Hazel's medical thread

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Zaphy

Post   » Wed Feb 14, 2018 10:50 pm


No, her tummy's been soft throughout this. It's not uncommon for her to have gas though, so I am watching her for it. I do have some meloxicam but I know it can cause GI upset, and since I suspect that's what's causing her pain I'm hesitant to try it with her now.

She does look a little better and more active tonight.

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Zaphy

Post   » Fri Feb 16, 2018 2:34 pm


Update (probably for my own benefit to keep track of things): I've continued to feed Critical Care even though I have noticed her eating and drinking some on her own, because her poops are the same- teardrop, mixed light and dark sections, and a bit smaller than normal as well. She doesn't look as bad as she did a couple days ago when I first updated the thread on this latest episode- a little brighter and more active. So I've been leaving her at home instead of taking her with me to observe overnight, but stopping by my apartment more often to check on her. Weight is also still stable. But when I come by in the mornings she's still been hunched/poofed. So, slight improvement in attitude/demeanor, but doesn't look like there's any improvement in the stool quality (though I am hardly any sort of professional so my judgment may be off). Will probably continue CC feedings even with her eating and drinking some on her own, since I can't think of anything apart from stasis that it might be. Well, not without a vet's judgment anyway.

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Lynx
RESIST

Post   » Fri Feb 16, 2018 4:06 pm


I wouldn't discount your opinion on the poops. You know her best of all!

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Zaphy

Post   » Thu Feb 22, 2018 2:11 am


Hazel's been looking better over the weekend, and seemed pretty much back to normal by the time her vet visit came yesterday. I stopped the Critical Care on Sunday to see how she'd do and she kept looking fine so I left it.

New vet this time, I think she was a senior student rather than faculty. TL;DR: Vet gave her a checkup and everything pretty much looked ok except she was a little gassier than the vet would like, and a little thin- not really underweight, but kind of close. So it doesn't appear that I've missed anything major, and we're keeping a closer eye on her diet to make sure she is getting enough hay and not just gobbling up everyone else's share of pellets.

The vet did recommend full diagnostics on her, but I wonder if that was due to a miscommunication on my part? Cause if she is getting better and there's no visible symptom that I've overlooked, then I see no need to go through radiographs/ultrasounds/etc unless she regresses. I wonder if she misunderstood the timeline I had explained.

She was pretty pushy about the testing, which surprised me since it seemed she had more or less given Hazel a clean bill of health. I actually thought that I'd misunderstood something about how the physical exam had gone, it sounded so urgent. Not super happy about that. Discussing it further, it didn't sound like there was really a reason for the imaging other than just an extension of the wellness check. It also didn't seem like the results from any further tests would change her treatment plan except to possibly add pain medication. Which, since she's no longer displaying signs of pain, doesn't seem super necessary. If I were made of money I'd be happy to let them do all the imaging and even run her through their MRI machine they have to find out exactly what is going on inside her... but since I am not, I think I'd better save that money for the next time one of my pigs really needs those tests.

I let them go ahead and run bloodwork on her, but I declined anything further for now. I wish I had declined the bloodwork for the same reasons as well... it was money I probably didn't need to spend, but more than that it was so stressful for Hazel and she's already a highly stressed pig just at her baseline. I didn't realize they couldn't get enough blood from a toenail overclip for the workup and would need to take it from the jugular. That will definitely be something I'll keep in mind if I'm ever asked to consider blood work in the future :/ Anyway, the blood work was "unremarkable" so that's good at least. The vet did think that she most likely did have a bit of stasis in her gut, so that's how I'll continue to approach it.

She had a bit of a rough time re-acclimating to the cage, though I can't say for sure if that was the blood draw or just her smelling like the vet's office and having been poked and prodded from the exam. I think she might have been too stressed out to venture out and eat, since she was a little lighter than normal this morning. I've restarted the Critical Care today just to be sure, but she is now back to acting as normal in the cage behaviorally. Will continue CC and weighing daily until she stabilizes out.

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Lynx
RESIST

Post   » Thu Feb 22, 2018 8:19 am


I do find that it's helpful to write things here so you can go back and look at them for the big picture. I certainly understand holding off extensive diagnostics for now. I truly hope she stays in as good health as she can. I know you will be on top of things if it changes. You might also want to keep track of what vegetables you are feeding in case there are digestive issues in the future that might be related to it.

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Zaphy

Post   » Thu Feb 22, 2018 11:52 pm


Yeah, I definitely appreciate being able to document everything as it happens here. It's especially helpful to be able to go back and figure out what things I've under/overestimated. I hope she stays in good health as long as possible, too... It's not my intent to be stingy with the vet fund, but I'd definitely kick myself if I burned it all off now for something I'm pretty sure we already know the solution for, and then next week one of my pigs develops an abscess or a blockage or something.

