weight loss in older piggy

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Tracy

Post   » Sun May 18, 2008 7:55 am


Talishan, is your hyperthyroid pig the same one with heart problems? Based on your earlier post, I read the thread about Bonita-asthma-heart, which was helpful.

I asked my vet about thyroid norms when we first tested Inca, and she provided them from a textbook (forgot which one); they are posted in the T-4 sticky.

She also does not recommend tapazole without a diagnosis of hyperthyroid because "we don’t want to inhibit the production of thyroid hormone if she is at a normal level." She went on to say that tapazole (methimazole) is not totally benign -- "it has other systemic effects (e.g., bone marrow suppression)."

Inca has always had a shiney, healthy coat (except during hair loss from ovarian cysts), but I wouldn't necessarily say "full" (as in extra plush?). Her coat is actually not as nice as previous years (maybe thinning out a bit), which I attributed to age.

We'll probably re-test for thyroid first, and then do an echo to check Inca's heart (unless my vet is willing to try heart meds without echo).

Thanks. And if anyone has had sucess with weight gain, please send along your tips.

Talishan
You can quote me

Post   » Sun May 18, 2008 5:56 pm


"I read the thread about Bonita-asthma-heart,"

Yes, that was her. She also had a number of other problems, including salivary glands in the wrong place, and a pedunculated mass from her anal area. We were at a loss to try to help her, hence the Tapazole trial. In the absence of desperation, I'd agree with your vet.

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Tracy

Post   » Sun May 18, 2008 9:10 pm


Too bad Bonita had so many weird things going on. But sounds (from that thread) like the heart meds helped, or do you think it was both heart meds and the tapazole? I doubt I'll try both for Inca -- probably one or the other to see if she improves. But yes, I think we are approaching "desperate" soon since diagnostics have not revealed the problem, and I'm struggling to manage her weight loss. Thanks

Talishan
You can quote me

Post   » Sun May 18, 2008 9:49 pm


1. Heart med
2. She had a true COPD-like disorder and also took Ventipulmin

The Tapazole trial did nothing. Didn't hurt her but didn't help her. We discontinued it after a week or so, maybe a little more.

The biggest help to her, although it didn't help her weight as much as it did her behavior, was benazepril.

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mmeadow
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Post   » Sun May 18, 2008 11:37 pm


A week may not be enough to see results from the Tapazole. Tracy, maybe if the vet reviews Scooby's records, she'll see something helpful? I remember there was some problem getting reliable test results. (RIP Scooby--lost her one year ago today. She was the Best Pig.)

In the meantime--I bet Inca would enjoy eating alfalfa, which packs a bit more nutritional punch than timothy.

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Tracy

Post   » Mon May 19, 2008 9:19 am


Thanks, mmeadow. I did mention Scooby to Dr. O, since Inca's excitement about syringe feedings reminds me of when I cared for your guys (before Scooby's diagnosis). I think Scooby's T4 results were pretty clear-cut, though, whereas Inca's don't show hyperthyroid. Maybe it just doesn't show up until more "advanced" -- I dunno.

Believe it or not, Inca's not very interested in alfalfa (hay nor pellets). I should probably try again, but right now the only alfalfa she likes are some crunchy little snacks that I give during the day. Thank goodness she doesn't have calcium issues! Oh, and I suppose I can grind up alfalfa pellets to mix with her Critical Care; she won't refuse that.

Of course, my other challenge lately is that Winnie has become quite the "chunky monkey," so I've got to beef up Inca and try to help Winnie slim down...simultaneously. I don't want to separate them, so I've been removing Inca for some of her supplements.

They're definitely keeping me on my toes!

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Tracy

Post   » Fri May 30, 2008 10:00 am


Spoke to my vet about possible heart problems, and we'll probably do an echocardiogram next week to take a look (rather than the ultrasound I was considering).

We'll likely retest Inca's T4 level, too, because it seems like "classic" hyperthyroid, according to my vet. She's calling around to some vet labs to confirm the norms and how protocol for cats is adapted for piggies. And she said, in cats, heart issues often (?) go hand in hand with hyperthyroid, so maybe Inca's dealing with both.

We're going to attempt to get a blood pressure on Inca, too, because giving heart meds to a GP that doesn't need them can cause a drop in BP, which I may not be willing to risk.

