Smokey - pharyngeal abnormality

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jacqueline

Post   » Wed May 21, 2014 6:38 am


I just took in Smokey. He's a beautiful all black american short hair, about 1 year old now. He was rescued from an owner who was about to have him pts, due to his breathing problems.

The foster/rescue treated him for a URI and that disappeared but he continued to have difficulty with breathing. Their vet suggested it may be allergies or asthma and that he would need nebulizer treatments daily. The foster was giving him nebulizer treatments 3-4x day. That's when I got him.

It turns out he sounds exactly like my other pig Olive who had a pharyngeal abnormality. Their breathing sounds awful. Here's a clip of how smokey sounds (please ignore the video part, I was just going for the audio). Just click on the picture:
Image

So, the treatment that we've used is to discontinue to nebulizer since it actually adds moisture into his system that he can't clear out because his throat muscles can't clear them away. We added metacam to help with inflammation - a very small does of 1.5 ml 2x day.

This has all helped significantly. However, the prognosis is a significantly reduced life span. Eventually the pharyngeal muscles stop working and he's at risk for aspiration and a total shut down of his respiratory abilities. That's how Olive passed.

I would like to extend Smokey's life and improve the quality for as long as I can. What I've notice is that his breathing stays pretty quiet unless he gets anxious, startled, etc. He's still in quarantine, so as long as I carefully warn him I'm coming into the room, he's fine. If he'a surprised, his breathing immediately goes into stress mode.

He will most likely remain a lone pig, out in the same room as others eventually. I give him cuddle time daily. He gets calming gentle touch, a modified kind of Reiki, gentle massage, etc. His breathing is always better after that.

For you brainiacs out there - I know there's no anti-anxiety meds for guinea pigs, but is there anything close? Are there anti-anxiety meds for other animals that we could perhaps try? I have wondered if some kind of medication that lowers heart rate might work if given at a very very low dose.

Any ideas folks?

SardonicSmile

Post   » Wed May 21, 2014 7:49 am


No ideas but he sounds like one of them overbred dogs with mushed in faces.

I hope you can keep him happy and as healthy as possible for a long time.

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Lynx
RESIST

Post   » Wed May 21, 2014 10:10 am


Is there any chance you could write up something on the pharyngeal abnormality your other and this pig possibly had? Maybe with your vet's help and how it was diagnosed? This could be very valuable in the Records forum.

Talishan
You can quote me

Post   » Wed May 21, 2014 11:06 am


Ditto Lynx.

Three thoughts: has his heart been checked? Heart medication might help (or it might not). Just a thought.

Guinea pigs can be given Valium. There are other anti-stress things out there, but I don't know if there's any history with guinea pigs for them.

A bronchodilator? Not sure that would help the pharyngeal abnormality or not. Muscle relaxant? Don't know if that would actually weaken the muscles (the reverse of what you need) or not.

Just throwing things out there as ideas.

Good luck with him. I'm very glad he found his way to you.

User avatar
Kimera

Post   » Wed May 21, 2014 12:32 pm


I have heard such sounds in dogs, but never in guinea pig yet. Sounds very stressful for the piggie. Poor baby!
I don't know what would make him breathe easier, but if you are looking for a very mild sedative which could be acceptable (and palatable) to a piggie, try melissa herb (Melissa officinalis), called also lemon balm.
http://en.wikipedia.org/wiki/Melissa_officinalis
Melissa teas and extracts are used to help in calming down and reduce stress in human medicine, and are safe enough for children.

User avatar
jacqueline

Post   » Wed May 21, 2014 2:25 pm


Thanks for all your ideas. Yes, Lynx, I'm more than happy to write something up. In fact, I think it is important. Both times I adopted these pigs they were receiving nebulizer treatments, and labeled as "special needs" pigs. Sadly, nebulizer treatments were the very worst thing for them The diagnoses was critical, and I'm so grateful to Dr. Doolen for bis brilliance in spotting it.

I'll keep you all posted.

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Delaine
Supporter in '14

Post   » Wed May 21, 2014 6:51 pm


I am a great fan of Rescue Remedy for myself. It is a Bach flower remedy and can apparently be used on children (over 12) and animals. I have heard of it being used on dogs. I am not sure if it would be safe for a guinea pig.

