Dental Chronic teeth problem - Please advise

[Ketoprofene17]

Hi all and happy holidays. I have a matter on which I'd like some advice. I'm starting to despair.

My male 4.5 y.o. pig has been having teeth problems for quite a while now. After several x-rays and teeth filing session (probably 4-5 by now over a period of less than a year), the vet has suggested to keep him on daily 0.7mg of Meloxicam + 2 natural remedies (0.25 ml of liquid Aleve and 2 drops of Perognidol with CBD) to see if without pain he'd be able to eat more hay and file his teeth naturally, like he's supposed to. This doesn't seem to have solved the problem. The last filing session was around 2 weeks ago and today it already seems like he's eating at a much slower pace (I'd say around half the speed of the other, healthy, pig) and he's always asking for food, to then refuse to it (when he realises it's not "soft" probably?). He does occasionally munch on some hay, but not as much as he did last week (when he was on a higher dosage of Meloxicam). Obviously vets are hard to reach over the holidays, but I'm tempted to increase the dosage back to what it was (0.6mg twice a day), to see if it helps him. Also, as he had been losing weight recently (he had a rare skin cancer successfully removed + poop parasites, that I'm still treating him for), I've also been feeding him a good amount of Oxbow Critical Care twice a day, but I'm wondering if that's making him lazy on the harder foods, as he knows he can count on a more liquid snack. He has been gaining weight though, which is good.

I'm starting to struggle to see him suffer for his teeth every month. I don't know how healthy and comfortable it'd be for him to live the rest of his life on daily pain killers and sedation+teeth filing every 3-4 weeks. Just to clarify, I don't worry about the money aspect of a life at the vet's, just about his actual wellbeing. I'm maybe too attached to him (but that's human I guess) and I'm not living this constantly reappearing issue as well as maybe I should, but I'm really struggling.

Has anyone been through something similar? Or has anyone got any advices?

Thanks in advance.

 

[Free Ranger]

It is really useful if you can add your country into the location bar. We are mainly UK based but there are members in many countries and vets/medicines all have different approaches to piggies. In the UK we have one or two specialist vets that people on the forum will travel cross-country to for teeth problems but if you are in Europe, Hong Kong, the US or Australia there's not much point recommending them.

We don't really see much in the way of poop parasites here in the UK although obviously they can get things. What did he have and how is he being treated?

When he's had his teeth filed is he eating well afterwards and putting on weight? Perhaps he has to have painkiller at first but does he improve and then start to deteriorate later? Has he had any x-rays to look at the roots of the teeth?

The critical care doesn't make them lazy to eat. All they want to do is eat! If he's not eating there will be a reason. Some piggies take the CC much on its own out of a bowl - do you have to syringe feed or will he take it himself?

Sorry this is all questions but is is helpful to the experts to have a bit more background.
Good luck and Happy Christmas little chap x

 

[Ketoprofene17]

Thanks for the tip about the location bar, I didn't know about it! We were based in Birmingham up until March 2019, when we moved to Rome. The vet is one of the most recommended exotic vets in Rome (he's even published a book about guinea pigs). His name is Alessandro Melillo and I found out about him on several Italian forums as the one of the 2-3 go-to vets in Rome for pigs.

Parasite-wise he had Coccidi+ and he's been taking Sulfametopirazina for it. He's done with the 14 days of drops tomorrow.

For his teeth he had several x-rays and a CT scan (whilst they were looking at the cancer). One of his teeth was gonna be removed as it seemed broken under the CT scan, but they said it felt stable when he was in surgery and they left it there. After his teeth filing he's usually in pain for 2 days, then starts to improve a lot when the Metacam dosage is higher, but now I've decreased it he seems to be once again uncomfortable.
He would happily take the Critical Care from a bowl but he'd end up making a mess of his face, so I syringe feed him (also the other pig would probably steal it all ).

 

[Free Ranger]

@furryfriends (TEAS) have you heard of anything like this before?