I'll post again when I know more. Meanwhile, I'm back to work and cannot give Inca supplemental feedings throughout the day like when I was home job hunting. But I'm doing what I can mornings and evenings, and she seems to be holding right around 675g. Seems active and mobile and not uncomfortable...she just begs a lot, hoping I'm bringing over the syringe or snacks.

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mmeadow
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Post   » Fri May 30, 2008 10:02 am


Let us know what you find out. I hope to see you and Inca and Winnie on Sunday.

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Tracy

Post   » Fri May 30, 2008 10:30 am


...and Trixie, too! how many piggies will you bring to Pignic, mmeadow?

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Mum
I GAVE, dammit!

Post   » Fri May 30, 2008 10:50 am


You might want to read the T4 thread too:

http://www.guinealynx.info/forums/viewtopic.php?t=28492

because giving heart meds to a GP that doesn't need them can cause a drop in BP, which I may not be willing to risk.
Generally, if you give heart meds to a pig that doesn't need them they will just become quieter and more lethargic. That's also how you adjust the dose to know exactly how much the pig needs.

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Tracy

Post   » Sun Jun 15, 2008 8:45 am


Time for an update on Inca, since yesterday we went to the vet.

She was about 670g according to my scale at home, yet in the hospital she was 634g -- broke my heart! I've been supplementing with probably 40-70cc of Critical Care per day, depending on my time at home, plus snacks and baby food and oats (and regular pellets/hay/veggies).

We attempted to get blood from her leg (rather than anesthize to collect from her neck) because Inca is a very good patient, but her skin seemed thicker than other piggies (acc. to my vet) and the "poke" that was required (plus multiple pokes to hit such a tiny vein) stressed Inca out and made her too squirmy. So we can't retest her T4, which was normal when we tested a month ago (might have been 2 months ago?).

Inca also had an echocardiogram. With the stethescope, my vet said her heart was racing -- I think about 400/minute. She said even when they're stressed it's not that fast. When the cardiologist listened, she thought maybe she heard a murmur or an arrythmia, and my vet thought maybe a "gallop." Then the cardiologist listened again and said the puzzling sounds were really respiration, not heart. With all that discussion about ascultations, I was glad the machines would show us definitively. Only finding with echo was a slightly enlarged left ventricle (I think), and they said there's not enough diagnostically to conclude she's got a heart issue.

Most significant finding of the day was that my vet felt a lump in Inca's neck, and she actually let me feel it. I want to say pea-sized, but after reading some thyroid threads here, I think "blueberry" is a better size description. So, since Inca's clinical signs/behavior are "classic hyperthyroid," we figure the lump is a thyroid tumor.

Lynx, I read that Monique2 was compiling a chart of thyroid piggy cases for reference -- where did that end up? I know about the skinny/T4 thread...is hers something different?

I'm not sure I want surgery for Inca since she's 5.5 years old and 634g. But we may try tapazole to attempt weight gain. Will be tricky since we don't have a T4 level to go by and I probably won't want blood tests (anesthesia) every 3 weeks to adjust the dose. Also a bit risky since we don't know about her kidneys; the blood levels seemed okay when we last tested (1-2 months ago), but we haven't been able to get blood since then. If we do try tapazole and she gains some weight, perhaps I'd consider surgery when Inca is a bit bigger/stronger.

Any/all thoughts welcome as I try to sort this out. Thank you!

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Mum
I GAVE, dammit!

Post   » Sun Jun 15, 2008 11:31 am


. Only finding with echo was a slightly enlarged left ventricle
she thought maybe she heard a murmur or an arrythmia, and my vet thought maybe a "gallop."
And her heart was racing?

I wonder why the heart issues are being ignored.

I don't think you can give the Tapazole without getting baseline blood tests. Is there some reason your vet won't collect with a toenail overclip?

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Tracy

Post   » Sun Jun 15, 2008 12:22 pm


Mum, whatever possible abnormalities were heard with a stethescope were attribtued to respiration, not heart...or the two being hard to separate in Inca. When the echo showed normal rhythms/patterns, that was the basis for concluding her heart is okay.

My vet said not enough blood can be collected from a toenail clip. They might do that for a blood-glucose, which only needs a drop or two on the gycometer, but for T4 or for checking kidney function, they need larger quantity.

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Mum
I GAVE, dammit!

Post   » Sun Jun 15, 2008 12:24 pm


But a slightly enlarged ventricle sounds like a heart issue. I've had at least two pigs with enormous ventricles - found on necropsy.

