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GP showed signs of improvement but back to being lethargic

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KikiKaka

Junior Guinea Pig
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Hi all,

Possibly a long one so apologies in advance!

We've had two guinea pigs, Kiki and Kaka, since July 2022. We were told they were around 1.5 to 2 years of age upon getting them, but they weren't 100% sure as they were both rescues. Both piggies have grown in size since getting them, so we don't believe either of them to be particularly old if they were still growing when we got them.

We noticed last Tuesday that one of our girls (Kaka) had diarrhoea and wasn't eating/drinking as much as she should. We immediately took her to an out-of-hours vet (Emergency Vets Glasgow) who weighed her (710g, which is quite low for her - usually around the 800g mark), gave her some subcutaneous fluids as well as an Metacam and Emeprid injection (0.2ml and 0.7ml respectively) and prescribed Metacam Cats (0.28ml once per day) and Emeprid (0.35ml once per day). She was in gut stasis at the time so these were prescribed to help recover from that. Upon returning home, we also noticed some red staining in her urine (pictures here:
https://imgur.com/a/e9ckho8
) which we initially thought was blood but we're not 100% sure on this. They're not fed anything heavily pigmented, but we're also not sure if it could be oxidisation or anything similar to that. The emergency vet advised that if this is blood, then it could indicate a UTI and that we should take her to a specialist vet for a thorough check. The (potential) blood was a one-time thing and we haven't noticed this again since.

Since then, we've been giving those medications at 12pm daily as well as 3 doses of Fibreplex a day and a syringe feed every 6 hours. The syringe feed started as Excel DualCare with water (2.5g pellets to 5g water), but upon running out we switched to a mix of her standard Excel pellets with water. This switch took place on Monday.

She still seemed quite low, but we took her to a more specialist vet (Robb Vet Motherwell) on Thursday, after which she immediately perked up somewhat! They advised that she seemed to be heading in the right direction despite still being lethargic, and that we should continue as advised. They said we could get her in for an ultrasound to check for a UTI if needed, but didn't think it was necessary given she seemed to be improving, and there were no signs of sludge or stones.

From Thursday to early Tuesday, she seemed to improve - her weight stabilised at 660g-670g (she was this weight between last Wednesday and yesterday), drinking water of her own accord, grazing, and eating veg when it was given daily (albeit not as much as usual). Her poops were on the mend - still small and quite dehydrated, but getting better.

Last night, however, she went downhill again - we're still syringe feeding her successfully, but she seems lethargic and isn't moving around much. We weighed her before bed, she was at 654g, but when we woke up for another syringe feed 5 hours later, she was at 640g, indicating that she hadn't had anything to eat or drink in that time. We fed her, which got her up to 645g, but upon checking on her 2 hours later, she hadn't moved from the hay she settled in at 7am. Poop-wise, there seemed to be 6 or 7 long, thin, and quite dehydrated ones between 2am and 7am, which seems like a very low amount. Her poops have been quite dehydrated ever since the diarrhoea.

We called our vet again this morning, who advised we can take her off the Metacam and continue administering the Emeprid and syringe feeding. They offered to refer us to the Hospital for Small Animals at the University of Edinburgh if needed.

Our plan is to take her off the Metacam but continue with the Emeprid and syringe feeding as advised and see how she fares, then opt for the referral if she shows no sign of improvement.

Would anyone be able to provide any advice to confirm whether we've been advised the right course of action please? I'm very conscious of the fact that getting care at the recommended vet in Edinburgh could be incredibly expensive but I'm more than happy to go down this route if needed - however, if there are more affordable specialist vets around the Glasgow/Hamilton area, this would definitely be preferable! We were originally referred to ARK, but they're not currently taking on new patients.

Many thanks in advance, and apologies for the long read! Happy to answer any questions if more information is needed.
 
And of course after reading and re-reading my post to make sure I hadn't forgotten anything, I had indeed forgotten some things!

When we took her in on Thursday, they advised that her temperature was slightly low, so we bought her a microwaveable heat pad as advised. She's been alternating between sitting on that, in her snuggle sack, and burrowing in hay for the most part.

On Tuesday night, after the vet visit, we also noticed some poop that was quite sticky - this was also a one-off.
 
KikiKaka said:
And of course after reading and re-reading my post to make sure I hadn't forgotten anything, I had indeed forgotten some things!

When we took her in on Thursday, they advised that her temperature was slightly low, so we bought her a microwaveable heat pad as advised. She's been alternating between sitting on that, in her snuggle sack, and burrowing in hay for the most part.

On Tuesday night, after the vet visit, we also noticed some poop that was quite sticky - this was also a one-off.
Click to expand...

Hi and welcome

HUGS

What a worrying time you are having!

I am so sorry. All you can do is trying your best and keeping at it. The lowered body temperature is concerning. The persistence and the lowered body temperature may be pointing to an underlying issue that could be causing the bloating/GI stasis; either a heart problem or an internal growth pushing on the heart/gut. But of course I can only guess here.