It is a natural stress relief formula.

Here is some information on guinea pigs and Rescue Remedy. I think they might make it for animals, but I am not sure. I just did a quick google search.

http://cutiecavies.proboards.com/thread/5463

User avatar
jacqueline

Post   » Wed May 21, 2014 7:57 pm


So, one by one:

I just asked my vet about any literature about this and she doesn't think there is any, but she'll look. I'll be getting Olive's xrays sent to me, and be able to point out (hopefully) what Dr. Doolen noticed.

I'll write up what I know, and at least that will be a place to start.

Talishan - I'd love to hear anything else you might know about dosing valium for piggies. Initially, Olive did have a slightly enlarged heart. It seems it's a chicken and egg thing. The effort she put into breathing may have strained and enlarged her heart, or the other way around, who knows?

I love the idea of Rescue Remedy and am going to get some and give it a try.

Did I mention this little guy has stolen his way into my heart? Silly peeg. . .

More later. . .

Talishan
You can quote me

Post   » Thu May 22, 2014 12:41 pm


I haven't used Valium myself, but there are rescuers on this board who have used it in extreme mites cases, to help the pig avoid seizures until the mites die off. I think there's a dose in Carpenter's 4e for it, if you have that. I'm not at home so I don't have it with me. Email me through the mailer if you can't track it down and I'll look it up.

Enlarged hearts don't go back down. In my opinion too it's a chicken-and-egg thing, or mutually reinforcing thing if that makes any sense. That said, I'd want to look into that a little bit more if it were me. The initial heart enlargement, even if it didn't cause a problem for her earlier, may be causing a problem now. (There are degrees of enlargement in animals, same as there are in humans and it does work both ways, so to speak.)

I've tried Rescue Remedy and it is safe for guinea pigs (recommended by a vet), but I have never had the slightest success with it. Your mileage may vary. It's worth a try.

User avatar
jacqueline

Post   » Sun May 25, 2014 9:58 pm


Lynx - here's brief summary of the course I went through with Olive (and am now eerily going through with Smokey. Please feel free to save this however you wish, though I would suggest that the video and xray would be helpful. Feel free to edit.

I'm trying to get the xray lined up clearly for illustrative purposes.

June 21, 2013: adopted Olive from a rescue in Mayland. She’s an American short-haired, intact female ~1.5 years old. I was told she had scarred lungs and would need nebulizer treatments 2x day for the rest of her life.

Her breathing is short and quick, coming from her lower belly area, and very loud. She eats okay, but does better when her vegetables are cut up into smaller pieces.

June 29 2013 (Day 8): I take her to Dr. Doolen (truly an exotic specialist): the xrays of her lungs are clear. Her heart is slightly enlarged. Dr. D. believes the noise is coming from her throat area. The rattling, wet, breathing that was originally diagnosed as scarred lungs is coming from her throat, not her lungs. She also has a slightly wet chin. Her teeth check out fine. Dr. D. examines her xrays and keenly notices an unusual shape at the place where her spine meets her skull.

Olive is eventually diagnosed as having a "pharyngeal dysfunction". This is a neurological issue, not merely an acute inflammatory episode, that makes it difficult for her to use her pharynx properly. She can’t use her muscles to properly clear her throat of phlegm. It is a progressive disorder and will make it more and more difficult for her to swallow, risking aspiration, etc.

Olive also has an odd shape to her - she looks a bit like a badly drawn cartoon. She had a little tiny head and a torso that was just not the right size to match. Dr. D. suspects a motility issue and puts her on Cisapride .2ml 2x day.

8/15/2014 (about 2 months later) I came home from work today around 3pm to find Olive hunched up in a corner really struggling to breathe. She doesn't get up for veggies or for our usual greeting. Her breathing was short, gaspy, abdominal breathing - clearly exhausting for her. Her teeth are chattering and she’s shaking. She looks like she’s in pain.

The vet checks her out and finds that her lungs are clear. Her difficulty in breathing is indicative of the progression of her disorder. The vet prescribes metacam (to help reduce the inflammation and help her breathe easier) and cisapride.

