Hemangiosarcoma in cavies -- advice needed

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Post   » Thu May 31, 2018 6:39 pm

One of our piggies has been diagnosed with cancer at age 4 and a half and I'm hoping to draw on everyone's experience and ask for some advice.

A mass was found on her spleen recently after her appetite declined, and we opted to have it removed. The vet ended up taking out her whole spleen, and also her ovaries, which had cysts on them. Unfortunately, the mass turned out to be cancerous, specifically a hemangiosarcoma.

This type of cancer is almost exclusive to dogs, where it's extremely aggressive and even after removal, survival is usually limited to a few weeks. When the cancer metastasizes, it usually results in a burst tumor that causes the animal to bleed out rapidly and sounds like an awful way to go.

However, it's very rare in piggies, and of the three vets we've seen in this process, none seemed to have seen it firsthand. One of them did refer to this paper about an 18-month-old piggy who lived another 17 months after a splenectomy with this kind of tumor. I've searched the forum here and found a handful of other posts that suggest this kind of tumor doesn't necessarily always metastasize in piggies once removed, but there aren't a lot of data points to go on. Luckily, her liver biopsy was clear and the surgeon saw no immediate signs of metastasis elsewhere, including her lungs via x-ray.

The big concern now is that our piggy's surgery was three weeks ago and her appetite still has not returned other than some occasional nibbling. So we're still spending a lot of time syringe feeding, and have also begun giving her sub-q fluids this week after she had a bad bout of diarrhea last weekend (we think due to the cisapride she was on). The diarrhea took so much out of her that we thought she was going to pass earlier this week (she was very sluggish and largely unresponsive), but once we started giving regular fluids she rebounded surprisingly fast and is actually starting to show just a little interest in eating on her own today. She's even harassing her sister and showing some other signs of typical piggy life.

So two questions: previously we worried her lack of appetite was due to the cancer having already spread, but is it possible everything else she's been through (massive surgery, loss of organs, bad diarrhea and dehydration) could be what's making her not want to eat instead?

Second, does anyone have experience with hemangiosarcoma in piggies and what happened after the tumor came out? We were starting to make arrangements to euthanize because she was so lethargic and not eating, and we still wonder if we should be ready for that outcome in the near future. But based on her improvement in the last day since starting fluids, we're hoping we may get a few more months with her if there's a realistic possibility that this form of cancer isn't going to rapidly take her down, as it does in dogs.

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Post   » Thu May 31, 2018 7:57 pm

I don't have any experience with pigs and hemangiosarcoma, so can't comment on that.

But any major surgery can cause lethargy and lack of appetite for several days, particularly if the pig is on post-op meds, especially an antibiotic.

Good luck with her, and do keep us posted on how you're doing.

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Post   » Thu May 31, 2018 8:42 pm

I am sorry she is not eating well enough post surgery. The article you linked to, the abstract mentions this guinea pig survived for 17 months.

Perhaps an appetite stimulant might help?
Diazepam (given intravenously, intramuscularly, or by mouth according to Harkness and Wagner) is one of several drugs that can be used to stimulate the appetite. Diazepam (also known as Valium) can encourage eating within a few minutes and will last up to a half hour but also causes sedation and ataxia [loss of coordination of the muscles, especially of the extremities].

Cyproheptadine (Peri-Actin 4mg - 1/8 pill, twice a day) has been used as an appetite booster by some vets.


Post   » Fri Jun 01, 2018 10:19 am

Thanks for the well wishes. She's doing something strange that I wonder if you all might have some insight into (and I'm sorry for the long winded posts, we're just so worried about her).

She's become quite bright and alert since we started giving the daily fluids two days ago, so the only way you'd know she's sick now is that she isn't eating. I'd expect an animal with no appetite to avoid food entirely, but it's often the opposite with her: when we bring greens to the cage for her and her sister, she can spend 5 or 10 minutes nosing around in them, almost gumming them, very interested in checking them out, just not actually eating them. It's almost like she wants to eat but forgot how.

