Judith's Medical Thread: (Urgent) - Bloody Stool/Trying to Vomit

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seasterly1

Post   » Thu Jul 06, 2017 12:51 am


Hi there,

Writing urgently about my one-yr old female guinea pig. She had loose stool this afternoon (while she was incidentally at the vet). Just discovered her retching as if trying to vomit, and realized that there is a LOT of diarreah looking stool in her house, some of which is bloody. I picked her up and it definitely seems she is bleeding from her rectum. Any ideas? (Calling the vet simultaneously.)

Thanks in advance!

Sara

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seasterly1

Post   » Thu Jul 06, 2017 2:25 am


Update: I am at a 24-hour emergency vet. Not our primary vet who I trust wholeheartedly, but a reputable exotics center.

The vet said she felt a tubular "structure" in Judith's abdomen. Judith was squealing quite a bit while touched there... as she was today during her annual exam, but frankly at the time we simply thought she was being dramatic. (She squeals a lot when I massage her body too deeply, too.)

This vet is suggesting x-rays and blood work to determine if GI tract or urinary tract. Perhaps stones. She says they need to put Judith under anesthesia to do either, which concerns me a bit - my regular vet does x-rays without putting my piggies under. However, I don't want to stress her out anymore, either.

It is late so nobody may read this until I have to make a decision, but thought I'd check and reach out just in case anyone is reading and has thoughts.

Thank you, in advance!

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seasterly1

Post   » Thu Jul 06, 2017 3:35 am


One more update: proceeded with the anesthesia and X-rays, blood work.

Blood work normal - kidney and liver ok.

No signs of stones in bladder.

Ruled out GDB (flipped stomach).

Stomach does not look bloated but colon/GI tract is enlarged and has a lot of gas. Feces are larger and spread apart.

Vet thinks this could be early obstructive pattern. Catching very early whatever is going on, but right now can't tell what that is, definitively.

Vet wanted to give sub q fluids to rehydrate Judith and keep her hospitalized overnight. The vet said nobody is here overnight - Judith would be in an incubator with an IV that could be in her bone (and could break a bone), so I said i would rather bring Judith back home with me, where she will be more comfortable and I can watch her.

So we are being sent home with pain meds, antibiotics (one of these is also an anti-inflammatory). I'm planning to syringe-feed some water every 3-4 hours until I can get in to my regular vet (or back here, whichever comes first) tomorrow... both open at 8 am and it is 12:30 am here.

Vet is unsure about critical care and whether it would help or hurt - she is thinking it over while preparing the meds.

Talishan
You can quote me

Post   » Thu Jul 06, 2017 11:12 am


How is she doing now?

Fluids are essential. You were **absolutely** right to bring her home, but she needs fluids. Try offering her water or unflavored Pedialyte (infants' electrolyte solution) by syringe.

Did the ER give you any motility agent (Reglan or Cisapride are the commonest; Reglan's a bit gentler)?

My very best to her and to you. Please let us know how she's doing.

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seasterly1

Post   » Thu Jul 06, 2017 12:11 pm


Thank you, Talishan.

Last night's ER vet gave her an injection of Buprenorphine. And when I got home I gave her the Metcam, Metronidazole, and Enrofloxacian that they sent me home with. Per the vet's instructions, I gave her 4 cc of water via syringe (every 3-4 hours was their recommendation) and I was able to get her to take 5 cc of critical care. I gave her another 3 cc of water and 1 cc of critical care this morning at 6 am, roughly 3.5 hours later. (And I'm about to give her more.) She isn't loving the critical care and the vet ended up saying yes to it, but not to force it.

Thank you for mentioning the Cisapride (and the gentler version)! I asked the ER vet about that drug last night but at 2 am my brain was not working and I could not for the life of me remember the drug name. The vet looked at me blankly and so I did not get that.

Judith was in great pain when we first got home at 2 am. She seemed to perk up during the critical care feeding around 2:45 and started nibbling on the hay that was on my lap and her puffed out (pain) hair was coming down a bit. She was doing well around 6 am today but right now appears to be in pain again. I have a follow up appointment with my regular vet in about 90 minutes...

By the way, I was mistaken about the retching/appearing to be trying to vomit when I first saw Judith. Now that I'm not so panicked and have seen it happen more, I see that she seems to be trying to pass something painful form her bum -- hunches up in pain and makes a noise (of pain, I think) -- which at first reminded me of my dog when she is heaving and about to throw up.

User avatar
seasterly1

Post   » Thu Jul 06, 2017 12:13 pm


Also, I should have thanked all of you on this list for my insight to bring Judith home from the vet and not go the incubator route. That was definitely information/learning I have gleaned through the reading of so many others' posts and advice given here! Phew!

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seasterly1

Post   » Thu Jul 06, 2017 10:43 pm


Judith saw our regular exotics vet today, who diagnosed her with a bacterial infection in her colon. I have officially become a piggy pharmacy -- lots of meds for Judith to combat this. (My heart piggy is on three different meds ongoing, as well.) In any case, Judith is doing better, but then slipping into pain again -- in waves throughout the day. The bleeding seems to be slowing down a little. Judith is clearly much more comfortable at home than at the vet so I'm hoping we are on the other side of those rush appointments for a while. She is still on critical care and syringe-feeding water every 3-4 hours, in addition to the pain meds and antibiotics/probiotic.

