Token's Medical Thread

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Butters

Post   » Thu May 17, 2018 8:42 pm


Hi everyone,

I'm after a bit of advice and to see if anyone else has encountered this issue. My guinea Token is 6 and a half years old. Five days ago we discovered some cloudiness to his left eye (a blue-ish tint). This is the same eye that had a small ulcer in it 3 months ago, but with eye drops it cleared and hasn't recurred since.

Two vets later all they could tell us was there is no ulcer and the corneal oedema is a symptom of something else, but they don't know what. We took him to an animal ophthalmologist who diagnosed his problem as two-fold - corneal epithelial degeneration (where the lining that siphons fluid away from the cornea is damaged or no longer there, hence fluid is entering his cornea and causing swelling) and uveitis (inflammation in his eye due to occurrence of cataracts). The cause of this could simply be old age or could be from the previous ulcer we don't know.

We can try to treat the inflammation with Acular eye drops, but the epithelial degeneration can't be fixed. He suggested topical ointment Muro-128 which basically draws out the fluid, but we cannot get here in Australia and must order in from the States so will take a few weeks. As an alternative, we can mix up a solution of 10.4ml 7% NACI with 4.6ml water for injection to create eye drops that will act in essentially the same way. But as its eye drops and not the ointment they need to be dropped 6 times a day.

We are very fortunate my partner is a vet nurse and was able to get what was needed immediately and we began treatment last night. 6 times a day is very taxing and Token will have to go to work with my partner everyday to get his treatment throughout the day (we are spacing it out 3 hours beginning at 7am and ending at 10pm).

We have a recheck with the ophthalmologist next Thursday (1 week after) to check if the eye has deteriorated further or if we have been able to stabilise it with the treatment. If so, we may be able to continue the treatment the rest of his life but there is always a chance an ulcer could form and the eye may deteriorate further.

The ophthalmologist says the eye currently is "pretty bad already". Given the rate of deterioration and his age, we are wondering if we should consider having the eye removed now while he is still healthy and in good spirits and has more chance of surviving the surgery. Rather than continue the treatment indefinitely knowing it could go bad at any stage and if his eye needs to be removed in the future he may be too old to go through a big op.

Needless to say we are devastated! The ophthalmologist says we cannot expect his eye to ever get better, the best we can do is stabilise it and hope it does not deteriorate further.

He is currently in very good spirits, appetite has not waned and poos look very good. Aside from some mild puffiness around his face from the discomfort I think he is doing well at the moment. (The pain is being treated with Metacam)

Has anyone had experience with this or have any advice for us??? Thank you so much!

bpatters
And got the T-shirt

Post   » Thu May 17, 2018 9:21 pm


I don't have any experience with something like that. But I do know that pigs who lose an eye, for whatever reason, generally do very well. And also, giving eye drops six times a day for the rest of his life would be a monumental pain in the rear.

Good luck to you, whatever you decide. Keep us posted on how he's doing.

Butters

Post   » Fri May 18, 2018 12:05 am


Thank you for your reply! Yes I have heard guineas don't have great vision anyway and can function without an eye pretty well. My only concern is putting him through the surgery and it's inherent risks at his current age. Will let you know how we go. Thank you! :)

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Lynx
RESIST

Post   » Fri May 18, 2018 9:25 am


Creams do seem to stay in the eye longer. If you have ordered the cream, I hope you are able to get your hands on it quickly and that it helps.

I did not know anything about corneal epithelial degeneration until you brought it up and I did some looking around online.

Hoping for a good outcome.

Butters

Post   » Fri May 18, 2018 5:32 pm


Thank you! I believe it is more often seen in dogs, whereby they recommend cataract surgery. Unfortunately that sort of surgery is too high risk for a guinea pig and too finicky on a small eye.

The specialist hadn’t seen a guinea pig with this before but it could just be that not many people would go to an eye specialist so it may have gone undiagnosed.

We have a recheck with the eye specialist Thursday week to check if we’ve stabilized the eye and decide whether or not eye removal should be done. But it’s worth giving the treatment a shot. Thanks again!

squeaky3

Post   » Sat May 26, 2018 3:47 am


My 4 year old sow has just had an eye removed, the operation was relatively quick and it has healed very well (it’s now about a month) however, she is younger than 6.5 years. I would opt for surgery before the eye becomes infected or an emergency situation if you think he can cope with the anaesthesia. Definitely worth giving treatment a shot first, I hope it works out for you. My guinea pigs name is Ginger and she has a thread about her eye on here.

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Lynx
RESIST

Post   » Sat May 26, 2018 8:00 am


I would second squeaky3's recommendation, especially trying to avoid an infection of the eye, which would complicate healing after enucleation if that was required.

Butters

Post   » Fri Jun 01, 2018 5:20 pm


Hi guys, thank you. I will check out your thread!

The recheck with the eye specialist went well. His eye has actually improved significantly with the eye drops and the cloudiness has cleared a lot. The eye specialist says it will not ever come back to normal but he does not recommend removing the eye at this stage.

