Midnight's Medical Topic

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AviN4
Supporter in '21

Post   » Wed Sep 01, 2021 4:00 pm


OK, new development. Midnight and his cagemate Moon normally go crazy for carrots, which I give them as a treat. Today I fed them small pieces of carrots. Midnight seemed interested but would not eat it. So I gave him shredded carrots instead, and he did eat that. I tried this experiment a few times with the same result. So I'm now thinking maybe it's been malocclusion all along, and has now become worse?

Also, he's lost almost another oz since Sun 8/29.

I have an an appointment with a different vet next Wednesday 9/8. I may be able to get an earlier appointment if I tell them it's an emergency. Should I?

I'll try to pay close attention to his eating habits in the meantime and ensure he can eat what I'm feeding him.

bpatters
And got the T-shirt

Post   » Wed Sep 01, 2021 4:47 pm


Yes, you should try for an earlier appointment. Teeth problems never improve, and the sooner they're treated, the easier it is for you, the pig, and your pocketbook.

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AviN4
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Post   » Fri Sep 03, 2021 8:19 pm


Thanks for the advice. I took it and got an emergency appointment yesterday. ($60 extra for an emergency appointment, which was insignificant compared to the total $435 bill. Yikes.)

The vet did an examination and could not find anything wrong with Midnight. He mentioned there was food in Midnight's mouth and seemed like he may have been skeptical that there was any problem at all. (I probably should have shown him the weight chart so he didn't think I was crazy.)

He said the examination included a look at his teeth, including his molars, to the best of his ability. He said this included removing the food from Midnight's mouth and using the appropriate tools. (Because of COVID-19 protocols I could not be in the procedure room at the time.) I asked if he could do an x-ray to look at Midnight's teeth. He said that would require general anesthesia, which has risks. Given his observations of Midnight, he did not recommend it either. So I did not request the x-ray. (He also said a CT scan would be better, but that they didn't have a CT scanner in the office.)

He said he could do a blood chem / CBC panel which may or may not require sedation. He also said he could do a fecal test. I agreed to both and should get the results in a few days. (Fortunately Midnight did not require sedation.)

They also gave me some Critical Care and instructed me to use it as needed, up to 3 times per day. I fed him some yesterday, but I don't think I'll continue. For now it seems unnecessary, given that I can see him eating at least some food and is still a healthy weight. Still, it seems good to have it around if he gets worse.

He still seems to be repeating the behavior I described regarding carrots: Refusing to eat the hard pieces but sometimes eating the shredded carrots. I think he's eating less overall but it's hard to tell for sure.

His weight is still declining (~1oz lost since 8/29) though there is nontrivial variability.

He seems to like celery so I've been adding celery to his diet, sliced and strings peeled off. Probably not the best long-term though given the high calcium content. I also experimented with tomatoes, cucumbers, and okra but neither him nor Moon would eat much of any of those.

I'm not sure if he likes the Sweet Meadow pellets any better than the Oxbow pellets, but it's hard to tell. It might be a red herring either way.

Is there anything else I should be doing at this point other than waiting for the test results?

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AviN4
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Post   » Fri Sep 03, 2021 8:45 pm


A few things I missed in the last post:

- The vet also suggested I separate Midnight from Moon temporarily to see how much Midnight is eating. They get stressed when separated though, and it seems like I'd have to do this a full day to get reliable results. So I'm not sure if this is worth it. But maybe I'll try it this weekend.

- Since they seemed to like KMS timothy pellets, which are now out of stock, I'm somewhat tempted to give KMS alfalfa pellets a try. Is this a bad idea, given the circumstances? The calcium in KMS alfalfa pellets is reported as no higher than the KMS timothy pellets. Plausible explanation here, though not sure if I'm totally convinced.

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Lynx
Celebrate!!!

Post   » Fri Sep 03, 2021 10:16 pm


Okay. Since this was an emergency appointment, I take it this was not an exotics vet real familiar with guinea pigs?

If they are teeth problems, an xray, read by a skilled veterinary dentist who has worked with guinea pigs or a veterinarian who can read them well is important. What could turn up is elongation of the roots, a minor spur (that this vet missed), an abscess, or something else interfering with his ability to eat. It is good that he can still eat most things okay (still eating hay, right?). I think you are focusing on the gradual weight loss and his problems eating carrots (let me know if I missed something).

If separating them is hard on the pair, I would not do so long term. I do not recall Pinta or anyone else mentioning a CT scan as a primary diagnostic for malocclusion, which you are worried about right now.

