Background information: Her name is Buttercup, she is female and around 2 years old, and has short hair. This has been an ongoing problem since adopting I adopted her around 3 1/2 months ago.
Ever since I have had her, Buttercup has had abnormal, mushy poops. When pooping, she arches her back and strains her body and often squeaks. She is also frequently gassy and often passes gas that is very audibly loud (can be heard from across the room). She often farts right before she poops, so that her droppings seem to be "exploding" out of her butt. To get a better idea of what I am describing, you can watch these two videos of her going to the bathroom here.
You can't really hear the squeaking in the videos, but you can definitely see the straining. Also, if you turn up the volume you can hear the "pop" as the stool "explodes" from her butt.
I thought that she had diarrhea at first, but now realize that they are just soft stools. They are sometimes very long (even up to 1"-1.5" long) and much more foul smelling than her sister's. Since they are so wet, she often gets "poop shoes" from stepping in them. Despite her gastrointestinal issues, Buttercup is very active, energetic, and alert, in fact I would say much more so than Piggy!
When I was at home over winter break I took them both to see a supposedly cavy savvy vet. She was very nice but I wouldn't really call her an exotics specialist (had never heard of impaction in male guinea pigs; for Piggy's very fungal looking nose did not even mention the possibility of fungus let alone doing a culture to test for it. Instead suggested the crust was from an URI despite the fact that Piggy showed no other symptoms of having one and the majority of crust and hair loss was at the top of the nose, above her nostrils). Again, very nice but not exactly cavy savvy.
Anyway, back to Buttercup - The vet did do a fecal float using one of Piggy's stools - Buttercup would not cooperate in giving a sample - and said that anything Buttercup had would show up in Piggy's stool as well. The fecal float showed of Piggy's stool showed that stool was normal, and she did not address Buttercup's squeaking/straining. Rather, she told me that Bcup's soft stools were most likely the result of an intolerance to one of the veggies I was feeding (green and red leaf lettuce, romaine lettuce, green bell peppers, cilantro, occasional zucchini, and a little bit of carrot each week). She instructed me to cut vegetables out entirely until her stool firmed up and then start re-introducing them one by one. I felt bad cutting out veggies and thought that maybe the mushy stools were due to too many veggies as opposed to an intolerance to just one, so instead started to slowly decrease the amounts that were given in the hopes that at a certain point the stools would get better. Eventually we got down to no veggies, and there was absolutely no improvement whatsoever. I thought back to the vet's original advice and decided to continue feeding no veggies and wait until the poops firmed up. The vet had not given me any sort of timeline, so I thought it was just a matter of waiting long enough. Fast forward a veggie-less month later and nothing had changed. At this point I start to think that maybe this is not normal and that perhaps veggies aren't the problem. This is when I start the thread about it on Guinea Pig Cages.
Based on the advice there, I called the original vet telling her that Buttercup has had no veggies in a month and that her stools are still mushy. She asks me to bring her back in, which isn't possible now that I am back at school and in a different state. Instead, I bring Buttercup in to see a new vet, Dr. McDermott, at UPenn Vet's Exotic Companion Animal Medicine and Surgery department (this was last Wednesday). By the way, they are AMAZING there. We were there for almost 2 hours and they did such a thorough examination of Bcup - the difference between them and the first vet was like night and day. They suggested doing a fecal float as well as a whole panel of bloodwork, but the bloodwork was going to cost an additional $200 so I asked if we could just start with the fecal float instead. The fecal float of Buttercup's stool came back as normal, and based on these results they but her on a 14 days course of Metronidazole (Flagyl) of 0.27 mls 2x a day.
Today is her 4th day on the Flagyl, and things haven't really changed. She is still squeaking, straining, passing gas, and having soft stools, but not any worse than she was before starting the medication. Today she made a stool that was extra large and mushy, but it definitely isn't the norm.
bpatters mentioned on the Guinea Pig Cages thread it is odd that there hasn't been any improvement on the Flagyl so far, and that her pig's soft stools got better on it after only 24 hours. I know that Buttercup is supposed to be on it for 14 days, but if there hasn't been any improvement so far does that mean that it's not likely to work at all? I think it is possible that her system is on overload because she hasn't had veggies for so long, and now that I am giving them to her again she's been going kind of crazy with them and absolutely vacuuming up whatever I give her. I have also been giving her strawberries about every other day because she loves them so much and I think I felt guilty for depriving her for so long, but I am definitely going to cut those out and stick with only lettuce and bell peppers until things get cleared up.
