CinnaMoo (F) - Inflammatory Bowel Disease (IBD)

Diarrhea · Bloat · G.I. Stasis
Post Reply
Talishan

Post   » Sun Aug 10, 2014 3:40 pm


Here is Couchon's experience with IBD in her pig CinnaMoo.

"Lynx, I wanted to do a write-up of Inflammatory Bowel Disease (IBD) in guinea pigs. So few vets know it even exists, never mind treatment and management. Yet, I learn of more and more people whose pigs either had IBD or had something very similar to IBD. I know after CinnaMoo passed, you suggested I do a write-up of her condition for the website. I am sorry it took me so long. It's hard to write about. I still feel I didn't do enough or not all I could for her. But, I finally did the write up.

If you are at all interested in putting IBD as a condition on the medical page, I could also give you a list of symptoms and possible treatments/ways to manage it. I could get CinnaMoo's x-rays, etc., so people can see what it visually looks like. I really want to do all I can to help other pigs and their people. Hopefully, this is a start.


I got CinnaMoo in May of 2009 from a rescue in Center Moriches in Long Island. She was born there on April 28, 2009.

After quarantine in a pet-store cage, she started living in a 2x3 C&C cage with Couchon, who was a little over a year older than her. For the first two and a half years of her life, she seemed the picture of health. I worried about Couchon's sludge and some skin issues, but with CinnaMoo I had literally 0 problems. She never needed to go to the vet. Unlike Couchon, who lived in poor conditions for a year, CinnaMoo had the proper diet and space from the very beginning. When she was about a year old, I put both of them in a 3x5 C&C.

In October of 2011 the first symptoms that something was wrong appeared. I started hearing her let out a single squeak as she would poop. It started out being very rare, every few weeks, but it was out of the ordinary, and to me it sounded like there was discomfort.

The winter of 2011/2013, I took her to the vet. They were sure her symptoms had to do with urinary issues, but I was not convinced. To me, it sounded like she squeaked only when she pooped, not when she peed. They ran urinary tests on her and an x-ray. Everything looked fine. We did an ultrasound - everything looked fine. She stopped eating for a day after the ultrasound - I still don't know if it was the first sign of what was to come or just the stress, but I took her back to the vet (I believe they just gave her some fluids), and she recovered pretty quickly. That same winter we did a bunch of other fecal tests and a fecal float, as well as a course of antibiotics and flagyl. All the test came back normal, and nothing changed.

It was also during this time that she lost some weight. She used to be 2 lb 12 oz to 2 lb 15 oz, but then her weight dropped to 2 lb 8 oz by around February of 2012.
With all the test coming back clear, the vets were stumped. Their feeling was that if it was something serious eventually we would see more clear symptoms. Nothing seemed to be happening, so we didn't do anything else from the spring of 2012 all through the fall of 2012.

In December of 2012, CinnaMoo started being extremely aggressive to her cage-mate, Couchon. She would chase her around, grumble, and she just would not leave her alone. I took her to the vet for more tests and an x-ray, but again nothing was found.

On December 29, 2012, I came home at around 2:00 am to find CinnaMoo puffed up and hunched over, refusing to eat, with a lot of discharge from her eyes. Her stomach felt unusually large. I took her to the vet the following morning. The vet's first instinct was that it was a URI (because of the eye discharge), but I told him I REALLY didn't think it was a URI. I pointed out to him that I though the discharge was there simply because she had stopped grooming herself. I also pointed out her huge stomach. The vet also found that her mouth was full of water.

They took her down for x-rays. The vet came back up to me and said that the x-ray found that her stomach is full of water (around 40 cc’s), and it was so full that the water had started to back up into her mouth. He said we had to drain the water by inserting a tube down into her stomach through her mouth, while she was sedated. There was so much water that the stomach had displaced some of her internal organs.

He drained the water, and we went home. The next day, we had to go back in, because she was not doing well, and water was re-accumulating in her stomach. At this point, she was in such bad shape that the vet (different vet, same practice) felt she may not make it through the night. It was December 30, and they were closed for the next two days. They felt she might need to be on an IV, but a nurse would only check on her a few times a day, since they would be closed. Or, I could take her home and do all the injections and sub-q fluids there.

