Endometriosis

[Andrea Marici]

Hi everyone,

I'm turning to you because I have a problem.
For some time my guinea pig, Stuartina, has been struggling to pee. So we took her to the vet who did a urine test and a complete ultrasound.
It turned out that the urinary system is fine. The problem is different and far worse.

Looking at the uterus the doctor saw that she suffers from endometriosis. A rather serious case too. The uterus is thickened and enlarged (4/5 times the normal size).
It caused a slight effusion of fluid in the abdomen and in one ovary she found an endometric cyst and in the other one there's a 1.5 cm ovarian cyst. The pain was due to generalized inflammation of the abdomen.

She prescribed a week of anti-inflammatory and two weeks of antibiotics, not to solve the problem but only to keep it at bay.
The doctor says it is a serious situation that can only be resolved with sterilization.
But given its severity and age (6 years and 1 month), the surgery is a question mark. The chances of success are 50%.
If we were not to intervene, however, there would be no possibility. She told me that it's a "ticking time bomb". If we don't operate on it, things will get worse. No one could say whether in weeks or a few months but it will happen. And in the meantime her quality of life will not be good.

The vet told me she is in a lot of pain now. If a woman had been in her condition, they would have operated on her urgently.

He wants to see her again next Wednesday to see how it's going and by then we should have made a decision.

Furthermore, she also suffers from significant pododermatitis on her front legs.


The doctor recommends surgery. She told me she understands our fear but at least this way she would have a chance.
But I wonder if it makes sense. She's old. Even if things went well, we don't know how much longer she would have.

I would like to know if any of you have ever found yourself in this situation. Have you ever had an elderly guinea pig sterilized? Do you know anyone to whom It happened? What would you recommend me?
Thank you.

 

[piggieminder]

I'm bumping your post up. Hopefully a health expert will be along soon.

 

[Andrea Marici]

I'm bumping your post up. Hopefully a health expert will be along soon.

Thank you

 

[piggieminder]

Bump

 

[Piggies&buns]

@Wiebke

 

[Teema]

Sending hugs, this is a really difficult situation to be in given her age and the risk.
I think it’s a case of reviewing her quality of life? If she is in a lot of pain without surgery, but the pain could be managed, I’d lean toward not having the surgery. However if the only way to resolve her pain is risk the surgery, I would go for surgery, plus, if your vet is recommending the surgery then I think best to go with your vet’s advice. Is it worth checking with another vet for a second opinion, just so you have all your options and risks clear infront of you for making a decision.
Good luck, sorry I have no experience with anything like that but just wanted to offer some support, poor Stuartina, I hope you get the answers you need for her.

 

[Wiebke]

Hi

HUGS

I am very sorry about the diagnosis and the bad news. When the womb is going seriously wrong then the only option is generally a spaying operation (i.e. the removal of the reproductive tract) or to euthanise at some point when quality of life is no longer medically achievable; there are sadly no easy options.

However, I have several 5 year old sows of mine successfully emergency spayed; the oldest was 5 years 9 months of age - she lived to 9 days before 8th birthday. I also know of 6 year old sows who have been successfully spayed. My oldest operated piggy (for a large burst bleeding sebaceous cyst with potential cancer concerns; it promptly put on a sudden spurt of growth and burst during my operating vets' summer holidays) was just one month short of her 7th birthday and lived several months past it. The recovery in older piggies will be quite a bit slower the older they get; the same as in old humans.

A full spay is however a major operation and very much down to the operating vet and their recovery nurses team, their experience with guinea pigs and their confidence.

That said, 6 years is a very good life span. You can get your piggies to a decent age with your piggies (genetics and other medical issues permitting) but what you have no control over is when or what eventually something goes wrong in small animals with a much faster metabolism. Quite often it is sadly something not very nice at all. Diagnostics have got a lot better in recent years but treatment options are still very, very limited compared to larger pets. It is something you will have to always decide on a case to case basis whether it is better to risk it all in an operation/recovery that may not come off with the chance of a longer healthy life span or whether you would prefer to concentrate on quality of life for as long as your piggy has got with medical support and for making the best of it in terms of enrichment and shared love.