Was the candidate for removal an incisor?
I had a girl, Zara, who had a troublesome incisor - the bottom left as you looked at her. We think it had been injured some months before without us knowing: her weight dropped a little but she seemed to maintain that slightly lower weight with no problems. Then suddenly it must have started to bother her and she stopped eating - she had syringe food or matchstick veg but her chewing was not smooth. Not knowing about the incisor I just thought it must be the back teeth but the vet spotted it and step 1 was to simply burr that tooth slightly shorter than its neighbour to take the pressure off and see if that helped, which it did. It took about 5 minutes and no anaesthetic was needed... just a firm grip! Zara was then able to eat hay immediately with a good chewing action so it looked like the tooth had just been catching as she chewed and causing her pain. I didn't think a problem incisor could have such a dramatic effect at the time as I know pigs sometimes break or lose them and people don't notice! Could this be a feature with your boy? Could the molars be a secondary issue?

Now I must add my story had a sad end. Unfortunately within a week poor Zara had stopped eating again and this time they could detect that there was infection at the root despite her being on antibiotics so they decided to take the tooth out. I couldn't get to a specialist as we were very much against the clock and it was august so a lot of people were on holiday - if they didn't have covid. My vet was concerned because piggy's jaw at the front is very fragile and thin and I was warned that if the tooth was firmly bedded in, the jaw might break and she would have to be pts. This is why they don't jump in to do this option - that and the general anaesthetic. It turned out that the tooth was very ready to come out - it looked really weird like it had extra enamel growing in lumps on the outside which you could only see when you pulled back the gum pocket. Surprisingly the whole op was done very quickly in 20 mins - the vet was delighted when she phoned. The wound looked very clean and started to heal straight away but tragically poor Zara never recovered properly from the GA - the whole thing had been too much for her and she didn't make it. I cried buckets - for her to die over such a little thing was unbearable. But they all take a little piece of you when they go.

 

[Ketoprofene17]

No, the candidate for removal was a back tooth, I believe.

I would love to be able to take him to a teeth specialist in the UK (I drove 2.5K miles in 4 days to get him and I'd do it again to make him feel better), but there's no way to do it after Brexit.

I think we'll need an early visit to the vet next week, but I'm starting to be afraid he'll suggest putting him out of his misery. Not sure how I could react to that.

 

[Free Ranger]

I was told in the past that removing back teeth in pigs is traumatic for them as they use them all the time so I'd have to say personally that might be a step too far for me to try. My generalist vets certainly advise that dogs/cats can manage but not piggies.

Is there a chance that there is any abscess or infection at the root of a tooth? Has he had any antibiotics over the time he's had his problems? There have been forum piggies who have had nasty abscesses which have resisted some antibiotics - there is apparently one called Zithromax that is supposed to be good for this. I know that some pigs can need repeated dentals but I'm not sure what the pattern of this is - whether it can start at 4+ years etc. If you are thinking he might be coming to the end of his journey I would say that there is no harm in trying to control his pain by increasing to the previous dose - but remember I am not a vet. If it improves his symptoms and his eating then you have more idea that pain is his problem. If he's not had antibiotics for anything recently I'd be tempted to ask for a decent course just so I could rule out any unidentified infection.

I had a little sow a few years back whose teeth overgrew. She was 3 1/2. The vet said we could file her and we did - but she also said that we didn't know whether the teeth were the problem or whether there was a secondary cause that caused her to eat less and thus the teeth overgrew. She had antibiotics and painkiller for a week after the filing but we kept her on the painkiller throughout as she had no trouble with it. In truth we never really found out her problem - she just couldn't seem to eat anything and hated the syringe but battled on for about 6 weeks before the back teeth started to overgrow again. We think she might have had trouble swallowing rather than chewing but the vet did say that you see something in cats where the roots of a tooth cause pain when they bite so they stop eating. With cats you have to ID the tooth or teeth and try to remove but not in pigs - see above. I wondered whether I'd be able to make the final call but actually on her last weekend she just suddenly looked really rough - she'd had enough and although it broke my heart I took her in.

I can't think of anything further to add - I'm really sorry for your journey into uncertainty. Be kind to yourself and treasure every day x