Hibbert's medical thread - teeth problems and possible bloat?

calico88

Post   » Fri Mar 16, 2018 7:39 am


Hello all,
Hibbert went to the vet last Thursday with a slowly decreasing appetite and not eating his hay and pellets, though he was eating soft foods. He was sedated and had 2 x-rays done, a blood test, and all teeth examined. He had his top and bottom incisors trimmed due to the top ones being at a painful angle, two small bladder stones removed, and was diagnosed with some bloat (likely cause he would only eat a bit of parsley, banana, and softened pellets - vet warned that banana is off the table now) and an infection that pointed to possible fatty liver disease. He was put on Metacam (pain med) for a week and chloramphenicol (antibiotic) for 2 weeks. He also got some Beta-bac.

He hasn't been able to feed himself since the vet visit a week ago. I've been syringe-feeding him daily about 40-50 cc's worth of about 75% pellet slurry and 25% Critical Care in 4-5 feedings a day. Pellets are timothy hay pellets from KMS Hayloft. For the first 2 days, he couldn't pick up food at all, which I assume is cause of the teeth trim. He's now been able to scrape pureed food off with a spoon and pick up large pieces of food to move around, but he still cannot eat on his own. He tries to tear food through the side of his mouth, which sort of works but he still has trouble getting the food into his mouth. Smaller pieces of veggies or blades of grass just fall out. If I stick a piece of hay in his mouth, he is able to eat that. His appetite seems to have gotten back to normal; he really wants food, but he can't feed himself.

The vet has been keeping in touch regularly and when I brought up his teeth troubles yesterday, he thought Hibbert might still be in pain. He has stated that Hibbert's molars looked fine and overall Hibbert's condition is a mystery as his teeth condition wasn't horrible originally. However, the Metcam has made no difference in him. We are concerned with his stool, as it has been really small the whole week, though it's coming out at a nearly normal rate. The vet recommended to see if the teeth problem will resolve on its own first, as his experience is that you can go back and forth with teeth filings and it just causes more problems.

Just a FYI, I picked a vet that was on the recommended list (Dr. Peckham of Bellaire Blvd Animal Clinic in Houston, TX).

Questions:
1. How long should it take for Hibbert to get his normal teeth back? I've read posts where pigs with completely missing or broken teeth are able to eat on their own, so I'm concerned. His bottom incisors are a little uneven, but one of them looks like it should be good enough to meet his top teeth.

2. I just learned on these forums that I should be feeding Hibbert 100cc's worth of food. However, he has maintained his weight of a little over 1200 g the whole week, and he does have that small stool problem. Is he constipated? Is it gas/bloat? I've been giving him .15 ml of simethicone once in a day and upped the amount of water I syringe in him to make sure he gets about 60 ml a day.

3. I noticed Hibbert's bottom jaw is a bit shifted to the side, and he twitches one cheek. Could it be due to the uneven bottom incisor?

Appreciate to any who reads this. I know it's long!

lawngnome78

Post   » Fri Mar 16, 2018 7:53 am


So sorry to hear about little Hibbert. You are doing a wonderful thing for him, caring for him so much.

If the meds that your are giving him are by mouth, I wonder if they aren't effective because of his intestinal tract not moving well enough to get them into his system? I recently experienced that with my pig and the vet ended up giving us injectable meds to help.

Have you tried a vibrating pad to put him on and a hideaway for him to be under? I made one out of a massager and blankets, I just put it face down on some blankets and let him set near it and that can help get the intestines moving.

I suppose it could still be teeth, but it sounds like he got a thorough exam.

I'm no expert; there are many people on this forum who are, and will help you, but I wanted to at least offer the little knowledge I do have.

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Lynx
RESIST

Post   » Fri Mar 16, 2018 8:17 am


I encourage you to read all the pages in the teeth area. I don't know if the teeth were cut too short (www.guinealynx.info/teeth_broken.html , for example) or if there is a temporomandibular problem. Getting a second opinion would be warranted. You might ask your vet if they would be willing to get a second opinion on the xrays from a veterinary dentist experienced treating guinea pigs. The teeth pages should point you in the right direction.

I don't know about the fatty liver disease. I just learned that a deficiency in biotin can cause this condition in chickens but don't know if it would equally cause the problem in guinea pigs. How did the vet diagnose this? (what blood values, etc.)

