Heart Pig Primer

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Mum
I GAVE, dammit!

Post   » Thu Nov 02, 2006 11:23 am


Day after day we read about people who come home to find their previously healthy guinea pig has died suddenly. Many of these sudden deaths are, no doubt, due to heart-related problems.

While not all heart problems are treatable, it makes sense to be aware that not only do they exist but that they are extremely common. Many heart problems are very easily managed inexpensively with human heart medications. One of my vets has had various pigs doing well on heart meds for 4 years.

Even without xray there are signs that shouldn't be ignored:

A 'laid-back' pig is frequently found to have heart issues. Quiet pigs, 'belly pigs,' pigs who will sit in your lap for hours - all should be evaluated.

Sleeping very soundly - frequently eyes are closed

Hooting, wheezing, coughing, gurgling. Sounds may be very quiet. Heart pigs commonly hoot and then cough once in the morning. I have only ever had one pig where the sounds were heard by the vet using a stethoscope.

Unexplained weight loss. Some pigs have to choose between breathing and eating. Not all heart pigs will lose weight.

Labored breathing.

Frequent URIs.

Unexplained bumblefoot.

Pea eye.

Please note that these symptoms can also indicate other conditions and be unrelated to heart problems, but a heart evaluation should still be performed by a cavy-savvy vet.

Heart issues can occur at any age, and some are clearly congenital and are diagnosed in pigs under a year old (it's not uncommon for siblings to have heart issues). Such a high percentage of my middle-aged pigs have enlarged hearts that I suspect - like people - a high percentage of guinea pigs develop heart issues as they age.

If you suspect heart issues insist on an xray. Most heart pigs sound normal on physical examination at the vet's office. An xray will show whether there is an enlarged heart or fluid in the lungs. It's possible to have an enlarged heart with no fluid in the lungs. Most of my heart pigs had large amount of gas in their stomach on xray (from swallowing air). One of my very old boars also had a heart murmur which disappeared after 6 months on Lotensin (he still had an enlarged heart).

Be aware that not all heart issues show up on xray. Sometimes a trial of heart meds shows improvement, and you can conclude that there is a heart issue from the results of the trial, rather than going to the further expense of an EKG or an ultrasound. A 10-day trial is usually recommended, however I have one pig who showed no signs of improvement until day 16 when she popcorned (this pig is at least 6 years old).

I put all my heart pigs on human Lotensin (Benazepril - an ACE inhibitor). The vet phones a prescription into a compounding pharmacist, and then the Lotensin is compounded at 2mg/ml in a slightly sweet banana or strawberry flavoring. Most pigs are started at 0.5ccs (1mg) twice a day. Occasionally a pig needs to start at half this dose and work up to the full 1mg twice per day. Lethargy is a possible side effect and shows that either the pig doesn't need the heart meds or that the dose is too high. I've only had this happen with one pig.

If there is fluid in the lungs I give lasix at 3mg twice per day (also compounded by the pharmacist at 10mg/ml). Most pigs don't need lasix long-term, but I have a couple who will hoot and cough without it.

These meds are stable for 60 days if compounded with Oraplus (commonly used by pharmacists), so you can purchase 60 days worth of meds at a time. They must be refrigerated or they will become ineffective.

If you live in a country where Lotensin (Benazepril) is not available, you can use Enalapril (check the heart sticky for dosing guidelines). Lotensin is a newer generation drug that is easier on the kidneys.

Heart meds will not necessarily cure the problem i.e. an enlarged heart will not become smaller. However they can give many extra years of high-quality life. There is a downside, however: the laid-back belly pig may no longer be content to sit in your lap for hours - increased energy levels tend to turn lap pigs into wrigglers!

One of the most heart warming results of successfully treating a pig with heart problems is when you see that pig popcorn, gain weight, and run around like a young, healthy animal. And at the end of your friend's life you know that you did all you could, possibly extending that life by years.