The nurse at my vet's felt pretty strongly CinnaMoo should stay. The vet seemed to think either way was OK, and I think she thought CinnaMoo would not make it - she kept asking me, if CinnaMoo did not make it, what decision would I feel better about - having her at home with me or having her with them. I really just wanted to do what was best for her, and I just felt that being in her home environment with her family, and the other pig, would help her. I took her home. They showed me how to do injections (I had to inject her with Reglan at 0.2 cc's twice a day and give her oral Cisapride at 0.35 cc's 3 times a day) and sub-q fluids at 50 cc's twice a day. She was also on antibiotics, Metacam, and very small hand feedings (about 5 ml's every 4 hours - they didn't want to overwhelm her stomach).

My strong piggy made it through the night! And then she started coming out and munching hay and pellets and drinking a little on her own. She made it.

Unfortunately, it wasn't long before her stomach started filling up with water again. Basically, her pattern was this: her being more or less normal, then stomach starting to fill up with gas (she would sometimes fart, get mucus in her poo, and strain/squeak while pooping), then stomach filling up with water, than her not eating and pooping, and if that didn't get resolved, water backing up into her mouth and us having to drain her stomach.

That winter of 2012/2013 and into the spring of 2013, we had countless vet visits, trying to control her condition with motility drugs (Reglan, Cisapride, Metacam), as well as at least 3 or 4 emergency visits to drain water from her stomach, as well as countless follow-up visits. We had to go to the ER (not an exotic one, but a research hospital that is open 24/7) during the night several times. Since they are not exotics, my vet advised that, unless absolutely necessary, they shouldn’t drain her stomach and just stabilize her until morning. They had to put her in oxygen chambers, and on one occasion they did have to drain her stomach in the non-exotics ER. I had to guide them through the medications and method used by the exotics vet. She made it through everything.

This was also the time I realized that she was fighting very hard to survive. She would adjust her eating habits to her bloats. She would try to eat and keep going even when she was bloated. She really was learning to manage it, even on her own. Not once did I feel like she didn’t know what was going on. I felt very strongly she knew I was trying to help her.

In the meantime, all I wanted was an answer as to what was wrong with her. Winter 2013 through spring 2013 were spent doing tests and trying to find ways to manage her condition. We did a blood test, something like 7 x-rays, a fecal test, a test of the fluid that we drained from her stomach. All the tests came back normal. We went ahead and did a CT scan. The CT scan showed that she had cysts, but no other abnormalities. The vets thought the cysts may be causing her bloating somehow, so we had her spayed and did an exploratory surgery during the spay. Every. Single. One. of these test came back normal, including the exploratory surgery. Absolutely nothing was showing up wrong. In the meantime, during every one of her episodes, she kept losing weight (and not gaining it back). She lost almost a third of her body weight during this time period. By the summer of 2013, she was a little over 2 lbs, coming down from 2 lb 15 oz when she was healthy.

When the spay didn't fix the issue, my vet suggested taking her off of the cocktail of drugs that she was on (Reglan, Cisepride, Metacam, as well as Critical Care). She felt we may just be overloading her system.

In April 2013 I did just that. And she didn't seem worse. In fact, after taking her off Critical Care, her poops looked better. And Critical Care wasn't helping with the weight anyways. My vet said that Critical Care was not designed for long-term use and may just aggravate the digestive issues. We started using drugs just in emergencies.

It was also during this time that I discovered the things that would help me manage her condition:

1. Vibrating/heating pad: http://www.brookstone.com/nap-luxe-massaging-foot-warmer?bki ... List|638015p - there is probably nothing that helped her as much as this. By the beginning of 2014, she was on it about 5-6 hours a day, 1.5 hours in the morning, 2 hours after work, and 2 hours before bed, more if I was around more. It helped. It helped more than the meds more than almost anything. I would use mostly the vibrating function, with some heat if her feet felt cold. This helped her poop and water pass.

2. Simethicone. Even though water bloat was the reall life-threatening aspect of her condition, it was always preceded by gas. Simethicone helped her pass gas, in combination with the vibrating pad, and helped to keep her stomach from swelling up.

