Heart meds for heart murmer?

capybara
Supporter in '13

Post   » Mon Aug 06, 2007 1:23 am


Thanks for the ideas. We tried getting a hold of our vet Saturday, but when he finally called back, it was so much later than we expected, we somehow missed the call, and he had already gone home.

I'm almost certain it must be the Chloramphenicol causing Chester's excessive thirst/peeing. I know they can drink more due to pain, but there's nothing I can think of that would be causing any more pain to him now than what would have before he was getting the Chlor. And his behavior doesn't seem to indicate he's feeling bad. We've been giving him Metacam every other day in case his toe was sore and to see if it would help reduce inflammation. The crazy drinking and peeing only began a couple days after we began the Chlor.

His appetite is still ok, and his weight has held steady the last several days, so I don't think the Chlor is making him crash or destroying his appetite. It just seems like it's making him really thirsty. I really would hate to take him off it because it's the only thing that's reduced the swelling in his toe.

I hope we can get some answers tomorrow as to whether or not this is a possible side effect. We have had two other pigs on Chlor before and it did not affect them this way.

capybara
Supporter in '13

Post   » Tue Jan 15, 2008 2:23 pm


It has been far too long since we have visited the board or update this thread, but Mr. Capybara and I have some news on Chester, and are in need of advice.

I will try to keep it short and to the point, but I apologize if it gets long.

First of all, an update on the original topic of the thread--Chester's heart condition. Chester started getting a recurring runny nose that convinced our vet to let us do a trial of Enalapril. (All we could get at the time, which seemed better than nothing.) He had been on Bactrim for it several times, which would clear it up, but then it would come back. It seemed localized within the sinus--no congestion was ever heard in his chest, and cultures of the gunk from his nose never showed anything exciting.

Starting November 16 he was on 0.25 CC Enalapril once every other day for about 2 weeks. We didn't see much behavioral change although his runny nose seemed a little less worse. With our vet we decided to switch to 0.1 CC Enalapril once every day. During this time, Chester had 2 blood tests, none of which seemed to indicate any bad change to his kidneys. I only recently learned that only Creatinine was tested, but the vet felt there were no adverse affects.

Bad news is, early in December, Chester had blood in his urine. We thought it had to do with his interstitial cystitis he is on Polycitra for. He had not had blood in his urine for nearly 2 years. A vet visit confirmed a peppercorn sized bladder stone. Because of his heart murmur and other health problems, we and our vet felt that Chester is not the best surgery candidate. So we decided at that point to monitor this particular stone. Over the next several weeks, we continued with his 0.15 CC 2x daily Polycitra, added half a tablet of shilintong daily, lots of extra water syringes, and 0.15 Metacam every other day to try to limit the stone's growth and/or see if by some miracle he could pass it the way TWP's Sully did. No more blood showed up in his urine, but no miracle stone was passed either. We got another x-ray on January 7 and unfortunately there is now a second stone the same size as the first.

We decided with our vet that the Enalapril didn't seem to be making enough difference to continue using it, although he felt that it was unlikely the stones could have formed that fast by Enalapril affecting the kidneys. So Chester is off it right now while our vet wants to look into Lotensin. The runny nose seems to have gotten a little worse, but overall the Enalapril seemed to make little difference.

We are really not sure what to do. I feel in my gut like Chester may not survive a surgery. He's probably about five years old, with the heart murmur, and was slow to return to normal after anesthesia for a non-invasive cat scan. Just last night we noticed his eye with the osseous deposits in it has become blood red, like a blood vessel may have popped. The iris part of the eye looks cloudy. I'm scared the eye could be dying. We are trying to get him seen by an optometrist at UW ASAP. Seeing his poor eye just makes me feel sick.

I want to give him the best chance we can, but at the rate these stones have formed, I also feel like removing them might be a great risk if it all turns out to be futile. It seems so common for them to form over and over, like what happened with our Peppi last year and what I read about constantly here. I don't want to feel like we aren't giving him every chance, but I also have a great fear that the surgery will be too much a strain on his little body and we will either lose him during surgery or put him through pain that will be worse than if we just give him the best we can until the end.

Has anyone here had a heart pig or pig with multiple health concerns get through a surgery like this ok?

User avatar
Mum
I GAVE, dammit!

Post   » Tue Jan 15, 2008 3:58 pm


He's probably about five years old, with the heart murmur, and was slow to return to normal after anesthesia for a non-invasive cat scan
Heart pigs are always very slow to return to normal after anesthesia if they're not on heart meds.

Do try and get him on Lotensin. 1mg/kg twice daily works for all my pigs.

