Sounds like you found a good vet. I hope things work out as well as they can in the guinea pig health department.
Dammit! Despite triple-checking myself (or at least thinking I was-- the vet gave me syringes in units to dose Benji's Buprenex), I dosed the Buprenex wrong. I gave Benji 0.2ml when his dosage range listed on the bottle is 0.02-0.06ml (we wanted to start at the low end). This is 0.3mg/ml concentration, and from what I'm reading on the medications page here as well as on other sites, dosing for guinea pigs can go as high as 0.1mg/kg. So, given that (please correct my math if I'm wrong), Benji received 0.06mg, still within the safe range for his weight of just under a kilo.
Can someone please confirm that I haven't given my pig a lethal dose of Buprenex? I gave it around 6:30pm (it's now almost 11pm) and just now, as I glanced at the bottle while walking by realized in horror my mistake. God, and I seriously stood there for five minutes with that syringe making SURE that I was dosing it correctly. I guess I was concentrating so hard on making sure I was certain about the ml equivalents (one unit = 1/100th of a ml), I misplaced a decimal when I actually measured the dose.
If it were going to cause any severe reaction, wouldn't it have done so by now? He looks very out of it, but he's still eating.
Ahhhg, I am SO furious with myself right now!
Anyone? :( I just need someone to recheck my math here...
I wish I knew Chii, maybe someone will come on soon who knows. Good luck.
He seems OK, but realllllly out of it. I've been going over the math again and again, and I'm still getting that I gave him 0.06mg, which is supposedly an acceptable dose according to the guidelines on the medications pages (which states that 0.05-0.1mg/kg is safe). I'm just horrified because the dose I gave him is SO much higher than what the vet prescribed. And if the dosing guidelines here say the proper dose is so much higher than what the vet says to give, then... well then AGG, I'm just confused now!
Is it according to his weight maybe?
Can't be... or rather, it can't be based on the dosing guidelines here. According to my math, the 0.02ml dose that's at the bottom of my range that he can have is equal to 0.006mg. The high end of his dose (0.06ml) would be 0.018mg. Neither of those is even anywhere close to the 0.05-0.1mg/kg dose range, even given that he weighs less than a kilo. So now I wonder where the vet got his dosages. I guess maybe the doses I've been finding here and online could be post-surgery doses, which are usually much, much higher, but I have no idea.
I hate math.
You have some Cavy Health Record Books around, no? I have a page to aid calculations. Don't know if it will help you but I tried my best to make it understandable.
What I often find is after I calculate a dose, I go at it in reverse to check if it is correct. Sorry I wasn't up to help you.
Hope all is ok Chii.
Oh! I should have thought to look in there, Lynx.
At any rate, everything is well. Benji is just fine. I really do think that what I gave him was actually within the safe dosage range for guinea pigs. I'm now wondering how he'll respond to the minuscule dose the vet prescribed. Guess we'll try it and see.
I'm waiting until this afternoon or evening to dose the Buprenex again just to make sure that the massive dose I gave last night is completely out of his system before giving him more.
PS- I hate whoever came up with the "units" measurement. Why not just SAY 1/100cc or 0.001cc? It makes me nervous every time, even though it's so simple.
I understand the unhappiness with the units measure. I am totally a cc person. 0.3cc, 0.05cc, anything cc. We know what they mean by tenths or hundreths of a cc.
You did give him 0.06, which is within the guidelines here and elsewhere, as you have found. Dr. Dan is saying 0.006-0.018, so your calculations are correct.
Buprenex is a strong sedative, and I'm going to take a guess that the safe doses you found are indeed for post-surgical use.
My husband says that narcotics often work 'linearly' -- that is, the more you give, the greater the effect, in a simple, straight relationship. NSAID's often have a 'threshold' -- that is, up to a certain dose it does nothing, then it works.
So: I'm guessing 1) you didn't hurt Benji at all, and may have helped him a little given his stressful day, and 2) Dr. Dan wants to use a very low dose to start, hoping that will help his orthopedic problems just a little ... then, if more needed, a little more ... etc. until he is comfortable.
My uneducated opinion *only*.
Time for an update. Benji is doing well in some respects, not so well in others. He's now maintaining his weight almost completely on his own. I had been worried the last couple of days because he had been rejecting his hand feeding after less than a syringe full (I use a 12-cc syringe). I was worried that after a day or two of this, I'd see residual weight loss, but amazingly, he's still maintaining. I guess the tooth trim really helped in that respect.
