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Dental issues but no signs?

AbbieMiddleton

AbbieMiddleton

Junior Guinea Pig
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Location
Hucknall, Nottingham.
Good afternoon all,

You guys are always so kind and helpful and while I've spent the last week trying to avoid coming back on here and testing you all for information, I've reached a brick wall and I'm currently banging my head against it.

From February to March I had a sow with dental issues (Floof) and while we managed to medically (Zithromax) resolve a dental root abscess and incisor infection, she's suddenly stopped eating again. She was happily plodding along at 1050g in weight but very suddenly declined to 967g and 927g the next morning. We immediately feared the dental issues had returned, despite six weeks of peace and normal behaviour, and upon offering her some salad right after weighing her we noticed the same unusual mouth motions, head shaking and lack of appetite we'd seen before. This was last Thursday evening, so we immediately rushed her to the vet on Friday morning. They diagnosed mild bloat (She had been having fresh grass, so it's certainly possible) so I've been given 1ml Emeprid to administer twice a day and been encouraged to increase her Loxicom dosage from .25ml once a day to twice a day. (She's on Loxicom for life due to shoulder injuries/bone malformation/Arthritis.) She's also being given Pro-C probiotics regularly throughout the day with water.

Floof was still attempting to eat the occasional pellet and strand of hay last week, but no way near enough to sustain her so I stepped in with Critical Care, but she's now stopped eating anything at all. The vet has said there's no signs that the dental issues from before have returned. No abscess, no infection, nothing. She had a full check up including her back teeth being examined. The only possible dental issue was very, very early signs of possible molar spurs but we were told that they shouldn't become a major issue, if an issue at all, for 10 to 12 weeks and that the Loxicom should help with any discomfort from them rubbing on her gums. Unfortunately, she's done nothing but decline. She's not eating or drinking independently but you can tell she wants to. She maintained weight until yesterday, so I'm going to up the feeds today, but the Emeprid is just flushing her out. She's sometimes doing normal poops but generally it's just a big, soft, splat. I just don't know what to do next! I can tell she's in digestive distress because she has a very distinct smell. A bit like vegetables going off.

We're waiting on a call from the vet (typically, our car is in the garage...) as we're wondering if stopping the Emeprid is an option because I feel it's contributing to her losing weight and I'm also wondering if I should offer her some of the Tramadol we have left from last month. At this stage I just don't know what to think. We're essentially being advised that it's not dental related but it looks exactly like it did before when it was dental related.

Does anyone have any ideas, please?
 
Hi, I am very sorry 😞 It does sound like there may be a dental issue going on. I see you’re in Nottingham. Can you get to the Cat and Rabbit care clinic in Northampton at all? Simon and Kim Maddock are excellent dental vets and they’re the go to vets for anything dental and if there is a dental problem, they will find it and discuss treatment options with you. They do conscious dentals so no need for a GA. If Northampton is to far, there’s Ellie Whitehead in Matlock. I’m not sure of the name of the vets but if you Google ‘Ellie Whitehead, guinea pig vet’ it should come up with her details. She also does conscious dentals x
 
Thank you so, so much for the reply. Sorry, I should have specified that the vet we're currently using is Simon and Kim. We started visiting them when the dental issues started in February. That's why I'm at such a loss. If they say it's bloat and there's no signs of dental problems (despite the slight possibility of spurs in 10 to 12 weeks) then we really have nowhere else to turn. We are also registered with Ellie in Matlock too but we chose Simon and Kim last week specifically because it looks dental. 😓
 
I’d call them and ask if you could up the pain meds to see if it’s pain related. Also an abscess can take a couple of weeks to show up. When my Pepper had a tooth root abscess last Summer he lost weight quickly, he had a dental done at local vets and then a week later the abscess became visible. Up until then it had just been weight loss and wonky incisors. Then we went to see Kim and Simon.

Maybe the abscess is returning but you can’t feel it yet. Also how long was the course of Zithromax? Pepper had a 6 weeks course. Good luck.
 