I forgot to ask him during the appointment but emailed him afterwards about the possibility of a urinary tract issue or stone. He wrote back:
"Usually with urinary tract issues we can see a change in the color or frequency of the urination. If she does have a bladder stone, the best way to find it would be on x-rays. We could run a urinalysis after trying the Metronidazole to see if she has any signs of infection."
so I think that if the Flagyl doesn't work out the next step would be x-rays. I was just wondering, I know that bladder stones can cause squeaking while passing stool and would also probably responsible for the straining, but could that cause the large, soft stools as well? If they didn't find anything in the fecal float so the problem isn't parasites, and if the Flagyl doesn't work and the problem isn't bacterial, what else possibly could it be? I am bringing Piggy in to see the vet next Monday and will obviously ask him all these questions and give him an update on Buttercup then, but until that time I guess I was wondering what you all thought.
Thanks in advance!
Diagnosis 1 (Historical): Soft stool
Diagnosis 2 (Confirmed): Tenesmus
Diagnosis 3 (Confirmed): Flatulence
Chief Complaint and History:
Buttercup presented to the Exotic Companion Animal Medicine Service at VHUP on 2/15/12 for evaluation of chronic soft feces and scratching at herself. You report that you adopted Buttercup and her cagemate, Piggy, on October 31st, 2011. Since you adopted her you have noticed that Buttercup is about half the size of Piggy and has always had large but soft bowel movements that cause her to strain. You also report that she seems to have a lot of flatulence and may be drinking more than normal. You are also concerned that she might have mites or fleas because you see her scratching herself a lot. She was seen by another veterinarian in December, but no medications were started at that time. The veterinarian's recommendation at that time was to remove the vegetables from her diet. This had no effect on her feces or her flatulence.
Buttercup and Piggy receive timothy hay, timothy hay pellets, and approximately one cup of greens and veggies every day.
Upon physical examination, Buttercup was very bright and alert. She weighed 0.648 kg (roughly 1.4 pounds) and she has a body condition score of 1.5/5.
Weight: 0.648 kg (roughly 1.4 pounds)
Heart Rate: 228 bpm Respiratory Rate: 160 breaths/min
Oropharyngeal: sneezing occasionally during physical exam, brief dental exam performed which showed no dental problems at this time. Mucous membranes pink and moist. Good tongue movement.
Eyes: nuclear sclerosis OU, some minimal corneal scarring OS
Ears: mild ceruminous discharge AU
Respiratory: normal referred upper airway noises, no crackles or wheezes noted upon auscultation
CV: No murmurs or arrhthmyias noted upon auscultation
GI: small amount of soft but formed stool during PE and in rectum, nonpainful, gas-filled abdomen
UG: intact female, no vulvar discharge, normal mammary glands, soft and full bladder
Integ: crusted and dried feces on paws, mild scaling on dorsum
LN: No peripheral lymphadenopathy noted during exam
MS: Underweight, no fractures, ambulatory X4
Nerv: bright and alert, mentally appropriate
Procedure 1: Physical Examination
Procedure 2: Fecal Examination
Diagnostics, Treatments and Progress:
Fecal Flotation- We recommended doing a fecal examination to test for any internal parasites that Buttercup might have. No parasites were found on the fecal.
Buttercup has been having soft stools since you got her on October 31. Since this is a chronic issue, it is likely that she has some changes to her GI tract (parasites, disruption of her GI flora) that she has been living with for a long time.
Metronidazole - please give 0.27 mL by mouth every 12 hours for 14 days. This drug is an antibiotic.
DIET: Please continue to give Buttercup and her cagemate free choice timothy hay. You can increase the amount of pellets and dark leafy greens that Buttercup receives. Please make sure to provide both Buttercup and Piggy with enough Vitamin C every day. Adult guinea pigs require 50 mg of vitamin C each day. Sources of vitamin C in vegetables include parsley and red bell peppers.
MONITORING: Please continue to monitor Buttercup's stools. If she stops producing stools, seems to be straining more or there are any other unusual changes in the stools, please do not hesitate to call us.
RECHECK: Please email Dr. McDermott in 14 days to recheck Buttercup's stools. If Buttercup is not doing well before this time, please contact Dr. McDermott to have her re-examined sooner.
Drug - Metronidazole (50 mg/mL)
Quantity - 12 mL 10 mg/kg
Dispensed Dosage Instructions - Please give 0.27 mL by mouth every 12 hours for 14 days. This is an antibiotic.
