Baxter's med thread
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- You can quote me
"Will exotic vets generally try a heart medication without an xray?"
How good a negotiator are you? ;-) If you ever thought you might have liked to be an attorney -- or did moot court in school -- now's the time to brush up. If you explain the situation clearly, concisely, and objectively (with backup from some of the material on GL), the chances should be fairly good of yes.
I think Stahl has experience with heart pigs. Not sure on that. Email JudiL and see if she knows.
Lasix is not necessarily lifetime. Lotensin, if needed and efficacious, is. Lasix is fairly cheap. Benazepril (Lotensin) is all over the map. It can be ridiculously expensive, or quite reasonable. It'll need to be compounded, so if you have (or know of) a good compounding pharmacy that will work with you, so much the better.
Human Lotensin is cheap. It is my understanding it dissolves in water. You may be able to compound it yourself. I take lisinopril (also an ACE inhibitor). It's one of the $4.00/month ones at Walmart.
As you describe I think Tuesday will be okay. Watch him very carefully in the meantime (which I know you will anyway).
How good a negotiator are you? ;-) If you ever thought you might have liked to be an attorney -- or did moot court in school -- now's the time to brush up. If you explain the situation clearly, concisely, and objectively (with backup from some of the material on GL), the chances should be fairly good of yes.
I think Stahl has experience with heart pigs. Not sure on that. Email JudiL and see if she knows.
Lasix is not necessarily lifetime. Lotensin, if needed and efficacious, is. Lasix is fairly cheap. Benazepril (Lotensin) is all over the map. It can be ridiculously expensive, or quite reasonable. It'll need to be compounded, so if you have (or know of) a good compounding pharmacy that will work with you, so much the better.
Human Lotensin is cheap. It is my understanding it dissolves in water. You may be able to compound it yourself. I take lisinopril (also an ACE inhibitor). It's one of the $4.00/month ones at Walmart.
As you describe I think Tuesday will be okay. Watch him very carefully in the meantime (which I know you will anyway).
Thanks so much. I really know nothing about compounding so I'm not familiar with what pharmacies would do that. I feel very out of my league here! Do exotic vets normally just call it into a pharmacy that they are accustomed to working with? Is this relatively common for pet medications in general? I've only ever gotten meds directly from the vet but I'm not sure how unusual this is for vets (and therefore how streamlined/easy it'll be to accomplish).
Sorry, just saw this. Talishan is giving you good info as far as the meds go but compounding the Benazapril is easy. If you do a search under my name I think I have a thread on compounding Benazapril yourself.
My druggist is not a compounding pharmacy but used to do it for me anyway with water, pills and a suspension agent.
Lotinsen (Benazapril) is forever, sadly, but piggys seem to do well for a long time on it. You may be lucky and not have to use the Lasix for very long (depends on what's wrong and far along it is). Unfortunately mine was on it every day.
My recommendation is to get at least an x-ray if not an ultra-sound. It's true, they won't always show anything but they will give you a base-line for any further changes that might occur.
My druggist is not a compounding pharmacy but used to do it for me anyway with water, pills and a suspension agent.
Lotinsen (Benazapril) is forever, sadly, but piggys seem to do well for a long time on it. You may be lucky and not have to use the Lasix for very long (depends on what's wrong and far along it is). Unfortunately mine was on it every day.
My recommendation is to get at least an x-ray if not an ultra-sound. It's true, they won't always show anything but they will give you a base-line for any further changes that might occur.
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- You can quote me
"Do exotic vets normally just call it into a pharmacy that they are accustomed to working with? Is this relatively common for pet medications in general?"
Yes and yes.
BM has a very good point -- if at all possible, an x-ray is a very good baseline for future changes. Cardiac ultrasound or echo would be very valuable as well, but depending on your vet, area, and capabilities accessible to you may be 1) very expensive and 2) not worth it if they can't read it properly.
Lasix (a/k/a furosemide) is a loop diuretic. It relieves stress on the heart by clearing away any excess fluid that may be in the lungs or around the heart. Once that is cleared and the heart is supported by use of an ACE inhibitor like benazepril, or even a Ca-channel blocker like Vetmedin (see https://www.guinealynx.info/forums/viewtopic.php?t=21897 ), the fluid shouldn't return. If, however, the pig's heart just can't keep up, period, he or she may be on Lasix as well for good.
Point: many vets are completely familiar with Lasix (it's used on lots of animals, human included) and think that's all the "heart med" you need. It's not a heart med, per se, and addresses a symptom, not the cause (although it does a superb job on fluid).
Yes and yes.
BM has a very good point -- if at all possible, an x-ray is a very good baseline for future changes. Cardiac ultrasound or echo would be very valuable as well, but depending on your vet, area, and capabilities accessible to you may be 1) very expensive and 2) not worth it if they can't read it properly.
Lasix (a/k/a furosemide) is a loop diuretic. It relieves stress on the heart by clearing away any excess fluid that may be in the lungs or around the heart. Once that is cleared and the heart is supported by use of an ACE inhibitor like benazepril, or even a Ca-channel blocker like Vetmedin (see https://www.guinealynx.info/forums/viewtopic.php?t=21897 ), the fluid shouldn't return. If, however, the pig's heart just can't keep up, period, he or she may be on Lasix as well for good.
Point: many vets are completely familiar with Lasix (it's used on lots of animals, human included) and think that's all the "heart med" you need. It's not a heart med, per se, and addresses a symptom, not the cause (although it does a superb job on fluid).