3. Fuzzies Kingdom Supplement - This had been really invaluable. I emailed the woman that puts the supplement together and asked her to make a digestive support mix for CinnaMoo - she modified this supplement http://www.fuzzieskingdom.com/herbs/treats/organic-supplement.html to make sure it included things good for digestion and took out high-calcium clover and alfalfa per my request. The first week we used it, there was pretty much no bloating. The bloating did come back, but I still feel the supplement was really valuable for managing her condition as well as giving her vitamins, as I was concerned with vitamin deficiency because of her diet (will explain below). I also added extra DANDELOIN ROOT - it's already in the mix, but I added about an extra 1/4 teaspoon, as it seemed to help. She didn’t eat the supplement on her own, so I ground it up, mixed it with water, and hand-fed it to her. She also got an Oxbow digestive and urinary health tabs as well as an Oxbow vitamin C.

4. Diet - originally, thinking her issues may be a reaction to food, we put her on a hay-only diet. I still feel that pellets didn’t agree with her, so she didn’t get any pellets (hence my huge concern with vitamin deficiency). I got her different types of hay from different regions, but manly she did well on Mountain Grass from American Pet Diner. After she started doing a bit better with fewer vet visits, I also added a tiny amount of lettuce (half a leaf a day of green or red leaf) and a small piece of bell pepper (green or yellow). I know this diet is NOT ideal, but stabilizing her digestion was my #1 priority. That was all the more reason the Fuzzies Kingdom supplements were so important, as they provided vitamins.

5. Probiotics - the best probiotics that I have ever had that my vet really recommended were Proviable-RB (not DC), but they were out of production, being reformulated. So, I had to use Kyo-Dophilus - one capsule every day.

6. TEMPERATURE - I had always noticed that she seemed to do better in the summer. I still don't know if it was me learning to manage her condition better or if it was the weather. I was not about to take any chances, so I invested in a very good space heater (http://www.amazon.com/Honeywell-HZ-370BP-Digital-Ceramic/dp/ ... space+heater) for the apartment (not next to the cage, and I kept the heater at about 78 – my apartment is in an old, drafty building, so the temperature was probably in the low 70’s – it was where I was comfortable in shorts and a t-shirt. The heater was on 24/7. I have always felt temperature had a significant impact on her condition.

With all these changes, I did feel her condition was much more under control. However, she would still have an episode where she would have drained about every three month. Each time they drained more and more water. In the winter of 2013/2014, there was so much water, possibly over 100 cc’s that the vet said they didn’t even have to pump the water out. It was under so much pressure that it was literally like turning on a hose. It was also during that episode that she was actually throwing up water. Yes, guinea pigs can’t through up, but the pressure was so intense that she was just coughing up water.

I think, because she learned to manage her condition, it also would take her longer to get to a really bad state. Whereas during our first emergency she only had about 40 cc’s of water and basically shut down, I think she went longer and longer without shutting down as she learned to live with her condition.

Now, comes the really hard part. I still feel a lot of guilt and responsibility for CinnaMoo’s death. I do feel it was my fault for not acting fast enough, being too complacent.

She wasn’t feeling well. On Sunday, April 27, 2014, she had pure diarrhea, but I’ve seen some pretty liquid poo before, and I felt we could manage it at home. Plus, I had a vacation coming up, and she could be on the vibrating pad every 4 hours. April 28 was her 5-year birthday, and she seemed to have improved. I thought we were fine. Then, starting on Tuesday, almost no poop was coming out. There were literally just a few poops Tuesday and Wednesday. I will always wonder what would have happened if I took her to the vet sooner or put her on motility drugs at least.

Starting Thursday morning, I put her on motility drugs and made an appointment with the vet. We went to the vet on Friday morning. He wasn’t sure if we should just continue on motility drugs and see what happens or drain her stomach. We decided to give the drugs a shot. I brought her home. But I felt she was really not doing well. So, I took her back and made the call to drain her stomach. This time was unusual, because it wasn’t just water, it was full of dissolved food as well.

I took her back home. That evening, I noticed that she wasn’t moving her back legs well, almost dragging them. Her stomach was JUST drained, but she was “throwing up” again, even though there was no pressure. I rushed her to the ER. On the way to the front desk, she suffered what I think may have been a seizure. She squealed really loudly and twitched.

The vet (non-exotic) felt she was too weak to do an IV. He said we should just put her on oxygen. He said she may not make it through the night. I have been told that a number of times before, but when I saw her, I thought he may be right. She was just lying on her side. I begged him to let me stay with her. So, he put together a portable oxygen chamber. I wrapped her in her blankie inside the chamber and sat with her and told her the story of how I got her and just tried to let her know I was there.

