- Supporter 2004-2019
For my hypothyroid pig Scooby, it required about 80 grams of Critical Care per day to keep her weight stable while Dr. Orcutt slowly and cautiously increased her methimazole dose, using the cat protocol for guidance. Scooby's blood tests were inconclusive so we stopped trying them and went with her observed clinical signs. Eventually the med reached a level where she obviously felt better and therefore ate more on her own, plus presumably her metabolism slowed and so was able to keep more weight on. At that point we did continue to supplement but didn't need to do nearly as much.
Scooby's case was back in 2006-2007. At the end she was suspected of having a thyroid tumor. I hope there is newer information out there about managing this.
Is there a thread about the piggy you're worried about now? With a search, I see a bunch of threads started by you and would like to read the history of your piggy's thyroid problems. Has he been diagnosed, or your current vet is just pursuing this "path"?
I agree you shouldn't start tapazole unless there's really good reason to do so... that is, if hyperthyroid is very likely or has been shown with blood tests. Inca's symptoms were very representative of thyroid issues, plus she had a lump on her neck. We presumed hyperthyroid and treated for that, despite inconclusive T4 tests.
Also, I know your pig's weight loss is concerning, but don't panic at 1100+ grams; that's still a good weight. Just for reference, my Inca dwindled to half her ideal weight... died at 505 grams. Also, are you supplementing his normal feedings? Especially with a picky eater (as you've said), don't rely on him to eat enough. Experiment with different foods/treats and try to help him put the weight back on. Does he take syringe feedings well? I'm sure you've been trying already -- keep at it!
Honestly, I don't know what a thyroid storm looks like nor how docs attempt to manage it. Maybe someone else can chime in about that. And I don't have strong memories about what docs said; I will try to find the hospital notes from Inca's final visit.
I know that the morning Inca died, she was facing the corner of cage with breathing difficulty and foam coming out of her nose -- just horrible to see. We rushed to the ER, and they gave her oxygen and perhaps an injection of something (if I had to guess, maybe Lasix). The foam indicated too much fluid in her body, a complication from rapid heart rate I believe.
I don't remember that emergency visit well since I was very upset and in shock. I left Inca at Angell, where they were going to try everything to help her... while I went home to try to make good decisions and think more clearly. They called to say it doesn't look good and I should return; as I wrote (somewhere) I didn't arrive in time. She seemed fine/happy just the night before.
I'd love to read more about any piggies who underwent the iodine treatment. Where are those threads??
- Supporter 2004-2019
Although it's pretty clear that she was hyperthyroid per the T4 tests, Scooby was never over-active. (At her worst, she could barely stand up or bother to eat.)
A quick brain dump based on our Scooby nursing notes:
Scooby's lowest weight was around 670 grams, August of 2006. Her T4 was 12 mcg/dl, against a normal of 3.2. Scooby then started on 0.1 ml of Tapazole 1x a day. After a month, there was no change, and we doubled the daily dose to 0.2, at which we started to see a small improvement in weight. We went to 0.3/day in November and then 0.4 in December. At that point she weighed around 800 grams. We then stayed at that dose, although in retrospective should probably have continued to increase. She had one more blood test that continued to show high thyroid, which we thought was a mistake, but probably was accurate.
In May of 2007, Scooby's weight suddenly crashed (from 800 to 750 in two days); she was inert, had a fever and rapid pulse, and the vet palpated a probable thyroid node. This was the final thyroid storm.
Yes, I've been syringe feeding, though am now going to be reinstating my spreadsheet to keep track of count (we've used this in the past with our others when we've needed to know how much food and juice at given times, times of meds or probiotic, or what things worked during the session. It helped to have this to tally up the # of cc's given in 24hr period where days run into one another easily and sometimes two people were giving food or meds).
