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Advice Required - Possible Heart Piggy!

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ghostbusterbunny

ghostbusterbunny

Adult Guinea Pig
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My poor little Muffin has suspected heart or renal/liver failure and is currently suffering with a fluid buildup around her tummy (feels like a hardened strip from lady parts up to under her chin) which we are currently trying to shift with 0.2ml frusemide twice a day. She's going back for a review on Friday after a week on the frusemide but unfortunately it looks like it's at best stopping the build up getting worse.

Is there anything you can suggest that I ask the vet to look for or perhaps prescribe for Muffin on Friday? She wasn't happy making a decision either way on what was causing the fluid build up at the first consult which I understand and being an older piggy vet and I don't want to put her through too much if she's essentially a terminally ill piggy. The vet did say her heart rate was lower than she would have expected, being able to count her heartbeats which shouldn't be easy/possible. But there were no signs of an iffy heart pattern or chest infection to explain it and Muffin wasn't best pleased with the vet trying to feel for an enlarged liver (as she is also a bloat prone piggy who gets gassy very frequently - managed with infacol or gripe water for now).

She's bright, she's squeaky, she's Muffin still so any supportive care we can give her is certainly something I want to look into.
 
@helen105281 regarding heart meds. My vet uses Fortekor in preference to other heart meds unless your vet is 100 % positive what type of heart problem it is, Fortekor is the safest. So sorry about poor Muffin, hopefully Helen can give more advice x

Have you considered her having an ultrasound scan of the heart & liver/kidneys? She doesn't need a GA for those x
 
Would your vet be happy to do either a conscious xray or an ultrasound (as Poppy's Mum has suggested)? That way she could see if the heart is enlarged or with a scan she should be able to see how the heart valves are working.

If a heart issue is found, Benazapril would help. It is sold as Fortekor or Nelio and is an ACE Inhibator. Vetmedin could also be added in though none of mine have had that yet.

Do you know what your Frusemide dose is in mg? I assume your vet has made up a suspension.

With a heart issue she may have some of the following symptoms:

Nodding when breathing
Blue tinge to nose or ears
Difficult to rouse from sleep
Hooting followed by a cough
Random coughing
Abdominal bloating
Ascites (which is fluid on the sides I think)
Recurrent URIs
Pea eye
Bumblefoot
 
Thank you for the information! I raised the possibility of more diagnostic tests and at the moment the vet's suggested we carry on with the frusomide (Frusol is the solution I have) as Muffin's improved quite a bit this last week. The vet was able to feel her tummy organs this time which wasn't possible last time and has no concerns about her liver or any other possibilities in the tummy.

Muffin's heart rate is still slower than it should be so it's more likely that it's her heart that's showing early signs of problems but there's nothing setting off immediate alarm bells. The vet's said for an older lady, Muffin is sounding quite good and her breathing has improved with the Frusol treatment. I'm to try dropping from 0.2ml twice a day, to 0.1ml twice a day to 0.1ml once a day to try and stabilise her on the lowest effective dose and to increase if I feel she's having a bad day or the build up is getting worse. That way we can minimise the stress on her heart and other organs with the fluid build up and she'll be reviewed again in 4 weeks and we can decide if further treatment will help her out.

I think I'm happy with that at the moment but it's definitely nice to know there's more options if things get worse. I love this pig, she's my last remaining 'original' herd pig so she has just that little extra bit of space in my heart, bless her. The vet knows that I'll do anything to help her and in turn she's more open than I think a lot of vets out there would be to help us out and look into whatever options we've got.
 
So we've gone back for our one month checkup today and it's not good. We did quite well for a couple of weeks with the frusol/frusomide to the point where I got her off it entirely but this last week it's all come back on again so we're now back at 0.2ml twice a day to try and shift it. Looks like our hopes of removing the fluid and having her off the frusol have been well and truly dashed - she'll now be on it for the rest of her days.

Her heart rate is still very low - the vet estimated it to be between 80-100 so considering you shouldn't even be able to count it it's not good and now almost certainly her problem.

The vet I saw today was a different one who wasn't sure whether a heart medication should/could be prescribed so he's referring it back to my usual vet to see if there's anything we can prescribe to give her a boost.

I made it quite clear that I wasn't going to give up on her so if there's a treatment they're willing to prescribe (because obviously most of these drugs aren't licensed for use in guinea pigs), I'll want it. So I'm hoping for better news from Muffin's usual vet tomorrow - she's been great for investigating options for us.
 
Hopefully if your vet will agree to an ACE inhibitor you may in time be able to lower the diuretic.
 
They did! They've prescribed her 0.625 of fortekor a day for two weeks then we're to go back and see how she's doing. I might be wrong but I think she may be one of, if not the first piggy they've prescribed this to which I'm kinda proud of because if this works for Muffin and buys her a bit more time with us, it could help other piggies in future.