You are doing a great job hand feeding. You might up the proportion of CC in your mix for now.

bpatters
And got the T-shirt

Post   » Fri Mar 16, 2018 11:38 am


If the incisors were slanted, he almost certainly has a problem with the molars or with the jaw.

calico88

Post   » Fri Mar 16, 2018 10:02 pm


@lawngnome78 - Thank you for the kind words! I didn't think about the meds not being absorbed properly. I'll ask about that the next time we're at the vet. I ordered a vibrating pillow for infants. I'll see if that helps.

@Lynx - Thanks for the link! I'll see if the vet is ok with sending out the x-rays. That's a good idea. The vet told me yesterday that feeding Hibbert will help resolve the fatty liver disease issue. I'm not exactly sure what it is either, but the vet diagnosed it from a higher than normal level of A.T.L from Hibbert's blood test. Unfortunately I don't know what that stands for, but the vet said it indicated an infection, most likely from the liver. If I remember, I'll ask during the next vet visit. I really appreciate the encouraging words about hand feeding! I'm a tired piggie mom from doing the hand-feeding several hours a day and sleeping less so Hibbert doesn't have to wait long overnight until breakfast, but at least Hibbert is thriving despite not eating on his own.

@bpatters - It's hard to figure out what the real issue is, but hopefully the vet can finally find something with the next vet visit tomorrow. Thanks!

calico88

Post   » Sun Mar 18, 2018 8:44 am


Hibbert got another vet visit yesterday. Good news is that he's making progress. His appetite is excellent and the vet noted that this time, Hibbert's mouth was cleared of food, which means he's not having trouble swallowing. The vet noted that last time, Hibbert still had a lot of food in his mouth despite fasting for some time (as requested by the vet to see his molars easier). Vet said some issue with Hibbert's molars was the original problem, and possibly some internal issue as well. The original problem appears to be out of the way.

Now it's to help Hibbert with his teeth so he can eat on his own. Vet said that his molars are too tall, which is causing Hibbert to have his mouth hang open and preventing him from eating on his own properly, despite his incisors growing back. This explanation makes a lot of sense, as I've noticed that Hibbert will have a squeaking or louder crunching sound sometimes when I make him eat a strand of hay. Vet explained that molars can be filed down, but it is a risky procedure as gpig's mouths are so small, and you're going in there with a diamond drill bit to try to level out tiny teeth. The best action right now is to try to get Hibbert to level down his molars on his own. I have been feeding in individual strands of hay into Hibbert to get used to eating tougher material (as he's been eating the pellet slurry), and the vet recommended that I keep doing that as that will work the molars a lot. Vet also trimmed his incisors a bit to force Hibbert to use his molars more. Now it's another week of hand-feeding, but this time trying to work hay into Hibbert while syringe-feeding. This will be a slow process...

So @bpatters- you guessed right!

@Lynx - I forgot to ask about A.T.L., whoops. As for the slurry, the vet said a good timothy pellet and CC are practically the same nutritional content, which I confirmed with the nutritional labels, so nutrition-wise, it doesn't matter what proportion I mix. I'm putting in more pellet slurry cause Hibbert hates CC, but I put in some CC fine grind anyway cause it makes the slurry easier to work with.

User avatar
Lynx
RESIST

Post   » Sun Mar 18, 2018 11:02 am


Have you read EVERYTHING on the teeth pages?
www.guinealynx.info/teeth.html

It is also possible the roots are elongated. A chin sling could help but ONLY if the molars are brought down to the level they should be. Examine all the pictures in the teeth section, esp. the illustrations. Make sure the vet has taken proper dental xrays and still consider getting a second opinion.

I strongly suggest seeing a veterinary dentist who has dealt successfully with guinea pigs. Note the link to the The Academy of Veterinary Dentistry page.

bpatters
And got the T-shirt

Post   » Sun Mar 18, 2018 12:24 pm


You need a new vet. I don't care what kind of recommendation the one you've got has, I wouldn't take my pig back to him.

You don't "fast" a guinea pig for a vet to be able to see the teeth. In fact, I can't think of a single reason why one shouldn't be fasted unless it has a intestinal obstruction. And the incisors don't keep the molars from working -- it's the grinding action of the molars that keeps the incisors ground down.

The best exotic vets in Houston are at Gulf Coast Veterinary Hospital. I use Dr. Dan Jordan at Animal Medical Center of the Village. I don't know whether he has exotic dental experience or not, but I' ve been perfectly satisfied with him otherwise.

calico88

Post   » Mon Mar 19, 2018 11:31 am


@Lynx - I did read everything, but it's taking time for me to figure out what information is useful. Sorry, I've been flooded with guinea pig medical info for over the past week, so I'm now having a hard time deciphering what I need. I did make contact for the chin sling. I did check out the Vet Dentistry page. Unfortunately the closest for small animals would be about 5 hours away.