Well, unfortunately our guy is not a fan of critical care or the task of taking syringe food, though has grown more comfortable with this in a very particular way. He needs free roam on pillow on my lap with no significant physical contact in order to stay calm enough to want to eat. He seems to want to teter the edge of the pillow which is why I keep a pillow also on the floor below and why I'm sole syringe feeder and my husband is not helping with this task. He moves quickly sometimes so am having to think ahead of his every move and be preventative with either turning pillow around, blocking him from getting too close to edge or distracting him somehow. As soon as I try to reposition him or guide side of face to try to get him not to turn away while introducing syringe, he just tries to run off. He gets pretty worked up after awhile and has now a habit of getting down to the back of the chair for cooldown, potty, rest. We do that many times during session in order to regroup and rest where his breathing and heart rate are already higher and are affected when he moves around often. Usually he's taking a break every few bites or as little often as we have to so we don't run out of steam and short sell the syringe. Have been using various juice blends and various critical cares, and grind treats or other things he might like to dip the syringe tip into, though tonight carrot juice on the tip was most effective with getting him to want the next bite. Lots of tricks, but it's quite an ordeal to have our feedings, more than I've ever had with any of our others. In the end, he often uses so much energy that I wonder how much the food will help with weight gain, at least nutrition is being added. He was able to get 20cc in between 5:30-6:45p and appears we'll need to at least increased our 3 sessions a day to 4 at this time given he has lately been more picky with foods. At the midnight session, I do have to say he was very calm and went through record number of cc's before his first chair break. He did quite well.
I'm not sure that we are going to give it another try for blood in order to check T4 and/or CBC and Chem Panel. It would be better that we have this information, but not sure anyone feels they can promise a successful draw to get enough blood to be able to run tests. But am still thinking on this. Have been researching any other possible causes for his condition, ways of testing that could help shed light other than blood test (ie urine - ketones/sugar. this morning ketones were neg btw. the test strips i ordered were wrong, ended up with ketone strips, but tried using where had read that some diabetics have increased ketones). Had even wondered about testing hair for information (was reading that some minerals findings or deficiencies in hair may give more information related to thyroid, though probably only inconclusively).
Am going to finish writing this when am not falling asleep, but he had another good session a little after midnight (approx 23cc crit care, loving his juices - wheatgrass parsley blueberry, kiwi, pear, yellow bell and esp his carrot juice again). We just finished a little while ago so am going to nap while he naps. But will start writing with how we noticed any of his changes, the original reason for our doctor's visits, etc.
He originally went to doctor to check mouth where he had been off most foods last fall and was making a strange mouth motion. At that time, a tiny nodule at base of neck was detected, but not much said on it, and nothing visually abnormal seen with the teeth. He went back to eating normally and then had another bout of not eating as much a few weeks ago. We went in again to have him checked, this time with our usual doctor, and she also checked the nodule, which seemed about the same size as three months before. His weight was a concern, however, and we were worried about some squeaking while pooping, so had ultrasound to check for stones. We went back for follow up to have full body xray (which ended up not including head unfortunately) and the only other test that was able to be done was the needle aspiration of the nodule, which showed only yellow "thyroid juice" without cells (doctor said if cells seen, she would have sent to pathologist).
More when able...sorry for the broken thoughts (and the length...will try to bullet point later when awake
Will need to weigh again today and have decided every 6hrs for crit care will get him to approx 80-90cc/day, if he concurs, which will adjust based on how well his weight is responding. Am hoping we can keep his weight up, though will have to see if he can balance out the in between by eating on own. Where I have to convince him that crit care isn't so bad for most bites, the process takes longer, which means more energy spent during feedings. In general it is as peaceful and interesting a session for him as possible and he will request a bite or drink here and there. Can just say am thankful for a lighter weekend as far as work schedule so can spend more time here putting down fresh things.
Am sorry for the excess reading due to tiredness, will shorten it up on next entry.
Tracy, thanks for the clarification with who was thinking of performing iodine trial for piggies. I wonder if this had been done, as you said. I was also wondering if folks here who were talking about iodine treatment did in fact have the treatment (and if so, where? and who treated them?). I'll go back and find where I'd read about this.
For history, our boy (Capy) came to us in May '15 looking very plump. His former family had him for some time after taking him from son's friend, I believe. They were not sure of his age, but guessed around 3. He was set up in small cage at the front of their kitchen with a dog, visiting grandchild, smokers in the house, so while he was loved he had some conditions that I believe led him to being more skittish with getting picked up or handled. The only other thing they shared was that former owner used to take him out to soccer field (my main concern when i'd heard this was pesticides, but not sure how often he was put on this field).
FOOD: With other family, he was on Sun Seed Vita Prima pellets, Kaytee timothy hay with cranberries (didn't eat cranberries) and a baby carrot now and then. From the start, he was a good pellet eater and avid drinker, and loved his hay.
