Timothy - weight loss

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Bugs Mom

Post   » Sun Jul 27, 2008 11:41 am


Down with stubborn vets! I'm sorry too that you have to deal with this. My Lady Bug was just the way you're describing and no x-ray or ultrasound showed a heart problem. She just continued to deteriorate 'till it got to the point a went to her vet and demanded heart meds. I got them and she's been fine since.

Just a few months ago an x-ray FINALLY showed an enlarged heart but it was long AFTER she was on her meds. How frustrating for you.

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Lynx
Celebrate!!!

Post   » Sun Jul 27, 2008 2:47 pm


Some pigs do cough associated with eating too fast. Are you sure this is not just what is happening and it is not a sign of illness?

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GuineaPigFun

Post   » Sun Jul 27, 2008 3:10 pm


Some pigs do cough associated with eating too fast. Are you sure this is not just what is happening and it is not a sign of illness?
That was my thought also since it only seems to occur while eating.

Alibabble

Post   » Wed Apr 21, 2010 3:08 pm


So, my vet and I agreed that if Timothy had one more episode of unexplained weight loss, hooting, or a URI then he would agree to a trail course of heart meds. Thankfully, nothing has happened since then so it hasn't been an issue.

On Sunday I noticed that Timothy was occasionally making painful noises and hunching up. His weight was down 100g from the week before and his appetite was slightly decreased. I got him in to the vet I work at because the vet on that day does see exotics on a regular basis at her other job. We collected a cysto urine sample and took x-rays. The rads showed one large bladder stone that will need to be surgically removed.

The urine results have been coming in slowly, the UA showed a low specific gravity (1.012), lots of calcium crystals, and some blood. We're awaiting the culture results. I took him in with me last night to get blood drawn to make sure that his kidneys are doing well, and to give us some idea of what challenges we'll face with his anesthetic.

Currently he's not on an antibiotic as we didn't want to stress his system without any determination of what, if any, antibiotics are needed right now. He's got buprenorphine for the pain and he can have it as needed 2-3 times a day. He is still eating but I'm supplementing with CC every 4-6 hours.

So, the questions: Should I start him on some SQ fluids. His hydration is good but I remember that when Gavin had stones he felt better with some extra fluids. What is everyone's stance on starting antibiotics? If he stays semi-stable I was going to wait until the culture results come back. It's possible that there isn't an infection right now but I think we'd have him on on something post-op to cover our bases.

Any ideas for anesthetic protocols in case he does have kidney disease? My vet doesn't see guinea pigs often, rabbits and rats tend to be more popular in her area. Her colleague had suggested doing a similar protocol to what would be done for a rabbit, once I get it I'll post it for any feed back. I'll also post the UA and bloodwork results. If I'm feeling completely computer genius then I'll figure out how to get the digital x-rays online as well.

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Lynx
Celebrate!!!

Post   » Wed Apr 21, 2010 3:52 pm


SQ fluids certainly could help. Most pigs tolerate Bactrim (trimethoprim sulfamethoxizole) pretty well. I don't know enough to comment on aneshtetics if there is kidney disease. Hoping for the best!

Alibabble

Post   » Wed Apr 21, 2010 6:08 pm


His bloodwork was perfect!!! I think that entitles me to an abuse of punctuation. Just waiting to hear back on when the vet can come in to do the surgery for us. He's actually looking okay right now, he's put on another 20g from his weight yesterday at the same time. He's a bit quiet on the pain meds but I think he his eating a bit more this way, no painful noises in the past several hours.

Talishan
You can quote me

Post   » Wed Apr 21, 2010 8:16 pm


Buprenorphine has something of a muscle relaxant effect. Depending on how large the stone is, it could conceivably help him pass it.

If it's too large for that, it will help him regardless, as long as he's not too zonked to eat.