The bad news is that I'm seeing almost no improvement in his rear legs. He still can't walk, though I do feel like at times, he's trying harder to move. He's actually look like he *wants* to walk forward, but can't quite make it. I think having him on the good pain meds (Buprenex) accounts for him feeling better, but he obviously still can't walk yet. He's now to the point where we've halved his Pred dose to start reducing it, but he's shown no improvement yet. I need to call Dr. Dan tomorrow to ask him if we should continue the Pred longer. (He has been on Pred for 6.5 days now.)
I'm still giving him fluids twice a day just because I'm paranoid and because his stool has been soft-ish, probably from the antibiotics. He does drink from his water bottle, but with the soft stool (it comes and goes), I don't want to risk him getting dehydrated.
Oh, also-- Dr. Dan had me putting Chlorhex lotion/cream (available at most vets) on Benji's feet to help with the bumblefoot sores. Let me just say that this stuff works like magic! It makes the Carefresh stick to his feet, but I clean that off every morning and they're continually looking better and better underneath. I feel like it gives the same effect as foot soaks, but it lasts for hours and moisturizes better, plus it provides a protective coating. I just slather a bunch on all of his feet before bed and leave it. (I don't think I'd use as much with a pig that could reach around to wash, probably just a thin layer, but since Benji can't move, I think he needs more protection.) I wish I'd had someone suggest this when I had Miss Pea. The lotion I found at my vet is called ResiChlor-- it's sold with the prescription shampoos for dogs and cats. It's just a leave-on chlorhexidine lotion. No other active ingredients. I highly recommend trying that or something similar for pigs with bumblefoot.
I added your recommendation to the pododermatitis page. Glad you've had some success.
" ... though I do feel like at times, he's trying harder to move. He's actually look like he *wants* to walk forward, but can't quite make it."
This is the first step.
Be patient. It may be weeks more before you see improvement.
It looks more and more like Benji's reaching the end of the road. Dr. Dan isn't encouraged by his lack of response in this past week. He says there's no point in continuing the Pred any longer than planned as it will only reduce the initial inflammation. He says the only things I can do are to wait and/or try acupuncture therapy. He's seen acupuncture do amazing things for pigs, so as long as he's not in pain, I'll probably consider it. I'm going to let him finish off the Pred first and see how he does. Dr. Dan doesn't do acupuncture himself, but he can refer me to a vet who does. Back when I had Miss Pea, we were experimenting with acupuncture with Dr. E to help her bumblefoot, but she passed away before we got a chance to see if it did anything for her. I may try to consult with Dr. E about the acupuncture if this is the route we're going to take.
If nothing helps, I can't see any option but to put him to sleep. It's not fair for him to spend his entire existence sitting in his pigloo and only coming out when it's time for me to feed and medicate him. It's sad because other than the walking problem, he's doing so well... I just wish this had never happened to him. I have no idea how he ended up with a herniated disk, but I wish to god it had never happened.
I spoke with Dr. Dan about his euthanasia process. After reading the recent thread about it, I'd like to make this as painless as possible for him if that's what we have to do. The vet says he usually gasses them and then does a cardiac stick. I asked him about Propofol, but he says that he'd have to hit a vein to use that, and poking him so many times would probably be more traumatic than simply gassing him. He says that he can give him a valium/ace injection prior to gassing to make the gassing less traumatic, so I guess that's the route I'd probably go. I could have this done at my own clinic, but I've really come to like and trust Dr. Dan, and I just want to know that if I have to do this, it's going to be done in the most comfortable way for Benji.
If I don't see improvement in the next week and he's still eating well and not in pain (the Buprenex is working great), I'll go see the acupuncture specialist. I have to admit that I'm skeptical about how well it will work in Benji's case (he has so many problems), but I'm willing to give it a shot both for him and for the sake of trying new medical methods that may help other pigs in the future. The acupuncture isn't fun for pigs (poor Miss Pea used to cry a bit), but I don't think it's terribly traumatic for them. The needles are the tiniest things ever... much smaller than anything we'd use for fluids or injections. And who knows... it might just help him.
I'm worried about the cost, though. Things here can be so expensive, and when I did acupuncture before, Dr. E did it for almost nothing since she was just learning the techniques and wanted to get experience practicing them and seeing if they benefited the animals. I can probably get a discount since I work for a vet, but I just have this feeling that it's going to be awfully expensive, and will probably require very frequent trips that will be difficult to time with my work schedule. I know I'll work it out, but it's hard to let myself get too excited about it since there's a good chance it may not help him. I guess I feel like if he were a younger pig, he might stand a better chance, but at his age, and with all the problems we're seeing, it's hard to be optimistic.
