Emergency-- meds and dosages for bloat

chii
I Love Lucy

Post   » Mon Jul 09, 2007 10:19 am


I have a rescue pig with bloat-- I'm at the clinic I work at and just snapped an x-ray to confirm. No vets will be here for at least another 45 minutes. I read that I can give Cisapride... anyone know the dosage on this? How is it usually administered? Any other meds that may help? He weighs about 1 kilo.

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Lynx
Celebrate!!!

Post   » Mon Jul 09, 2007 10:37 am


It's in the guide under motility drugs (I'm pretty sure).

TX Rustlers

Post   » Mon Jul 09, 2007 11:40 am


Reglan (Metroclopromide) sub q 0.1cc and pain meds Bupronex

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rshevin

Post   » Mon Jul 09, 2007 2:38 pm


My pig has also received Cisapride orally at approximately 0.1cc/kg q12h although concentration isn't noted on the bottle. He receives a big sub-Q of lactated ringers at the vets and some thing injectable that they never tell me what it is and I was too frazzeled to ask. I always combine this with simethicone 0.2cc 2-4 times a day.

chii
I Love Lucy

Post   » Mon Jul 09, 2007 4:55 pm


After speaking with several exotics vets in our area (my usual vet of choice is out of town for a week!), we used the ultrasound and tapped his stomach and cecum, pulling off 200cc of gas. It appears that gas is reforming in the stomach as of the last x-ray I took about half an hour ago, but he was comfortable enough after we removed the gas to eat a little hay on his own. I suspect we'll have to tap him again though.

We started him on Reglan 1mg q3-4h and Simethicone 1cc (yes 1.0) q8h. I've given him small (10cc) doses of LRS, but I'm hesitant to do more than that at a time as I've had suspicions that he may be a heart pig. We're also giving him Burprenex q6h.

The vet I spoke to seemed very knowledgable... we discussed the risks of the various treatment options, but I agreed with her that we should pursue the most aggressive treatment possible as quickly as possible.

He seems to be stable right now, but our biggest concern is torsion. Our vets aren't experienced reading exotics radiographs. I'm encouraged that he's eating some although it's only a little. If he's still stable by the end of the day, I'll be sending out his x-rays to the radiologist with the labwork.

Thanks for all the responses... by the by, the piggy is Perriwig. Please keep him in your thoughts.

cutemomomi
Obey My Authority

Post   » Mon Jul 09, 2007 5:08 pm


Please feel better Perriwig, we send you ninja vibes and good thought.

Talishan
You can quote me

Post   » Mon Jul 09, 2007 8:29 pm


This is what my veterinarian has prepared for rabbits. Modify for a cavy:

***********************************

Normalize body temperature FIRST – be sure not to overheat!

Administer Analgesics for Pain Relief
Flunixin meglumine (Banamine) for up to 3 days usage
1-3 mg/kg IM or SC every 12 to 24 hrs
Contraindicated in animals with kidney disease
Sulfasalazine (500 mg tablets)
1/8 to ¼ crushed tablet per rabbit every 8 to 12 hours
Butorphanol

Subcutaneous fluids (warmed LRS) - 100 ml/kg/day divided every 8 hours

Restore Gastrointestinal Motility
Cisapride given at 1- 1.5 mg/kg every 12 hours
Metoclopramide given at 1 – 1.5 mg/kg every 12 hours
(May work best using both medications in combination)

AVOID in cases of TRUE OBSTRUCTION

Stimulate appetite
Vitamin B Complex added to the fluids
Cyproheptadine 4mg tablets or 1 mg/ml oral liquid
Give 1 mg per 4-6 lb rabbit every 12 hours

Prevent/Treat Enterotoxemia
Questran (Cholestyramine) – 2 grams suspended in 20
ml water every 8 hrs PO
Antibiotics only if indicated (Trimethoprim-Sulfa 48 mg/ml
dosed at 30 mg/kg every 12 hr)