The medication is a bit on the low side. How much feed are you getting into her in 24 hours as she is clearly not eating on her own? The poo output is always running 1 day behind the input; it can be 2 days with a sluggish gut.

The pee looks like a phorphyrin (a natural dye) coloured pee in combination with calcium excretion. You tend see them at the start of a sterile cystitis (more likely than a bacterial urine infection UTI), which in your case could be a stress related low level one-off if you haven't seen any more. :(

Please contact your vet asap. If there is an underlying issue, this will have been progressing. It's not because you haven't done anything wrong or because you have bad vets. Secondary bloat and GI and similar issues are usually well masked and can often not be detected with a scan or x-ray as I know only too well myself.
Primary GI stasis is overwhelmingly a one-off life event that should have been cleared up or mostly cleared up by now. Persisting or deteriorating events tend to be a reaction to something else. I am sure that your vets have checked the heart (that is routine).
You have certainly done your best but you may be up against something even more serious hiding behind the gastric symptoms that is increasingly showing its hands. :(

Step up the feeding frequency as much as you can the less she can take in one go. Stop feeding if she becomes too weak to swallow or if she is fighting the syringe well in excess to her weakened state. We have got a chapter on that aspect in the syringe feeding guide with further guidance if needed.

You may find these links here helpful:
Weight Loss Explained: BMI, Weighing, Poos and Feeding Support
All About Syringe Feeding and Medicating Guinea Pigs with Videos and Pictures

Wiebke's Guide to Tummy Trouble
Digestive Disorders: Not Eating - Diarrhea - Bloat - GI Stasis (No Gut Movement)
 
Thank you for the reply @Wiebke!

We're doing 2.5g of pellets mixed with water every 6 hours, which was what our vet recommended based on her weight - which works out to about 10g of pellets a day (plus water).

We did weigh her Monday night, and despite pooping she weighed the same Tuesday morning, but the weight loss last night was concerning.
 
KikiKaka said:
Thank you for the reply @Wiebke!

We're doing 2.5g of pellets mixed with water every 6 hours, which was what our vet recommended based on her weight - which works out to about 10g of pellets a day (plus water).

We did weigh her Monday night, and despite pooping she weighed the same Tuesday morning, but the weight loss last night was concerning.
Click to expand...

Hi

With a piggy off any food you need to aim for ideally 60-90 ml in 24 hours (whatever the feed) whether it is mushed up pellets or recovery formula. In a life or death crisis 40-60 ml or as close as you can come. Your first aim is to stabilise the weight from dy to day.

Please also offer water from a syringe but do not force it down. The need to drink comes before the need to eat, so a piggy totally off their food can become dehydrated. The more watery your feed, the less fibre your piggy takes in and the more syringefuls you need to give. With pellets you soften the mix enough so the rougher fibre can pass.

Please take the time to read the links in my previous post if you haven't. You should find them very helpful because they are very practical and how-to with useful tips.

Ideally you weigh once daily first thing in the morning when the daily weight swing of ca. 30g is at its lowest for best day to day comparison; this also allows you to plan the day ahead. The more you weigh at different times of the day and the more often you weigh, the more the weight will jump around. The difference between a full and an empty bladder is 10g, if that helps you to put things into perspective.

You manage the feeding frequency according to how much a piggy is willing to take in one sitting. This gives you actually a better clue as to how badly the appetite is affected than frequent weighing. Less than 10 ml usually means that they have lost their appetite completely. If getting to 5 ml is a real battle, then your piggy is in crisis.
You may want to count each syringeful per sitting with a dash on a note next to your seat; especially when exhaustion is setting in. This helps you keep track over the overall intake. You can also note down the morning weigh-in weights and the syringe feeding amounts to take to your vet. It can help them with their assessment.

I hope that this will help you with managing the coming hours. My thoughts are with you in this anxious time.
 
Just a quick update on this:

We upped her to 20ml per session as of midday yesterday, which seemed to help, and she gained some weight earlier on today in the space of an hour and a half which is a good sign!

We took her a vet again today as a precaution given her frail state over the past couple of days, who said she seems to be on the tail end of the gut stasis, and gave us some Emeraid Intensive Care to give her. She's still seemingly not eating much of her own volition (she had her veg last night and grazes every now and then, but still less than usual), but the vet said to give her a couple of mls every 2 hours. This goes against what's mentioned on the packet, which says to start at 1% of her bodyweight and work up to 3%, which would eventually be 19.5ml in her case, 4 times a day - this works out to a lot more than "a couple of ml every couple of hours"!

Would it be possible to get some advise on the best course of action here? I'm inclined to feed her more rather than less given that the only sign of weight gain was this morning, but I don't want to arbitrarily go against the vet's guidance.
 
The amount you feed is directly linked to what her morning weight each day is telling you.
The packet for how much to feed isn’t helpful - it’s literally the daily weight check which tells you whether youve got it right or not.