I wouldn't put him under anesthesia without having him on heart meds.

I'm sorry you're facing so many difficulties with this boy.

User avatar
Lynx
Celebrate!!!

Post   » Tue Jan 15, 2008 5:36 pm


You have my sympathy. I understand your reluctance to remove the stones surgically. Were you giving pain medication? Do you think it would help? Sorry I don't have answers to all your questions.

pinta

Post   » Wed Jan 16, 2008 3:22 am


Coincidentally I just received this info from an email from Vicki of JPGPR. She said it was okay to post with the caveat to mention that the article is old and hasn't been updated recently:
____________________

From Vicki of JPGPR:

Below is information I wrote regarding Actigall/Ursodiol several years ago. Most of the info. is still valid, however I now use
pretty much just KM Hayloft timothy pellets and various grass hay (such as bluegrass, orchard, timothy) for all but growing,
pregnant, or malnourished cavies.

There is an email list devoted to bladder and kidney stone problems. I suggest you contact this list for further ideas and
information.
Email stones@gpigs-database.org
Web site http://gpigs-database.org/
--------------------------------------------------------------------------------

9/2000 Short Summary of My Experiences With Cavy Bladder Stones/Sludge

I do have quite a bit of experience with stones - we've had dozens of surgeries done to remove them. Many years ago I made it my goal to learn as much about stones (causes, treatments, prevention) as possible. I contacted many cavy experts all over the country, and Vedra Stanley-Spatcher at the Cambridge Cavy Trust in England. At that time Vedra told me about a human drug, Destolite, they were using on cavies with bladder stones. My vet cross-referenced Destolite and found it is the same thing as Actigall here in the states. Actigall is a human drug used to dissolve gall bladder stones, which are made up of cholesterol.

We don't know why the Actigall would work on bladder stones as the composition is different from gall bladder stones. Unfortunately there have been no organized studies done on using Actigall on cavies so we don't know why it does sometimes work, what percentage of stones it actually helps with, or if it works better on certain types of bladder stones than others. All I can say is, it does seem to help break down some stones and it does seem to sometimes help keep sludge broken down enough to pass through.

I do have one instance where a sow was X-rayed, showing a good sized stone in her bladder. I started Actigall immediately as I could not get her in for surgery for a few days. On the day she was to have the stone surgically removed, my vet took another X-ray, the stone was gone. All that was left was a hazy puddle of grit, which the sow was able to pass on her own.

I've used Actigall on countless cavies, for very long periods of time. We have not noticed any bad side affects from it. Actigall is expensive, $3 or more per capsule. If you're only treating one or two cavies it isn't so bad, but at one point I had about half dozen cavies on it as a preventative for reoccurrence of stones. Finally had to discontinue that as I literally couldn't afford it. There is now a generic version, Ursodiol, that is a little cheaper.

About the same time we started using Actigall I also made some diet changes that seem to have helped reduce the instances of bladder stones in my herd. I switched from Cavylets pellets to L'Avian Guinea Pig (See update below, I currently feed Oxbow Cavy Cuisine) and started feeding much much more grass hay. I also started giving a whole food supplement called The Missing Link (www.designinghealth.com). I use the equine formula but the dog/cat vegetarian formula is virtually identical. Apparently some or all of these changes helped, as surgeries to remove bladder stones are now few and far between. KNOCK ON WOOD! We have had more cases of bladder sludge though since the diet chances. But this is generally easier to deal with and usually doesn't require surgery.

The vet that originally helped me with the Actigall has since moved too far away for me to frequent, but we still keep in touch and I do see her once in a while for second opinions. She has asked me to not give out her name and phone number. If your vet is interested in talking with her directly about Actigall or our experiences with bladder stones, please have them get in touch with me. I will see if it's OK to pass the contact information on to your vet. My email address is JPGPR@aol.com.

I have also tried potassium citrate to prevent reformation of stones. It's doubtful potassium citrate will break up stones. My vet is skeptical as to whether it was helpful in prevention either. The idea is to change the urine PH, making it less conducive to forming stones or sludge. I've had several cavies on potassium citrate for months, without a significant change of PH. For now I've discontinued using it, but am willing to try it again if I think it will help in a future case. I have heard from other cavy owners who believe potassium citrate has helped their stone or sludge forming cavies.

It is important that owners realize surgery, done by a veterinarian knowledgeable and experienced with cavies, is usually the best way "and the only immediate way" to remove a bladder stone. There are risks of ongoing irritation, infection, pain, damage to the bladder wall, and even obstruction while waiting to see if the Actigall will be effective. Your veterinarian may be able to decide if your cavy can wait after taking an X-ray and examining your cavy to see how it is doing and feeling with the stone. In cases where a cavy is not a good candidate for surgery the Actigall is certainly worth a try. My current vet has little faith in Actigall working on cavy bladder stones, my previous vet thinks it does work in some cases for stones/sludge.