Then I felt something was wrong, and I took her out and put her on my chest, and she passed away within a few seconds. She just took a few breaths and passed away at around 5:30 am on Saturday, May 3, 2014. I remember it very well, because the sun was rising. I think she passed away right at sun rise.

I feel I did a lot of things wrong that last week, for many very stupid reasons. I wish I acted sooner. I will always carry that with me.

I don’t regret treating her, not for a second. That, I have no doubts about. I know she wanted to live, and she lived a year and four months after her first emergency. She lived to be 5 years old, a senior pig.

After she passed, I felt we had to know what was wrong with her, so it can help other pigs. We did a necropsy and found out that she had Inflammatory Bowel Disease (IBD). Most vets don’t even realize that guinea pigs can get it, and it often can’t be diagnosed while the piggy is alive.

I hope that our journey will help another pig. I feel very passion about IBD and educating people and vets about IBD. A pig CAN live with IBD – it’s not a death sentence. We had to do a lot of things by trial and error, but hopefully our journey can help others, so they are able to start managing it right away, without having to go through as much guesswork.

Remember, you are your pig’s advocate. By the end, the vets looked to me for decisions – they said I knew her and her condition best. We have x-rays, her medical file, tests, etc. I would be happy to share it with anyone. I am available to answer questions, etc. If there is anything I can do, I want to do it – I want to do anything I can to help other piggies with IBD.

Below are the necropsy findings:

Microscopic Findings:
1. Mild, chronic, proliferative esophagitis.
2. Severe gastric edema with muscular atrophy.
3. Moderate, chronic, lymphoplasmacytic enteritis.
4. Mild, chronic, fibrosing peritonitis.
5. Lipoma, small intestine.
6. Moderate, chronic, lymphoplasmacytic cecitis.

Comment:
The patient has chronic inflammation in the GI tract compatible with
chronic inflammatory bowel disease (IBD). In most species, the cause
of IBD is infrequently determined in the individual case, but many are
probably immunologically mediated. Hypersensitivity to dietary
glycoproteins may account for the majority.

Bacterial overgrowth/infection and parasitic infestation may account for some
cases. Alternatively, the immune system misperceives normal enteric
microflora as pathogenic which elicits an immune response to harmless
bacteria.
******The predominant lesion in the stomach is edema and muscular
atrophy. It probably manifested clinically as gastric atony leading to gastric distension.
The esophageal lesion is a consequence of gastric reflux disease.
There is also a benign lipoma which appears to be partially occluding
the lumen of the small intestine. Perhaps slow gut transit time
contributed to the patient's GI problem."


"I also wanted to repost some of my posts that I think show the key aspects and struggles with CinnaMoo’s condition. I think there is value in them, because they are more detailed than the summary, and they show our thoughts on things as they happened.

April 2, 2012

"Unfortunately, I have more bad news and confusion.

Here's a quick recap.

I started hearing squeaks here and there last fall. First, I couldn't connect it with anything, and they weren't lound or long, so I though it was just of the noises they made. Finally, I figured out that it was associated with pooping.

I brought my pig to the vet in early January. We did an x-ray, which found no stones or sludge. We did an ultrasound, which found nothing. She stopped eating after the ultrasound, which I now believe was due to the stress.

The day after the ultrasound, I found a smudge of blood on a poop.

I brought her in to the vet again, mostly because she wasn't eating. They said she looked fine, stable, gave her some fluids. and she was back eating and drinking that same day.

We did a urine test and found some blood cells and white blood cells, so we put her on Baytril for two weeks. She had a horrible reaction to it. Her weight dropped. She wasn't eating as much. I had to hand-feed her. Also, it MAY be around this time that the mooshy poops started. We finished the course and decided to give her a break from antibiotics.

Throughout this whole time, she has remained pretty much the same with the squeaking, although I do think she does it more than in the fall. There are some days it's very quiet or not at all, and there are some times that it's every time she poops.

I brought her in again (also for an inflamed toe). The vet examined her and again said she looked fine and even healthier at the lower weight of 2 lb 10 oz.

We put her on Flagyl, and I keep giving her kyodophilus as probiotics.

After 10 days, she started squeaking more again (I attribute it to the cycles she seems to go through). Also, reading other people's threads, I tried to take out veggies or pellets. Finally, I tried giving her JUST hay for a few days. To my surprise that actually made her poop a lot worse, and it started making the other pig's poop mushier.