We right away offered Oxbow and KMS pellets, which he nibbled at, and the variety of vegetation/fruits/hays that our other boys get. He seemed interested in certain hays, and a particular type of hay head, that we have to hand pick from KMS 2nd Timothy box regularly for him. It took him a long while to pick up on additional vegetation, but he's had (with very limited interest) - blueberries, romaine shreds, garden radicchio, outdoors grass, dandelion, a few clover, carrot tops, fennel root/hair, pear, plum, black grape, pizzazz apple, corn husk/silk/kernel/leaves from stalk, brussel sprout leaf, broccoli leaf, wheatgrass, corn husk/silk/kernel/leaves from stalk, brussel sprout leaf, various carrots, stem of red dandelion, only once yellow bell pepper, very rarely parsley, red leaf lettuce or chicory.
Most of these he will not eat regularly, it's hit or miss, but he's been fairly consistent lately with eating a little carrot, romaine, plum, outdoor grass, while over the past couple of months blueberries had been a favourite until recently.
Right now we're giving him anything he will show interest in within reason, things that have value, fragrance, whatever will keep the weight on, so there are about 6 types of pellets in there including KMS, Oxbow, Sweet Meadow and supplementing vitamin C with crit care, parsley and/or bell pepper based juice, and addition of ground up Oxbow Vit C hay tab. At least 7 types of hays, including a bit of alfalfa here and there.
DEMEANOR: He's always had good energy, hopping over piles of food when excited or running/hopping up onto small pillow we gave him, stretching high up on his back feet to see what we have. This is all the same today as last year. Very young acting.
He was a regular pellet-to-bottle-to-pellet eater. He would run out of his igloo rapidly if we touched or removed his water bottle to refill, chewing at holder until we got back with bottle, a very strong attachment to his water bottle. Because of this, we introduced a juice bottle (since he seemed to be liking juice that I would syringe to him) and he took off with it instantly. This was a way of getting vit c into him, but he's not been choosing juice bottle as of past couple of weeks. He will not take crit care from spoon as all of our others do (we give this daily as treat).
He is frequently up and down, moving around, then plopping down for nap, but quickly up again, which has also been the case since the beginning.
DOCTOR VISITS: In Oct '15, we brought him to doctor as he was making a strange mouth motion (opening wide as if trying to get something out that was stuck), and he was not eating much on own (only carrot and hay heads), so he had a crash course in syringe feeding for about a week and a half until he suddenly started to eat on his own again. Doctor could not figure out cause, teeth looked fine from visual.
*She did notice at this time a 5mm moveable harder lump deeper to base of his neck. Had decided to observe it for any changes.
In Jan '16, he again stopped eating, this time doing a strange up/down head and mouth motion on occasion which he would do for awhile then snap out of it, but was also squeaking while pooping (not peeing) so was concerned he might have stones. Ultrasound of bladder showed no stones. I mentioned the nodule at neck that other doctor had seen, which Dr. Kilgore palpated as well at this next visit. She said she had seen another pig recently with a similar lump which she said turned out to be thyroid, so was considering Capy's lump could also be thyroid. She guessed the size was about 7mm and suggested we do a needle biopsy and then remove it if cells are seen in-house (she mentioned they are not pathologists so would not be able to determine if cells are benign or malignant, but would recommend it being removed still if cells seen).
His weight was taken and he had dropped over 100g since Oct '15 visit, so we were concerned about this.
Mid-Jan '16 (about a week later), we returned for some tests. He weight was now another 40g down, though he had started eating on own many days beforehand, and I was giving him crit care 2ce/day.
FULL BODY XRAY: showed no stones in urethra. Was to be also a look at the head to see if we could figure out what was causing him to make the head/mouth movements and if anything had caused him to stop eating earlier. Xray did not include image of head, however. Doctor did point out some areas of concern on xray - fused lower spine at one juncture, which could cause pain while pooping she thought - ribs were apparently mostly abnormal (suggesting possibly rickets/vit c deficiency early in life) - some additional cartilage-like areas at knees, which she said according to an xray manual is mostly seen in older pigs.
BLOOD: we were hoping for T4, CBC/Chem Panel, but veins kept "blowing" so not even enough blood was achieved in order to get a T4.
