Moon's Medical Topic

[AviN4]

So, I think when Dr. A wrote "intermittent irregular suspect VPC noted", he was referring to this one abnormality here:



This seems to roughly match the image of a premature ventricular complex (PVC). Mayo Clinic says that PVCs in humans can cause skipped heartbeats, and can have several causes. Among the causes is "Increased levels of adrenaline in the body due to exercise or anxiety" and "Injury to the heart muscle due to disease." I think it's very likely Moon was experiencing anxiety at the time, which seems likely sufficient to explain the PVC.

[Lynx]

That is very interesting you were able to find a possible explanation! I expect with all your research, you will soon have a better understanding of these tests than I do!

[AviN4]

Thanks Lynx!

Unfortunately Moon can't catch a break. It looks like he may have now have pododermatitis on his two front feet, perhaps on the milder side?

Front left foot:



Front right foot:



This seems to be a new development. None of the vets had reported it previously, and the first time I noticed it was yesterday morning (Feb 14).

I have read the pododermatitis page and the associated links page. The optimistic interpretation I can see is this one from pinta:

Non ulcerated bumblefoot cases we ignore. We have noted that bumblefoot comes with inaction. Once a pig starts getting active (after a long illness) the bumblefoot tends to go away...

I don't think this would be considered ulcerated (yet), so maybe we can wait and see with minimal treatment? In any case, we'll do our best to keep his cage lining more clean and dry. We may also try chlorhexidine ointment or soak, though I'm not sure if it's it's warranted yet? I notice that Baytril is mentioned as a common antibiotic used (for more severe cases?), but given how poorly he reacted to it for the suspected respiratory infection, I don't think it's an option. We also have some animax ointment (nystatin-neomycin sulfate-thiostrepton-triamcinolone acetonide ointment) on hand, but I don't see much mention of antibiotic ointment and I'm not sure it it would be warranted.

I also considered that these could be just spurs. I think this better matches the photos for pododermatitis, though I could be mistaken.

Moon's two rear feet look fine.

Meanwhile his stools were looking better yesterday, and he seems to be eating more hay on his own, though this isn't obviously reflected in his weight, and I think we need more time to see if these are real effects.

[Lynx]

I am guessing caused by inaction (standing on wet bedding more). The chlorhexidine is drying. That page on GL about pododermatitis is the best I can offer (it has been a long time since I took care of Nina and her foot problems). I don't think it is spurs. Your plan to keep the bedding as dry as you can is a good one.

[ItsaZoo]

My Millie had the start of podermatitis when I got her. The vet prescribed Mupuricin ointment 3 times daily. She had dirty feet from sitting around, so I washed her feet with an antifungal shampoo. Sometimes I spray cleaned them with Vetricyn Wound Care. Then I buttered her feet with Mupuricin and it improved a lot. She still gets a foot buttering once each day.

[AviN4]

Thanks Lynx and ItsaZoo for the suggestions. After considering this further, I think I have a more likely hypothesis about what's going on. Since Moon became sick, we've observed significant mobility issues. In particular, we sometimes see one of Moon's front feet slipping on a surface while he attempts to stand. He then tries to catch himself, which sometimes causes a repeat. On occasion we've seen this happen for several minutes, maybe longer. This may be causing irritation on his feet. This seems to fit the observed evidence better than urine or fecal contamination being the cause. If one of those were causes, why only his front feet, and not his rear feet?

We'll work on changes to see if we can prevent the slipping. For now we've replaced fleece as the top cage liner with a towel. If he does repeatedly slip it might hurt his feet even more, but we're hoping it stops (or significantly reduces) the slipping. A towel might expose Moon to too much wet urine, so we're going to try some of these rubber tiles as a top layer see if that helps. (I found this after reading some of the discussion about EnviroTiles on Guinea Lynx, so that was helpful.)

Moon's front feet also sometimes slips while on a towel on my lap during hand feeding. Moving forward, I'm going to try to layer it like Moon -> towel -> large pillow -> lap and see if that helps.

[AviN4]

Some updates on Moon:

• The surface on the rubber tiles would not drain properly and would stay too wet, so it wasn't working out. Moon is back to towels. I'm not sure if Moon's feet are improving but I don't think they are getting worse. We've been applying chlorhexidine 2% ointment to his feet, 3 times per day.
• Moon's diarrhea-related symptoms seem to be completely resolved. Moon produces a ton of poops (mostly in large piles) with near perfect shapes. We are continuing the diarrhea-related treatment and dietary changes as a precaution, but we are planning to gradually revert them.
• We've reintroduced the meloxicam at a lower dose. He was on 0.250 mg every 12 hours, and is now at approx. 0.090 mg every 12 hours. We may try gradually increasing the dose again to see if it helps him without causing more diarrhea-related symptoms.
• Moon's weight has been mostly stable, but that's with a lot of syringe feeding by hand. He may have lost weight after we stopped meloxicam and gained some after we restarted it, but that could be noise.
• Moon eats hay, and occasionally some treats, but doesn't eat pellets and doesn't drink water.
• Moon's mobility is still poor. He struggles to stand up and move around. We have ordered this guinea pig wheelchair as an experiment, perhaps to use as a kind of physical therapy aid.

[Lynx]

You are very observant and detail oriented. Glad to hear poops are looking good.

If you wish to increase fluids beyond what you are giving when hand feeding, you can soak a handful of hay in water and put it on a plate. Some guinea pigs really like it but it can't be left to sit due to possible bacterial growth (I don't really know a safe window but removing it in perhaps an hour or two sounds reasonable). Eating hay is big. It will help his teeth.

[AviN4]

Lynx, thanks for the suggestion. We decided to just reintroduce vegetables, so we'll hold off on the wet hay.

Unfortunately his poops have been getting worse again. This began before reintroducing vegetables, and happened shortly after reintroducing meloxicam at a lower dose. So I think it's the meloxicam, but could be mistaken. We are discontinuing the meloxicam again for now, but I'm not sure what to do about pain medication in the intermediate term. If meloxicam is causing diarrhea, is there any reasonable hope that carprofen or another NSAID would be any better?

Also, his rover has arrived. Here's a cute photo:



He doesn't like (or isn't able) to move around in it. But it seems to be helping him stand and eat food placed right in front of him, hopefully with less pain. It's early and inconclusive, but yesterday he was able to maintain a stable weight after 12 hours on the rover, which is unusually good for him. Still, it's not clear whether this will persist long term. And to have a life worth living, I think it's going to be necessary for him to move around on his own.

Also, as if he didn't have enough problems, I noticed he has lost a lot of hair on his belly. I'm guessing it's some kind of irritation from laying on his belly on the floor for a long period of time, but I don't really know. We're planning to take a wait-and-see approach for now but are open to other suggestions.

[Lynx]

Abrasion can cause hair loss. Also if he gets wet there, that could contribute too.

Hope the rover works out for him. If you notice more irritation of the belly, perhaps a layer of soft cotton gauze might help.

I don't know if carprofen would help, if the meloxicam might be causing soft poops. You can discuss this with your vet if with more evidence and experimentation you are more sure about the meloxicam affecting poops.

[AviN4]

Thanks Lynx. Cotton gauze is a great idea. We've started putting gauze wrap on the rover to hopefully keep Moon's belly more comfortable and dry.

We're continuing to do experimentation on what might be causing the diarrhea. I thought it was the meloxicam, but it got even worse after discontinuing meloxicam for a few days, so now we're trying to discontinue vegetables (again) instead. Since then it's been improving somewhat, but we'll need more time to better understand the cause(s).