So, I switched the hay. I went from Kleenmama's bluegrass to Oxbow's timothy hay. Almost instantaneously, her poop firmed up. It's not quite as good as the other pig's, but I would go as far as to say that it's in the normal range.

BUT, the squeaking won't go away (remember, when it all started, there was no mushy poop at first - I don't remember when it started, so maybe it was due to the antibiotics, stress, etc.). So, it's basically back to square one. She squeaks when she poops, NOT when she urinates.

What's worse, I saw blood again. There is NO blood in the urine, JUST when she poops, and it's a very tiny amount. It's small specks on a mucus coating of the poop. I saw it on two different poops on Sunday. We have also tested for parasites. It came back negative. Oh, and she has been on Metacam, which doesn't seem to make a difference.

I emailed the vet again. I don't know what to do. I don't understand what it can possibly be. I feel very tired. I was in bed this morning, and I wouldn't get up, because I didn't want to start the day and have to deal with all of it. Don't get me wrong, I WILL deal with it. I am not abandoning the pig, and I will keep doing anything she needs. I just feel so tired and helpless. Also, my eye is twitching, which is actually kind of funny if you think about it.”

May 14, 2012

“I finally got around to writing an update.

I did go to the appointment with Dr. Quesenberry. Unfortunately, there was no new information. She said CinnaMoo looked completely healthy, and while there were a few things that were remote possibilities, based on the symptoms, she said that she didn't know what was going on. Her only suggestion was to redo the ultrasound if things got worse, just in case the first ultrasound missed something.

Since I have changed the hay and taken CinnaMoo off of all medication, she has been doing better. Her poops are firm most of the time (although not as firm as the other pig's), although they are not perfectly shaped - they are pointy at the top and flat or caved in a bit at the bottom. I don't hear her making noises when pooping, although I still think she does sometimes, just more rarely and very quietly.

Dr. Quesenberry did suggest maybe not feeding as much cilantro. At first, I thought it was odd, but I do think she does better with less cilantro.

As for the next step, I am not sure. She got really stressed out by the ultrasound last time, to the point of not eating and having to be rushed to the vet. She also seems to do better without any drugs.

I am definitely open to comments or suggestions. It has been about half a year since I first noticed something was off. Since she doesn't seem to be getting worse, does it mean whatever it is is not life-threatening, or is it just lying in wait?”

December 13, 2012

“It's been almost a year and not much has changed. She still squeaks sometimes; she has irregular poops sometimes. Her weight is around where it should be, although she lost about 2 ounces recently, which is exactly what happened last year at this exact same time of year.

I wonder if the weather/lack of sun might have something to do with it, because her condition seems to intensify around this time of year.

Here are some of the symptoms:

She squeaks when going to the bathroom (I think when pooping) sometimes - it usually happens every few weeks for a few days.

She is more 'grumpy' to her cage-mate

Sometimes she loses some weight - not a lot, maybe an ounce or two - she usually gains it back.

THIS IS A NEW ONE I OBSERVED: She lowers her butt and wipes it on the fleece/drags it across just for a second every once in a while

There have been no extreme changes in months/almost a year - the reason I mention that is because I wonder if it eliminates a UTI or stones or cysts, because wouldn't something else show by now?

I wonder if it may be environmental - I use PiggyBedSpreads, and the waterproof layer is PVC.

I would love to hear some opinions. If at all possible, I really want to avoid another ultrasound or find ways around it. It's a huge burden on her. It's also really pricy - $400. I don't mind paying it, if necessary, but if possible, I would rather keep that for a medical emergency for them.

She is 3 years and 7 months and weighs 2 lb 9.3 oz as of yesterday.”

March 25, 2013

“Bpatters, let me try to explain in a little more detail what I mean.

Water bloat is a term I learned on this website (same with the turning them and hearing if they sould like a water bottle test).

Basically, here's what happens. Her poops, which have been discolored, soft, and misshapen for a really long time start becoming very dry and crumbly on the inside (while remaining moist on the outside). That's my first sign.

My second sign is that she starts to poop less and less.