You are always entitled to an open but respectful talk with your vet and how confident they feel re. an operation.

Below are some information you may helpful. Please be aware that you won't find much re. endometriosis in guinea pigs - it is the first time I have heard of it. Wombs go wrong much more rarely compared to ovarian cysts, the most common problem being pyometra (infection of the womb lining) or very occasionally cancer.
My Cariad had a fluid-filled grossly enlarged and borderline womb removed which also contained a likely cancerous lump and some nasty looking ovarian cysts; she lived for another 1 1/2 years and died from an unrelated issue. It is not something I have seen coming up on here in another piggy. Yours is the first coming somewhat closer.

Sows: Behaviour and female health problems (including ovarian cysts)
Tips For Post-operative Care
A Practical and Sensitive Guide to Dying, Terminal Illness and Euthanasia in Guinea Pigs (see chapter on terminal care if you decide to go down that way)

All the best. Please give yourself time to mull it over and then listen to your gut when it comes to making a decision.

 

[Andrea Marici]

Sending hugs, this is a really difficult situation to be in given her age and the risk.
I think it’s a case of reviewing her quality of life? If she is in a lot of pain without surgery, but the pain could be managed, I’d lean toward not having the surgery. However if the only way to resolve her pain is risk the surgery, I would go for surgery, plus, if your vet is recommending the surgery then I think best to go with your vet’s advice. Is it worth checking with another vet for a second opinion, just so you have all your options and risks clear infront of you for making a decision.
Good luck, sorry I have no experience with anything like that but just wanted to offer some support, poor Stuartina, I hope you get the answers you need for her.

Thank you. I appreciate it. Unfortunately, i live in Sicily and there are very few exotic vet and a lot of them aren't really qualified. A few years ago we found this vet and since then she has helped us many times.
Anyway I don't know if the pain can be managed. In four days, we'll have an appointment to tell the vet our decision and we will see how to manage this situation.

 

[Wiebke]

Thank you. I appreciate it. Unfortunately, i live in Sicily and there are very few exotic vet and a lot of them aren't really qualified. A few years ago we found this vet and since then she has helped us many times.
Anyway I don't know if the pain can be managed. In four days, we'll have an appointment to tell the vet our decision and we will see how to manage this situation.

Wishing you all the best. You sound like a very caring owner and your vet like a decent vet, even if they are not all that familiar with treating guinea pigs - their instincts seem to be in the right place.

Would they prescribe dog metacam (1.5 mg/ml concentration) or off license opiates like tramadol or gabapentin for extreme pain?

It is so gutting when you come up against something like this where there are no choices.

 

[Andrea Marici]

Hi

HUGS

I am very sorry about the diagnosis and the bad news. When the womb is going seriously wrong then the only option is generally a spaying operation (i.e. the removal of the reproductive tract) or to euthanise at some point when quality of life is no longer medically achievable; there are sadly no easy options.

However, I have several 5 year old sows of mine successfully emergency spayed; the oldest was 5 years 9 months of age - she lived to 9 days before 8th birthday. I also know of 6 year old sows who have been successfully spayed. My oldest operated piggy (for a large burst bleeding sebaceous cyst with potential cancer concerns; it promptly put on a sudden spurt of growth and burst during my operating vets' summer holidays) was just one month short of her 7th birthday and lived several months past it. The recovery in older piggies will be quite a bit slower the older they get; the same as in old humans.

A full spay is however a major operation and very much down to the operating vet and their recovery nurses team, their experience with guinea pigs and their confidence.

That said, 6 years is a very good life span. You can get your piggies to a decent age with your piggies (genetics and other medical issues permitting) but what you have no control over is when or what eventually something goes wrong in small animals with a much faster metabolism. Quite often it is sadly something not very nice at all. Diagnostics have got a lot better in recent years but treatment options are still very, very limited compared to larger pets. It is something you will have to always decide on a case to case basis whether it is better to risk it all in an operation/recovery that may not come off with the chance of a longer healthy life span or whether you would prefer to concentrate on quality of life for as long as your piggy has got with medical support and for making the best of it in terms of enrichment and shared love.