The following week, her breathing becomes increasingly labored, in spite of extra doses of metacam. When she's really distressed, she comes out of her hidey and sits on top of her sleep sack, hunched up, taking short gasping breaths from her abdomen. She looks exhausted. She isn't eating many veggies or pellets, and only a little hay. She’s getting supplemental CC.

8/18/14: back at the vet’s, her breathing continues to be labored. We discuss treatment options. There is no cure, and no surgical intervention. It was decided that the kindest thing was to allow Olive to be PTS and so she can finally rest. She was ~1 year 8 months when she died. I had her only 2 months.

User avatar
Lynx
RESIST

Post   » Sun May 25, 2014 10:12 pm


Thanks for posting this. I'll see if I can get a post in the Records forum tomorrow.

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jacqueline

Post   » Mon May 26, 2014 4:38 pm


I haven't done this before (I don't think) but I'm really asking for the collective wisdom and help of all of you here. I'm trying so hard to improve Smokey's quality of life, and so far it's not going well.

Saturday night he starting sneezing and getting snotty, so off to the vet. He's now on Baytril for a URI. His breathing continues to be labored.

He is now on Metacam .2ml 2xday; baytril .3ml 2x day; rescue remedy, topically 2x day; benebac sprinkled on veggies 2x day; 50 mg vitamin C daily; supplemental feeding with CC.

I'm trying to do my own research here, and coming up empty. I did find a similar kind of problem in rabbits, called "stertorous" which just means loud breathing. Apparently it's more common in rabbits. There was some suggestion of the use of steroids to help with the inflammation.

I'm still really studying Olive's xrays to see where the abnormality is, not that that will help much.

If there's anyone who can find any literature on pharyngeal or neurological disorders in guinea pis or rabbits, I'd appreciate it.

I'm so worried that we may not find anything that helps soon enough. Right now, he's struggling so hard to breathe, and doing little else. I can hardly stand it.

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Lynx
RESIST

Post   » Mon May 26, 2014 9:05 pm


I added a link back to your thread here:

http://www.guinealynx.info/records/viewtopic.php?p=366#366

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jacqueline

Post   » Mon May 26, 2014 9:27 pm


Thanks, Lynx. Hopefully it will be helpful to someone else along the way.

Talishan
You can quote me

Post   » Wed May 28, 2014 10:05 am


Gabapentin (Neurontin) is a neurological agent that can be used in guinea pigs. We've used it for one of ours. There's a dose for it in Carpenter's IIRC.

Steroids are the most powerful anti-inflammatory agent there is. That said, I'm sure you know they're tricky to use in guinea pigs. That said, we've had two on a low dose of prednisolone long-term, with great benefit and no side effect that I could tell.

The two we used pred for did not have a condition like Smokey's, so I can't speak to whether it would help him or not. At this point I'd want to try it if it were me. There's an old saying out there, "better pred than dead". Harsh, but if his quality of life is really declining I'd want to try it.

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jacqueline

Post   » Wed May 28, 2014 5:10 pm


Thanks, Talishan. We go to the vet tomorrow. I appreciate the info you posted.

Can you tell me what conditions your pigs had that led to them being on prednisolone and also the neurontin?

I'm struggling with what exactly to do here. In the past my litmus test has always been "are they able to be guinea pigs?" Can they eat, play, interact, etc like "regular" guinea pigs?

That's not the case with Smokey, and probably never will be. He struggles to breathe, and any movement worsens that. He stays in his hidey 90% of the time that I'm around. He occasionally will leave to sit right next to that on a warming pad. There's very little poo any where else in the cage, so even when I'm not around he probably isn't moving around the cage much.

He wasn't going to the hay box or water bottle. I placed a handful of hay near the hidey and he ate that. I've moved the water bottle closer.

I sit with him in my lap at least twice a day. He gets snuggled in fleece, I give him his medications and then some CC, which he eats pretty well. The time he spends on my lap is just lovely - he seems content, and I'm certainly happy. Occasionally he'll seem brave enough to venture out of the fleece and start walking around my lap and even tries to jump onto the couch.

