Poppy's Medical Thread

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Zaphy

Post   » Wed Sep 21, 2016 11:49 pm


I adopted Poppy from a rescue about two months ago, so I do not know her medical history. She is about two years old and appeared in good health, weighing about 850g when I adopted her. I went out of town for a couple weeks and let my husband take care of the pigs, and when I returned I found that Poppy had lost a significant amount of weight, she is now right around 700g. So I'm starting her on CC tonight and taking her to the vet tomorrow. I suspect ovarian cysts, but wanted to put a list of her symptoms here in case anyone's experienced the same and had any comment so that I could make sure to be prepared for the appointment tomorrow- we've moved states and it's a new vet for us, he's highly reviewed but I'm always wary of new vets, heh.

First, her nipples are somewhat crusty. They don't appear inflamed or swollen, just looks like dry skin and dirt (?) there. This is the main reason I suspect cysts though, I haven't read a thread where dry nipples hadn't turned out that way.

She's also got an interesting growth on her bottom- at first glance I thought it was a penis, but upon closer inspection it's just some weird growth on top of her vulva (as she does possess a vagina, and no testicles). She was seen by a regular vet soon after adoption for a wellness check, and that vet didn't think it was anything to be concerned about, so I've just been keeping an eye on it and it hasn't changed appearance or seemed to bother her. Here's a picture:

Image

If I'd had a third hand I'd have moved it so you could see, but that little mass kinda tapers down a bit in its attachment to the body, it really just looks like a shriveled-up penis with a smaller base, if that makes sense.

A few weeks ago I noticed some blood coming from her bottom. I kept her in the quarantine cage overnight but didn't see any blood in her urine, so figured it to be one of those rare times a sow bled while in heat. But now I'm not so sure. Haven't seen any bleeding since, though.

Her appetite is unchanged, she's even become more vocal at feeding time. No hair loss either.

While I was gone I noticed her sitting poofed up on a number of occasions (webcam set up to monitor the pigs while I was away).

Her coat appears somewhat duller now than before.

Any thoughts?

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Lynx
Celebrate!!!

Post   » Thu Sep 22, 2016 7:29 am


If you were very proactive, maybe an ultrasound would show more. The plumpness around the anus also makes me think of a male. There are extremely rare circumstances where a guinea pig can have both sex organs present. The poor coat reminds me of one of my guinea pigs who had internal tumors but there certainly can be other causes.

If you can take clearer photos, that would be of great help. I can't really make out much.

The hair loss didn't happen right away with my sow that had ovarian cysts. The crusty nipples preceded the hair loss.

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Zaphy

Post   » Fri Sep 23, 2016 1:40 am


She's definitely female (I even made sure to confirm with the vet today) and I don't believe it is a penis... just looks like one from that angle. I'll have to put up some more detailed pictures in the future when I can get a helper, it's really an interesting location for a wart/skin tag/whatever you'd call it. Thanks for sharing the experience- after today I do wonder about tumors...

She weighed in at 775g today, up from 700g yesterday. Kinda big fluctuation.

Got an xray done today, apparently the vet doesn't have ultrasound equipment (for pocket pets, anyway). There's a lot of options the vet gave me to consider... I have no idea how to organize this, sorry. I'll try to be as coherent as possible.

First off, during the physical examination the vet was able to palpate a mass in her abdomen. It feels pretty round. Everything else looked good- fur looked clean, teeth were great, no swollen gums or anything that would indicate problems with the molars that she could feel. The vet did note that she seemed a bit bonier than a regular pig- not to the point of worry, but noticeably.

Here's the X-ray, hopefully the image is not too wide- if you want I can split it into two if that would make things easier to see:

Image

So the mass is the dense bit in the lower left part of the ribcage in the first picture, and again in the second picture it's to the right of the liver, in the gas pocket area (by the way, those are normal amounts of gas for a pig right? The vet wasn't concerned at all but it still looks so uncomfortable to me... I just look at it and want to fart it out for her, y'know?). Vet said that it's possible that it's something ovarian, but the ovaries are usually located higher than that, same for kidneys, which is another thing she was thinking it might be.

Also there's a stone there, as you can see. Vet thinks it's so close to the end that she'll probably be able to pass it on her own- I guess we found the reason for the bloody urine the other week? I asked if it looked too big for her to pass and she didn't think so. Will continue to monitor her urine output just in case. Also, I suppose this means I need to be more careful about her greens... will probably stick to green leaf lettuce instead of any romaine with her. She did pee at the vet today and it looked quite normal on the white towel.