AbbieMiddleton said:
Thank you so, so much for the reply. Sorry, I should have specified that the vet we're currently using is Simon and Kim. We started visiting them when the dental issues started in February. That's why I'm at such a loss. If they say it's bloat and there's no signs of dental problems (despite the slight possibility of spurs in 10 to 12 weeks) then we really have nowhere else to turn. We are also registered with Ellie in Matlock too but we chose Simon and Kim last week specifically because it looks dental. 😓
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Hi

I would contact the clinic and see whether upping the painkiller will help. Please be aware that the pain from a developing root abscess can make itself felt several weeks before it actually becomes visible. Zithromax can sometimes nip a developing abscess in the bud but not always; in the latter case the abscess will unfortunately come back sooner or later if the least spec of infection is left. :(

Anyway, I was very lucky with my Dylan that two courses of Zithromax over Christmas not only got him through the holidays (even though it completely knocked his appetite) but his jaw abscess which was not developed enough for lancing before Christmas stayed put for the rest of his life. My Hywel was not so lucky with his root abscess coming up twice; each time while Simon was not around and one on the eve of a hernia op of my hub's (no car for two weeks), just for added stress.

Fingers firmly crossed.
 
Yeah, our plan is to up the Critical Care and the Loxicom and potentially add Tramadol. Kim and Simon spotted the last abscess before it was even properly visible. She was put on Zithromax for 10 days to slow the abscess growth but make it big enough for it to be drained but it never materialised. So we were advised to keep her on the Zithromax for a couple more weeks by which time Simon confirmed it definitely wasn't there anymore while he had her under GA for the draining; which wasn't necessary. We kept her on Zithromax for a few more weeks as a precaution and Kim said on Friday that it's not returned. She was probably on it for around 6+ weeks. Then we had six weeks with Floof being completely normal. Kim did the examination herself last Friday and for the back tooth examination I think Simon was present too. It seems unlikely they'd miss something.
 
Zithromax can sometimes really mess up the gut microbiome and cause total loss of appetite for quite some time in some piggies; it is a very strong antibiotic.

It could however also be something totally unconnected. We can only guess even more so than a vet since we do not have access to your piggy nor do we have the necessary medical training.

Please step in with upping your feeding support and with managing the support level by weighing daily on your kitchen scales first thing in the morning for best day to day comparison.
Here is the link to our new updated guide: All About Syringe Feeding and Medicating Guinea Pigs with Videos and Pictures
 
She's been off the Zithromax for over a month and was putting on weight but we did know how harsh it can be on their systems so we kept up probiotics for her, but the introduction to grass has clearly thrown her somewhat. I feel like the weightloss and decreased appetite definitely started within a day or so of some spring grass being introduced but I thought the Emeprid would have solved that by now. Kim said it was very mild bloat but she did do a very thorough dental examination too because of Floof's history. Floof can eat, if I insert hay like money into a vending machine but gives up when I'm not helping her. She doesn't fight the syringe feeding but isn't lethargic either. It's really unusual. I'm weighing twice a day already, which is why I'm increasing the feeds. 🥲

I appreciate that you aren't vets and can't offer any form of diagnosis. I was just asking for opinions, suggestions, similar situations etc. I appreciate your time though. Thanks.
 
I'm sorry you are going through this ,ive had two dental piggies.On both occasions it was down to pain in the body,which then stopped them eating so much.Once the pain was under control.teeth were filed twice,they both went back to eating.i go to both cat and rabbit clinic,Ellie whitehead at Matlock,she is very good with teeth,and guinea pig medicine and surgery,
maybe you could get some telephone advice from either vet.i hope you can get to the bottom of all this.
 
Thank you so much, Eileen. That's really interesting to know! I'm hoping Floof's decline is just the tummy ache which we're trying to control and maybe even all the prodding and poking from her dental exam. I'm still waiting on a call back from the vet. We might approach Ellie too. I'm hoping the Emeprid will start to solve something. I've never used it before, so I don't really know what to expect or what I'm looking for.
 
Emeprid is a motlity drug to help the bowel to keep food moving through the gut,especially if bloat is present which in itself its very paniful.That can make the piggie not eat enough hay,which then causes the teeth to not wear down,and overgrow.You cannot do any more than you are doing.
 