Inhalant anaesthetics (isoflurane, sevoflurane) are not particular kidney stressors as I understand it. I don't think the kidneys have much to do in clearing the drug from the body postop, unless someone with more med knowledge than me says otherwise. However, if it were me, I'd want the vet to induct and maintain *as if he were a heart pig*. That is, monitor exceedingly closely and put him no further under than he needs to be. Do the surgery as quickly as possible, while still being safe and complete.

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Lynx
Celebrate!!!

Post   » Wed Apr 21, 2010 9:32 pm


I kind of thought the anesthetics (generally inhalants) didn't affect the kidneys but I wasn't positive.

Alibabble

Post   » Fri Apr 23, 2010 12:52 am


Culture results came back with no growth. Basically, we're in a really good position right now since I've got a fairly healthy pig who simply needs to be one giant bladder stone lighter than he is right now.

The plan is for me to bring him in about an hour before we're ready to start. We'll do an exam then and give him his premeds and likely shave the site before we induce. Quick induction in the handy little induction chamber that my coworker put together and then a speedy cysto.

Standard procedure in my clinic is to monitor and record vitals every 5 minutes so we'll be doing at least that. I wish we had better/different equipment though, it's frustrating that we won't be able to have a SpO2 or even a doppler on him for monitoring as the ones we have simply won't fit him. It might end up being one of those fun surgeries where someone spend the entire time with a stethoscope on him unless I can come up with a way to make the doppler work for him. I'm working the evening shift so I'll be the one doing his post-op care which is comforting.

Alibabble

Post   » Sat May 01, 2010 10:41 pm


Timothy had his surgery on Tuesday and it all went smoothly. The stone was quite large and his bladder wall was thickened and inflamed. It's definitely good that it came out when it did, it should increase his comfort level drastically. I've sent off the stone to be analyzed but haven't received results yet.

I thought I'd post the anesthetic protocol as it worked quite well for him. He was pretty stressed when I first brought him in so we opted to sedate pretty quickly. He was at 1.113 kg and we used Ketamine - 20 mg/kg, midazolam 0.5 mg/kg, butorphanol - 0.5 mg/kg, glycopyrolate - 0.02 mg/kg in a cocktail for a total of 0.3 mls given SQ. Once he was sufficiently sedated we took a lateral abdominal xray to assess where the bladder stone was located (and that it hadn't miraculously passed on its own). We then administered 20mL of warm LRS SQ and induced using a mask and isoflurane.

My vet removed the stone and took a sterile swab for a culture and sensitivity on the lining of the bladder. She then flushed the bladder with warm saline and passed a catheter from the bladder through the urethra followed by further flushing. She closed with subcuticular sutures and tissue glue. Mid surgery we gave him metacam and baytril by SQ injection. We were very careful to maintain his body temperature during surgery and post-op. Post-op we also did a follow up xray to make sure that no uroliths remained.

For aftercare he's been on buprenorphine, metacam and baytril. The first two days I used the buprenorphine every 8 hours and then backed off to twice daily. The metacam and baytril were both SID. He began eating on his own that evening, although not enough to maintain his own body weight so I supplemented with CC. By Wednesday afternoon he was begging for veggies. He's still not eating quite enough to maintain his weight so I'm feeding ~30 mL of CC a day.

His culture came back today with no growth after 72 hours so we've stopped the baytril. I'm going to try backing off on the buprenorphine today as he seems a bit sedate. His incision looks fantastic and he's been very vocal in his demands for more veggies and fresh hay. Honestly, I think he's enjoying the extra pampering at this point.

Does anyone have advice on how best to taper off his pain meds? Or even when to start?

Talishan
You can quote me

Post   » Sat May 01, 2010 11:10 pm


In my opinion and experience, right about now, in light of the fact that he's doing so well postop.

I've had good success tapering the opiate down while ramping the NSAID up, then ceasing the opiate, then tapering and eventually ceasing the NSAID. Visualize it sorta like two overlapping roller coaster humps, if that makes any sense at all.

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Lynx
Celebrate!!!

Post   » Sat May 01, 2010 11:39 pm


Glad to hear he seems to be recovering well. Thanks for the sedation details.

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