Anyway... vet gave me several things to think about.

She did mention that she could call around to try to find someone with ultrasound equipment that could be used on pocket pets. So that is an option. There's gotta be at least one here, and if not, the university has got to have it (Colorado State, she spoke very highly of their vet teaching hospital's exotics program- they're just very pricey, is all). We could also try doing some blood work to see if anything's out of whack there. Not sure if further testing would tell us anything we don't already know though.

Another option would be to go ahead with exploratory surgery, and remove the mass if necessary/do pathology/etc. Obviously if it's a benign fatty lipoma or whatever and something else has caused her weight loss, then I worry that the surgery will be too much additional unnecessary stress. Will handfeeding and pain meds be enough to mitigate that, I worry?

And then there's always the "wait and see" option. If it gets better... or if it gets worse. I'm not a huge fan of this one, but maybe it's best? I don't want to wait too long and then find out she's gotten so much worse that she's no longer a good candidate for surgery if she does need it.

I'm just kind of at a loss for what to do right now. She is still active and eating and pooping and everything, but she doesn't seem quite as chipper as she once was. Seems like there's a risk either way I go, but I don't know which one is the worse risk. Could I please ask for opinions on what to do for her at this point?

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Lynx
Celebrate!!!

Post   » Fri Sep 23, 2016 7:49 am


I'm going to add your xray and break it up into two images (since it is large). I am not quite sure I understand where the dense lump is located. Is it on the right or left side of the body looking from the top? Looking from the side, is it the lump at the top, middle, or front/rear bottom?

Did the vet discuss manipulating the stone out? It looks painful and somewhat large. I think that's what many skilled vets will do. I encourage you to write Talishan and see if she has time to look at your thread.

Image

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Last edited by Lynx on Fri Sep 23, 2016 7:51 am, edited 1 time in total.

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daisymay
Supporter 2016-2021

Post   » Fri Sep 23, 2016 7:49 am


Our vet doesn't have Ultrasound equipment either. When an ultrasound was needed for any or our piggies she would just call the lady who did them. She used the same machine on dogs and cats too. I had no idea pocket pets needed a special machine.

I suggest watching her closely to see if she passes the stone. Then I would ring around for Ultra machine for your piggy. I'm in Australia and it cost me $460.00AUD for Jessie and that was 4 years ago. Or you could just try hormone treatment if it might help. Perhaps the rescue where you got Poppy from might help with Ultrasound machine? Hoping all goes well!

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Zaphy

Post   » Fri Sep 23, 2016 12:15 pm


Thanks for splitting it up for me, Lynx! I've circled what the vet pointed out to me:

Image

Image

The vet didn't discuss much about the stone, only that it didn't seem to be hurting her or impeding her ability to urinate, and that she'd classify it as an "incidental finding". Perhaps I should look into that more thoroughly though...

Not sure if hormone treatments would be a good idea right now given that we don't really know what kind of mass it is, or what it's attached to. Would an ultrasound really tell us more than what we already know from the x ray?

bpatters
And got the T-shirt

Post   » Fri Sep 23, 2016 1:04 pm


I'm not a radiologist, but it doesn't look in the right place for ovaries or kidneys to me. They're both normally closer to the backbone.

You might be able to flush that stone out by syringing her lots of fluids. Pedialyte, even diluted, would be better than plain water, and she might take it more readily. On the other hand, the vet could have given, and taught you to give, subcues, and that would have gotten a lot of fluid in her quickly.

I'd watch her like a hawk with that stone in there to make sure it doesn't fall into her urethra and totally block the flow of urine. That's a full-on medical emergency if it happens, and you'll need a qualified cavy surgeon immediately.

And you might be able to gently manipulate that stone out by putting her in your lap in an upright position, back to your chest, and seeing if you can gently work it out. Just be careful, because sometimes they're adhered to the bladder wall and won't move. Of course, then there's no danger of blockage, but it will keep the bladder irritated and at least intermittently bleeding.

Talishan
You can quote me

Post   » Fri Sep 23, 2016 2:15 pm


The vet should be able to manipulate that stone out with a little bit of iso or sevo, if it's not adhesed to the urethral wall. It's **right** at the opening to the outside.

