Heart failure advice please - Stan's thread

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squeaky3

Post   » Thu Aug 31, 2017 12:43 pm


Hello, I have been visiting the Guinea Lynx forums for many years, but never managed to sign up for an account until now! I hope someone can help me, as I am hitting a dead end with 2 medical issues I have with 2 of my guinea pigs at the moment.

I will talk about the first one in this post.

Just a bit of background - I've been keeping guinea pigs for over 20 years, and have been a member of the CCT off and on during that time. At the moment I am trying to rejoin, but not having a lot of success getting a response, so in the meantime I thought I would post here and see what people think.

I rescued 2 boars about 6 years ago, who despite both having bladder stones and bladder issues all their lives, were pretty much healthy and happy. In February, one of them suddenly developed severe breathing difficulty. I could not hear his heart or lungs, so I knew it was fluid retention of some kind. I searched high and low for some Lasix, but none to be found so I went off to the vet in the hope of getting some, at least to make Charlie more comfortable. However the vet wouldn't give any and during a rather vigourous examination, Charlie died on the vet table. Ok, I thought. He was old and in respiratory distress. There probably wasn't much I could have done.

6 months on, and Stan begins showing the same symptoms, but not as severe. Again, when I hold him to my ear, I cannot hear the characteristic lung whoosh noise and his breathing is lower and more laboured. There's a guinea pig dental specialist near me and I asked her to have a listen, but she wasn't sure it was fluid. She ruled out a URI though and suggested a decongestant might help. Later on in the day, I still wasn't happy with his breathing so headed off to the vets again.

Different vet. Before I told him what I thought it was I just asked him to listen. Be he still didn't think it was fluid. In fact he didn't think it was that bad. I suggested to him what I thought it was, but he also said it could be tumors. Fair enough I thought. Stan is an old boy after all. Any way, we both came to the conclusion that a little trial of heart meds would not hurt and would either improve the situation or rule it out. I asked about Frusemide and he said he'd never heard of it being used on Guinea Pigs! But he said he would try it, starting off with an injection. I'm not sure of the dose he gave, it might have been 0.2 or 0.4 ml subcutaneously. He was a little concerned that I would not be able to chop the tablet small enough, but I said I would give it a go, he wanted me to then continue with 1/8th of a 40mg tablet twice a day.

By the time I got home, Stan had done a big wee and his breathing had improved a lot. It was even better by morning, almost back to normal. I've given him his 1/8th of a tablet for this morning. The chopping is a little hit and miss.

These are my questions:
Does he need to stay on Lasix now for the rest of his life?
Is the only way to tell if there is still any fluid left to have an xray?
Will he need another heart med... as someone who has blood pressure issues myself I know that fluid retention is an effect and not a cause
Is the dosage ok, or would he be better with 5mg a day rather than 10?
Do you think the vet would be able to order the smaller 20mg tabs or liquid Frusemide or does anyone have any experience with the 40mg tablets?
Does the dose need to be super accurate - like I think some of the pieces will end up being 4mg and some 6mg, but over the day he will get 10mg
I am giving him extra water and I'll probably add a little banana to his diet for potassium and look up some other electrolyte type foods or add something like Critical Care once a week - any tips from heart pig owners regarding diet?
He does have a bladder stone. This could cause complications, but only the same ones as leaving the heart issue untreated. Anyone got experience here?

I am aware from reading other people's stories that often Lasix will improve heart failure for a while and then they will suddenly go down, I know it's kind of a palliative thing and there is no cure. But then he is somewhere between 6 and 7 years old so he's done really well, I just hate the thought of him in pain at all.

Thanks for reading my long post!

[Changed topic title - Lynx]

C Cole-Chakotay

Post   » Thu Aug 31, 2017 8:47 pm


I would keep your boy on Lasix. I had a girl that was on it for 5 years for congestive heart failure, and she did fine up until the day she passed. Tulip also took another medication (I can't remember the name) with her Lasix.

I'm sorry your boy has a bladder stone. Best wishes.

User avatar
Lynx
RESIST

Post   » Thu Aug 31, 2017 9:48 pm


You have read www.guinealynx.info/heart.html ? There are a couple medications that could help and be given along with the furosemide (Lasix). An xray could have shown either vet that there was fluid around the heart and perhaps in the lungs.

Some guinea pigs do indeed do fine on heart medications long term. I am sorry you lost your other guinea pig.

Talishan
You can quote me

Post   » Fri Sep 01, 2017 2:24 am


You are one of the first on here to recognize that fluid retention is an effect, not a cause. Kudos to you for that.