Thank you for bringing Buttercup in to see us today! She is a very beautiful girl and has a lot of personality!
I didn't want a fecal done but did it anyway, 99% of the time there's nothing to come from that test. So we did a blood test and found that his bilirubin was twice the value it should be and his poop was 50% gram neg. So he obviously has liver issues. Diarrhea is a common symptom of liver issues and cannot be seen with an xray or ultrasound (unless it's enlarged of course).
I highly suggest the blood test since nothing else is working.
Have you tried simethicone? Acidolpholus?
If it were me (and i know people will disagree) would give her a whole raw piece of corn, with husks (especially the husks)
This has firmed up my piggies soft poops every single time.
I would get some "Critter Be Better" from American Pet Diner. Its high fiber and contains probiotics.
Comes in pellets and powder. Just like Critical Care, but better (in my opinion), piggies will willingly eat it, and it contains probiotics (which CC does not)
Thats where I would start. Corn husks, and Critter-Be-Better.
In the meantime, I'd go ahead and add probiotics to her diet to try to keep the gut flora from getting any further out of whack. My guys love this stuff:
Is she staying well-hydrated?
Good luck. I hope they can figure out what's causing this.
I asked her vet about using probiotics to help the bacteria in her gut, and he basically said there wasn't any point and that based on the literature on it's use in both humans and animals, it is unclear how much of an effect it really have. Also, there are so many different types of bacteria in the gut and even though they could test to see what the different levels of each one were, it is hard to treat for that because there are not yet any clear standards of which levels are normal and which are not. Lastly, he said that since most probiotics would be given orally, they would have to go through the stomach before reaching the gut, and the majority of bacteria would be killed off in the there due to the ph levels anyway. So, based on those factors, he would not recommend as a primary consideration or treatment. I was surprised to hear this because I know a lot of other members have used probiotics and see positive results, but he is also a very knowledgeable exotics specialist/cavy savvy vet, so I trust his opinion too.
gvstate01, when they did the blood test did they test for certain things or did they test for everything? I am just a little bit scared of the $200 cost but definitely think it will be worth it if nothing else works. Buttercup also has really foul, strong-smelling, putrid poops. They literally stink. Does your piggy also have issues with gas and squeaking/straining while pooping? Also, despite havinga very healthy appetite, Buttercup only weighs 650 g and was given a body score of 1.5/5 (which I think is basically in the middle between emaciated and skinny). When you stroke her back, you can feel all of the bones in her spine. She hasn't been losing weight since I got her, but has always been that skinny. Still, that combined with her excessive thirst, suggests that she might have hyperthyroidism.
It is just confusing because she has so many different symptoms. Correct me if I'm wrong but from what I gather, hyperthyroidism would explain her drinking, low weight, and soft stools, but not the squeaking/straining and putrid smelling poop. Liver problems would explain the soft stools and putrid smell, but not the squeaking and straining. Stones would explain the squeaking and straining, but not the soft stools and putrid smell. And I don't even know where her gassiness fits in to all of this!
Unfortunately, she died & we don't know what was wrong with her. Not very helpful - sorry.
Here are a couple of links threads with similar issues:
I'm sure there are other threads as well. I think squeaking when pooping may suggest bladder stones, but I don't think that was the case with Elle.
In the second link, you'll see my discussion of our Elle. This happens to quite a few pigs and there doesn't seem to be a single, effective treatment. Some things work for some, some for others. Some get better, some have a chronic problem.
Good luck with her.
Edited by Bookfan on 2/20/2012, 3:46 pm
It seems the digestive system is completely out of wack. I would do a fecal culture and see if there is an overgrowth of gram positive (I think) bacteria which would account for what you are seeing. I believe the fecal float primarily tests for parasites. The stinky poops may also be the caecal feces that the guinea pig reingests.
The advice to rule out vegs was good, but didn't work. I'm not seeing what pellet you are giving. They are usually grain based and can help keep a gut that has a bad balance of bacteria out of wack. You need to stop feeding pellets too until things clear up (this is on the diarrhea page).
I doubt your pig has hyperthyroidism. There are much more likely causes for the soft stools.