She's such a good girl, took it without any fuss. I love all my piggies but this girl is so, so special. Even with all this fluid and a heart that isn't working properly she's still quite a happy little piggy who'll let you do anything to her. Fingers crossed this helps her!
 
Hi ghostbusterbunny,

I had a heart pig that presented much like yours. It took a good few weeks for the fluid to go down but it did. She was on Fortekor and Frusemide every day for the rest of her life and she lived at least a good year and a bit until the age of 9. In my opinion, you should keep yours on the meds long term. I wouldn't stop them to allow the fluid to build up again, just keep with the maintenance dose. Our girl made such a good recovery and she was a fighter to the end. I'm so thankful to heart meds! I hope yours does well. :)
 
Great she has Fortekor, that is an introductory dose so you may find it needs increasing at some point. As a guide most of my heart pigs are on 1.25mg a day split in 2. Hope it helps. I think my pigs were the first at my vets too, it's great to know they can help others.
 
I have a heart piggy, presented with fluid in the lungs and lethargy. She has never had oedema (fluid under the skin) or ascites (fluid in the abdominal cavity) although these are common when the fluid isnt under control. Fudge is on 0.625mg fortekor also, but alot of diuretics. We only got it under control with 1ml frusemide (4mg) 3 times a day (maximum dose). This lasted around 5/6 months before we added in another diuretic, spironolactone, 5mg every 24 hours which is now every 16 hours. Its a progressive disease, and we where never able to stop fudges diuretics so be prepared that this may happen. What strength is the frusol? Its usually 20mg/5ml or 40mg/5ml . The usual dose of frusemide is anything from 2mg once daily (maintenance) to 4mg 3 times daily. Vetmedin is usually added if their is a murmour or irregular beat- fudge was tried on vetmedin but it made her very flat, off her food and had diarrohea, but this was a rare reaction. We are around 10 months into fudges diagnosis, she turned 7 last month and is a happy girl. Her off days are very far and few between, although she now has comprimised kidneys- this isnt a surprise due to being on over and above maximum dose diuretics for so long, shes done amazing to get this far as her case is severe. However, the kidney issues where picked up accidently and she isnt showing any symptoms of it. Her weight is just as it was when i took her on 4 years ago. Dont lose hope, you still have a good scope for increasing meds and the fact she is happy is the main thing. My vet said fudge is one of the happiest, brightest and full of life piggies shes ever met.. Despite the fact all the xrays and test readings say shes falling apart at the seams! Their happiness is the best guide, and fudge still wants to live her life.. The day that changes, i will give her that help she needs to end her suffering.
 
Wow Adelle, your piggy is a fighter, that's for sure! I'm not sure what strength the frusol is but I will definitely find that out. When speaking to the vet she advised that 0.2 twice a day is already quite high but looking at what your piggy has got up to I think that could probably be looked at again and I should definitely have the scope to increase if she needs it. Like you, I've already decided that the day she looks at me and tells me she's had enough I'll help her on her way. For now though, she's definitely still my Muffin and one of the greatest little piggies that walks the earth, in my opinion.

Thankfully the fortekor already appears to be helping the fluid, it's slowly disappearing once again. However, one thing that has started to happen since saturday really is that she is now getting incredibly dry skin (especially where her fluid has built up) all over her body. Is this something that can happen with heart piggies and if so, is there anything I can do (topically, diet or medical/supplemental) to help it? I made the decision to use some aveeno on her today as she's starting to scratch and make herself a little raw so hopefully that'll soothe her skin in the short term.
 
ghostbusterbunny said:
Wow Adelle, your piggy is a fighter, that's for sure! I'm not sure what strength the frusol is but I will definitely find that out. When speaking to the vet she advised that 0.2 twice a day is already quite high but looking at what your piggy has got up to I think that could probably be looked at again and I should definitely have the scope to increase if she needs it. Like you, I've already decided that the day she looks at me and tells me she's had enough I'll help her on her way. For now though, she's definitely still my Muffin and one of the greatest little piggies that walks the earth, in my opinion.

Thankfully the fortekor already appears to be helping the fluid, it's slowly disappearing once again. However, one thing that has started to happen since saturday really is that she is now getting incredibly dry skin (especially where her fluid has built up) all over her body. Is this something that can happen with heart piggies and if so, is there anything I can do (topically, diet or medical/supplemental) to help it? I made the decision to use some aveeno on her today as she's starting to scratch and make herself a little raw so hopefully that'll soothe her skin in the short term.
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Glad she is improving. I'm not sure if there is a correlation between the conditions and meds with dry skin. However fudge has recently presented with this, along with hair loss. Due to illness reducing their inmune system, these piggies can be more susceptible to mites- so fudge was given her first round of 3 mite treatments the other day. This may be something to consider, especially if shes itchy. Please see a vet to get the treatment for this as shop bought products rarely work and can sometimes make the matter worse x
 
Adelle said:
Glad she is improving. I'm not sure if there is a correlation between the conditions and meds with dry skin. However fudge has recently presented with this, along with hair loss. Due to illness reducing their inmune system, these piggies can be more susceptible to mites- so fudge was given her first round of 3 mite treatments the other day. This may be something to consider, especially if shes itchy. Please see a vet to get the treatment for this as shop bought products rarely work and can sometimes make the matter worse x
Click to expand...