NEEDLE ASPIRATION: yellow fluid was drawn from nodule in neck. The sample was to be sent to pathologist, but when looked at in-house, no cells were seen, so was not sent to lab for further eval. At that time, the nodule was said to be about 6mm and had decreased to nothing after fluid removed. So I'm to observe and make sure it is not returning and becoming larger, for now, as we figure out next steps.
Arriving home after tests - he came out of anesthesia more slowly (likely due to pain med given), but once he did about 5-6hrs later, he was spastic, impatiently pawing through food bowls to get at what he wanted, knocking them over, running all over the place, could not serve him new things quick enough, was giving fresh foods every few minutes to every two hours depending on my work schedule, which he would take or not take, and this happened for the next day and a half. He finally started to settle to his usual activity level a day and a half later. Since visit, there has been alot of skin itching, various locations, but mostly face and this general area, sometimes feet (perhaps where the needles were placed? but cannot be sure that's the reason). I even asked doctor if any of these post-procedure behaviours could have been related to working on nodule/removing fluid. It was nothing he had ever done before. She said possibly, or due to the anesthesia.
He otherwise looks perky and happy on the most part. Does not appear in pain. Not excited by many food options, but will go for what he likes for a little while, and definitely is picking out what I feel may be wheat middlings from his treat pellet bowl (I try to pick the junk out, but there are some that remain). He goes for the bottle fairly regularly (drinks about 1/3 bottle per day, approx 5-6oz would guess, which may also make sense where he doesn't eat much vegetation. Our others get multiple servings a day, equiv to 2 dinner plates, and yet they still hit the bottle here and there).
Another thing to note, since we had brought another pig home (who occasionally has clear nasal discharge and sneezes fairly often, that doctor didn't see concern with), he's also developed a fairly regular sneeze. The sneeze is happening quite a bit more since we returned from having tests last Friday as well, but I did listen to lungs and they seem clear. The nasal discharge is also clear.
Next crit care session shortly and this is already too long to read, but hopefully formatted so easier to read.
I do think maybe try to minimize his stress until you know more; with hyperthyroid everything is already sped up (heart, breathing, energy).
After reading his history, I'm still curious about the head motions... did he have a good mouth/dental exam?
Granted the neck mass could be related to thyroid, not sure there's enough to go ahead and start treatment for that. And even though some folks have been able to taper off with tapazole, personally I'm inclined to believe it may be a medicine for life. It affects overall metabolism, and the body adjusts to new levels of the hormone... ideally back to normal levels when gland is not producing on its own. So (I think) you don't really want to try med just to see what happens. That said, I do know experimenting with dosages helps docs to determine whether it's working well or not, and perhaps it's discontinued for some patients as a result.
What would you say is most concerning about your pig right now? I'm not crystal clear after reading thru the whole history. Sounds like he's fussy about eating so maybe not eating as much as usual and losing some weight. Some "hyper" episodes maybe, and stressed during syringe feedings. Mysterious itchiness. And sneezing. Of course a lump on his neck, too.
If he were mine, I might take a step back and investigate his mouth/teeth again. That weird motion plus changes in eating plus not wanting the syringe could point to some "mechanical" problem. I'm just brainstorming a bit here; obviously I don't have expert advice nor know what's best.
Do want to say it's clear you love him very much, and it's great that you're trying hard to figure things out... also that your vet is willing to keep exploring, too. I wish your little guy all the best and admire all your efforts and decision making (been on similar adventures with nearly all of my 9 piggies who are now departed). And I'll be reading along, cheering for you all.
As far as what is most concerning, anything that is pointing to something that is not benign is concerning to me. At this time, I don't know if some of his issues are benign or not (like the itching, or even the nodule, where it seems it had not changed size much if at all over the past couple of months, and with the negative finding (no cells seen in the fluid drawn), though it may well be part of the underlying issue).
Well, we had a heart stopping scare a little while ago when weighing him...the scale had recalibrated twice so had though he had lost 145g, I could barely breathe. Then rechecked a different way and thank God the first two tries were mistaken. (It was particularly scary after having read Mmeadow's comment about Scooby on having a severe drop of weight in a day or two and then having a final thyroid storm.) He is up 17g from yesterday, and I burst into tears. He has been doing well with crit care and exploring his foods so when scale error happened had thought nothing I was doing was helping. Am thankful we're doing okay today. He did exceptionally well, increasing number of cc's each time, with last session at 28cc crit care, about 14cc juices, so since 1:15a he's had 75ccs today already.