Exploratory surgery rarely works well in small herbivores. They have a hard time with surgery period, and rummaging around without a clear, specific goal isn't a good idea in general, the way it can be done for dogs and humans.

The mass looks kind of diffuse or dispersed to me. I am NOT a radiologist, but the tumors I've seen on x-ray tend to be more coherent/compact than that -- for whatever that may or may not be worth.

I'd definitely want an ultrasound of it if at all possible. Also, I'd ask if a fine needle aspirate would be possible and helpful.

She does look a little gassy, even for a guinea pig. Hopefully this will have resolved a little by now. This may have been caused by her not eating quite enough while you were OOT. Is she eating and drinking more or less normally now?

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Zaphy

Post   » Sat Sep 24, 2016 3:19 am


I just realized I phrased it poorly- the vet was thinking it was kidneys or ovaries prior to x-rays, afterwards she pointed out to me that it was too low. She said something to the effect of it being slightly possible for something to get shifted out of place while something's growing on it like this, but it sounded like that was a pretty remote possibility.

It is strange to me that the mass doesn't appear to be defined well, too, especially given how smooth and round it feels. But, well, I am also not a radiologist. Also something to note is that when I feel it, it feels higher than what is on the x-ray. So I guess it's somewhat free-floating and I'm able to push it around a bit.

So I've poked and prodded at the stone a few times, it's definitely palpable, and definitely close to the opening. Not quite close enough to protrude, though. But when I poke at it, she starts straining a bit. I don't know if she's necessarily trying to pee, but it does feel like she's flexing a pee muscle.

I set her back down in the cage after doing so and she pooped a bit of a poop mound, and this morning I made awkward eye contact with her while she peed, and she didn't appear to be straining then (may have moved since then, as it's evening now). The urine was not cloudy at all. She's also peed this evening while I was in the room and I didn't hear her crying or anything. She'll whimper a teeny bit when I'm poking her but it didn't sound like an injured whimper. I haven't pressed very hard at all out of fear that the stone might be sharp and cut her.

I don't think I'll be able to manipulate the stone out on my own, I don't think I have the experience necessary, and from my poking it doesn't feel like it's going to be a super easy task. I think I'll call the vet tomorrow and see if I could make an appointment for her to try to remove the stone, if it hasn't passed by then. If it is adhered, do they usually remove it surgically or do they just leave it? I don't see that information on the GL stones page.

Here's what I'm thinking about doing: If the stone's able to be removed successfully, I'll wait for a while (a week, maybe?) and see if she perks up again. Then make a decision on ultrasound/surgery/FNA. I assume during this wait, that if it's a cyst, it will cause her noticeable pain and discomfort before it gets to the point of being in danger of rupture (someone please correct me if this is not normally the case). I'm kind of leaning towards skipping the ultrasound and going straight for surgery- we know that there is a mass, and I'm not sure if an ultrasound would tell me anything that would change the necessity for surgery. Either it's a cyst or a tumor, and the US wouldn't be able to tell us if it was malignant or not. I hope someone here will let me know if they think that decision is a poor one, especially if they have experience with unidentified lumps like this. Hearing about similar experiences and their resolutions, or links to useful threads I could read through, would be welcome. (And also if I misunderstand the point of the ultrasound).

I've been supplementing her with CC a little bit, but not a whole lot since her appetite is still pretty good. She's eating lots of hay, drinking lots, and urinating well. Her poops are a bit teardrop/misshapen right now- possibly from too many veggies for bribes yesterday at the vet's and today while trying to get a good look at the stone area. But there's plenty of them. She's not on any pain meds at the moment.

Thank you all for your input so far. It has been very helpful.

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Lynx
Celebrate!!!

Post   » Sat Sep 24, 2016 7:48 am


I would continue to keep an eye on the stone on the chance it has moved closer to the opening and you can remove it. Sorry I have no other advice but hoping this resolves well!

bpatters
And got the T-shirt

Post   » Sat Sep 24, 2016 11:06 am


Ditto Talishan about asking for a needle aspiration. That would almost certainly tell you definitively what it is without the trauma of surgery.

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Zaphy

Post   » Sun Sep 25, 2016 3:31 am


So, after sleeping on it... since she's still been urinating and pooping well (and maintaining weight at 775g), I opted to wait some more to see if the stone passes on its own, then reevaluate.