More Recent Update (3/2002): I fed L'Avian Guinea Pig Food for about 2 + years before switching to Oxbow Hay Co. cavy food a couple years ago. I now use a mixture of half Cavy Cuisine/half Cavy Performance. Cavy Cuisine is a timothy based pellet, Cavy Performance is an alfalfa based pellet.

For a while after making the diet changes we started seeing more cases of bladder sludge than bladder stones. Now we don't see many cases of either. Any cavies that do form stones or sludge are put on the timothy based Cavy Cuisine rather than the half and half mix. I HIGHLY recommend this food for cavies with bladder problems.

User avatar
Lynx
Celebrate!!!

Post   » Wed Jan 16, 2008 8:35 am


Interesting. I did a search on Actigall and mostly found references to its use for gall bladder disease. KM found a patch that can administer a continuous amount for her dog. Older discussions included mention of its use in combination with polycitra and not knowing what would help. Comments by Josephine that it will NOT dissolve large stones and you still need surgery. Comments that vets were skeptical about using it.

There are not many people who have used it on their pig in this forum so there is no overwhelming evidence it would help. I think it would be great if it did though.

I will reformat your post to remove the weird tags.

User avatar
Mum
I GAVE, dammit!

Post   » Wed Jan 16, 2008 9:17 am


I do have one instance where a sow was X-rayed, showing a good sized stone in her bladder. I started Actigall immediately as I could not get her in for surgery for a few days. On the day she was to have the stone surgically removed, my vet took another X-ray, the stone was gone. All that was left was a hazy puddle of grit, which the sow was able to pass on her own.
About the same time we started using Actigall I also made some diet changes that seem to have helped reduce the instances of bladder stones in my herd
Hmm, interesting. Looks as if we should start our own GL study on this drug! And I'm pretty sure we have enough pigs for a study :-)

pinta

Post   » Wed Jan 16, 2008 10:20 am


It seemed pretty benign as a treatment and worth mentioning.

User avatar
Mum
I GAVE, dammit!

Post   » Wed Jan 16, 2008 10:25 am


Pinta, I do think it's worth a try. Quite of a few pigs on this board are not fit for surgery, and at that stage - if this was my pig - I'd definitely give it a try.

In fact I'm about to email somebody who has a 7-year old pig with an inoperable stone to see if she wants to consider this.

capybara
Supporter in '13

Post   » Wed Jan 16, 2008 1:45 pm


Lynx, yes, to answer your question, Chester is on Metacam every other day at 0.15 CC. We were hoping it would alleviate possible pain and reduce inflammation in case the stones could possibly pass but I think they're just too big. Luckily they are not currently near the opening of the bladder to get stuck but we're watching diligently.

Mum, I will give that dosing info for Lotensin to our vet. He was not against trying it but was having trouble finding a recommended dose for GPs.

And Pinta, thank you for sharing the info on Actigall! I'm going to print this out and fax it to our vet. It sounds like there are no bad side effects, and it is definitely worth a try for Chester even if it's not proven. I hope my vet can get some for us.

Chester is at UW vet school with my husband today to check out what happened to his eye with the osseous deposits. I hope it's nothing horrible.

Thanks to all of you!

capybara
Supporter in '13

Post   » Wed Jan 16, 2008 7:12 pm


Chester is home from the vet and luckily the bad looking eye is just infected. They guessed it might be more susceptible to infection because the osseous deposits cause it to bulge. I was so afraid that something really horrible had happened to his eye from those deposits! I've seen eye injuries before and it looks just yuckier in general.

We're to put Triple Antibiotic Ointment and Ciprofloxacin in it 4x daily. I'm not familiar with the Ciprofloxacin, but UW school has always been good about prescribing safe meds so I am assuming it's fine. Is anyone familiar with it?

Glad this wasn't bad news but wish we could figure out the right way to deal with the stones. Our vet researched a non-invasive treatment that uses powerful sound waves to break up stones so they can be passed out in the urine. It would still require anesthesia but for less time, and no surgery. Unfortunately, Purdue University where they can provide this treatment does not have any equipment that can focus on a small enough area to benefit a guinea pig.

User avatar
Mum
I GAVE, dammit!

Post   » Wed Jan 16, 2008 7:28 pm


Poor boy!

I believe Cipro is the next generation of baytril.

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