I've never had a situation before where I had *time* to make a choice on euthanasia. It's so much easier when you know they are suffering and that it HAS to be done. With Benji, it's not currently so much a suffering thing as a quality of life dilemma. It's hard to consider letting them go when there's just one thing holding them back from having a normal life. It's a power I don't want to have to be the one to say "His life isn't good enough, so I should let him die." I wish he could talk to me and tell me "I'm miserable and I'm done with this life" or "I'm OK with this, just keep feeding me and taking care of me and let me live". It's because of this that I have to give him the time and a chance, but I worry that it's ultimately going to come back to the same dilemma. And admittedly, there's a selfish side to this, too. If I *did* think he was happy the way he is and decided to let him live his life out this way, it would be a commitment for the rest of his life to probably hand feed him multiple times per day, bathe him very frequently and apply lotion to prevent urine scald, rearrange him every few hours to ensure that he's comfortable, able to reach food and not sitting in his own waste. But then again, while those things can be selfish, I have to wonder if he wouldn't be unhappy living that way. Again, I just wish he could tell me.
On a random aside, I was trying to think of ways to encourage him to start trying to move on his own. I feel like he'll never recover if he doesn't do some sort of physical therapy, but I don't know what else to do besides arrange his legs for him in a comfortable position and hope he'll try to move. Do you think that having him visit with other pigs would make any difference? He's always loved to visit the womens (he's neutered). Would it be cruel to arrange a little visitation with a female to see if perhaps that allure could encourage him to try walking again? I don't think food is enough motivation for him. I try holding the Critical Care just out of his reach to encourage him to move, but when he just shuffles his front feet and doesn't move, I can't very well deny him his food because he didn't come to get it. He needs it to survive, so I give it to him. I just... I don't know how to do physical therapy with a guinea pig. Everything I've read about herniated disks says that pain medication, anti-inflammatories and physical therapy is crucial to recovery... I know how to provide two of those, but I don't know how to provide the physical therapy. Does anyone have any suggestions on things I can try to help him move again? I can't help but wonder if he's just so used to pain when he moves that he's not willing to try it. And I'm sure being sedentary for so long doesn't help... he's probably lost a lot of his muscle mass on his legs and the muscles that control walking.
Any advice? How long did it take for your pig to start moving (real movement-- walking) again, Talishan?
He never really 'walked' again, per se. He learned a kind of hop motion where his back legs together propelled him forward and his front legs did most of the work. He became amazingly fast at it, and I will assume his front legs and shoulders became quite strong, like a good butterfly-stroke swimmer. He could turn quite agile-ly, but only in one direction, to his left. He became very fast at that, too.
Our informal PT included 'walking' him -- we'd gently put both hands under his belly, lift him up and encourage him to make even just rudimentary walking motions with his feet and legs. I believe this helped maintain a minimal amount of muscle tone. He also slowly lost weight during all of this (he had other, digestive, problems as well) and ironically, that may have helped him. The lighter he was, the better he could move.
We'd also gently move his limbs, joints, feet and legs when we picked him up, cleaned him, medicated him or cleaned his cage. He never showed any indication of pain or stiffness.
I think reintroducing him to the ladies may help -- but cut it short if he becomes agitated, frustrated, starts thrashing around or something like that. I would think that would only do more harm than good, emotionally as well as physically.
'"I'm OK with this, just keep feeding me and taking care of me and let me live".'
This is the conclusion we came to with ours, though ours was, I think, more mobile and perkier than Benji (though he had plenty of down time, too). Now having said that, both my husband and I work odd and off hours, with a varying schedule (in his case) and a very flexible one (in mine). We also both work very close to where we live. We would arrange to meet at home to do things in the middle of the day that required us both to be there (or were easier to do if both were there). Most of the time one or the other of us was within no more than 2-3 hours of being home, or being able to be home. And even with all of that, it was a tremendous amount of work.
But very, very, very well worth it. For him, first, and for us, too.
I guess I'll just have to keep trying and see what happens. I'd be happy if Benji could just have the amount of mobility that you're describing. I feel like that would make his life worth living. Sitting in his pigloo all day, every day, day after day does *not* make me feel that his life is worth living. If he could just walk, even slowly, the length of his cage, I'd feel like it's worth it. I just want him to be able to do what he wants, when he wants. Go to his water bottle and pellet bowl without me having to position his face an inch away from them.
Only time will tell... I know that. And I'll give him time. It's just hard not knowing.
Sorry I can't offer any advice. Sounds like you will have to evaluate things as time passes. It does not sound like he has much of a life, as you point out.
Why don't you make him a cart - see the Roxy Roller thread in Reference. Roxy lost the use of her back legs and did great in her cart and actually regained the use of her legs in time. While in the cart, her legs began to start the walking motion.
She also got laser therapy from an animal physio therapist.
I've had the skinnies go thru acupuncture for roached backs. The only problem they had with it was being held up while the needles did their work. The PT used the same points for lasering and it helped enormously.