Syringe feed if not eating - liquid important to soften/rehydrate stomach contents
Oral fluids (no sugar) 10-20 mls every 8 hours
Papain and Bromelain powders (health food stores) – in
pedialyte
4-6 Tbsp. softened rabbit pellets soaked in Pedialyte
Combine with vegetable baby food
Blend ingredients in blender and feed with syringe
First day (rabbit) - feed 20 ml every 6 hours (4X per day)
- increase to 30 to 40 mls every 6 hrs until eating well on
own
Vegetable baby food - 15 ml/kg every 6 hours

Critical Care for Herbivores (Oxbow Pet Products) may
also be utilized

Fresh, wet, leafy greens – 4 cups per 5 lbs of rabbit daily
Kale, mint, basil, dill, cilantro, tarragon, sage, fennel,
parsley
Snip ends off stems and wave under nose, place in
mouth, or tap face

Pediatric gas relief simethicone liquid ( 20 mg / 0.3 ml ) – to reduce gas pain
1 to 2 ml once an hour for 2-3 doses

Exercise can help get the gastrointestinal tract moving again

Administer gentle abdominal massage (head down, rear up) several times daily

***********************************

I would add gentle sessions on a massage pad or muscle relief vibrating pad, to tolerance.

Good luck with him. Please let us know how he's doing.

[edit 12/22/2019 - adding link to useful article - Lynx]
http://www.bio.miami.edu/hare/ileus.pdf

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amy m guinea

Post   » Mon Jul 09, 2007 8:32 pm


I'm thinking of Perriwig. I went through the same thing recently, although it sounds as if your piggie is having a worse time of it. She was on Reglan and Metacam for 5 days. I gave some Simethicone, but not regularly.

She has recovered but for some reason will not eat pellets, but has gained weight due to CC mixed in with pumpkin.

Is he eating hay only? My vet had Jenna on hay only for almost a week (and hand feeding CC).

chii
I Love Lucy

Post   » Tue Jul 10, 2007 2:40 am


First of all, thank you all for the kind comments, especially Talishan for the detailed treatment regimen info.

Perriwig is still hanging in there. I took x-rays on him throughout the day and by late afternoon, he appeared to have a significant buildup of gas again. We decided to tap him again. This time we only drew off 45cc, which was encouraging compared to the 200 we drew off earlier. I really thought based on the x-rays that we'd get much more. I did follow-up x-rays and there was still one large bubble of gas around his cecum, but we decided to hold off on tapping him again. About 1.5 hours later, I did another set of x-rays and they look the most normal of any so far. The large bubble of gas appeared to be gone, though there is still a lot of gas in his intestines and some in his stomach along with fluid. We're unsure if he has stomach torsion or not, but sent off the radiographs to the radiologist (with a STAT request) for interpretation. I should have the results back early tomorrow.

I'm now just trying to keep him stable tonight. He IS still eating, albeit very small amounts and only of hay. I didn't have pellets at the clinic today, but tonight he is back in his cage with hay and pellets. I'm hoping the pellets will entice him to try to eat more. I'm encouraged that he's eating at all since I would suspect that if he had torsion, he wouldn't feel like eating. Perriwig is very big on veggies and it makes me sad that I can't give him some... I think it would make him eat more, but we can't risk it. At this point, I have not force fed any at all, but I may gently offer Critical Care tonight with a syringe and see if he's interested.

Does anyone think that pellets are NOT a good idea at this point? From what I know, I think they're OK, but if there's any contradiction, I'll remove them.

At the advice of the wonderful exotics vet who helped me over the phone today, I've been keeping Perriwig pretty well drugged on Buprenex. This particular vet feels that good pain control is critical in treating cases of bloat, though I feel like he's more sedate and less likely to eat when it kicks in (this I decided just from observation).

My vets have made it extremely clear that Perriwig's prognosis is still very grim, but that being said, I can't help but be impressed by this little pig. Even at the worst of it, he was hanging in there, and when relieved of some of the gas, he is eating and moving around and enjoying being petted like always. He feels so thin now compared to his normal self, it's scary, but he is FIGHTING. As long as he keeps fighting, I will too. My vets talked with me earlier today about how far I wanted to pursue treatment and how they suspect torsion, but with none of them being exotics vets and me having seen how he's still fighting and eating, I'm not willing to give up yet.