Before his anesthesia/tests, he was fasted only slightly. No syringe food more than 8hrs prior, only kibble/vegetation a couple of hours before, and he was eating on own decently. Otherwise had hay until we got there. We did have a few bites of syringe food and juice while at doctor's office after he had woken just to get something into him before our trip home, so the spastic behaviour starting 6hrs after he came out of anesthesia, and for a day and a half, was definitely very unusual.
Dr looked at his mouth again while he was under anesthesia, I believe, and did not see anything alarming. If we are under anesthesia again at any point, I will ask again for head xray, as agree with you, we do want to find out if there is anything going on with mouth to cause him to go off food now twice as he has.
He has no issues with being able to handle foods/hays or hard items (he loves to chew). He navigates all food well. Have seen a right upper lip motion a couple of times, but otherwise never see warning signs with the teeth, other than the head and mouth motions (I did take video of this and posted on his "Squeaking When Pooping/Strange Head Movement" thread). I have not seen the head motions for this past week or so. It is possible where his ribs looked abnormal on xray that jaw/teeth may also be abnormal from an earlier deficiency. He had put on a good amount of weight with the pellet from his former family, so had no issues with weight at that time. He's picky, but when he has liked something he will go for it (primarily the pellets). I was wondering if it's possible, if he did have hyperthyroidism, that he would just not choose food that he doesn't feel like eating, regardless of desire to eat, so perhaps will go for hay and water bottle to fill the void when food is not interesting enough to him?
As you mention, Tracy, that rapid breathing and heart rate has been what I have been concerned about, and want to keep it at a normal rate as much as possible. It has been one of my first concerns and have asked doctors each time to check his heart. Then as I read more on hyperthyroidism, started to think maybe there could be this reason as well.
I have been working with him on accepting touch. He's come to relax with slow touch and has lowered respiratory rate with gentle head to neck rubs and massage. I hope that this comfort will help him to cope better when being handled by medical staff/doctors, but it will make a huge difference in how gentle/slowly they work with him. He cannot tolerate otherwise very well, gets completely wiped out.
For feeding today, we tried a new spot on couch vs chair for change of pace and to not have sun directly in our eyes, which was a good distraction and made eating his crit care more successful and even quicker (otherwise he would want frequent excursions to back of chair, which we still did since he enjoys this or needs this (potty/cool down break), just not as often as he did not seem to request it as much). He may get bored after awhile during sessions, too. He certainly does like to move around, yet does also settle or even start to fall asleep on the pillow or chair. He is also sniffing out his sister just in front of us, I think. I watched him sleep the other day and was very happy to see respiratory rate similar to our other boys. I had thought of reducing his running space so that he would not burn off as many calories (where we moved him to this space a couple of months ago), but figured he probably needs to keep lungs/heart in shape to handle workload as long as he stops when he needs rest.
As you are saying, when a drug that replaces a biochemical is introduced, going off the drug might leave the body in a position where the biochemical is not being produced at same or enough of a rate, which can be risky. There may be a chance that body can reproduce certain biochemicals again, to some level, and not sure exactly how quickly or how much, and if thyroid is one of the glands that can actually do this as some other organs or glands may be able to.
Thanks for being in touch...it's been very good to bounce things off from you and hear your thoughts from experience. And you're right, it seems as though we have always something to keep watch of for nearly all of ours, too, especially as they get older. And I'm glad they have been put into our lives (yours and mine). We've been very blessed to have them with us.
Anyway, back to your current piggy... glad feedings went well today and your scare was due to a scale malfunction. You may not be able to address his bone issues, and the aspiration from his neck mass was OK. Minimizing stress for any pig is always a good idea, as is monitoring their eating and weight. Rapid heart or breathing deserves continued exploration... did his heart look like the right size in Xrays (per vet)?
I know all too well how confusing and stressful it is with multiple abnormalities and trying to figure out next steps and prioritize concerns. Definitely bounce ideas around in this forum; community members here have helped me through very difficult times with multiple piggies.