She's still looking and behaving well today. Haven't seen any overly malformed poops in the cage, either- just a few with a bit of teardrop to 'em. As an aside, she does not get any vegetables at all- I've tried all different kinds and trying to start with just a bite or two and gradually increase the amount, but no matter what I try she can never tolerate more than maybe 1 square inch of lettuce. So for vitamin C we supplement with the Oxbow Vitamin C tablets, and keep her in our lap to give it to her while the other pigs get their veggies. She'll occasionally get the Oxbow Simple Rewards cookies or a pinch of rolled oats as a treat. Vet suggested eliminating the rolled oats as carbohydrates can change the gut flora for the worse. I've never fed her very much at a time, but it doesn't take much in the way of fresh veg to trigger a poop explosion for her either so it's worth a try.

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Zaphy

Post   » Sat Feb 24, 2018 2:47 pm


You know what? I think Hazel might be avoiding hay after all. I recently (within the last month or two) changed their hay area in an effort to control odor better- I've got one of those plastic Rubbermaid tubs that I cut three entrance/exit holes into the side of and put bedding into for a big litterbox. That's where I put their hay now. Before, when I just put it down in the cage corner, she used to immediately divebomb into it and just hang out there. But since I changed she doesn't do that anymore, and now that I'm paying attention to it I notice that I rarely see her hanging out in the new hay box any other time of day either. She sits in a pigloo and pulls a pellet bowl into the entrance to barricade herself inside instead.

I suppose she feels too easily trapped in the big tub. I thought three exits would be enough to avoid that, but I guess it's still too restrictive. She's always been socially difficult... anyway, I might try putting some hay out in the open again and see if I start seeing her hiding in the hay more often.

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Zaphy

Post   » Tue Mar 06, 2018 6:45 pm


Gah! This pig's guts just will not quit causing issues! I changed things up a bit in the cage and I notice her eating hay more often now, and I'm about 95% sure that she has not gotten any fresh veggies from the other pigs, and I make sure to supplement with a vitamin C tablet every day, and since the last post I've been supplementing her with Critical Care every day- but now we've looped around from stasis back to diarrhea again! >:(

I thought that it was just Hazel returning to business as normal with her intermittent soft stool problem, but am more concerned than usual this bout because

a) it seems more intense than usual- I notice some pain behavior in her and the consistency of the soft stool is the softest it's been in a long time, at least a year or two (not watery yet, but still softer than the usual soft-serve consistency)
b) her diarrhea has returned despite me actively controlling her diet this whole time
c) most concerning to me- I've been giving her probiotics since I noticed her stool start to soften a couple days ago but the problem has only progressed since then.

The probiotics I've given her are ProBios and poop soup. I ordered some BeneBac that'll come tomorrow in case I've got a bad batch of ProBios, but I'm very surprised that even the poop soup hasn't seemed to help.

Her weight has remained constant and she's been passing the skin pinch test for dehydration throughout this.

Two days ago I gave her a small dose of meloxicam when I noticed the pain symptoms, and she perked up quite a bit behaviorally. So when I noticed her looking painful again yesterday I gave it again- but I wonder if it also contributed to the diarrhea since that's gotten worse. I'm not going to give it today and probably tomorrow as well to see if stopping it helps (even though she's looking pained again- sorry, Hazel :().

I'm also making a change in her Critical Care supplementation- previously I was giving her a bigger feeding once a day with the thought that she needed time between hand feedings to return to regular eating on her own. But since she's only developed different problems I figure that warrants taking a heavier hand in her diet control. To make sure that things are functioning as normally as possible I'm changing to feeding smaller amounts more frequently. She is still eating on her own, but maybe it's not enough.

I figured it wouldn't be a bad idea to run a fecal test as well just to be sure, so I also plan on having that done tomorrow when the vet diagnostics lab opens.

Naturally, again, I am about to leave town at the end of this week. The pigs will be in the care of my husband who works full time, so he won't be able to monitor them as closely as I typically do. Or keep her feedings as evenly distributed as I'd like... but I plan on continuing with the poop soup and more frequent feedings until I leave, so hopefully things will calm down before then :/

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Lynx
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Post   » Tue Mar 06, 2018 10:38 pm


For what it's worth, if you think she is in pain, don't wait until you see signs. Heading it off by giving pain medication regularly will help prevent pain more.

I am sorry she is having trouble with her guts again :-(

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Zaphy

Post   » Wed Mar 07, 2018 4:24 am


Hmm, my thought on stopping the meloxicam was that it might have been a significant factor in what was causing the pain to begin with... My main/usual vet believes that meloxicam can cause GI upset, though I think it's a somewhat uncommon opinion (the vet that saw Hazel most recently mentioned that she disagreed with the head vet, and that evidence is not conclusive). But it does sound plausible to me since I think there is evidence to suggest that NSAIDs can trigger inflammatory bowel conditions in humans as well... so I figured it would at least be worth a shot. But we'll see I guess, I'm really taking shots in the dark with this.