Is anyone on this list familiar with bacterial infections in the colon, by chance? While at the vet I was in problem-solving mode, but as the day has progressed I am wondering if there was some way to prevent this? If perhaps some veggies hadn't been as thoroughly washed as they could have been, or something had gone bad, or something like that. Judith is the "bandit" of the group so if that were the case, she would certainly take the biggest hit with this, as she eats super fast and then sneaks bites of the other two's veggies. That said, her other two cagemates are just fine as far as their digestion is going.

Finally, does anyone have thoughts on keeping the herd together or separating Judy? Obviously I had to separate her throughout last night -- and today, due to all of her hands-on care and pain. She was briefly back with her two cagemates this afternoon, but they were picking on her (the baby, who is a skinny pig mix, was pulling out tufts of Judith's hair, and then the older 7-year-old piggy started to do the same. Judith remains in a lot of pain still, and was uncharacteristically just sitting in the corner while they were picking on her. So for now she is separated again.

Thank you in advance for reading and sharing any insights if you have them!

User avatar
Lynx
RESIST

Post   » Thu Jul 06, 2017 11:11 pm


I guess I would separate her too. Is the cage large enough you can give her a place of her own so she still kind of has company?

By the way, your description of the pain being associated with "she seems to be trying to pass something painful form her bum". This makes me think of possible stones.
www.guinealynx.info/stones.html

User avatar
seasterly1

Post   » Fri Jul 07, 2017 12:19 am


Thanks, Lynx. Yes, it's a 2x6 so I should be able to make a dividing wall work. Sadly she's still moving so little she won't need very much room herself.

I looked at that stones page last night, as well. The x-rays ruled out stones, though. (Hopefully that was a correct diagnosis!)

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Lynx
RESIST

Post   » Fri Jul 07, 2017 10:01 am


How long ago was the xray taken?

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seasterly1

Post   » Fri Jul 07, 2017 10:18 am


The x-ray was taken on July 5th - two nights ago, in the ER. Judith is doing quite poorly this morning - seeming to be losing the will to live (curling away from the water and critical care I'm offering, feeling limp, not interested in the lettuce or raddichio that semi-appealed yesterday). Would you recommend another x-ray this morning?

I should add that there is not a lot of stool coming out now.

Talishan
You can quote me

Post   » Fri Jul 07, 2017 11:48 am


1. Did your regular vet give you any motility agent(s) to help move the infected stool/ileus on out?

2. Was your vet able to identify a specific bacterium in her feces that is responsive to enrofloxacin? Part of her decline may be due to enrofloxacin (Baytril) further messing up her already thoroughly messed-up GI. Unless the bacterium causing her problem was isolated and identified as responsive to Baytril, I'd pull her off that.

3. Is she still on metronidazole (Flagyl)? Most GI microbes are responsive to Flagyl, and it's easier on the GI.

4. Less is coming out because less is going in. Forcefeed aggressively, 60 cc's/kg of pig daily (over a 24-hour period, split into as many small feedings as you can manage) of mixed-up Critical Care.

5. Is she still on pain medication(s) and if so, which one(s)?

Hang in with her. Pull out the stops and keep going.

User avatar
seasterly1

Post   » Fri Jul 07, 2017 1:57 pm


Thank you so much, Talishan. I just left my regular vet's office, and thankfully saw your note in time to ask about the Cisapride, which she thought was a good idea. She has no way to test the fecal bacteria (or could, but it takes 3 days to get results back), but does not feel the Baytril is causing problems because there is no diarrhea. Also, yesterday Judith had a temp of 104, which has come down today to 101 or 102 (now I am forgetting which, but the vet felt that the fever drop was a good sign).

Right now, Judith's medicine program is:
* Baytril (twice/day)
* Metronidazole (twice/day)
* Gabapentin (every 6-8 hours as needed)
* Metacam (once/day)
* Benebac (once/day)
*Cisapride (just introduced)

Vet ran more x-rays - still very gassy but the gassy area seems to have moved from where is was at the ER vet two nights ago. My regular vet (and another colleague) still thinks it is bacterial overgrowth, but has sent out the xrays to a radiologist to review and weigh in, as well. I hope to hear back soon -- it was requested "stat."

The vet is keeping Judith for a little while to administer an injection of fluids and lots of critical care, as well as closely monitor her for a bit, and will hopefully be calling me soon with more from the radiologist.

Thank you for your support to keep going and pull out the stops. It helps when others who don't have piggies don't seem to get it and I start questioning whether I've lost my marbles here. But she is just one year old and I really do not want to give up on her -- unless, of course, there is no hope and this is all inhumane. And it doesn't seem that way yet.

User avatar
Lynx
RESIST

Post   » Fri Jul 07, 2017 4:47 pm


Read over www.guinealynx.info/diarrhea.html too. It could be that Bio-Sponge might help with the gas, which is likely produced by bacterial growth.

