Moon's Medical Topic

[AviN4]

Last night I discovered a very thin piece of hay stuck behind Moon's eye. It was lodged in kind of deep behind the eye, maybe 1/4 inch? I flushed it gently with homemade saline using a plastic bulb syringe (for ear wax removal), and was then able to carefully remove it. Here's a photo from after the removal. As you can see, part of his eye is cloudy:



This was familiar territory for me, since his brother Midnight had an eye ulcer back in 2019:

https://www.guinealynx.info/forums/view ... 2#p2299832

My regular vet could not see Moon until May. So I took him to an emergency vet this morning. They told me they didn't know much about guinea pigs, but said they could look at his eyes, and assured me they'd check with me before performing any procedures or administering any medications. They did an eye staining exam, and said his eye had significant abrasions and an ulcer. Surprisingly, they said his other eye had some abrasions as well.

They gave me Ofloxin 0.3% eye drops, with instructions to apply them every 12 hours, 2 in the worse eye and 1 in the better one. I'm not sure how many days, but I should be hearing back on that. They suggested applying some kind of injection for pain, which I declined. They also put on a little head cone, which I removed. And they suggested I bring him to a guinea pig specialist within a few days.

So, a few questions about this situation:

1. Is Ofloxin 0.3% eye drops OK for eye ulcers? I knew to watch out for penicillin based antibiotics, and confirmed that these are not. But I also can't find see much about their use in guinea pigs, other than people mentioning that that their guinea pigs were prescribed it. Midnight was prescribed gentamicin eye drops for his ulcer in 2019. I still have some left, but I'm concerned it may not be safe to use after 2 years.

2. I don't think the head cone is necessary and removed it. I can't find any recommendations online to use a cone in this situation and Moon doesn't seem to be touching his eye more than normal. Am I making the right decision here?

3. The vet seemed to be concerned about the severity of the problem and suggested I should schedule a follow-up with a guinea pig specialist within a few days. How important is this? Would it be sufficient to wait a week or so to see if the cloudiness improves with the eye drops? I ask because it seems especially difficult to get guinea pig specialist appointments these days, and I may need to take a half day off from work and travel an hour each way to do so.

4. I was surprised to hear about the abrasions in the other eye. How normal is it for guinea pigs to get hay pokes in both eyes? I'm not sure what else would have caused this. He and Midnight never get into violent fights.

5. I'm concerned I may be doing something wrong to cause this. Specifically, when I add new hay to the hay rack, Moon and Midnight often get excited and run to the hay while I'm still adding it. This results in them being covered in hay. They don't seem to mind, and I figured they can just shake it off. But I'm now wondering if this could be causing hay to get stuck in their eyes. Should I be more careful when adding hay?

6. Is there anything else I should have done differently, or should do differently moving forward?

[Lynx]

I take it this is the ophthalmic version. https://www.drugs.com/mtm/ofloxacin-ophthalmic.html says:

Ofloxacin is a fluoroquinolone (flor-o-KWIN-o-lone) antibiotic that fights bacteria in the body.
Ofloxacin ophthalmic (for use in the eyes) is used to treat bacterial infections of the eyes.
Ofloxacin ophthalmic is also used to treat an ulcer in the cornea of the eye.
Ofloxacin will not treat a viral or fungal infection of the eye.
Ofloxacin ophthalmic may also be used for purposes not listed in this medication guide.

Eyes are very resilient. You gave prompt treatment. You might try giving them a handful of hay on the floor instead of allowing them to jump into the hay rack.

I looked over your other eye topic. If you don't see improvement, perhaps the vet could prescribe that opthalmic ointment.

[bpatters]

The ofloxacin eye drops are fine.

You might call them back and ask for an oral pain reliever. Metacam isn't a pain reliever as such, but may help.

I agree with Lynx about a hay pile instead of a hay rack.

[AviN4]

Thanks, Lynx and bpatters. I greatly appreciate you taking the time to provide this advice.