I don't trust the claim the KMS alfalfa pellets and timothy pellets have the same amount of calcium. I would use the timothy pellets when you can get them if those are the ones you want.

I can say if they are still using the same labels Linda was using before she sold the business, it is complicated to make any changes to the labels themselves (you need the software to do it). I know this because I used to be the person who made the label changes for KMS Hayloft before it was sold when there was an error or change in the ingredients.

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AviN4
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Post   » Fri Sep 03, 2021 10:47 pm


He is an exotics vet. Dr. Julian Rivera at The Center For Avian & Exotic Medicine:

https://avianandexoticvets.com/team

At what point is an x-ray worth doing, given the risks of general anesthesia? Maybe if the blood and stool test return nothing? Should I also wait and see if the weight loss continues? For how long? I'm not totally convinced that my interpretation of his carrot eating behavior is correct.

Or is it feasible to x-ray teeth without general anesthesia, and I should just find a vet who will do it?

Identifying a "a skilled veterinary dentist who has worked with guinea pigs or a veterinarian who can read them well is important" seems like a challenge. It seems especially hard to get appointments these days too. :( I have a generally good impression of my regular vet's knowledge about guinea pigs (Dr. Lawrence Buchholz at Animal Clinic & Hospital of Jersey City) so maybe I should schedule an appointment, even if it's a month out.

Midnight is still eating hay. And at least nibbling on vegetables and pellets. It's a little tricky for me to tell how much he's eating. I can try to watch him more often / more closely.

I'll avoid the alfalfa pellets.

Thanks for all your advice.

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Lynx
Celebrate!!!

Post   » Sat Sep 04, 2021 8:22 am


Did the vet suspect internal parasites for the weight loss? I ask because I don't recall many stool tests being done unless one is looking for particular parasites. And even then, some parasites can be hit or miss as far as finding them in the stool.
https://www.guinealynx.info/diarrhea.html

It sounds like you have decent vets and will be waiting for the results of the tests and moving from there, continuing to monitor weight and behavior.

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AviN4
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Post   » Sun Sep 05, 2021 8:12 am


Yes, he suggested an internal parasite as a possible cause. I am skeptical given that:
- Moon seems fine.
- The gradual weight loss only began ~5 months ago, and it's not clear how they would have become infected unless it was from before I adopted them 3.5 years ago.
- I see no evidence of diarrhea.

But was non-invasive and relatively inexpensive so I agreed to proceed.

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AviN4
Supporter in '21

Post   » Wed Sep 08, 2021 8:35 pm


Both the blood test and the stool test were clean. Dr. Rivera asked me to bring Midnight back if I see 5% more loss in body weight, decreased fecal production, excessive salivation, seizures, etc. He said next steps could be teeth or abdominal imaging depending on symptoms.

Midnight is still exhibiting the unusual behavior with regard to carrots. Today I persuaded him to try eating a small carrot piece. But he took a few bites, mostly let it fall out of his mouth, and then lost interest.

To me all this seems like evidence of teeth problems. :(

I'm trying to get an appointment with my usual vet (Dr. Buchholz) next week. But it's possible I'll need to wait until Oct 4th.

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Lynx
Celebrate!!!

Post   » Wed Sep 08, 2021 8:43 pm


If you read the most recent topic in the med forum, you will note how complicated sorting out some of these issues can be! It looked like teeth issues but may instead be ovarian cysts interfering with eating enough food. At least your male would not have this condition.

I hope you do not see excessive salivation and certainly hope there are no seizures.

I wish all we needed to do was pop a couple nutritious treats into their diet to maintain weight. Hope you are able to see your usual vet sooner rather than later.

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AviN4
Supporter in '21

Post   » Wed Sep 08, 2021 9:01 pm


Thanks for your support.

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AviN4
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Post   » Sat Sep 11, 2021 8:09 am


There are Midnight's test results from the visit last week. Dr. Rivera's interpretation was that these results are all fine. Glucose (147 mg/dL) to me looks on the high side, but probably not high enough to indicate diabetes or similar? Also, I suspect perhaps not reliable unless the test was done after a fasting period?

The reference ranges I've seen (such as the ones cited on GuineaLynx) indicate that 60-125 mg/dL is normal, but other sources (such as this old study) indicate that diabetic is more like >= 300 mg/dL.

I do have the impression that Midnight has been drinking more water, and my interpretation of that is was that eating less washed vegetables results in drinking more water. But I do see that both weight loss and excessive water drinking can be symptoms of diabetes.

I haven't noticed increased urination but it's hard to tell with their absorbent bedding.

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