See also www.guinealynx.info/probiotics.html
Regarding your first vet, male guinea pigs can indeed get impacted: www.guinealynx.info/impaction.html
I read the Diarrhea page, and if I am not mistaken I think that it is an overgrowth of gram-negative bacteria such as Clostridium that causes diarrhea. It also says that Flagyl may help with that, which is what she is on now. Since parasites have been ruled out by the fecal float, the next two most likely causes would be bacterial and fungal. If the Flagyl doesn't help and that makes it seem less likely to be bacterial. Does that fecal culture also reveal information about the gram positive/negative bacteria, or can you only find that out from the gram stain? I guess this next question is kind of dependent on that answer, but do you think we should do a gram stain or fecal culture or both? And I guess if none of those tests reveal a cause, then we will move on to the bloodwork/x-rays/sonograms (although I really hope it doesn't get to that point!).
I got a lot of great ideas from the threads that Bookfan posted and the Guinea Lynx page on probiotics. I will continue Buttercup on her course of Flagyl, but will start giving her "poop soup" made from Piggy's stools, which are nice and normal. Two questions though:
(1) It said that the "poop soup" is most effective when made with the caecal pellets of the healthy pig/ But I can't exactly pull the caecal ones out of Piggy's butt or mouth, so any other ideas on how to get to them? I think she must eat all of hers because I never see her leaving any around the cage. In the meantime, I will make the poop soup using one of Piggy's regular poops.
(2) It is okay to make poop soup using Piggy's poop, right? Because Piggy currently has a fungal infection on her nose (which has not yet been passed to Buttercup), so I just want to make sure that Buttercup will be OK eating Piggy's poops.
Also, I am going to ask the vet about Bio-Sponge when I bring Piggy in next week. Even though it sounds promising, I don't want to start putting her on a million things at once.
It will be trial and error for you to determine what helps. If it is a bacterial problem, identifying the bacteria will tell you if Flagyl was the way to go.
I don't think a fungal nose infection will affect the poops.
Edit: and regarding the stain/culture, it seems a gram stain is one of the tests that can be done on a fecal culture:
The gram stain may include fungi (in the form of yeasts or molds) in a fecal culture according to that article.
If she is still squealing, straining, having gassiness, and soft stools by next Monday though, when I bring in Piggy I will also bring in a sample of Buttercup's stools and ask them to run a fecal culture on it.
I tried giving her some poop soup tonight. I made sure that I got a really fresh stool to make it with - I scooped it up right as it was coming out of Piggy's butt! Buttercup REALLY did not want to eat it though, and would not open her mouth for the syringe. Next time, is it okay if I smush Piggy's poop between two pieces of lettuce and get Buttercup to eat it that way?
My girl has had a fecal float(negative) as well as a culture(negative). She's been on flagyl, bactrim, a no veggie diet, vitamin c, probiotics...you name it. Still no improvement. Sometimes they will look "better", not normal by any means but better, only to return to mush again.
Yesterday I just threw my hands up in the air and decided that I am going to give her veggies anyway. Why make the poor girl miserable when the mushy poos are not going away when I omit the veggies, what's the difference?? I might as well let her enjoy.
That being said, she's eating well, drinking well, is maintaining her weight, and is otherwise the picture of health.
So puzzling. I sure hope you can get to the bottom of this and that something works for you!
Also, similar to your piggy, besides Buttercup's GI issues she too is the picture of health. Even the vets wrote in their report that she is "bright and alert" and "has a lot of personality!" (Haha, I like to call it bright eyed and bushy tailed, even though they don't have any tails). I am really hoping to be able to get to the bottom of this, but have also started to accept that maybe it is a chronic condition. Either way I love her so much, stinky, mushy, poops and all!
2-23 Long, soft stools with squeaking/arching. No pellets. Weight: 669 g
2-24 Long, soft stools with squeaking/arching. No pellets during the day but given back that evening due to concern over weight loss. Weight: 624 g.
2-25 Stools have improved! Observed her going to the bathroom with no squeaking/straining; stool slid right out and was completely normal looking.
2-26 Observed Buttercup squeaking, straining, and passing a long, wet, stool once again. Based on this pattern, attribute the brief improvement in stools to the time without pellets and the relapse to the reintroduction of pellets. Take away pellets again that night. Based on the belief that the pellets are the problem (and not a bacterial cause), stop giving the Flagyl four days early to avoid any possible further imbalance unnecessarily caused by the antibiotic (stupid, I know). Start to give 50 mg of liquid children’s vitamin C supplement daily.
2-27 Beautiful, normal sized, normal shaped stools. Still soft enough that if they are stepped on they will get squished between the toes, but they are *so* well formed. No pellets. Weight down to 628 g
2-28 Stools are 50/50. Some are passed effortlessly, with no squeaking or straining and yet others seem to require more effort. Stools are more misshapen than the day before, but still pretty small. No pellets. Weight down to 623 g.