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Lynx
RESIST

Post   » Thu Nov 02, 2006 1:05 pm


I can add a link to this thread to the first post in the heart sticky.

I think you had guidelines from your vet on how to determine if a heart was enlarged? Don't know if you (or anyone else) have an xray of a normal heart and an enlarged heart.

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Mum
I GAVE, dammit!

Post   » Thu Nov 02, 2006 1:32 pm


I've started a photobucket album and will scan the rest in when I pick them up. So far I have Fweep's Jiffy, and Sparkles N Daisy's two girls (hope they don't mind).

http://s22.photobucket.com/albums/b310/a10101/xrays/?sc=1&addtype=local

When I pick up the rest of the xrays and get them up, I'll be sure to put up a normal one for comparison (I think I may have one of those!).

Josephine
Little Jo Wheek

Post   » Thu Nov 02, 2006 3:55 pm


I think it is EXTREMELY important to add the VALUE of an ultrasound. It tells you which defect is present and which medications would be beneficial. One can always opt out of it, but it certainly aids management and specific diagnosis of a cardiac problem.

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Mum
I GAVE, dammit!

Post   » Thu Nov 02, 2006 4:15 pm


Thanks, Josephine - good point.

And, I'd like to add that if I'd had one on Heddwyn to start with I might have been able to save a fortune instead of having the pile of xrays I have here (which are still inconclusive).

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LAWomans
"Live Long and Prosper"

Post   » Thu Nov 02, 2006 4:36 pm


These really came out great! Very helpful. Can you show one with a normal heart, maybe Muffin, so we can see what the difference is.

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Mum
I GAVE, dammit!

Post   » Thu Nov 02, 2006 4:38 pm


Yes, as soon as I pic up the xrays (or get them to send them digitally from LBAH).

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luvmypigs2

Post   » Thu Nov 02, 2006 4:40 pm


What is the approximate cost of an ultrasound?

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Mum
I GAVE, dammit!

Post   » Thu Nov 02, 2006 4:51 pm


LBAH charges $315 for a cardiac ultrasound, or $450 for both a cardiac and abdominal (to show kidneys).

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Lynx
RESIST

Post   » Thu Nov 02, 2006 7:42 pm


I think some vets want to have echocardiograms done too.

There are a number of different heart problems -- the treatments are different too. I wish I understood more about this. All I have is an article about rabbits.

User avatar
Mum
I GAVE, dammit!

Post   » Thu Nov 02, 2006 7:45 pm


the treatments are different too.
Lynx, I don't think this is necessarily true. If the problem can't be treated by lotensin and/or lasix, then as far as I know there is no treatment. There are things like vetmedin that can supplement the lotensin.

And of course there are some problems that are just not treatable. But please let me know if I'm wrong.

Josephine
Little Jo Wheek

Post   » Thu Nov 02, 2006 8:55 pm


Yes, Mum, the treatment MAY be different based on the ECHO. Your explanation I think needs supplementing if you are going to post this as a "starting" guide for newbies with pigs with heart disease.

Whether a radiologist does the ultrasound or an internist, etc. has a lot to do with the info gleaned and the costs. So does location.

An ECHO around here is usually in the $250 range and whole-body is about $300. Things may differ +/- 10% in the surrounding counties. A GP (general practioner) with experience may be as much as 50% less, though. It pays to talk and ask around for the best experience at the best price. Sometimes you get the best info for $300, and sometimes not. It depends, just like everything else.

Talishan
You can quote me

Post   » Thu Nov 02, 2006 9:25 pm


The cost of ultrasound will vary by location. Metro Atlanta runs $189-$220. Cardiac may be slightly more, but won't be way out of line with abdominal.

I just don't want casual readers to see those numbers and get totally freaked.

User avatar
Mum
I GAVE, dammit!