I've removed the hay rack and moved their hay to the floor. I'll try this for a while. So far, Moon seems to be happy that he can reach more of it.

Moon is behaving normally and showing none of the signs of pain here:

https://www.guinealynx.info/pain.html

Is it likely he's in pain but hiding it? Is it still worth asking for an oral pain reliever?

If the cloudiness subsides with the Ofloxacin, is a follow-up appointment still important?

[Lynx]

If you are seeing great improvement, you could call the vet and see if it wasn't appropriate to cancel the visit.

If he is maintaining weight fine and showing no signs of pain, he is likely not in pain. Pain treatment is most important when a guinea pig hurts so much they do not eat or start losing weight. Any time a guinea pig is ill, it's a good idea to start a routine of once or twice daily weighings.

[AviN4]

Hi Lynx,

Thanks for sharing more helpful advice!

I've been putting him on a scale each day, and his weight has been stable. Less than 10 grams in changes compared to a month ago.

His behavior also seems happy and normal. He is even putting up with the 3x daily eye drops with minimal complaint.

His eyes seem to be improving as well. Very little cloudiness at this point.

Moving forward, I'll put an effort into giving Moon and Midnight weight and eye checkups more frequently.

[Lynx]

That is great news! Thanks for the update!

Yes, weekly weighings are so important. They can clue you in to a developing problem. You will also be able to see normal minor fluctuations.
https://www.guinealynx.info/weigh.html

[AviN4]

Moon's eye appears to have recovered just fine.

But, I am now slightly concerned about another issue. About 20 minutes ago I saw Moon sleeping with his eyes open, as he often does. But this time, part of the white in his eye was exposed, and his eye was twitching. (This was his other eye, not the one with the obvious hay poke.) I was worried he was having a seizure or something. I removed his hideout, and observed no change in his behavior. Then I tapped his behind a few times. After a few taps, he woke up and ran away. Though his response time was notably slower than normal. Normally, I'd expect him to become alert immediately upon removing his hideout, and to jump or run as soon as I touch his behind.

Moon's behavior looked very much like the guinea pig in this video:



The explanation there is that the guinea pig is in REM sleep with their eyes open. That seems like a plausible explanation for what I observed, including Moon's slow response time (consistent with deep sleep) and his behavior reverting to normal after being awoken. Is that what's going on, or should I be concerned?

[Lynx]

So glad his eye recovered fine!

Comparing it to the guinea pigs in the video, the explanation given sounds plausible to me too. I would just keep an eye on him and not worry too much.

Perhaps you can take a video if you see it again.

[AviN4]

A week ago I noticed some hardened crusty compound just below Moon's right eye. I thought it was just normal discharge that somehow had collected there, so I spent a few minutes carefully breaking it apart and removing it. But then yesterday, I saw it again. Upon closer inspection, it also looks like his right eye may be slightly more watery than the left. Here are photos of both eyes from this morning, which was after I had already removed most of the hardened crusty compound.

Right eye (unhealthy):



Left eye (healthy):



I've been weighing Moon weekly and his weight has been stable. Behaviorally, he seems totally fine too. (Better than I anticipated, given that he lost his cagemate on 2022-07-01 and has been alone since then.)

Any thoughts on what's happening here? Some kind of infection? Moon spends a lot of time with his head buried in hay, so perhaps it's another hay poke? How urgent is a vet visit?

I have some partially used Ofloxacin antibiotic eye drops, but it expired 2021-07-09, so I'm not sure if giving him that would be a good idea.

[Lynx]

I would watch for any changes in the eye. What can happen, is that for some reason a tear duct will be blocked in one eye preventing the natural drainage of fluids and resulting in crustiness in that eye as the fluid dries up. Sometimes people recommend gentle soaking and massaging of the eye with a damp/wet/warm/clean cloth to see if that helps open up the tear duct.

This may or may not be what has happened. I know how closely you watch the health of your guinea pigs and am sure will watch for any other signs of illness.

[AviN4]

Lynx, thank you! I'll try the gentle soaking and massaging approach and will continue to monitor for changes.