I've seen some people describe it as, essentially, a laxative? Her guts are definitely moving. How do people know when to stop using Emeprid? Kim suggested a five day course but to keep going as needed but if Floof is struggling to eat because of something else, I don't know when to stop it. 😅
We did just speak to Kim who sounded very surprised at our suggestion that it all seems dental related. She says there were absolutely no signs last week but if there's even a small chance of a brewing abscess we're to take Floof back in as soon as the car is fixed; probably tomorrow or Saturday. We've been advised to add in more Emeprid. 0.8ml three times a day. To leave the Loxicom as is but to add 0.1ml Tramadol twice a day and monitor to see if it makes her too drowsy. Thank you for the reassurance and information though, Eileen. I massively appreciate it.
 
My Little had two dental root abscesses which resulted in the loss of both his bottom incisors. There were some months between the first and the second one. The second one presented in a similar way as your pig, he stopped eating and just started to be off. I rushed him straight to Simon who couldn’t find anything wrong. About a week later, his tooth split in half all the way to the bottom and we felt the abscess on his jaw, we took him back again and Simon could then see it. So it’s possible that it was showing no physical signs at your last appointment but still causing internal pain, like with Little. You might even be able to feel it on your piggy’s jaw/neck yourself.
 
Thank you, we're trying to get her back there ASAP by enquiring about a courtesy car on the insurance. Do you have any description on what a jawline abscess would feel like to touch, please? I can feel the entirety of her skull quite easily and one side does feel larger than the other but it just feels like bone and is on the opposite side to the original abscess. It's difficult to tell with her because her shoulders have issues so she's always slightly out of alignment. Her neck and lower jaw feel fine. No lumps, bumps or swelling. Please may I ask how you handled your situation with Little?
 
I've just checked one of my other piggies and he also has a 'dominant' side to his skull which makes one side feel a bit larger and more bulky and he definitely doesn't have any eating issues, so I'm probably feeling the wrong area or for the wrong things. 🙄
 
AbbieMiddleton said:
Thank you, we're trying to get her back there ASAP by enquiring about a courtesy car on the insurance. Do you have any description on what a jawline abscess would feel like to touch, please? I can feel the entirety of her skull quite easily and one side does feel larger than the other but it just feels like bone and is on the opposite side to the original abscess. It's difficult to tell with her because her shoulders have issues so she's always slightly out of alignment. Her neck and lower jaw feel fine. No lumps, bumps or swelling. Please may I ask how you handled your situation with Little?
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Badly drawn circle, but I *believe* Little’s were in around this area on either side, possibly even a little lower.
A6D56E14-496D-4A82-8DF6-61356FEE39FF.webp
In this picture, he’d already long since recovered from both abscesses and no longer had his bottom teeth.
The lump size can vary depending on how soon it has formed, but you might feel a slight protrusion, I believe Little’s was around a pea sized lump, it’s also hard and fixed to the body, so it doesn’t move around with the skin. From what I remember, the protrusion felt like bone, but it was more of a circular protrusion. This all happened back in 2020 during the first Covid lockdown, so it was a while ago, so the details aren’t so easy to recall.
I can’t comment on what a tooth root abscess would look like if it were the back teeth, but from an incisor abscess, it is around the region photographed that you want to be feeling.
Actually the whole process was pretty straight forward, the first abscess nearly cost him his life as it was missed by the vet but Simon saw it immediately and performed an emergency operation. There were maybe a few months in between before he became off again and not wanting to eat or do much. We took him to Simon who didn’t find anything, about a week or so later he went back and the second abscess was found. Each abscess was drained in an operation and his incisor was removed, never to return. We didn’t have to drain either abscess ourselves post surgery, just cleaned over the wound twice a day and gave him the Zithromax. He picked up extremely quickly post each procedure. It was actually easier for us as owners after his second incisor was gone too. Because he lost a tooth, his teeth began to grow and he needed a dental every 2 weeks with Simon, which is a 3 hour drive for us. Once his second tooth was gone, we could then go to a local vet every 2 weeks for his incisors burring as they no longer had to be cut precise like Simon would do it since he wasn’t using them to grab in the same way. Aside from the fortnightly dentals and cutting his vegetables into strips and hand-feeding him, nothing changed and he lived a very full life afterwards. On top of that, he was blind too, but none of it bothered him. He was also about 6 years old, so he wasn’t a young pig going through all of this!
 