@bpatters- I considered your feedback and decided that Hibbert does need to be seen by a *third* vet (the first vet was nice, but didn't do anything at all). I'm looking around at all my options and making calls.

Thanks all. It's been a long and stressful 2 weeks, with 4 vet visits, lots of $$$, and having to syringe-feed regularly. Lots of tears cause I don't know how this is going to end. Hibbert is fortunately generally still happy but he's got to eat on his own. Sorry for a bit of a rant.

A note, I just learned about a ECM specialty for vets. Perhaps putting a note about this in the vet list section could help people find a good vet for their pigs, which has been absolutely difficult for me. Here's a link: https://www.aemv.org/index.php/abvp-ecm-certification-process. Who do I go to with that suggestion?

bpatters
And got the T-shirt

Post   » Mon Mar 19, 2018 11:48 am


As I understand it, that certification has nothing to do with the treatment of animals.

lawngnome78

Post   » Mon Mar 19, 2018 6:25 pm


Calico,
Hang in there, dear. I'm sorry your and Hibbert are struggling. I know how stressful and consuming it can be to try to make sure to do the right thing. It can make your head spin!
I hate that there aren't as many vets who are as educated and experienced with our pigs as there are cat and dog doctors in this country. They give us so much love and are just as important as other pets.
Keep feeding the guy and watching his poops, make sure he gets enough water and take it one day at a time! We are here for you! You got this!

User avatar
Lynx
RESIST

Post   » Mon Mar 19, 2018 8:15 pm


I understand your worry and tears. Teeth issues can be difficult to treat - and we are here, on the internet -- we can't see your guinea pig and are not veterinarians. So we are only speaking from what we know. You have our sympathy.

calico88

Post   » Sat Mar 24, 2018 6:10 pm


@lawngnome78 and Lynx - thanks so much for the kind words. This has been an incredibly frustrating experience, particularly with getting the right vet. Any support is really appreciated.

Update:
I made arrangements with the best cavy vets in town, Gulf Coast Veterinary, specifically Dr. Antinoff. They certainly aren't cheap, but I decided that I better just go for the best than risk having to go to a *fourth* vet (I didn't mention the first one, he was nice but didn't do anything). Dr. Antinoff used a different dental examination tool than the previous vets and saw right away that Hibbert had an overgrown molar on his left side that was blocking his tongue. Finally! A real diagnosis! Because Hibbert was shifting his jaw to the right and was pulsing his left cheek, she also did a neurological exam, which basically requires poking each side of his face to test his reaction. Fortunately he passed, which meant that the jaw shifting wasn't a neurological issue but almost certainly due to the overgrown molar on the left side. She did the molar filing on Hibbert, which she said went well, and he is now recovering with pain meds and antibiotics. I don't know if the antibiotics are standard with molar filings, but Dr. Antinoff stated that he should continue the antibiotics that the previous vet prescribed.

The bit of good news is that as I was taking a few days to research and arrange for another vet, Hibbert was doing really well. He started eating chopped leafy vegetables by himself, was gulping down hay that I hand-fed to him, loved to roam around during free time, and squeaked for food often. The introduction of more solid foods was getting his previously tiny stool back to normal, and I had to up the amount I was syringe-feeding him to about 60 cc to maintain his weight, probably cause he was getting more fiber that was getting him to poop bigger stools.

It's been a day after the molar filing, which required sedation, and the poor pig isn't himself yet. He'll eat a bit of chopped romaine lettuce by himself, and has eaten a bit of hay himself as well, but hasn't called out for food. He doesn't really want to move. He doesn't struggle when I syringe-feed him like he was starting to (when he started eating some solids, he was *so* over the pellet goop!). From the vet's instructions and reading other tales of molar filings, this sounds normal for a few days. Does anyone have any experience on how long the recovery period takes? The vet also recommended I massage Hibbert's jaw. Is using an electric toothbrush much more effective than by hand?

I'm crossing fingers that Hibbert having to be sedated twice in 2 weeks didn't seriously damage him somehow. Ugh, I wish I knew to go to this last vet in the first place!

bpatters
And got the T-shirt

Post   » Sat Mar 24, 2018 6:54 pm


Did they give him any pain meds? It's very hard for even a good vet to keep from nicking the tongue/gum/cheek during a molar filing, so it's painful to eat for a few days.

I believe most pigs start to eat again by themselves after 2-3 days.