You are always entitled to an open but respectful talk with your vet and how confident they feel re. an operation.

Below are some information you may helpful. Please be aware that you won't find much re. endometriosis in guinea pigs - it is the first time I have heard of it. Wombs go wrong much more rarely compared to ovarian cysts, the most common problem being pyometra (infection of the womb lining) or very occasionally cancer.
My Cariad had a fluid-filled grossly enlarged and borderline womb removed which also contained a likely cancerous lump and some nasty looking ovarian cysts; she lived for another 1 1/2 years and died from an unrelated issue. It is not something I have seen coming up on here in another piggy. Yours is the first coming somewhat closer.

Sows: Behaviour and female health problems (including ovarian cysts)
Tips For Post-operative Care
A Practical and Sensitive Guide to Dying, Terminal Illness and Euthanasia in Guinea Pigs (see chapter on terminal care if you decide to go down that way)

All the best. Please give yourself time to mull it over and then listen to your gut when it comes to making a decision.

Thank you. I appreciated hearing your experience but, like you said, this case is more problematic and differently from ovarian cysts the surgery would require one bigger cut under her belly. This will require a longer time under anesthesia, a longer recovery and higher chances of infection. Next Wednesday we'll have an appointment with the vet to tell her what we have decided and discuss what is better for her.
Anyway here are two photos of her. I love her so much. I'm not ready to let her go

 

[Wheekallweek]

Oh she's gorgeous - and she looks in generally good health in those photos (as far as you can tell from a photo!)
For me personally I would go ahead with the surgery. It sounds like you have a great vet and, as she has no chance of recovery without, it's worth a shot. As long as her pain is managed correctly post op I'd give it a go.
Best of luck

 

[Wiebke]

This was my Cariad with the funny fluid filled womb back in 2013 - she had her emergency spay at just 700g of body weight only 6 months after an emergency bladder stone operation when her calcium absorption suddenly flipped. Amazingly, she just sailed through her spaying op without losing any weight at all was back with her group within a couple of days.

I appreciate that Cariad was around 4 years at the time and not 7 years.

 

[Teema]

I am so glad you have a caring vet who sounds eager to help you. What a gorgeous piggie, she really is a cutie. Wishing you all the best with her care, whatever decision you make it will come from a place of love, care and will be conscientious and thoughtful proving you are a wonderful pet owner and she is in good hands. I think surgery might be worth a shot too. Feel better soon Stuartina xx

 

[Andrea Marici]

Oh she's gorgeous - and she looks in generally good health in those photos (as far as you can tell from a photo!)
For me personally I would go ahead with the surgery. It sounds like you have a great vet and, as she has no chance of recovery without, it's worth a shot. As long as her pain is managed correctly post op I'd give it a go.
Best of luck

These photos were taken an year ago, really. We will see what's best for her on the next appointment, next Wednesday. I still have some questions for the vet.
But thank you very much

 

[Andrea Marici]

View attachment 242888

This was my Cariad with the funny fluid filled womb back in 2013 - she had her emergency spay at just 700g of body weight only 6 months after an emergency bladder stone operation when her calcium absorption suddenly flipped. Amazingly, she just sailed through her spaying op without losing any weight at all was back with her group within a couple of days.

I appreciate that Cariad was around 4 years at the time and not 7 years.

Thanks. My case is different and more complicated but I think it's useful to know this. I had never seen the wound from this type of surgery

 

[Wiebke]

These photos were taken an year ago, really. We will see what's best for her on the next appointment, next Wednesday. I still have some questions for the vet.
But thank you very much

All the best. Ask all the questions you have before making any decisions.

 

[Andrea Marici]

I am so glad you have a caring vet who sounds eager to help you. What a gorgeous piggie, she really is a cutie. Wishing you all the best with her care, whatever decision you make it will come from a place of love, care and will be conscientious and thoughtful proving you are a wonderful pet owner and she is in good hands. I think surgery might be worth a shot too. Feel better soon Stuartina xx

Thank you for your kind and touching words. Thank you for the love and best wishes