Here's an off-the-wall idea. To give you a better idea of the timeline here, her appetite first declined in mid-March and we immediately started syringe feeding her, which is when we found the abdominal mass via x-ray. However her appetite spontaneously came back in full force after a week, so we decided not to put her through surgery, but that only lasted for maybe three weeks before she stopped eating again and we had to schedule in the procedure after all (in retrospect we're glad it happened this way, because it's likely this type of tumor would have eventually burst and killed her if we didn't get it out).

In other words, she's been subsisting almost exclusively on Critical Care for the better part of two months now, both before surgery and during recovery right up to now. So is it possible that so much syringe feeding has somehow made it difficult for her to eat normally? Something about her teeth or mouth or throat that may have become irritated or just... not operable in some way? Maybe I'm grasping at straws here, and none of the vets we've seen have mentioned this as a possibility, but my gut is saying that she wouldn't act so curious about food if she didn't have some instinct to eat it. So I can't help wondering if something else is in play here besides the cancer or post-op (which has been over three weeks now).

Just to make the thread less depressing, here's a pic of the little sweetie in healthier times.


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Post   » Fri Jun 01, 2018 10:42 am

My guess would be that the lack of hay while she's been on the Critical Care diet has allowed her molars to overgrow, and she can't chew and swallow normal food. I'd want an evaluation by an exotic vet with rodent dentistry experience ASAP.

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Post   » Fri Jun 01, 2018 8:34 pm

Ditto bpatters.

She is a lovely little guinea pig.


Post   » Thu Jun 28, 2018 11:25 am

Thank you for the replies. I wanted to give an update on our piggy Gracie's situation.

Sure enough, she did have a dental issue -- but unfortunately it's more severe than the simple malocclusion our primary vet expected. She found a big lump in the back of Gracie's mouth that she couldn't diagnose, so she sent us to the closest vet school (two hours away) for a CT scan and anesthetized exam.

In short, Gracie has a bony growth on her jaw that's interfering with her chewing. They did a biopsy and there's no immediate evidence that it's cancerous, so they don't know what's causing it. There were signs of infection, so they've put her on marbofloxicin and chloramphenicol, but they aren't sure these will make much difference. The only real cure would be a major surgery that might end up having to remove part of her jaw, but we can't put her through that much pain in good conscience, and the vet is worried it would interfere with her jaw function and was hesitant to recommend it anyway.

What's so difficult is that Gracie's brightness and energy have rebounded dramatically in the last couple of weeks. We've ramped up her daily Critical Care to 60cc and she seems to be putting a little weight back on, and she's now acting like her old piggy self--running out to greet us in the morning, wheeking for breakfast, climbing up on the side of her cage, running around in circles. She's always excited to see us, and she actually seems to have an enormous appetite because she tries and tries to eat regular food, but it seems to be getting harder for her. Even with softer foods like lettuce she's often picking them up, trying to chew them, and then letting them drop again. It's so tragic to watch because it's obvious she desperately wants to eat, her mouth just won't let her.

To add insult to injury, there are no signs that the hemangiosarcoma has spread elsewhere. So we're basically in what feels like an intolerably cruel situation where she may have actually beaten her cancer, but this separate oral issue is likely to do her in anyway. I don't know if there's any real advice anyone can offer here, but I guess I needed to type this out somewhere for my own sanity. After months of health problems, vet visits, surgery, and a cancer diagnosis, seeing our beloved piggy act so full of life, and knowing she's systemically healthy other than this simple obstruction that's stopping her from chewing the food she so obviously wants to eat, is one of the most heartbreaking things I've ever seen. It's so hard for my mind to reconcile the vibrant piggy we see running around in front of us with the decisions we may have to make for her in the relatively near future.

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Post   » Thu Jun 28, 2018 11:33 am

You're in my thoughts. I hope SOMETHING can help her improve. Sending warm hugs and best wishes.

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Post   » Thu Jun 28, 2018 11:48 am

Lumps in bones are generally very painful. That would have to count for a lot with me when trying to decide what to do.

Hugs to you and Gracie, and keep us posted.

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Post   » Thu Jun 28, 2018 11:05 pm

I am so sorry about this. Not fair after all you both have been through. I hope she has as many more good days as is possible.


Post   » Tue Jul 03, 2018 5:04 am

I hope you have a lot of good days tougether

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