Further he is also confident the likelihood of the same occurring in the other eye is very low. He recommends continuing treatment of eye drops 6 times a day and reducing Acular inflammatory eye drops to once a day (the inflammation has also gone down).

We have ordered in the Muro-128 ointment from America but it is still a month away :/ once Token has been on the Muro for about a fortnight we will recheck again.

It was the best outcome we could’ve hoped for and the eye specialist says if all goes smoothly he can be on Muro for life and the eye can be comfortable enough that it can stay in. I’m relieved at this stage not to put a 6 and a half year old piggy under anaesthetic to be honest.

While the eye has shown positive signs, a few days ago Token started to lose weight. He’s gone from around the 1.1kg mark to 966g. We’ve immediately begun critical care feed but it hasn’t improved.

We are trying to make an appt with the exotics vet today but they don’t have anything till Tuesday. They say it could very well be unrelated to the eye. We’ve collected a wee and poo sample to take with us. I hope it is not his teeth as he has a history of malloclussion (forgive me if I’ve spelt incorrectly).

Will post an update afterwards but he is otherwise bright and his usual self. Has a usual appetite and is eating his full meals and hay without problems so I’m not sure why the weight loss. It could be he is simply losing muscle mass with his age but anything under the 1kg mark makes me very uneasy.

Anyhow fingers crossed we can rule out some nastier suspects like dental issues soon. Thanks!
Last edited by Butters on Fri Jun 01, 2018 5:34 pm, edited 1 time in total.

Butters

Post   » Fri Jun 01, 2018 5:31 pm


Have just read up on Ginger what a gorgeous girl. Very glad she has recovered well! I’m sorry you had to go through all the stress about her eye, it did not look good at all and I can see why removal was the best option! Token’s looks very different I will try to post a pic from when this occurred to now but I can’t seem to do it on my phone. Will try soon!

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Lynx
RESIST

Post   » Fri Jun 01, 2018 8:32 pm


If you have a clear, crisp photo, you can email it to me:
Image

I would watch for any signs of pain, which could affect appetite.
www.guinealynx.info/pain.html

squeaky3

Post   » Sun Jun 03, 2018 10:52 am


So glad that non surgical treatment is working well for you, the whole process of the op was more stressful for me I think than it was for Ginger, but she's a happy girl now!

Butters

Post   » Sat Jun 16, 2018 3:30 am


Hi guys, Token’s eye is much improved thanks to the eye drops I can barely tell the difference now between the left and right eye!

The ointment we were so desperately waiting for has arrived from the US two days ago, however we are having a lot of trouble getting it in his eye. Due to guinea’s eyes being quite bulgy we can’t seem to really pull down the eyelid and pop it under the eye (which is what is recommended) and I find it just goes everywhere!

I don’t know if it’s getting in at all.
I’ve also noticed he winces a lot more with the ointment, it seems to sting more so he’s puffy around the face, and today his poos are soft and clumped together. So I think he is in a bit of discomfort.

I want to go back to the eyedrops but the specialist assures me they are essentially the same thing just in different form. And I don’t know if it’s good for him to swap back and forth like that.

Does anyone have any advice on applying ointments please?? Thank you!!

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Lynx
RESIST

Post   » Sat Jun 16, 2018 8:50 am


That you have seen a great deal of improvement says to me that the drops were doing a great job. If I were you, I'd continue with them but monitor closely and be ready to try the ointment again. The ointment might also be handy for longer time periods if he still needs treatment.

I guess I have never had to put ointments or drops in guinea pig eyes so someone more experienced might have better tips for you if you continue with it. I am surprised that it appears the ointment might sting more. Perhaps there is an ingredient he is sensitive to.

Butters

Post   » Thu Jul 12, 2018 12:47 am


Hi all,

My 6.5 year old guinea pig Token underwent dental surgery 2 days ago. His front tooth had broken off and was infected within the gums, and his back teeth had overgrown (mild to moderate, they said). The last time he had a dental was at 3.5 years of age and has not needed a dental since.

I don't know if the teeth overgrew due to changes that had been happening with his eye. See thread here: viewtopic.php?f=2&t=76547

The exotics vet said he came through the surgery very well and was eating pretty much straight away, but that night when I brought him home he could not chew. He would take food into his mouth, chew for ages, then gag and spit it out (or I would have to pull hay/grass out) so he wouldn't choke on it. He was not swallowing anything at all.

He has been on critical care 60ml a day but has dropped weight to 910g (previously 1.04). Yesterday and today he has not eaten anything. He would mildly attempt to take some food into his mouth but not be able to consume it. Long foods like hay come out lumpy at the top. The vet is convinced he was eating heaps post-surgery and he could just be in pain, but he is already on Meloxicam.

They also found an inner-ear disease which is being treated with Tramal. The gum infection is being treated with Doxycycline for a month, and he is on Zantac for 7 days.

I'm very concerned at his lack of ability to eat. Food is being chopped up very small and he still is having trouble. I know each pig is different but how long before he should be showing signs of being able to chew normally again?