See if the vet will do a trial of benazepril (Fortekor). It's an ACE inhibitor. For many pigs, once benazepril starts helping, the dose of furosemide can be lowered or discontinued. Some pigs will be on both meds for the rest of their lives, but that can be months or years. Like humans, they can take these supportive medications long-term. It's a tweaking process.

Dosing on furosemide does not have to be ultra super-precise; what you're describing should be fine.

Diet I think would be more of a stone concern than a heart concern. Limit or eliminate high-calcium greens, and watch to make sure he does not become obstructed (that is, cannot urinate).

In my limited experience, pigs that form stones late in life tend to have slow-growing ones. Hopefully that will be the case with your boy.

Very best wishes to him. Please let us know how he's doing.

squeaky3

Post   » Fri Sep 01, 2017 11:23 am


Thanks for the replies.

I managed to get in touch with Vedra and I am heading up to the CCT tomorrow so she can examine him and possibly try a different med.

He's very sprightly today, so obviously the fluid was giving him a few issues.

Later on hopefully I can post about my other guinea pig who has a mystery eye issue! Vedra is going to look at her too.

Thanks again guys :D

squeaky3

Post   » Mon Sep 25, 2017 9:10 pm


So, I kind of let Stan's thread sink because Vedra seemed to think that Stan's problem was a fungal skin infection.

Even though he was responding to the Lasix, I trusted what she said and thought to try that treatment first. Well the skin has cleared up, but the breathing got a lot worse without the Lasix. So he's back on it, and of course it has improved. Also, his heart sounds fine to everyone who listens to it... which of course would suggest not a heart problem, except that the Lasix is the only thing which clears it.

OK, so now it's about week 4 I guess, and I did 3 separate trials of Lasix just to be sure it was not coincidence. His breathing is generally greatly improved on it, though it can be a bit up and down, and, as I expected due to his age, whatever is causing this does seem to be causing him some deterioration in general health. Then, other times, he is sprightly as a bee in spring and you would never know he is an old guy with a dicky ticker!

My main concerns now:

I'm not necessarily trying to fix anything, he is elderly after all.

He has 10mg Lasix (frusecare) a day in 2 doses, I have thought of trying to bring it down to 5mg a day as I am concerned about loss of electrolytes, but each time I decide to try reducing the amount, he seems to need the next dose. I know there was one pig on here who was on 12.5mg a day. There's no way I could split the tablet again into two 2.5mg pieces, so it would be 1 dose a day.

Tonight I found him covered in pee and he obviously had not been moving around a lot (I know lethargy can be a sign of low blood potassium) although I have been trying to give him potassium veg every day (most veggies have at least some anyway) I gave in and offered him some spinach which I generally avoid as he has had bladder stone issues. I have given him Dioralyte previously, but I have not worked out the concentration for using a smaller amount of the powder and he does not like it anyway, so it seems like a lot of waste for a few ml.

So I gave him a little wash in water to clean the pee off and he happily ate some carrot, then some spinach and a bit of spring green leaf and then a baby plum tomato. I cleaned his cage (it was due for a clean, he is peeing a lot now) and he perked up a bit and was munching hay and pellets, which he has barely touched the rest of the day (typical!) He did a pee on the fresh bedding so I know that there is no blockage.

I was wondering what other supplements people have used on their Lasix pigs? What veggies are good... I am still trying to avoid the calcium veg, although he has not had any bleeding now for over a year, it's possible the stone was small and he passed it or it broke up. He will try and eat most things, although he doesn't like banana.

Are there any good alternatives to Dioralyte? Or does anyone know the correct ratio of powder to water so I don't have to use the whole sachet just for 1 day's worth of rehydration?

Any help or advice is greatly appreciated!

bpatters
And got the T-shirt

Post   » Mon Sep 25, 2017 9:30 pm


Actually, there are other meds that can be used to help deal with heart problems, and can extend a senior pig's life by many months, even years. Lasix by itself isn't enough.

See http://www.guinealynx.info/heart.html for some more information. There's also one thread on heart disease, but I don't have a link to it. Maybe someone else will come along and post it.

squeaky3

Post   » Tue Sep 26, 2017 6:14 am


Thanks.

Noticed today a little stubborn patch of scurf, so back on the bathing routine and can't rule that out just yet, although surely the Frusemide would make no difference here?

He seemed to have been a little more active overnight, he way dry underneath and his pellets were almost all eaten. So we've had a bath and blowdry this morning. I used Vet-Sect repel and in a couple of days he will get shampooed in Dermacton. I'll do that for the next 3 weeks, as long as it doesn't stress him out too much.

bpatters
And got the T-shirt

Post   » Tue Sep 26, 2017 10:56 am


Is he having some particular problem that needs the pesticide shampoos?

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