And I agree with you that Antinoff is the best exotic vet in town.

calico88

Post   » Sat Mar 24, 2018 7:36 pm


@bpatters- Hibbert does have Metacam. The previous vet had prescribed him 2 weeks worth after the last incisor filing, and said to use if needed. Hibbert didn't need it so I just saved it. Dr. Antinoff said to go ahead and use that Metacam now. I don't know how effective it is - Hibbert whimpers when he eats a bit of bell pepper - but at least he is swallowing his pellet slurry with no issues.

A fun note, Dr. Antinoff is actually allergic to guinea pigs so she had to wear a mask to examine Hibbert! That didn't stop her from providing great care. I believe Dr. Sue Chen is also one of the Gulf Coast vets that is an exotics expert.

Another note for any other Houstonians, I did ask the Animal Medical Center of the Village for information and they do molar filings as well. Based on their estimate, they would have been roughly $200 cheaper. I was just at the point of losing sanity so I went with the best in town to give Hibbert the best chance of finally getting over this soon.

bpatters
And got the T-shirt

Post   » Sat Mar 24, 2018 8:46 pm


I actually found Dr. Jordan at AMC of the Village because Gulf Coast referred me to him. I had a guinea pig with a bladder stone. Gulf Coast gave me an estimate of $1600-$2400 to remove it, and I just didn't have that kind of money for it. When I asked if I could do time payments or if they had other suggestions, they suggested I contact him. They'd had a number of referrals from him when he had a patient he wasn't comfortable treating, and they'd been impressed with his knowledge and care. I've been very happy with him.

calico88

Post   » Sat Mar 24, 2018 9:26 pm


Wow, that's an insane estimate! I've had a guinea pig undergo bladder stone surgery and it was more like $500. Good to hear that about Dr. Jordan. I plan on trying AMC of the village for future cavy vet needs after this particular issue is resolved.

User avatar
Lynx
RESIST

Post   » Sat Mar 24, 2018 10:13 pm


Sounds like you will be weighing daily, hand feeding to maintain weight, and giving pain medication. It can take a while to eat on his own. I hope he gets better! I am also very glad you found a good vet.

calico88

Post   » Mon Apr 02, 2018 7:25 am


Update - Unfortunately Hibbert hasn't improved much compared to before molar trim. He has a re-check exam scheduled today and we'll see what Dr. Antinoff says. Right now he's perky and seems like he doesn't have trouble eating anything he wants to, but he refuses to touch his pellets or hay. It's been a frustrating *fourth* week of syringe-feeding. Here's what happened this week in case this info becomes useful later:

Days 1-2 after molar trim: Sleepy during the day, a bit more active during evening. Would eat a bit of romaine lettuce and bell pepper.

Days 3 after molar trim: Started to eat blades of grass that I handed to him. Squeaked once in evening for food.

Days 4 -5: Started gagging more and more during syringe feedings, even though I hadn't changed the formula and made sure it was thick. He would cough up some of the slurry liquid. I switched to 100% pellet slurry (no critical care, which he never liked), and this helped some, though it's harder for me to syringe through. Would eat a bit of hay if either handed to him or mixed with something (like a basil leaf, or some grass). Improved activity level - started to demand food more in evening. Liked munching on grass for a little bit outside (own backyard, no pesticides).

Days 6-7: Not good. Appetite went down, and slightly decreased activity level. Lost 20 g. Would grab veggies or grass, nibble, but then just let go - if he was even interested. Not interested in grass outside. In a desperate move, I skipped his day 7 evening dose of antibiotics and gave him simethicone in case he was having bloat. He improved around evening of day 7 as he was perkier. I switched back to pellet and CC mix after a stuck syringe fiasco ended up with pellet slurry stuck on ceiling. Very little gagging issues.

Day 8: Improvement. Gained back 20 g. Activity level normal. Appetite good, though he wasn't eating anything he should be. He munched on grass for nearly an hour. Very interested in my potted plants (which I promptly moved away) and ate some of my seedlings (argh!). Not interested in his usual favorite veggies (would grab but never finish - and these are very small half-dollar size portions), but was happy to demolish 2 leaves of yu choy (Chinese leafy green veggie - kinda like spinach). He would have likely eaten more but I am careful not to give him very much outside of recommended veggies. Refused to eat hay, even though he is capable of eating it.

User avatar
Lynx
RESIST

Post   » Mon Apr 02, 2018 1:33 pm


I sure hope he does improve. I understand how frustrating it can be to get some guinea pigs eating again after a molar trim.

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