Is there a standard time estimate for stones to pass in guinea pigs? I'm sure it just kinda depends on the pig... kinda like in humans... but is there a time frame where I should start to get concerned? I can still feel the stone, if it has moved it's not by much. Maybe I just need to be patient.

I will contact the vet when they open on Monday about ultrasound/FNA possibilities. I tried shooting them an email today during their business hours, but no response, not entirely unexpected for Saturday.

I am going to give my pigs a stern talking-to about their bad habits of growing mysterious lumps... the new vet is significantly more expensive than my old vet in my old town. Bye vet fund! Hopefully they at least have the decency to wait a few paychecks before the next lump comes along.

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Lynx
Celebrate!!!

Post   » Sun Sep 25, 2016 7:33 am


You want to avoid pain and an emergency situation whereby there is a blockage. That she's urinating and pooping well along with maintaining her weight is very positive.

gl/pain.html

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Zaphy

Post   » Mon Sep 26, 2016 12:50 am


So far the only symptoms of pain she's shown are poofing up and the weight loss. Speaking of which, last night she weighed in at 780 and today she was 790 (her low was 700)- I know it's probably just water weight fluctuations, but the fact that she's going away from the 700 mark makes me pretty happy. It would be great if she could get back to her regular weight before surgery if she does end up needing it...

But yes, other than those two things she's been pretty perky. She was climbing all over me looking for her treats and getting in my face about it during lap time today. The vet also mentioned the poofing might just be her getting cold easier because of the weight loss...

Stone still hasn't budged today.

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Zaphy

Post   » Tue Sep 27, 2016 7:19 pm


The vet finally got back to me today, and apparently even with like a million veterinary practices in my town, none of them can do a guinea pig ultrasound. But there is CSU, so I've called them. They close a bit early so I'll have to wait till tomorrow to get everything figured out. But my plan for now is to ask for an ultrasound and FNA if the mass is solid.

Poppy's weight has actually still been creeping back up. She just weighed in at 810 grams, which is great if it's regular weight being put back on, but less great if it means the mass is growing. She complained a bit when I tried to feel for it, so I didn't continue poking her sides in case it's a cyst that's getting larger, didn't want to risk rupturing it.

Stone is still there. The vet said that it ought to have passed by now if it were going to, but since she's still pooping and peeing okay she suggested just leaving it be for now and focusing on the mass.

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Lynx
Celebrate!!!

Post   » Tue Sep 27, 2016 7:51 pm


I hope you can get some answers with the ultrasound.

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Zaphy

Post   » Thu Sep 29, 2016 10:37 pm


One ultrasound and very fashionable fur-cut later, the vets at CSU believe it to be ovarian. The vet was able to palpate a second mass on her other side. One of the masses looks cystic in U/S, and the other looks possibly neoplastic. We did not do a FNA- because of the presence of both, they recommended a full hysterectomy/spay rather than HCG injections. It's scheduled for October 10th- the soonest slot they had available was the 5th. Since I'm out of town the 7-9th, I elected to schedule it for when I get back, since I wanted to be present for the postop. The vet didn't think that was unreasonable. The surgery will be with a different doctor than the one who performed her exam today, but the first vet assured me that he has just as much experience with exotics and pigs.

They said they normally keep the animals for a couple weeks post-op, but I'm planning on having her discharged ASAP after the surgery. Finances do play a part in that, but I also feel like from what I've seen pigs have tended to fare better when they're able to recover in a familiar environment. The vets recommended not discharging her till the day after her surgery, and I felt that to be reasonable. Gonna go review Talishan's post-op recovery page now...

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Lynx
Celebrate!!!

Post   » Thu Sep 29, 2016 10:58 pm


Yes, home! Care for her at home! I agree she will do better - you know what you are doing and are the best person to help her.

More here:
gl/postop.html

bpatters
And got the T-shirt

Post   » Thu Sep 29, 2016 11:42 pm


Two weeks in the hospital post-op? No way. That clinic is soaking owners for money.

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Zaphy

Post   » Fri Sep 30, 2016 12:47 am


Yeah, I was warned before taking Poppy there that they prefer to keep the patients till they're fully recovered so that jacks the prices up quite a bit. I would imagine that it does help the students learn proper post-op care, since it's a teaching hospital?

They didn't fight me at all when I asked if they could release her to me for post-op care though, just made sure to emphasize the handfeeding etc.

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