Del Boy's Med Thread - Heart

Hilary Holmes

Post   » Fri Jun 30, 2017 11:54 am


Hi Guys, Del Boy is currently residing with me. BamBam and I have been unable to get any appointment with an "exotics" vet until Tuesday, but he had been holding his own now the weather is cooler.
However, this evening he appears to be struggling more, although he remains alert and relatively active, possibly more active than usual. He is eating and drinking normally.
His arrhythmia continues although his lungs sound clear. His ear margins are dark, as are his lips. I have got an appointment with a cat and dog vet tomorrow morning as an emergency, but will see the out of hours vet if he deteriorates further.
He is a foster from the RSPCA. With that in mind, is there anything I can be doing in the way of supportive management?

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Lynx
Celebrate!!!

Post   » Fri Jun 30, 2017 10:25 pm


Were you ever able to try out Lasix? It sounds like he might benefit.

Hilary Holmes

Post   » Sat Jul 01, 2017 5:14 am


Thanks Lynx. We haven't been able to try Lasix yet. As he's a foster from the RSPCA we are limited as to what we can do without vet approval. I do have a vet appointment later today so hope I may be able to persuade the vet to try Lasix and Vetmedin. I'm now more convinced than ever that he has a heart problem as I heard him hooting whilst he was eating his vegs just now.
Will let you know what the vet says.

Talishan
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Post   » Sat Jul 01, 2017 5:46 am


Okay. If he's hooting on top of everything else, I def. concur with trial of Lasix and Vetmedin.

If you're hearing it while he's eating, that's at least in part because it's difficult for a heart pig to breathe and eat at the same time. Is he maintaining his weight? Steady? Variable?

You've probably already thought of this, but if the vet you'll be seeing isn't a cavy expert, print out the heart page and take it with you:

https://www.guinealynx.info/heart.html

From what you're describing, my gut hunch is that he'd benefit from a trial of heart medication(s) (start low and work up) before Tuesday.

Good luck to him and to you. Please let us know how it goes.

Hilary Holmes

Post   » Sat Jul 01, 2017 3:05 pm


Thanks for your expertise Talishan.

Del Boy was seen by the vet this lunchtime. She was very thorough and seemed quite knowledgeable, despite not being an expert in guinea pigs. She couldn't find anything to suggest this was heart related (despite me taking the heart info with me, which she was quite receptive to). However, she was extremely concerned about his lungs and was more convinced this is a lung related problem, especially as there was a lot of inspiratory noise, where she would have expected more expiratory noise. We discussed the pros and cons of an Xray and the necessary GA, as he is an extremely skittish pig, and decided to go ahead.

Fortunately, they were able to Xray him without the need for sedation or GA and surprisingly, the Xray has shown almost complete white out of both lungs, suggestive of pneumonia. His heart outline was normal. They gave him oxygen but that did not improve his colour much, so they think the dark lips and ears are his normal colouring. (I remain to be convinced). He has been started on Baytril and sent home, since there is nothing they can do that I can't do here.

He's not out of the woods by any means and I will be watching both him and his brother like a hawk. I'll keep you all posted.

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Lynx
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Post   » Sat Jul 01, 2017 9:51 pm


Is his breathing labored?

Talishan
You can quote me

Post   » Sun Jul 02, 2017 6:55 am


Please keep us posted on how he's doing.

I'm really glad to hear that the vet was knowledgeable, thorough and open to heart issues despite not being an exotics expert. The difference between inspiratory and expiratory sounds I've run into before, from a vet with asthma herself. This vet sounds good.

Ditto Lynx -- does his breathing seem labored?

My very, very best to him and his brother, and to you.

Hilary Holmes

Post   » Sun Jul 02, 2017 12:31 pm


Thanks Talishan and Lynx. Del Boy is holding his own. At least he's still with us!

Yes, his breathing continues to be laboured. He is using his abdominal muscles and his nostrils are flaring with each breath. He is still eating (despite Baytril) and is still bullying his brother Rodney, which I take to be a good sign. At least it's his normal behaviour.

