, everything I've been getting out of it is in chunks like that) is just a couple hours ago.

Image
^Before any flushing this morning
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^I'd gotten a few good squirts in but hadn't gotten much out so this was to see if anything looked like it should be moving (answer was obviously yes)
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^This was after the first flushing of the day.
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^Before the last flushing of today (obviously there'd been a couple sessions between this and the previous one)
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^After the last flushing of today plus bonus scabpustissuebooger thing at bottom right

She has her recheck scheduled for Monday morning. Unless she does something else awful to herself before then, heh. The receptionists and techs who answer the phone know her by name when I call now xD

She's only been bugging her wound during/right after I flush it today. So I've been popping the fabric sleeve on her when I'm done with a flushing to keep her from it:
Image

And then it'll take around 15-30 minutes for her to calm down about it- she'll try to shake it off and scratch, paw and bite at it but... I dunno, not that hard I guess, I know she's capable of removing this size of sleeve on her own because she has a couple times when I first put it on her, but maybe I just had to find the correct placement for it not to bother her enough? Cause she'll eventually moderately relax if I put it on right:
Image
And that's when I'll remove it again so that it doesn't dry to the wound or anything, she'll leave the area alone after that.

P.S. Lynx, thank you for adding my pictures, and double thank you for the nice crops on them :D

P.P.S. I am using different fabric sleeves each time and washing them between uses.

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Lynx
RESIST

Post   » Fri Jan 15, 2016 8:24 am


I did some drastic crops (that I will add in a bit) since there are so many pics. I'm on dialup and the smaller the images, the better! p.s. you do a great job with photo compression. I'm just making them a bit smaller yet (mainly cropping). Focusing on the injury.

Violet is a sweetheart.

That you are still getting pus (and can smell the odor) I think shows you how important the flushing is. I am betting the vet is learning a lot about guinea pig abscesses too!

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Zaphy

Post   » Sat Jan 16, 2016 4:31 am


Definitely! There's been so much gunk in it the last couple days... The smell has been reduced today though, so that's a nice sign! Still producing some pus but not nearly as much as yesterday. The vet said this is one of the most challenging cases he's had.

Today was another good day. Also! Violet finally started drinking on her own! Woo hoo! I'm thinking I'll probably continue to supplement with Critical Care for a while, make sure this isn't just a fluke, but I'm pretty happy about that. She's really active, I haven't had to give her burprenorphine in a couple days, and when I tickled her little feet (she'd caught some string in her toes) she did that little indignant popcorn thing that pigs do sometimes :D

Talishan
You can quote me

Post   » Sun Jan 17, 2016 9:50 am


Keep going. Less smell is good. Carry on and please keep us posted.

You're doing all the right things. Big chunks of scabpusboogerdeadtissue stuff is good.

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Zaphy

Post   » Thu Jan 21, 2016 4:14 am


http://i.imgur.com/9ZTTT2Ah.jpg

Violet's been doing pretty good the last few days! No major incidents. I've been slacking a bit on feeding her since she seemed to be eating and drinking pretty well on her own, plus she's been quite active and perky. This morning I weighed her and she was 900g... down from 925g over the last week or two and 950g in the days immediately following her first surgery (about the 7th of this month), and before the surgery she was 970-1000g depending on water weight.

Now, she was pretty chubby before this, and compared to my other two pigs she doesn't seem underweight in her build right now though she is noticeably leaner than before, so I'm not concerned about her weight currently. I think it would not be super good if she continues to drop weight. So I'm thinking about going back up to a full 60cc of Critical Care a day for a while.

Tonight she scared me a bit when I walked by her cage about an hour or two after I gave her her meds, she was hunched, puffed up and squinting her eyes. Upon closer inspection her recent poops looked kind of dry so I took her and fed her 10cc of water, then a couple cc of Critical Care for good measure. I also rubbed her belly for a little while, not sure if any of that did anything or if it was just a coincidence but she's laying down relaxed again now. She was pooping and peeing a bit more frequently than usual this morning, not sure if that means anything.