He doesn't seem to be suffering. He's on metacam. Maybe it's okay that he leads a quiet simple life. But he does struggle so to breathe, and I know it limits his life.

Heavens. . .I just don't know how to proceed here. I hope the vet will give me some useful info.

Talishan
You can quote me

Post   » Sat May 31, 2014 8:01 am


"Can you tell me what conditions your pigs had that led to them being on prednisolone and also the neurontin?"

One had a slow-growing, very large (not surgically removable) tumor. He was on pred for well over a year.

The other developed a diagonal paralysis, for lack of a better way to put it, after a very long and very intense surgery (stone was stuck in the urethra and the vet had to dig it out). He was on pred for over a year, and on gabapentin for a few weeks. We discontinued it after it didn't seem to help him. It didn't hurt him, though.

Please let us know what the vet says. If he doesn't seem to be suffering, I'd treat him the best I could and let him be who and what he is for as long as he has. That said, he's not my pig and I'm not you. Go with your gut.

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jacqueline

Post   » Sat May 31, 2014 8:49 am


So, the latest update is a sad one. I love Dr. M. because she's so willing to take the time and have really good discussions with me. We talk about what the problem is, what the treatment options are, and then what the ethical thing to do is. It's such a pleasure to work with her.

She's was really so distressed hearing Smokey's breathing. It sounded to her like it was coming from both his throat and his nasal area. His breaths come sharply and are not at all the gentle rise and fall or normal breathing.

Her best guess was that it's some sort of laryngeal paralysis. In terms of treatment options, there are very limited ones. Surgery is not an options. Steroids are risky and she hasn't seen much success with them (in her opinion). We opted to increase the metacam to keep him comfortable.

Olive was with me only 2 months. In the end she went into respiratory failure, which was quite upsetting to see. Anticipating that, Dr. M. suggested if/when Smokey went into failure, I could add a does or two of metacam. We discussed whether to bring him in for euthanizing, or just let him pass at home. It's hard to predict how long the failure could go on for, but Dr. M. doesn't think it would last long - so as long as I could keep him comfy. . .

She did, ever so gently, ask if I would allow her to do a necropsy afterwards, to determine what's really going on with him. I agreed, and will surely post those results when the time comes

So, I'm spending lots of cuddle time with him, monitoring him and keeping him comfy. This will be a hard one for me, but I'm hopeful that some useful info will come out of this for the next pig. . .

Talishan
You can quote me

Post   » Sun Jun 01, 2014 10:08 am


This will be a tough row to hoe, but you, in my opinion, are choosing the very best possible course. For Smokey, for Olive's memory, for other pigs that could benefit greatly from their experience and from what you've learned and posted, and for all of us.

Certainly not for you. You have chosen the hardest and most selfless route possible. Kudos to you for that.

In my experience (and this is *only* my experience, and not a recommendation per se), we have let pigs in similar states pass at home. We also keep injectable buprenorphine on hand. The injectable can be given orally (it's actually absorbed transdermally, but is such a small amount that just shooting it into the buccal pad area does the job).

Max Carpenter's for this med is IIRC 0.2 mL/kg of pig, using the standard 0.3 mg/mL injectable (or 0.06 mg/kg of pig).

I am NOT repeating NOT advocating ANY TYPE of home euthanasia. Please be clear about that (for other readers more than for you, you know what you're doing). That med, however, can definitely ease the trip over if it gets to that point and you know that's the point you're at.

Carry on, cherish your time with him and please keep us posted.

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jacqueline

Post   » Sun Jun 01, 2014 1:28 pm


Talishan - I can't thank you enough for your post. It means a lot to me.

I feel like I've learned so much from all these special pigs - from Jerry and Charlie Brown, and now Smokey.

I appreciate you sharing the info about medications and will keep that in mind. Yes, it is my goal to let Smokey stay at home. Why not?

I do hope the experiences will be useful to other pigs as well. I'll post with updates as they come.

Right now Smokey is doing well on an increased dose of metacam. He's on .3 ml 2x day and I rarely hear his raspy breathing - at least for now.

I'm enjoying my time with this special little boy.

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