I would definitely suggest you get another appointment, but do it with Simon rather than Kim. Both are good, but Simon is just slightly more of an expert and may be able to feel something brewing that Kim may not be able to.
 
Thank you so, so much. That's really informative. I genuinely appreciate you taking the time to recall all this for me. Little sounds like he was an absolute soldier. There's definitely no swelling like your description on Floof but we're currently scrabbling around to see if we can see Simon either tomorrow or Saturday to be safe. Might need to actually hire a car at this rate but I just feel the sooner she's double checked, the better. I'm pretty sure Simon was there last Friday for Floof's dental but we'll specifically ask for him; so thank you for the suggestion. I'm just hoping we can squeeze in before the bank holiday. I'd be really disappointed to take her elsewhere as I really do struggle to trust other vets. I'm due to feed Floof her night time feed in a few minutes and I'll be trying the Tramadol too. Fingers crossed....
 
AbbieMiddleton said:
Thank you so, so much. That's really informative. I genuinely appreciate you taking the time to recall all this for me. Little sounds like he was an absolute soldier. There's definitely no swelling like your description on Floof but we're currently scrabbling around to see if we can see Simon either tomorrow or Saturday to be safe. Might need to actually hire a car at this rate but I just feel the sooner she's double checked, the better. I'm pretty sure Simon was there last Friday for Floof's dental but we'll specifically ask for him; so thank you for the suggestion. I'm just hoping we can squeeze in before the bank holiday. I'd be really disappointed to take her elsewhere as I really do struggle to trust other vets. I'm due to feed Floof her night time feed in a few minutes and I'll be trying the Tramadol too. Fingers crossed....
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Ring as soon as they open for a same day emergency appointment with Simon, hopefully they have one available! He’ll be able to have a good feel of all her organs and everything and will hopefully find something treatable.
I’d up the loxicom to 0.4ml twice daily if you haven’t already, that’s typically what Simon prescribes us. Don’t worry too much about how the tramadol will affect her, I’ve never experienced it to cause drowsiness personally but anything that will calm the pain will help pick her up a bit.
 
Well, we tried everything to get our car sorted. Even started the process of hiring a car, so we rang the clinic to try and make an appointment to fit around car hire times but neither Simon nor Kim are in the practice until Tuesday. Floof is much brighter on the Tramadol and is definitely trying to eat more but I feel horrendous leaving her until Tuesday. We're going to ring around some local Vets4Pets places but they've never had any success with dental related issues and always use GA, so I'm not sure what to do next.
 
AbbieMiddleton said:
Well, we tried everything to get our car sorted. Even started the process of hiring a car, so we rang the clinic to try and make an appointment to fit around car hire times but neither Simon nor Kim are in the practice until Tuesday. Floof is much brighter on the Tramadol and is definitely trying to eat more but I feel horrendous leaving her until Tuesday. We're going to ring around some local Vets4Pets places but they've never had any success with dental related issues and always use GA, so I'm not sure what to do next.
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With dental issues, it is very easy to mess things up. I wouldn’t trust a regular exotic vet to do a dental, let alone a general vet at Vets4Pets. Exotic vets aren’t dentally trained when it comes to Guinea pigs, and just the smallest mm means the difference between eating and not eating. Not to mention that it takes a lot longer for piggies to start eating following a GA dental, at which point the teeth could already be messed up again. Moreover, the cause of this is not 100% sure to be dental as of yet, you could potentially be looking at teeth which are perfect but which will be absolutely ruined by an untrained vet. Personally, I think waiting is a lot better and far less traumatic than taking her to another vet. Having had several dental piggies, I would never put them through a dental which wasn’t with Simon as whenever I have done, I have strongly regretted it and he has had to correct the mistakes.
 