Thanks Bugs Mom, I just found that thread. I will print it out and add it to my growing stack of heart pig information along with a print out of this thread. Was really hoping I wouldn't have a pig ready to join the heart pig club but I'm pretty convinced that's what's going to happen. :(
Talishan, you mentioned that many vets think that Lasix is all that's needed. If the vet wants to give him just that initially, should I protest? Is it ok if it IS the only med? Or is lotinsen what treats the cause more and lasix treats a symptom?
Thank you all again. I am very overwhelmed but I honestly don't know what I'd do without GL. If it weren't for the fact that I frequent GL, I wouldn't have even known that hooting was a sign of something this serious. Instead, as soon as I heard it I knew exactly what I look up here. Phew. Better to have information overload than none available at all.
Edit: Ahhh, I just discovered that my vet has been removed from the staff list at Stahl Exotics! That's ok, I liked her but I'm fine with using one of the other vets. Was actually hoping to see Stahl or Crum this time since they're the ones I hear about most.
Talishan, you mentioned that many vets think that Lasix is all that's needed. If the vet wants to give him just that initially, should I protest? Is it ok if it IS the only med? Or is lotinsen what treats the cause more and lasix treats a symptom?
Thank you all again. I am very overwhelmed but I honestly don't know what I'd do without GL. If it weren't for the fact that I frequent GL, I wouldn't have even known that hooting was a sign of something this serious. Instead, as soon as I heard it I knew exactly what I look up here. Phew. Better to have information overload than none available at all.
Edit: Ahhh, I just discovered that my vet has been removed from the staff list at Stahl Exotics! That's ok, I liked her but I'm fine with using one of the other vets. Was actually hoping to see Stahl or Crum this time since they're the ones I hear about most.
This is just what I would do you understand-I would, politely but forcefully, tell the vet that in addition to the Lasix, I wanted to start my pig on a trial of Lotinsen. If necessary, politely, remind the vet this is your animal. A trial of Lotinsen won't harm the pig. If the heart is not the problem you won't see any improvement and can discontinue the Lotinsen. I suspect that with a trial of heart meds you will see an improvement though.
Lotinsen treats the heart - Lasix treats the fluid around the heart - two different things.
Lotinsen treats the heart - Lasix treats the fluid around the heart - two different things.
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- You can quote me
Phew.
"Or is lotinsen what treats the cause more and lasix treats a symptom?"
Exactly.
Ditto Bugs Mom -- but, especially if you are going to be seeing someone you haven't seen before, if it were me I wouldn't push too hard this first time. If you take Bugs Mom's approach and you see the hair going up on the back of the guy's head, drop back to starting with Lasix initially ... and then plan how you'll work on getting what you really need.
It's "okay" if Lasix is the "only" med ... for a little while. Lasix treats fluid in the lungs and around the heart, and does so very, very well. But why is the fluid there in the first place? Because the heart is not working quite as well as it should. So Lasix will not be the only med the animal should use permanently ... unless the vet just wants to use a permanent "bandaid". Unfortunately, that's exactly what a lot of vets will do. (And ironically, Lasix is somewhat harsher on their systems than benazepril is.)
Benazepril will treat the underlying cause. There is really no standard trial length. Some pigs can take up to a month to show improvement, so I'd use it for 30 days before deciding the pig will receive no benefit from it. However, our heart pigs have responded within days, one within *hours* of her first dose.
You may want to print out the "Request for heart pig stories" thread as well. If the Lasix helps him, the vet may very well say, "see, it helped him, he's okay now." Then you can say "but why does he need it in the first place?" and push for a trial of a relatively benign med.
With any luck at all, Bugs Mom's approach will work from the start.
"Or is lotinsen what treats the cause more and lasix treats a symptom?"
Exactly.
Ditto Bugs Mom -- but, especially if you are going to be seeing someone you haven't seen before, if it were me I wouldn't push too hard this first time. If you take Bugs Mom's approach and you see the hair going up on the back of the guy's head, drop back to starting with Lasix initially ... and then plan how you'll work on getting what you really need.
It's "okay" if Lasix is the "only" med ... for a little while. Lasix treats fluid in the lungs and around the heart, and does so very, very well. But why is the fluid there in the first place? Because the heart is not working quite as well as it should. So Lasix will not be the only med the animal should use permanently ... unless the vet just wants to use a permanent "bandaid". Unfortunately, that's exactly what a lot of vets will do. (And ironically, Lasix is somewhat harsher on their systems than benazepril is.)
Benazepril will treat the underlying cause. There is really no standard trial length. Some pigs can take up to a month to show improvement, so I'd use it for 30 days before deciding the pig will receive no benefit from it. However, our heart pigs have responded within days, one within *hours* of her first dose.
You may want to print out the "Request for heart pig stories" thread as well. If the Lasix helps him, the vet may very well say, "see, it helped him, he's okay now." Then you can say "but why does he need it in the first place?" and push for a trial of a relatively benign med.
With any luck at all, Bugs Mom's approach will work from the start.
Ok, thank you again. This is very helpful. I know SEAVS is respected around here and Stahl and Crum are both on the recommended vets list, so there's that! Hopefully it won't be too hard to get what Baxter needs. Since they understand guinea pigs, my hope is that they know better than to just shoot for a permanent bandaid... but if they do, at least now I'm armed with the information I need!
I will print that thread too, thank you for reminding me!
I will print that thread too, thank you for reminding me!