The other concern I have is that she appears to have a big scab forming over the big hole, as you can see in the photo above. Is that pretty normal for a wound this size? I've still been flushing the wound 3-5 times a day but I have no idea how a drain like this is supposed to heal, I can't think of what to Google for it. I'm concerned that there might be gunk hanging out under this scab, and I'm not sure if I'm supposed to wait till the scab falls off kinda naturally or if I'm supposed to flush the wound out completely till the scab comes out each time. I'm no longer getting chunks of boogerscab, the saline's coming back fairly clear each time. Violet still fights me when I flush it.

Her behavior's been pretty encouraging though. Since she was a little piglet she's always been excited about fresh bedding, and has popcorned like crazy whenever I changed the paper bedding (I have an adorable video of her doing a barrel roll through some fresh bedding when she was younger somewhere on my computer). Today I changed her litterbox and she did the same thing- popcorned all over her tiny quarantine cage. She also rumblestrutted at me as I walked past her holding my other pig Hazel. She wheeks and begs every time she hears the fridge door open or we call her for treats. When she sleeps she stretches out her little feet and lays her head down, so she seems pretty comfortable!

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Zaphy

Post   » Thu Jan 21, 2016 5:48 am


Hmm, looks like my photo disappeared. Here it is reuploaded- I'm on mobile now so hopefully I did it right.

Image

But yes, scab forming on top, still seems like there's gunk underneath it. It may be worth noting that the smell is gone now as far as I can tell, too... am I being stupid by not talking to the vet about this right away?

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Lynx
RESIST

Post   » Thu Jan 21, 2016 9:27 am


It is looking better. I think what you are hoping for is granulation of the skin at the sides. I think you do need to continue flushing if you can. That it is no longer smelling is super (good sign).

Note Snowflake's simple healing incision. What I thought was the incision coming apart was granulation (healing by forming new tissue over the opening):
Image

This is from:
http://www.guinealynx.info/spay.html#incision

It looks like there may be some granulation happening from the sides - and hopefully underneath the scab too.

Hopefully Talishan will comment. I have not had to deal with something like this and imagine she has dealt with open wounds much more frequently.

I am glad you are so observant. Weighing helps, the extra food helps, sounds like the massage helps (I suspect what you were seeing was signs of pain - which could have been intestinal).

I'll go add your pic.

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Zaphy

Post   » Thu Jan 21, 2016 3:37 pm


hm. The vets were in surgery when I called, so the receptionist couldn't ask em- Violet hasn't left any poops in her cage since at least 3:00am this morning. It's now going on 1:30pm, and though I've been asleep for a lot of that I haven't seen her ducking under for poops. She's still eating and drinking, also urinating regularly, though something unusual is that she's chewing the towels and eating the paper bedding in the litterbox quite a bit today and yesterday. I wonder if she's bored? So I put in a willow stick with her, she's always liked those.

Scratch that, she ducked under for a poop just now but I can't tell if she got anything- I'm feeding her CC right now and she wasn't chewing very long, so I feel like it might have just been the remnants of the CC she was eating.

If she's still eating hay and drinking water on her own, I shouldn't be too concerned about blockage yet, right? I'm just worried since I've seen her eating at the paper and towels so much.

I've been continuing with the massage. Also tried putting her on the dryer for vibration for a few minutes, no idea if it vibrated enough to be effective or not.

Also continuing with flushing the scab- no change today.

bpatters
And got the T-shirt

Post   » Thu Jan 21, 2016 6:37 pm


Chewing things is often a sign of pain. Is she on any pain medication?

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Zaphy

Post   » Thu Jan 21, 2016 9:10 pm


Yes, she's on Rimadyl still- it's a 5 mg/ml solution and her prescribed dose is .35 ml. I asked the vet and he gave me permission to give her half again if she still showed signs of pain- I've only done that a handful of times these last few weeks. She's still chewing the towels, though she stops when there's a willow stick available to chew instead. She does have plenty of hay and still eats that too.

She's passed a few droppings this afternoon, phew.

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Lynx
RESIST

Post   » Thu Jan 21, 2016 9:26 pm


You're still weighing daily right now? I would ask the vet if you could get some Meloxicam as a pain med. These days it is often prescribed and seems to be fairly effective.

I agree with bpatters that the chewing is more likely to be a sign of pain.