For what it's worth, she does seem normal behaviorally this evening now. Poops are a bit firmer than this morning's, but I think she tends to perk up in the evenings as a rule anyway. We'll see what tomorrow looks like.

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Lynx
RESIST

Post   » Wed Mar 07, 2018 8:03 am


Perhaps a different pain med then?
www.guinealynx.info/analgesics.html

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Zaphy

Post   » Wed Mar 07, 2018 11:27 am


That's true, that could definitely be worth looking into. Thanks!

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Zaphy

Post   » Wed Mar 07, 2018 3:21 pm


I will say though, she does look a little better still this morning- poops are still a bit soft but actually mostly well-formed. So maybe she will pull out of this latest episode without needing more pain meds! (though I'll definitely ask my vet about alternative meds to potentially keep on hand still)

Dropped the fecal sample off at the lab this morning anyway, so we'll see if they find anything unusual.

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Zaphy

Post   » Wed Mar 07, 2018 4:44 pm


*forgot to add, knock on wood- in the words of the great Michael Scott, 'I'm not superstitious... but I am a little stitious.'

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GrannyJu1
Supporter in 2018

Post   » Thu Mar 08, 2018 10:46 am


For what it's worth: I had one of my neutered males on long term Metacam (Meloxicam) and it never affected his gut. His poops were always nicely formed and firm. I think he was on the daily Metacam for a couple of years or more, until he died of what we believed to be age-related kidney disease. He was in the neighborhood of 7 years old when he passed.

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Zaphy

Post   » Fri Mar 16, 2018 3:34 am


That is good to note, GrannyJu. The specific study I am thinking of was in people who had irritable bowel syndromes already- a mix of Crohn's and ulcerative colitis IIRC- and it found a higher rate of recurrence in patients who used NSAIDs than those who did not. However causation or a lack thereof could not be proven- it could be that NSAIDs aggravated their diseases more, or it could be that they just had a more severe case of their disease to begin with and thus experienced more pain than those who did not take the painkillers, and the recurrence was due to the severity of the disease rather than the painkillers taken to manage the symptoms of the severity. So it's something I'm definitely taking with a grain of salt. I've caved a couple times since the last update and given her meloxicam again when she's looked more uncomfortable than I want her to have to deal with. :/

Anyway, the fecal float came back clear so that's good. I am considering getting another sample and having them do a gram stain or another float since I know they're not always super reliable, but not sure if I'm experiencing tunnel vision here cause I've been reading a lot about coccidia lately.

She's still been not perfect, but still not nearly as bad as in the past. Definitely better. I'd say behaviorally she's back to her normal self about 50-60% of the time. The rest of the time she's not super hunched up or anything, just a little more tense than normal. And then there were the couple times I resorted to meloxicam. Nothing that seemed like an emergency, just like she was really not having a fun time. So we'll see still I guess. I'm still supplementing with Critical Care 3-4 times a day, she's still really good about taking it. If I let her she'll take up to 40ml in one sitting, though she'll be a bit unenthusiastic and crabby about the next one then so I try to keep the feedings smaller. I also still see her eating hay/pellets and drinking on her own as well. She lost a small amount of weight under the care of my husband last weekend, but now that I'm feeding her she seems like she might be starting to creep back up again (or it might just be normal fluctuations).

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Lynx
RESIST

Post   » Fri Mar 16, 2018 8:33 am


Thanks for the update. It sounds like things are improving. I hope you get her back to normal!

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Zaphy

Post   » Sun Mar 18, 2018 2:20 am


Today was a good day for her! I know it doesn't necessarily mean that she's done with feeling cruddy. But it was relieving to see her hop around the dust broom and nip at my hands for treats while I swept up the cage with the rest of the pigs, instead of sulking in the corner trying to avoid attention. And popping between hidey holes, and poking her head out to see me when I came up to the cage, and feeling confident enough to eat at the same time as other pigs. I really don't think she's had what I can really call a good day since this whole thing started over a month ago. So I'm really happy about today even if it might be a fluke, and wanted to share :')

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Lynx
RESIST

Post   » Sun Mar 18, 2018 11:04 am


I forget, is she on pain meds right now?

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Zaphy

Post   » Sun Mar 18, 2018 12:09 pm


Nope, I've given her a dose of meloxicam here and there during the worst of this bout but have been hoping/thinking that if her diet were more firmly regulated it would fix the issue so my focus has been more on distributing the Critical Care feedings more regularly/evenly. Her last dose of meloxicam was four or five days ago, and I've given it I think four times over the last month.

Also I changed the fleece liner in the cage after I posted last night and she was the first one I put back in the cage after it was clean, and she ran zoomies and popcorned :) Which I think I've seen her do maybe once or twice before in her entire 2.5 years so far.

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