Finally her stomach expands out, and I can hear water wooshing around. The final step is her stomatch becomes so filled with water that it starts backing up and coming back out through her mouth. That's when I have to take her in to get her stomach drained. They put a tube in through her mouth and drain out fluid (the amount of fluid is usually around 40 cc's - last time, it was 48 cc's), and her stomach at this point is around 4-5 times its normal size.

The vets have always referred to her stomach, so I that's why I say it's the stomach. Dr. Wilson also calls it stasis, probably because in this conditions she doesn't eat, drink, or go to the bathroom.

I don't know why the water doesn't pass.

As far as heart/lung/liver/blockage problems, she has had a CT scan, a blood test, about 7 x-rays (in the past 4 months), and now an exploratory surgery. All of them come back clear. She does have some sludge, and she did have the cysts, but that's it.

If you (or anyone else) feels that there are other things we should be testing for to see if she has heart/lung/liver/blockage problems, please let me know! I would be happy to do the test. I simply don't know what those other tests are.

Bookfan, I am going to write to the vet, but this has happened many times in the past (twice it went to the point of having her drained), and they simply have no idea what it is. We usually try to get her through with drugs, but lately I feel drugs have not been working as well, and it has been becoming more frequent and severe.

I am absolutely open to suggestions.

I am wondering if it's something in their environment and/or bacterial. My other piggy has been losing some weight lately, and some of her poos have been misshapen/contained a little mucus coating, so we are having her poos cultured, just in case (we can't culture CinnaMoo's, because she is on antibiotics - she has had a fecal float in the past).”

December 13, 2013

“Quick update on CinnaMoo.

This particular episode has deviated from the 'norm' a lot of how these things go. It was a lot more violent with her 'throwing up', etc. Also, for some reason she felt overly warm, especially since she usually gets cold during an episode (I took her back to the vet, and they took her temperature, listened to her heart and lungs, and they said all sounded normal, so either she didn't have a fever, or Metacam calmed it down).

Also, we always assumed her water bloats had to do with motility issues, but this time she was pooping just as it was going on, but the poops were very dry. It seems to be more of a water absorbtion/renetion issue.

Also, for whatever reason, she just sat out in the open the entire episode. It would almost like she would freeze up and sit in one place. I have never seen this before. She usually goes to her house - I don't know what this means.

As for today, she seems to be in a bit of a better shape than yesterday. She has munched a bit and she doesn't freeze up and sit in the open quite as much.

I am still very concerned, because the tiny poops that are coming out are still very dry, which is an indication of a water bloat with her. And this last time, even though she was pooping, she went into this huge bloat, so I can't feel safe any more just because she is pooping.

However, the good news is that my brave little one is hanging in there. I am so thankful it's the weekend, so I can take care of her round the clock.

Thank you for everyone's comments and support! I read it all, even if I don't always respond, and it means the world!”

August 26, 2013

“And this is an update on what we have been doing since and what seems to be working as well as a brief summary of her case (I posted it in response to someone else's question just a day or so ago):

This is very, very close to my heart, as I have a pig who has had sever bloating issues (both gas and sometimes stomach filled with water - water bloat) in the past 7 month and gas probably going back to 2 years ago, although we didn't realize it back then. In the past 7 month, she has had gastro stasis more times than I can remember, especially in the beginning. She had to have water drained out of her stomach twice.

You can read our whole story if you search for a thread under my name, titled "how much to hand feed". However, I would like to share what I have learned. Keep in mind, all pigs are different, and I don't know that this is universal, but....

In the beginning, during her very first emergency bloat, things were out of control. For the first few months following it, we had countless vet visits, sub-q fluids, reglan, metacam, two middle-of-the-night emergency vet visits, and even an exploratory surgery. It was a really tough time, and I am still scared for her. She is a fighter, and she made it through all that. Here's where we are and what we are doing:

1. While drugs (Regland, Cisepride, sub-q fluids, Metacam) have been useful to us when her conditions was serious, or she was very bloated, myself and my vet team have come to the conclusion that unless they are absolutely necessary or she is in very bad shape, we will try NOT to use the drugs. We tried taking her off them, and they really didn't make enough of a difference (again, this for daily use, not in emergency situations or bad bloats) to justify the danges, potential side effects, and the toll they take on the body and the digestive system. I would suggest trying the routine described below for a few days and see if that can allow you to manage the condition without drugs.