Thank you, I needed that explained to me. We do try and use an exotics specialist at our local Vets4Pets for things that aren't dental related. He specialises in exotics and small animal surgery but definitely not teeth. We've never asked anyone but Simon and Kim to do anything dental related. I'm just really scared that it's another root abscess and that leaving it for 3 or 4 full days will do loads of structural damage to her mouth. (I've had dental abscesses myself so I know how destructive they can be!) The clinic said we can try and book an emergency appointment on Tuesday but nothing before then. I'm happy to hand feed her and give her painkillers and water round the clock but I feel dreadful at the thought of something possibly eating away at her while I just wait. 🥲
 
AbbieMiddleton said:
Thank you, I needed that explained to me. We do try and use an exotics specialist at our local Vets4Pets for things that aren't dental related. He specialises in exotics and small animal surgery but definitely not teeth. We've never asked anyone but Simon and Kim to do anything dental related. I'm just really scared that it's another root abscess and that leaving it for 3 or 4 full days will do loads of structural damage to her mouth. (I've had dental abscesses myself so I know how destructive they can be!) The clinic said we can try and book an emergency appointment on Tuesday but nothing before then. I'm happy to hand feed her and give her painkillers and water round the clock but I feel dreadful at the thought of something possibly eating away at her while I just wait. 🥲
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I do agree that Simon and Kim aren’t needed for everything health related, but dental issues are one thing you can’t really compromise on.
When Little first formed his dental root abscess, it was missed by a vet who then performed a dental on him which messed up his teeth. Because of this, he still couldn’t eat following the procedure but we assumed the problem now was the teeth being messed up. We then had to wait a couple of months for the teeth to grow back all whilst syringe feeding every few hours and being worried because he was plainly unwell. Once the teeth grew back to the right size, it was confirmed he was still having problems. It ended up being the abscess the whole time and he didn’t need a dental in the first place. He’d gone through months of agony with the abscess whilst we waited for his teeth to grow back, we rushed down to Northampton via train during the peak of Covid lockdown as it was life or death at that point and Simon saved him. All this to say, a few days won’t hurt in the grand scheme of things. You’d do a lot more damage by taking piggy to someone else.
 
I agree with @Little Ones ,I would carry on with syringe feeding and painkiller till Simon and kim are back.Ive had bad experiences with my local vets in the past( one did a dental) and I don't know of any vets who have the expertise they do especially when it comes to dentals.It must be a worrying time for you.
 
Thank you so much, all of you. I definitely needed some extra insight here to make a more clear headed decision. I'll do my best with her over the next few days. She's maintaining her weight, with my help, and since starting the Tramadol yesterday she's been a lot more active and willing to try to eat. And there's no guarantee it is even dental related or an abscess as of yet. Kim said it could be the start of molar spurs hurting her cheeks or that the incisor which got infected last time may have broken below the gumline, in which case it might just slip out and regrow.... but as long as I keep her pain under control and her tummy full, I'll sit tight until next week. ❤
 
Update for anyone following:

Not great news, unfortunately. Floof's older teeth issues and abscess have not returned but she has a completely different abscess starting up on the opposite side of her mouth; which is the side I thought felt a little bulky. Simon has given us a couple of options, the first one being surgery so that he can have a look at the situation and try to drain it and then leave it open for further drainage. It's in a very awkward position and while it doesn't appear to be causing issues to her teeth directly, yet, the pain of moving her jaw and the abscess itself is stopping her from eating. We've been asked to continue the Emeprid and the Loxicom. To slightly increase the Tramadol to 0.15ml and to start off a course of Zithromax, although she is scheduled for surgery on Friday if we decide it's the only option. I'll be maintaining syringe feeding regardless.

I would wholeheartedly appreciate any advice and suggestions on our next move....

To try a full course of Zithromax (which worked on her much smaller, previous abscess) and to reschedule surgery for 10+ days to see if that works or to just plough ahead with the surgery and see what's what, get it drained and then treat accordingly. I'm trying to process everything but not doing very well and would appreciate hearing the thoughts of others.
 
Aw I’m so sorry 😞 I’m afraid I have no advice as I’ve never been in your situation but I am thinking of you. I would have an honest chat with Simon and see what option he’s gearing more towards. It’s not an easy decision to make x
 
I think I’d go for the surgery! Even with the best antibiotic, you generally need drainage, if you’re to get rid of the pus completely! Occasionally you can get away with not going the surgery route, but it’s the exception rather than the rule! xx
 
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