My vet is able to get enough from a toenail overclip for both a full blood panel and a separate T4 test. There's a method for getting enough blood from the overclip.

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Lynx
RESIST

Post   » Sun Jun 15, 2008 5:02 pm


She is so tiny. It may be tough taking too much blood.

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mmeadow
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Post   » Sun Jun 15, 2008 11:40 pm


They didn't think Scooby had evidence of heart trouble either.

Nothing much to add except that it seems as though you might as well try the tapazole? The vet started Scooby with a very cautiously low dose, and it took an agonizingly long while and several slowly-spaced increases to get to an effective dose, at which she regained some weight and was obviously in less distress. (At least Inca is in good spirits.)

We tried to retest Scooby's blood levels, once, I think; although she had improved per the clinical markers, the test levels were still high. At the time, that was interpreted as a probable misfire in the testing. In retrospect, the test may well have been correct and perhaps should have been a signal to up the dose more; for all we know, doing so might have prevented her final "thyroid storm" episode. At that point, we opted to spare her any further discomfort.

If Inca's kidneys were OK only a month or so ago, not sure why you'd retest them so soon. Perhaps I'm throwing in a red herring here, but did they rule out diabetes?

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Tracy

Post   » Mon Jun 16, 2008 9:17 am


I believe we had ruled out diabetes with Inca's last blood draw (during her Xrays 1-2 months ago). I'm tempted to test her blood again before we try tapazole, to make sure her kidneys can handle the drug. From what I understand, kidney failure is not treatable/reversible (yes, daily subcues help take some of the strain off), so to possibly cause that and add to Inca's woes would cause me tremendous guilt. During her last bloodwork, her protein was a bit high, but vet thought overall her kidneys were working well. Since then, she's had a wet bottom on occasion, and I know dribbles of urine can be a first clue to kidney problems. I'm just torn because I don't want to anesthetize Inca anymore, yet we probably won't be able to collect enough blood without putting her under.

mmeadow, do you remember what dose of tapazole seemed to help Scooby and how much she weighed at the time? I don't think Inca and I have a lot of time to experiment with dosage adjustments, yet on the other hand, I don't want to overdose at the outset. (I'm going to try to contact Monique2, who at one point was compiling info on several thyroid piggies from this forum. The skinny/T4 thread helps a bit, but I want to gather as much info as I can about success stories so we maximize Inca's chances in minimal time.)

Inca is not suffering or showing signs of decreased quality of life, yet I don't know how much more she can lose before things take a turn. And she's definitely very delicate without much fat or muscle. I don't know which is worse -- her bloat episodes or this. And now I wonder if somehow thyroid issues could explain her gas/distension during her "mid" years -- maybe she was hypothyroid at some point (slower metabolism) and now hyperthyroid. I may ask Dr. O about that possiblity, just out of curiosity.

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mmeadow
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Post   » Mon Jun 16, 2008 10:43 am


I can't check our records right now, but I know that the initial Tapazole/methimazole dosage was that used in the established cat protocols, which are based on weight.

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Tracy

Post   » Mon Jun 16, 2008 2:14 pm


After reading a lot of hyperthyroid stuff online (about cats) and seeing so many words and phrases that echoed our vet visit over the weekend (gallop, murmur, racing heart, enlarged left ventricle, and others), I am convinced beyond a doubt that Inca has hyperthyroid and likely secondary heart disease as well. I don't need a postivie T4 test and "hit you over the head" echocardiogram to put it all together. I'm a bit disappointed that my top vet (and the cardiologist) isn't putting everything together instead of me, but she's certainly receptive to pursue what I want, for the most part.

And though there are risks (kidney failure, heart failure, problems with anesthesia), I think Inca and I need to go down the road to treat for hyperthyroid with tapazole, plus possibly blood pressure meds, with regular blood checks to monitor her levels and organ functions. I'm scared that we may create more problems, but to not attempt treatment of something that can be managed would be irresponsible. We've got to roll the dice, I guess. And if/when Inca dies, at least we'll go down fighting.

Would love to hear from any owners who gave both thyroid med and heart meds simultaneously...or folks who treated thyroid and then had to deal with kidney probs. Sounds like a careful balance is needed to succeed. Thanks in advance.

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Mum
I GAVE, dammit!

Post   » Mon Jun 16, 2008 2:44 pm


Email Pinta - she's had to treat both issues concurrently.

You'll want to use Lotensin at 1mg/kg twice daily, if you can get it.

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