2-29 Long, soft stools with squeaking/arching. Email vet and he is starting her on a full course of antibiotics (Flagyl) again. Since there started to be improvement after 2 weeks, this time he is putting her on it for a month. Unsure – was the period of improvement due to the Flagyl starting to kick in or the removal of pellets, as I had though? Still no pellets, and her weight is down to 622 g.
3-01 Long, soft stools with squeaking/arching. Weight down to 604 g and Buttercup is looking very emaciated and bony. Am very concerned about her weight potentially dipping below 600 g, so I add the Oxbow pellets back into the cage that night. Oxbow Daily C vitamin C tablets have arrive in the mail and I begin giving it to them that night as well.
3-02 KMS pellets have arrived! Was considering administering critical care or critter-be-better to Buttercup, but after just one night of having the Oxbow pellets back her weight has increased to 612 g. I feel hopeful that her weight will continue to increase with the KMS pellets. Stools are looking very nice – perfectly normal, in fact. But by this time I have realized that one day of normal looking poos means absolutely nothing.
3-03 Piggy and Buttercup absolutely love the new KMS pellets! Buttercup’s weight is slowly increasing and is now up to 628 g. Unfortunately, her stools have returned to being long and mushy.
3-04 Good news: Bcup’s weight is up to 648 g. Bad news: stools are absolutely awful looking - extremely long, soft, and misshapen. Strangely, Buttercup has started to fight back against taking the Flagyl although she *loved* taking it before (when the oral syringe was near her face she would grab it into her mouth and not want to let it go, even when all the medication had already been pushed out). Begin her on Bene-bac 2x a day a few hours apart from the Flagyl dosage. She does not mind taking the Bene-bac at all and gobbles it up.
3-05 Still fighting the Flagyl, wildly bucking her head and making it very hard to administer the medication to her. Takes the Bene-bac willingly. Poos are the same but her weight is up to 658 g.
3-06 Feeling very frustrated. Has now “turned” on the Bene-bac as well and refuses to take it that morning. During the day I go to the drugstore and buy a bottle of Kyodophilus and give it to her the first time that night (one capsule split open and the powder sprinkled over a piece of romaine lettuce). Thankfully she eats it with no resistance. By now I have figured out to work the oral syringe into the back of her mouth so that very little Flagyl dribbles out, but it was not a pretty sight getting there. That evening, she also refuses to take her oxbow daily C tablet. Unlike the Flagyl which I can force into her mouth with the syringe, there is no way to force her to take the vitamin c tablet. I hate feeling like I have to roughhouse her to give her the medication, especially when it doesn’t even seem to be helping. Stools are disgusting looking, extremely wet and mushy. Some do not even seem to have any shape at all. Weight: 647 g
3-07 Could the kyodophilus be working? The stools are looking SO much better today (normal sized, normal shaped, not even that mushy!). Weight: 635 g
3-08 Poos have gone back to mush, basically we are back at square one. Weight: 651 g
3-09 Stools are still nasty. Woke up in the morning and found a massive clump of mushy poo that had gotten stepped on and mixed in with hay. It was the size of a post-it note. Weight: 653
3-10 Stools are the same. Weight: 653 g
3-11 Stools are the same. Weight: 662 g
3-12 Stools are the same. Have not weighed her yet today. I feel like I am living in an endless nightmare of foul smelling and mushy poops, poop smeared fleece, multiple daily poop shoe baths due to poop shoes that are back 5 minutes after there has been a poop shoe bath. Should I try taking out the KMS pellets? Am just so scared of her weight dropping again. This has been an ongoing problem now for 4.5 months, ever since I got her, and I finally feel like I am reaching the end of my rope. I don’t know what to do and at times feel like doing nothing because nothing seems to work.
Would you like me to add all your photos to your thread permanently? I think this might be a very helpful thread in the future.
--I dont suppose it could be some sort of a food allergy? Such as to soy, which is in both KMs and Oxbow.
-- What about the water source and water bottle? Could there be some mold or gunk inside her water bottle?
Could something in your tap water source be upsetting her tummy? No one has really mentioned the water on this thread... Maybe try switching to a bottled water, just to see.
== I know she was on Flagyl with no improvement, right? What about trying Reglan?
== I would try something that is super full of fiber. Like give her an entire raw piece of corn, especially the husks.
Almost seems like human Crohn's or irritable bowel syndrome!