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Zaphy

Post   » Fri Jan 22, 2016 12:23 am


Yeah, she's been plateauing at one weight, then over the course of a day or two she'll suddenly drop 20-30g, then she'll plateau again, etc. Today she was back at 920g.

How does Meloxicam differ from Rimadyl, is it just a stronger NSAID? Would upping her dose of Rimadyl again for a while accomplish the same thing as switching medications?

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Lynx
RESIST

Post   » Fri Jan 22, 2016 8:08 am


All I can say is that in the 17 years Guinea Lynx has been around, we started out recommending Rimadyl and somewhere along the way it ended up being supplanted by Meloxicam. This is years ago.

I think it was to a great extent not used as much due to the flexibility of Meloxicam (dose rates can better be adjusted).

I don't have a scientific reason for suggesting it, just that it is much more frequently used and seems to work fairly well. The entry for Meloxicam does not indicate there is a range but posts here show varying doses for guinea pigs.

See: gl/analgesics.html

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Jaycey
Supporter in 2014

Post   » Fri Jan 22, 2016 11:31 am


I remember when I had to swap my arthritic piggy from Metacam onto Rimadyl because it caused digestive problems, I think it was Talishan (sorry it it wasn't you) that mentioned Metacam is harder on the kidneys and Rimadyl the liver, but they're very similar drugs.

I think in the UK we probably use Metacam (Meloxicam) more often as it's in liquid form and piggies tend to like it. The Rimadyl (Carprofen) I had was in tablet form and I had to cut them up and dilute them myself.

bpatters
And got the T-shirt

Post   » Fri Jan 22, 2016 11:36 am


My guess is that long-term use of either one has significant side effects. Most pain meds do, particularly the NSAIDs. You just have the weigh the benefits and the liabilities. You can't leave a pig in pain.

Talishan
You can quote me

Post   » Sat Jan 23, 2016 5:01 am


Rimadyl is an older drug. Vets have used it for ages in dogs, and many are more familiar with it.

Metacam is, in my experience, more effective, especially in short-term use (i.e., postop), but you can get the occasional pig to have problems with it. We've had several pigs get hyper on it, and one to basically just crap out (I thought he was close to death) after he had been on it for arthritis for four full weeks. We also have two on it right now for arthritis who are having no problems whatsoever, so there you go. I never had any sensitivity or reaction problems to Rimadyl, so basically if a piggy has trouble with Metacam, I ask for Rimadyl.

What concerns me more is that Violet seems to be regressing a little here -- evidence of pain, scant droppings or reingesting all of her droppings, maybe a touch of GI upset. I think it's a good idea to resume her Critical Care.

The standard advice on scabs is to rip them off and to continue to flush until the tissue fully granulates from the inside out/up from the bottom to the surface. I've never been able to do that, at least not exactly that way.

Might be worth a call to the vet.

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Zaphy

Post   » Sun Jan 24, 2016 1:18 am


Since re-upping her Critical Care feedings her poops have become regular again (though still a bit soft and teardrop shaped). She's also fighting the feeding less. I'll ask my vet about Metacam at her next followup appointment Monday morning.

So I tried to take the scab off today- obviously she wasn't going to let me grab it enough to rip it all off, but I was able to saturate the scab with saline enough to soften it a little and I could grab a couple very small pieces (<1mm) with tweezers. Next I enlisted the husband to hold her vertically/at a slight belly-up angle while we bribed her with a baby carrot to keep her from struggling. I picked off a few slightly larger pieces of it, then I held a warm compress to it for a minute or two, as long as she tolerated it, then I picked off a couple more pieces. I gave up picking after a while and gently wiped it with the compress, which got pretty much everything that was loose off. There's still a couple pieces that I thought were going to come off... but maybe not.

Here it is after all the attempts to get the scab off- you can see the flap I was trying to get hold of last at the bottom of the wound.
Image

Talishan
You can quote me

Post   » Sun Jan 24, 2016 7:59 am


That's looking better to me. More granulation and less what looks like dried pus.

Let us know what the vet says tomorrow.

You have done a fantastic job with a condition that is very difficult to care for. Kudos to you (and husband) and carry on.

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Lynx
RESIST

Post   » Sun Jan 24, 2016 8:34 am


Oh, it looks so much better!

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