The vet said if there is still pain 2 days post-op it could be related to something else as he had no ulcers in his mouth at the time of surgery. Why else would there be pain and why would it not dissipate? I would think he would be in less pain today than he was yesterday?

Any advice welcome!! Thank you!

bpatters
And got the T-shirt

Post   » Thu Jul 12, 2018 1:34 am


It's incredibly important that he eat. You can't give him any choice in the matter at all. Guinea pigs are wired to require food moving through their digest tracts at all times. Unlike people, dogs, cats, etc., which only secrete stomach acid at specific times, GPs secrete it continually. Lack of food in the stomach can cause ulcers which perforate the stomach (I lost a pig that way). It can also cause bloat, because there's no food coming in to stimulate the gut, so the intestinal contents ferment. Bloat is a serious medical emergency, and many pigs don't survive it.

I don't know about Zantac for guinea pigs. I suspect your vet is trying to address the problems associated with lack of food, but if it were me, I'd address them by force feeding him.

So I'd say keep feeding him the Critical Care. The rule of thumb for a pig that is eating nothing on its own is that you feed 100+ cc. per day for every kilogram the pig weighs, every day, split into 6-8 feedings around the clock. Adjust up or down according to the pig's weight, and down if it's eating some food.

He may be able to eat things that are cut into matchstick slivers rather than finely chopped. You'll have to push the slivers toward his back teeth, but if you can get them far enough back, he may be able to chew and swallow them.

It may take a few days for his teeth to meet properly again. But he should be able to eat within another day or so if the issue is that his are unevenly ground down.

The other thing I'd do is put him on a probiotic. Benebac is good if you can get it. So is poop soup with poop from a healthy pig. Failing either of those, you could give him human acidophilus or kyodophilus.

Good luck with him, and keep us posted on how he'd doing.

Butters

Post   » Thu Jul 12, 2018 2:16 am


Thank you bpatters! We will up the cc (have been doing around 60 a day but will do more).

The vet said the Zantac was to assist post-op and also to assist with him having to be on antibiotics for so long (one month). His med list at the moment is:
Muro 128 ointment 2 x a day (for the eye, for life)
Acular eye drops 1 x a day (for the eye, for life)
Meloxicam 0.14ml 2 x a day (for 3 to 5 days)
Tramal 0.1ml 2 x a day (for life)
Zantac 0.12ml 2 x a day (for 7 days)
Doxycycline 0.11ml 2 x a day (for a month or until infection clears)
And the vet wants to add Metamine to facilitate the gut.

I've tried every veg and chopped it up so finely but he just cannot eat it. It goes into his mouth then he gags and spits it out. I am beside myself with worry. Do you think I should just keep up the cc, and just have veg and hay available so he can try when he feels up to it? It breaks my heart to see him trying to eat then not being able to.

As of last night and today I can see him getting more and more dejected with not being able to eat and he is now not even trying to pick up food anymore. I wonder if we had made the wrong decision putting him under anesthetic at 6.5 years of age but he needed the dental and the vet was confident he would bounce back as he was in good health. :(((

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Lynx
RESIST

Post   » Thu Jul 12, 2018 9:13 am


I combined this thread with your earlier one. Please keep all your medical posts about Token here.

And I am so sorry about Token! bpatters is right about how vital getting food moving through the system is. I would call the vet immediately about this.

bpatters
And got the T-shirt

Post   » Thu Jul 12, 2018 12:08 pm


Finely chopped veggies actually aren't easy for pigs to eat. They need to be able to get food back to their molars to be able to chew and swallow. They may be able to pick up tiny pieces with their front teeth, but then can have difficulty getting them to the back of the mouth. Matchstick slivers work better, because you can push them far enough back for the pig to chew.

If it were me, I wouldn't do the Metamine. As far as I can tell, it's just another name for ketamine, which is an incredibly powerful drug. He's on enough stuff as it is. But I would add poop soup if I could find a healthy pig, or try the Benebac.

Butters

Post   » Thu Jul 12, 2018 7:47 pm


Hi, thank you both. And apologies I thought I should start a new thread if it was a different issue, will keep it all here now. :)

Some good news to report: Last night Token ate a bit of food! After I cc-ed him I sat there tearing up teeny tiny pieces of salad mix and he ate them one at a time, very slowly, but they went down! He even attempted some hay - couldn't manage to get it down but he did try! I am being cautiously optimistic.

My partner took him to work yesterday and administered subcut fluids as he was dehydrated. The dental vet said his jaw moved easily without pain and the back teeth are properly aligned, so it could be the front infected tooth is paining him.

Anyhow we will keep going with cc and hopefully he begins to eat more and more. We will get some healthy poos from his cage mate to mix in with the cc. He is still a bit puffy and looks to be in some pain still but hopefully is improving. We did not administer the Metamine.

Thank you for your advice it is very much appreciated! Many vets have told us he is considered to be quite old for a piggy so we must be prepared but I know he has a lot of life in him still so we will keep on trying hard for him as long as he wants to. x

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