2. Every day starts with me putting her on a vibrating pad for at least half an hour. That's the first thing I do when I get. I do it AT LEAST 3 times a day (half an hour when I get up, about 2 hours after work, and an hour before bed). It helps her pass gas and poop when she is holding onto poops and they build up inside. I use this massager http://www.brookstone.com/nap-luxe-massaging-foot-warmer?bki ... List|638015p (mainly just the massage function, almost never the heat). It's cheap, and it has broken on me, but I think it's PERFECT in that it vibrates rather than having the massage balls moving around. I actually just bought my third one to have as a back-up, just in case the second one breaks. It's worth every penny, even if I have to keep buying them - someone gave me advice to use a massager, and I wish I did it sooner - DON'T SKIP IT - use it diligently every day. Also, I know I can't leave her for more than 12 hours AT MOST, or she will start bloating again.

3. Infant Simethicone - as mentioned, we are trying to do no drugs, but when she is gassy, the one thing I will give her is Simethicone about twice, rarely 3 times a day at 0.25 cc's of the infant kind, as she is sitting on her vibrating pad. One of my vets is skeptical about it, but it seems to work for my piggy at least some of the time.

4. FUZZIES KINGDOM SUPPLEMENT - This has been really invaluable. I emailed the woman that puts the supplement together and asked her to make a digestive support mix for CinnaMoo - she modified this supplement http://www.fuzzieskingdom.com/herbs/treats/organic-supplement.html to make sure it included things good for digestion and took out high-calcium clover and alfalfa per my request. The first week we used it, there was pretty much no bloating. It did come back, but I still feel the supplement is really valuable for managing her condition as well as giving her vitamins, as I am concerned with vitamin deficiency because of her diet (will explain below). I also add extra DANDELOIN ROOT - it's already in the mix, but I add about an extra 1/4 teaspoon, as it seems to help. She does't eat the supplement on her own, so I grind it up, mix with water, and hand-feed it to her. She also gets and Oxbow digestive and urinary health tabs as well as an Oxbow vitamin C.

5. Diet - orignially, thinking her issues may be a reaction to food, we put her on a hay-only diet. I still feel that pellets don't agree with her, so she doesn't get any pellets (hence my huge concern with vitamin deficiency). I get her different types of hay from different regions, but manly she does well on Mountain Grass from American Pet Diner. After she started doing a bit better with fewer vet visits, I also added a tiny amount of lettuce (half a leaf a day or greed or red leaf) and a small piece of bell pepper (green or yellow). I know this diet is NOT ideal, but stabilizing her digestion is my #1 priority, as it's a very serious danger. That's all the more reason the Fuzzies Kingdom supplements are so important, as they provide vitamins.

6. Probiotics - the best probiotics that I have ever had that my vet really recommeded were Proviable-RB (not DC), but they are out of production, being reformulated. For now, I do Kyo-Dophilus - one capsule every day.

7. Bedding - we consulted a bunch of vets, because we couldn't (still can't as of right now) figure out the source of her issues. One of them thought she may be pulling out fleece fuzz, which is plastic, so she suggested doing a different bedding. It's a LONG shot by far, but for now I have her on Carefresh.

8. TEMPERATURE - I have always noticed that she seemed to do better in the summer, and things with her got easier this summer. I still don't know if it's me learning to manage her condition better or if it's the weather. I am still very afraid of the coming fall. One thing is certain. I am investing in a very good space heater for the apartment (not next to the cage) and maintaining it at about 73 degrees). I have always felt temperature had a significant impact on her condition.

Whew, I know this is a lot. Sorry. Unfortunately, even the best of vets seem to have very little understanding of why these things happen and about digestive issues in general. This is what I learned.

Your pig may be entirely different, but I hope it can help - I would say at the very least the vibrating pad is a must.

Most of all don't give up. My piggy is a tremendous fighter, as noted even by the vet, and I was kind of a mess in the beginning, with ups and downs as her conditions seemed to go all over the place. We are seven month out from the first major episode, and I honestly don't know what tomorrow or the fall may bring. I am immensely thankful that we have been able to get through the seven months. I am thankful for each day, especially for the days when she is not as gassy. My main advice is don't give up. It can take a while to find solutions, and even these solutions don't always work forever. As much as possible, don't let it phase you. Keep fighting for him every day and thinking of new idea, pushing your vet if necessary - don't become complacent.

Good luck!”

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