Post   » Thu Nov 02, 2006 9:52 pm


the treatment MAY be different based on the ECHO.
Josephine, would you elaborate? I've found it so hard to collect all this information even for the many heart pigs I have here. I would really love your input on this thread, since my knowledge is only gleaned from what I've been able to do for my own pigs.

Josephine
Little Jo Wheek

Post   » Thu Nov 02, 2006 10:03 pm


It is really difficult to post all outcomes and tx plans. There are valvular diseases as well as heart muscle diseases and so on. To post a comprehensive list won't help that much. And every disorder has its staging and associated problems. It's still really hard to tell which problems are the most prevalent since the info is not posted and a lot of tests not run in cavies right now.

As you said, some cardiac problems (especially valve diseases) are surgical fixes only and there is no true medical option, although ACE-inhibitors +/- Ca+ channel blockers may be beneficial and diuretics may be helpful to improve life. Every case is unique and I really wish that ultrasounds were more commonplace and accessible (in every way). That would help a lot more pigs in a shorter time. Even heart histos post mortem would help also. It is such a great noninvasive tool. So much better at diagnosing this sort of thing than an x-ray--although they, too, have their place.

The other thing is that the heart changes can be accurately measured with dopplar and an ECHO to monitor a patient and make changes to the treatment protocol prior to seeing visible clinical signs. By the time the signs you posted above are evident, major damage is done. Sometimes, it is so much harder to stabilize or even maintain them when they get to the point they are visibly ill. Makes sense, right?

And Talishan, yes, I agree, if people don't research things--who knows what kind of scan or report they're getting for what price.
Last edited by Josephine on Thu Nov 02, 2006 10:04 pm, edited 1 time in total.

capybara
Supporter in '13

Post   » Thu Nov 02, 2006 10:03 pm


For symptoms that may show a heart condition, but nothing shows up on x-ray definitively, how do you get a vet to give you a trial run of a drug? When we were trying to figure out why Momiji's weight would fluctuate no one was willing to experiment. Luckily we now think it's only a gas problem, but in case something that seems heart related comes up with any other pigs, how do we convince them?

Josephine
Little Jo Wheek

Post   » Thu Nov 02, 2006 10:07 pm


How do you convince them? Get an ultrasound done.

I got desperate with one pig and couldn't get drugs until after I had an ultrasound and emails in hand from exotics vets with drug doses. My pig was going to die. Heart meds certainly wouldn't hurt if he was dying anyway. Fortunately, he stabilized and lived another 5 years.

A lot of the signs of heart disease are so vague, really. They go with many illnesses. It is hard to just treat symptomatically.

Josephine
Little Jo Wheek

Post   » Thu Nov 02, 2006 10:13 pm


Oh, this is a nice explanation of how some of the cardiac drugs we use work:

Cardiac Failure

Different types of heart problems and tx:

SAS

CHF1

CHF2

CHF3

Josephine
Little Jo Wheek

Post   » Thu Nov 02, 2006 10:30 pm


OOH! Leave it to VIN...

Canine Cardiomyopathy

This one is more for the people with a little more medical terminology background. It goes to show that different types of cardiac problems need different treatment!

The whole point is early diagnosis and prevention of HEART DISEASE in whatever form to progress to CONGESTIVE HEART FAILURE. If you prevent this, the pig is going to live much longer. Maybe I was lucky with my pig since he almost died (or was euthanized by me) several times. He taught me so much about management, though. If you prevent CHF, one can hope to manage them for years to come. CHF, though, is almost always terminal sooner than later. It is end-stage heart disease.

Fweeprluvr

Post   » Thu Nov 02, 2006 11:23 pm


Mum, Jiffy gives her consent to use her radiograph. She is quite thrilled and honored.

If you need a normal heart rad, I have Gingers original X-rays on CD (somewhere, will have to find) and Dr. Ridgeway looked at them and so did his radiologist and they said her heart was fine. She also had an EKG and he said that was fine too (I don't have that).

Let me know if you want to use it.

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