- Supporting my GL Habit
Tracy, I wish we had known one another when Winnie and Wickie were here with us. That is so good, that she was able to live to 8.5, and hopefully very comfortably. Our boy was very spry and got around without issues with his. We had our (at the time) visiting doctor aspirate the tumour, which was inconclusive. With reading, had seen that most mammary tumours in guinea pigs are 75% benign, or non-metastatic, ant back then this is how we had met Dr. Graham (she was one of the only ones who was straight up with any risks related to surgery without having to take an hour trip one way for him to be assessed for what we already knew he had, which I appreciated). We were first-year piggie parents and I had read enough of piggies dying under anesthesia or post-op infection due to location, that I had decided to wait and watch as he was so young, healthy and happy, and with assumption we were not finding abnormal cells, we may be benign. Sure enough, his tumour grew very slowly. It took a couple of years for it to really grow beyond the size of a large blueberry, and all in one month at the beginning of his last year it doubled in size and I went into alert. It did grow a bit larger, and then we started to have bleeds, also scary. I was starting to try to measure them by using food colouring in milk and placing 1cc at a time on same blanket to see how much the fluid would spread out over the blanket, hoping not to see his spot take more than 1-2cc. I had prayed on this and direction for his care, and in the last few months of his life, likely when he needed the nutrients the most, the bleeds just stopped altogether. What an answer to prayer.
Our visiting doctor originally had been emphatic on removal, but then a year and a half later told me it was a good thing we didn't have it removed where it was slow-growing or it may have returned by that point in time. I had done some research on some similarities between human and guinea pig mammary tumours, and had read something along the line of cruciferous vegetables impacting a hormone and limiting tumour growth. So we began to do this each day regularly, but in very tiny amounts to prevent bloat. I mentioned this to Dr. Orcutt in our conversation, stating if it would be of any use to her patients, we relied on prayer (primarily) and cruciferous vegetables in moderation for his 3.5yrs.
I hadn't known that the tumour could be aspirated, and maybe that would have been better for him at points. Of course, may have been a bit nervous to do this when it got to the point of bleeding, but perhaps aspirating throughout may have lessened it's growth as well. Did you find this to be the case? I think the main concern was comfort...if they are not in significant pain or pain can be managed, and as I watched him closely it seemed he was not showing signs of being in pain often, and never more than modest, as he was nibbling even two hours before he passed.
I did ask Dr. Kilgore about Capy's heart with the xray and she didn't see anything alarming. You are very right about continuing to explore the cause of the rapid breathing/heart rate. It takes a bit longer for his resting rate to return after he's had a stressful event, he will lay on his side breathing heavy if it is too much for him, so this is the warning sign to me that stress cannot happen. I do see when he's eating that rate is good, and when he moves around alot it will increase and take awhile to relax, but that with calmness it is not heavy and starts to become lighter with rest.
PooksiedAnimals, does Cannoli have any other conditions that you are aware of? And is she with any others who do not sneeze? I had thought it's possible Capy sniffs his hays/foods more and while doing so gets dust inside, but not sure. Would think this would always have been the case if so, and it has not been. Our other girl who came to us early Fall '15 has sneezed right along, though doctor didn't see any issues with her upper respiratory, and her activity level is amazing (she's young). I removed anything that was near her, even candles stored in box behind her, just incase an allergy, but still sneezing. If we go back with her for any reason will probably have a nasal swab done. Perhaps Capy as well.
- Supporting my GL Habit
Cannoli has no other conditions that I know of, just the hyperthyroid symptoms: she ran hot, was nervous, was losing weight. She had a hard time sitting still, was itchy, drank a lot of water (still does - I'm bummed out that hasn't stopped).
For the water drinking...some drink a lot, some never (I have both for the first time at once now). They may compensate with vegetation if they don't drink, and those who do drink may realize something we don't (perhaps they need to filter their kidneys and liver more, cool down, etc). Drinking may be more of a blessing. Not drinking can lead to some stress on organs. Each is individual of course.
- Supporting my GL Habit
The bummer with the amount of drinking is that cage gets stinky from all the urine. Her water consumption has definitely gone up in the last year or so. I think she also drinks to help get the dry pellets down, since she drinks a lot more while eating pellets than any other time of the day.
At the start of treatment, Coco was 770g. We are on day two of the treatment and she is quite happy with taking the medicine. She does seem a bit calmer.
I'll let you all know how it goes.
For those of you who have guinea pig that doesnt like to take medicine, give them a treat afterwards. Coco had a spate of UTI's for which we treated her with Bayatril, Capbuprophen (strawberry flavored) Rowtinex and Hydrangea Tincture. Always in the same order (Calbuprophen was last). She had worked out the order and always looked forward to the Calbuprophen.