He's had one dose of intra-muscular Baytril and two oral doses but doesn't seem to have improved at all. I assume I'm being impatient. I assume it will take a couple of days before we see any sign of improvement? Would it be worth giving him some metacam as well? Having recently had pneumonia myself, I know how rough it made me feel.

Talishan
You can quote me

Post   » Sun Jul 02, 2017 2:54 pm


I would think a small dose would do no harm and may make him more comfortable, especially if his muscles are sore just from the labor of breathing and walking around.

Is there *any* way you might could rig up an oxygen chamber for him at home? O2 would be rx but I think some GL members have done it (I have not).

A combination of Baytril and doxy can have a whole-is-greater-than-the-sum-of-the-parts effect for really bad pneumonias. If nebulized, the med goes straight to the lungs. Again the vet would need to cooperate, but as I understand it a nebulization chamber is not hard to set up.

I think some have also brought them into the bathroom whilst taking a hot, steamy shower and that can afford some temporary relief. Just make sure he's thoroughly dry before putting him back in his cage if you do this; getting chilled is not what he needs right now obv.

Continued best wishes to him and to you. He couldn't be in better hands.

Hilary Holmes

Post   » Sun Jul 02, 2017 4:47 pm


Thanks again Talishan. I'll give him a dose of metacam tonight.

I could probably rig up an oxygen chamber but would have to get the vet to prescribe the oxygen which may be a problem. I'm not sure how beneficial oxygen would be when he showed no improvement whilst he was on it at the vet's. His lips and ear margins remained a dusky colour, apparently.

I'd forgotten about trying the shower. I'll give that a go later. Thanks for the reminder!

If there's no improvement after 72 hours on baytril I'll take him back to the vet and suggest giving doxy in addition to the baytril. He's due to be seen on Thurs but I can take him back sooner.

Thanks for your good wishes. I've been in the fortunate position of all my pigs being well for the past year or so ( I hope I'm not tempting fate), so I'm feeling rusty and lacking in confidence. Your advice and reassurance are very much appreciated.

Talishan
You can quote me

Post   » Mon Jul 03, 2017 9:12 am


No worries. I'm glad yours have been well. It's like riding a bike, though -- once the skills you have are there, it won't take much to knock any rust off.

I think your plan is a good one. If you do pursue a Baytril-doxy combo, ask about the possibility of nebulizing it. Nebulization not only bypasses the GI, but it delivers more of the drug directly where it's needed.

Nebulization also opens up the possibility of using ABs you otherwise couldn't. I think bpatters has used gentamicin in nebulization. You can also consider azithromycin; some have dosed it orally successfully (I have not needed to try it, yet anyway, thankfully) but I'd feel more confident using it in a nebulizer. If you could rig up an oxygen chamber, you could rig up a nebulizer; that's easier as I understand it. The only specialized part is the atomization head.

Hopefully he will begin to show improvement and none of this will be necessary.

Continued very best wishes and support sent.

Hilary Holmes

Post   » Wed Jul 05, 2017 3:57 pm


Thanks again Talishan. The rust is definitely being brushed off with this one. I'm having to dredge the memory banks to remember about respiratory and cardiac problems. Thank goodness for GL!

I took him back yesterday as I wasn't happy with him. He seemed a bit worse, went flat and his breathing deteriorated further. I saw a different vet who was again concerned about his colour although he had recovered a bit by this time. I suggested adding in doxy but she felt it wouldn't help as baytril is broad spectrum and I suspect because its not licensed for GPs. She suggested O2 therapy but decided that as it hadn't helped previously probably would not help this time. So I drew a blank there . We're going back tomorrow. I'm going to discuss stopping the baytril as it just stresses him out so much.

On Saturday BamBam and I are going to see another vet about 2 hours drive away. He is used by the CCT so should be more GP savvy and open to considering cardiac problems.

Will update later.

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