From a discussion in the medical forum, Pinta writes:
When we first twigged onto heart issues occurring in pigs it was with a pig named Zag. She had Pea Eye in both eyes that my vet informed me were fat deposits. She had a URI that would go away with drugs and always come back. We had xrays taken by a specialist(this was decades ago) who was renowned in his field. He declared her to have walking pneumonia. He did say there was fluid in the lungs. On a hunch I asked my vet if we could try lasix just to get the fluid out. We did and surprise surprise, the pea eye disappeared, the walking pneumonia symptoms disappeared. That was our eureka moment. She had heart issues. My vet, flying by the seat of her pants as there was no reference material dealing with heart disease in pigs(there is now), extrapolated heart med doses from cat to pigs and Zag never had a recurring URI again.
In the many years that followed we discovered in most pigs, it's almost impossible to diagnose heart disease unless you kill the pig and take a look at the heart. We did find a trial of Fortekor (our by-the-seat-of-our-pants dose is higher than the med references but has proven to get better results) works as a dignostic tool. If the pig gains weight, gets more active, is more alert, has better muscle tone, or breathes better after a few doses of Fortekor, you can be pretty sure the problem is heart. For me, unexplained weight loss is enough reason to try Fortekor. There have been countless pigs who turned around completely and started gaining weight once on Fortekor.
I had a skinny with weight loss after my vet retired. Because I wasn't sure what other issues a skinny might have that would cause weight loss, I tracked down a very pig savvy vet who was doing a shift at the SPCA. He's the type of vet who wants a clear diagnosis. Took advantage off all the diagnostics the SPCA hospital had available. The only thing we couldn't do was get blood as the skinny was so tiny. Absolutely nothing seemed amiss. I asked if we could try a trial of fortekor and the vet reluctantly agreed. But his dose was 1/3 the dose I was used to. No changes after 3 days. I upped the dose to what I was used to and within 24 hours she started gaining weight. I emailed the vet, told him what I'd done. I think he may have change his dosing. Her turnaround was rapid and lasted.
Willie came to us sounding like a freight train at the age or 2 months. Since he wasn't dying we ruled out a URI. My vet(before we realised how common heart disease is in pigs) thought it must be asthma. When he was two we finally tried him on heat meds. The asthma symptoms disappeared.
My vet confirmed heart disease in all our pigs on heart meds via necropsy. So we know although there was no "official" diagnosis, heart was the issue and it's incredibly common.
I think a trial of Fortekor would be safer for Buttons than Chloramphenicol which is a big gun in ABs and can often totally eff up the gut. Basically if he had a bacterial infection it should be gone by now(with the ABs he's been on) or he would be dead. This is important to note. Infections like URIs kill pigs rapidly if the AB doesn't work. If the pig has a URI for months, it ain't a URI.
By the way there is a 'cillin pigs can take via injection - Duplocillin(sp?). Dr. Legendre uses this frequently in his pig dental patients. I've had a pig on it for 2 weeks with no ill effects whatsoever. Shocked the hell out of my regular vet when she heard the dose and the med!
All of the stuff your vet wants to try is expensive or invasive. A trial of Fortekor is neither. If Fortekor doesn't make any difference, then it's time to try the pricier diagnostics. I know a vet wrote something on the heart thread for people to print off for vets who refuse to consider heart but I suspect your vet wants something in a textbook. I also suspect he has no interest in consulting with other vets....
Coincidentally I had a pig in heart failure this morning. I had just finished subcuing her fluids for a sludgy bladder when she went into death spasms. Lost all her muscle tone. Fortunately the oxygen was already out for another pig who didn't make it. I slapped the oxygen on her snout and when she started breathing again, listened to her chest and one side was sticky. Dosed out oral Lasix(10mg). She was too weak to take it orally so I called the vet and asked them to prepare a 10mg injectable lasix dose for me to grab. Told them it would be too much stress for her to bring her in and she was connected to oxygen. Had a slight argument with the receptionist about preparing drug doses over the phone but worked it out. Left the pig in the basket inside a plastic bag with the oxygen hose by her snout and dashed to the vet. My pig vet wasn't in so the dog and cat vet followed my instructions and gave me a syringe with 5 doses of Lasix. When I got back, Princess(came with that name) was still upright and breathing. Seemed more stable than when I left. Injected the lasix and in 30 minutes she was able to take her heart meds orally by syringe. Upping her Fortekor dose by 1/3 daily. Now she's outside munching grass with the rest of the herd. I will give her another dose of lasix tonight.