I think Talishan would encourage you to split the Metacam dose to twice a day. How much are you giving?

bpatters
And got the T-shirt

Post   » Fri Jul 07, 2017 9:26 pm


Talishan definitely would, and I would too. I divide it in half, then add a teeny bit more, just to make sure the pig has full coverage.

User avatar
seasterly1

Post   » Sat Jul 08, 2017 12:04 am


Right now the Metacam prescription is for .3 ml once a day (at night). So split to .17 ml twice/day?

Here is the complete pharma program as of tonight (Judith is just over 2 pounds):

* Enrofloxicin (Baytril) -- 0.2 ml twice/day
* Metronidazole -- 0.2 ml twice/day
* Metroclopramide -- 1 ml twice/day (just added for upper intestine)
* Cisapride -- .05 ml every 8-12 hrs (added today for lower intestine)
* Benebac (probiotic) -- 1 gram once/day (AM)
* Metacam -- 0.3 ml once/day (PM)
* Gabapentin -- 0.1 ml only if looking very uncomfortable (vet has experienced other piggies get upset tummies from this, so we are backing off unless necessary in case that is aggravating her belly right now).

+ Critical Care -- 12-15 ml 3-4 times/day until eating
+ Water Syringe -- 3-4 cc every 4 hrs

Syringe feeding the critical care has been very stressful. Judith hates it and puts up a real battle. The vet agreed with me that she is a rather hard one in this area. I've added some fresh-squeezed orange juice to help it taste better, but the last feeding about 15 mins ago was still awful for both Judith and me. I am lucky if I can get 5-6 cc in during one sitting, and it does not feel very humane forcing her the way I am -- especially as I worry if she could aspirate ... though I am sticking with it, of course!

The second x-rays today were examined by a radiologist who said it was not obstructive, not stones. Stasis - not moving.

As of 6 pm Judith's temp was 100.4 (normal); she ate a little raddichio this afternoon and pooped just a bit. She was a bit brighter/less hunched at 6 pm but now is just staring at the wall, immobile and not interested in food/hay. I can see a big lump in her side belly now where the gassy area is presumably.

I'll ask the vet about Bio-Sponge tomorrow. That sounds promising.

Thank you! Thank you!

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Lynx
RESIST

Post   » Sat Jul 08, 2017 7:48 am


What technique are you using for hand feeding? I have found the one with feet on the counter, corralled in the crook of my arm, trying to go easy seems to work best. I ran across one technique where you cover their eyes with your hand while holding the head (don't recall the mechanics of it but the covering the eyes seems to help).

I think for the Biosponge to work, it has to be able to move through the intestines. I hope food is still moving through. I'm sure you've read www.guinealynx.info/emergency.html#bloat It is possible to massage the belly and help work out some of the gas.

I am hoping for the best for you both!

GrannyJu1
Armcavy

Post   » Sat Jul 08, 2017 10:10 am


Do you have someone who can help you? I found that if my husband held her, I could see to force the syringe in properly to feed her. I'm shorter and could see her mouth better from that angle. It was a little less of a struggle so less stressful for all involved.

Thank you for taking the time and money to care for Judith. It bothers me so much that most people consider guinea pigs (or any animal for that matter) to be throw-away pets. A pet is a member of the family and so deserves the best of care right along side of the kids. You are wonderful.

User avatar
seasterly1

Post   » Sat Jul 08, 2017 11:53 am


Thank you! I watched the YouTube video linked from the hand feeding page and it helped. Somehow at 3:30 am last night Judith and I found our groove. Wrapping Judith in a towel helped. I tried all four paws on the floor which did not work as well, but lifting up her front paws a bit and resting her back legs and body on my leg seemed to go better. (And repeating the mantra "pull out the stops" to myself over and over again - thanks, Talishan!) I was able to get 12 cc down, along with 4 cc water ... three hours later, found two big piles of poopy pellets in Judith's side of the cage! I just gave her another big feeding of critical care and water, and she gave me the gift of 7-8 wet, but almost normal-looking, pellets on the towel. She is still mostly immobile and not eating on her own, but looking a bit perkier and less hunched/puffed. And I no longer see the lump on the side on her belly where the gas presumably was.

Thanks for reminding me of the bloat page, Lynx. I had read it a few days ago in my research binge, but since the vet never used the term "bloat" I hadn't thought more about it. I will see if I can find a vibrating pillow today and will definitely try the massaging.

Thanks so much for your links, advice, kind words and support. Hoping it isn't long now until Judith's perky personality and interest in living return. She is the cage announcer to notice the fridge opening and veggies coming, and also quite a bandit stealing her cagemates' food and popcorning around. It is too quiet with her so sick!

Talishan
You can quote me

Post   » Sat Jul 08, 2017 12:18 pm


Keep going. Keep going. Keep going.

You're doing everything right. Yes, the gas bubble was moving (vet had x-ray right, radiologist not so much imo).

You're doing the right things. Cisapride is powerful but effective. It and metoclopramide (Reglan) work on different parts of the GI.

One syringe at the time. Keep going. Keep going!

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