That would make sense. I've already got a bottle of ivermectin drops (vet approved) on the way (that time of year and a couple of my herd are starting to look a little scratchy) so I shall treat her as soon as it arrives. Have to order it by the bottle rather than the vet supplied pipettes due to the number I need!
 
Okay so now I'm not happy with Muffin's condition again. The fluid in her tummy and under her chin is back and not-for-shifting. She's back at the vet on Thursday for a review but I'd like to know what the options are to help her if any of you know?

We're currently on daily:
0.3ml x2 Frusol
0.625 mg Fortekor x1

She's now also starting to have digestive issues by the looks of things, really soft small poops. Her appetite is still there but not brilliantly so. Just about enough to keep her weight stable (but low, she's about 700g). Is there anything I can do to help the poop situation and stimulate her appetite?

The dry skin has been helped by a couple of gentle baths with Nizoral and then being moisturised, so I'm less worried about that than I was.

All in all, still my Muffin, but not a totally happy Muffin :(
 
You could ask the vet about increasing the Fortekor as that is an introductory dose. As a guide my girls are on that dose twice a day. Am not sure on Frusol dosing so not sure if that is high or not. @Adelle may know. There is also the option to add in Vetmedin.

Sometimes Metatone tonic can help encourage them to eat.

Is she nodding when breathing still? if she is struggling to breathe she won't want to eat as much.
 
Not quite nodding, but just this evening she's started to chomp and I think drool (it's wet but not slimy like I've had with dental piggies) while sitting still. I've also given her some metacam in case she's in pain. I'm going to see if they'll squeeze her in tomorrow. Looking at her this evening she's not looking too clever... :(

I've also given her 20mls of syringe food that she took happily and then walked away. I know she's still eating for herself, it just reassures me that I know she's had a nice warm tummy full before bed. I'm not going to stress her out anymore by trying to get a bit more into her or try and 'comfort' her if she needs it. Her husboar is doing a very good job of sitting next to her and letting her snuggle in. I just hope she makes the night, but today's definitely a bad day...
 
Sending her lots of love, keeping her in my thoughts x
 
We really need to know the strength of the frusol as doses without this doesnt mean much! Fudge is on the same dose of fortekor as your little one but my vets only tend to increase this if circulation is consistintly poor and she gets pale extremeties. The poos are probably due to the reduced food intake- this will be because of the fluid build up. Once u get this under control she should brighten up significantly and eat normally- poos may be soft with an increase in diuretics but soon sorts itself quickly. Be careful with syringe feeds (especially water) as a piggy with laboured breathing is at increased risk of aspiration which can be lethal, particularly in heart piggies x
 
Well she had her checkup and it's a mixed bag of news. I have to drop her back down to 0.2ml max a day of frusol as she's getting too dehydrated to continue on higher doses (I forgot to ask for the dosage while I was there, I will double check when I call them on Monday but whatever the strength, I can't increase it again until we get her hydration sorted). Her heart sounds very strong now though so the vet is happier with that.

I'm also suspecting that she's developing a problem with her teeth due to her reduced food intake (and next to no hay these days) which is going to be a massive problem for her as they won't put her through the anaesthetic needed to do the teeth with the state she's in + heart condition.

We're now on tiny pieces of veg (mouthful size), pellets which she is still capable of chewing with some effort and dioralyte syringed throughout the day to help keep her as hydrated as possible. Need to try and get more food into her and get a bit of weight on and she'll be reviewed again in 2 weeks, sooner if the frusol doesn't shift this fluid.

Fingers crossed for Muffin. She's having a brighter day today.
 
Muffin passed away just now, looks like her little heart wasn't strong enough to keep her going.

Thank you all for your advice, I truly believe it gave me a few more weeks with her. :(

RIP sunshine.
 
I am so sorry :-( you fought so hard for her and kept her comfortable after her diagnosis. Sadly it is just a matter of time for our little heart piggies but that still doesn't prepare us for it.

Thinking of you.

Sleep tight Muffin xx
 
I'm so sorry to hear Muffin passed over. You were a good mom & tried everything you could. Popcorn free over the rainbow bridge little one.
 
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