If he does have torsion, he will not be able to survive surgery and I'll have to put him to sleep, but as of now, my gut says it's not torsion. What pig with torsion would will move around and eat? He's not eating large amounts, but he IS eating. And he's still alive. That says a lot to me.

If Perriwig pulls through this, what special care/dietary needs will he require? I've read that bloat can tend to recur. Should he have a special diet or other special care to prevent future occurrences? Or is it a freak random thing that just happens? I've never had a pig with bloat survive, so I have no idea what to do if we get through this critical phase. I need advice and lots of it. At this point, if he does survive and requires special care, he'll probably be permanently adopted into the rescue as a sanctuary pig. He's an old man... and he's the sweetest pig. I don't want a random episode of bloat to end his life.

Hang in there, Pig-Wiggle. You've come this far...

maremma

Post   » Tue Jul 10, 2007 7:07 am


Did you send ALL the xrays to the person who can read them most accurately? If he originally had a torsion the wise decision to remove all the gas may have actually relaxed him enough to have it move back to the correct position and hopefully in time that no permanant damage was done.
As shocking as it was to me, my Sweetpea actually kept right on eating her hay until the moment I pulled her from her pen to rush her to the vet with severe bloat! Her stomache had turned inside of itself as well. Apparently torsion doesn't always mean total refusal to eat!

She had to have the gas removed from her too. I chose to have her sedated and a tube put down her throat to get it out. The vet got all the gas out and re-xrayed her to see if the stomache relaxed back into normal position after the procedure. Thank God it did and again thank God we caught it in time that it did not cause necrosis. She was also given a grim prognosis even after the gas was off and her stomache returned to normal. (She is still with me 1 year and 8 months later so do not give up hope!)

Please do feed him small and very frequent amounts of criti care mixed with pure pumpkin with lots of acidophilus or benebac mixed in it along with all his fluids. (I just very recently discovered that feeding her pumpkin with her criti care snacks is a tremendous help for her gas)
Do not allow him to eat to much at one time so he has fairly even amounts of food moving through his system at one time but not so much that it slows him down. You sure do not want stasis setting in. Fruits are an absolute no and very very few veggies are safe for Sweetpea. I am pretty sure the same is true for any guinea pig that has bloated.

I have discovered that Sweetpea has a whole lot more trouble if she doesn't keep eating small amounts all day long. If she woofs something down really fast she will surly be sitting on her massager or if she stays laying in bed to long. Keeping them moving is very very important once you rule out torsions.

Please be very careful about giving him so much simethicone. It doesn't help them toot out gas. It works by causing smaller gas bubbles to form into one larger one. That of course can be deadly to a bloat guinea. If the gas bubble is to big he sure can't toot it out, especially if it is stuck behind a lot of food working its way through his system. (thus why smaller more frequent food is better for them)

If Sweetpea has a tiny amount of gas it helps her but only if I give it and then use the massager to help it help her toot it out. If she already has to much gas it is not given to her because it makes everything far worse.

I really pray you are mistaken about his heart so he can safely have the reglan and cisapride. Sweetpea also has a heart condition and cannot have those type meds because of it.

I ma praying for your little man.

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Sef
I dissent.

Post   » Tue Jul 10, 2007 8:53 am


Talishan,
Maybe just a little too early for me yet, but what were you referring to when you said, "AVOID in cases of TRUE OBSTRUCTION"?

I want to print out this info and keep it handy.

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JudiL-MetroGPRescue
Poop Obsessed

Post   » Tue Jul 10, 2007 2:57 pm


Talishan, your vet has a wonderful plan. It sure is all-inclusive. It sounds like it should be written up for the 'references and first-hand accounts' section.
Maybe just a little too early for me yet, but what were you referring to when you said, "AVOID in cases of TRUE OBSTRUCTION"?
Sef, she was referring to the Cisapride and the metoclopramide. They are both gut motility drugs and if there is a true blockage in the gastrointestinal tract, the drugs could have devastating effects.

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