Please only weigh her once a day, first thing in the morning. Then you compare that weight to the previous morning’s weight and gauge whether you have syringe fed her enough in the previous 24 hours. If she lost weight then you need to feed more in the coming 24 hours. If stable; then you’re got it right.

Feed her as much as she will take at each sitting. The less she takes at each sitting, the more sittings you need to do. She may take 2ml or she may take 15ml - it depends on how she is feeling. A couple of ml every 2 hours is pretty normal for a poorly piggy.
You are looking to feed ideally 60-90ml each 24 hours. In a very poorly piggy you aim for 40ml - a very poorly piggy is unlikely to accept much. 40ml is minimum amount to keep them alive
 
I'm not quite sure I understand - a couple of ml every 2 hours is roughly 24ml in a 24 hour period - if we're looking to feed her 60-90ml in a 24 hour period, I'm not sure how this adds up!

Would it be possible to get some clarification on this please?
 
Also, just to be sure, do your comments apply to both syringe feeding normal food and Emeraid, or just normal food?
 
A very poorly piggy will not take much at each time. Little and very often. You aim for 40ml to keep them alive.

One who is eating some independently, may take more at each sitting and may get away with less sittings.

There is no set guide on how much to feed and when - you simply go by the weight checks and how much she is taking at each time. Don’t feed her x amount in a sitting and then stop because thats the ‘limit’. Keep giving her what she will take, stop when she has had enough.
 
KikiKaka said:
I'm not quite sure I understand - a couple of ml every 2 hours is roughly 24ml in a 24 hour period - if we're looking to feed her 60-90ml in a 24 hour period, I'm not sure how this adds up!

Would it be possible to get some clarification on this please?
Click to expand...

Hi

You are aiming at 5 ml or more every two hours; as much as she is willing to eat when you take her out for a feed.

If your piggy is very poorly and in crisis, then you basically feed as much as she will take, little but very often to get as close as 40 ml as you can.

If at all possible, you also want to be able to have a gap of at least 6 hours at night so you can get some sleep for yourself to prevent suffering from exhaustion after a few days. This means aiming at feeding more during each day and evening feeding session, as long as your piggy is willing to eat more than 2 ml per session.

If your piggy is taking in 15 ml or more in one session, then you can reduce the feeding frequency.
 
Okay, I'm even more confused now - @Piggies&buns' post mentioned that a couple of ml every 2 hours is "is pretty normal for a poorly piggy" but @Wiebke's post says this is far too little.

When we were syringe feeding her pellets, she was happily taking 15-20ml in a single session. Upon visiting the vet today, he told us to feed her a couple of ml of Emeraid IC every 2 hours or so, and only syringe feed her the blend of her normal pellets if she doesn't feed herself. Emeraid's website, on the other hand, says to feed them up to 3% of their bodyweight.

I seem to be getting a lot of conflicting information from various sources and I really don't want to make the wrong decision here. I don't want to disregard what my vet is saying, but similarly if you're saying a couple of ml of Emeraid IC every few hours isn't enough, I don't want to starve her. Would it be possible to get some unambiguous clarification as to exactly what my next steps should be please?
 
I think my throw away wording of a couple may have confused - it’s just how I speak

I think you may be looking too much for a particular formula of how to do it - there isn’t one.
Simply sit down with her, feed her as much and she wants and mark it down on a chart. Add up how much she has taken and is taking. The less she takes at each sitting the more sitting you need to do. You may have to feed every two hours, it may be able to be every 4 hours if she eats more each time.
 
Understood, thank you for clarifying!

Is it possible to overfeed Emeraid to a poorly pig? I would never go over what's recommended on the packet (3% of bodyweight per sitting, 4 sittings in a 24 hour period - so in her case up to 78ml in a 24 hour period), but 78ml is a *long* way from my vet's recommendation of "a couple of ml every few hours" which works out to a liberal estimate of 36ml in a 24 hour period (assuming "a couple of ml" can mean 3ml). He mentioned that we should syringe feed her normal food on top of this if she doesn't eat in the meantime, but I'm not sure how long I should allow before starting to syringe feed her pellets.
 
KikiKaka said:
Understood, thank you for clarifying!

Is it possible to overfeed Emeraid to a poorly pig? I would never go over what's recommended on the packet (3% of bodyweight per sitting, 4 sittings in a 24 hour period - so in her case up to 78ml in a 24 hour period), but 78ml is a *long* way from my vet's recommendation of "a couple of ml every few hours" which works out to a liberal estimate of 36ml in a 24 hour period (assuming "a couple of ml" can mean 3ml). He mentioned that we should syringe feed her normal food on top of this if she doesn't eat in the meantime, but I'm not sure how long I should allow before starting to syringe feed her pellets.
Click to expand...

Again, ignore the packet. She will only eat what she wants to eat. If a piggy was to happily take 90ml of syringe feed and maintains their weight the next day then the amount of syringe feed is right.

So I assume your vet is meaning mushed pellets then by ‘normal food’?
When syringe feeding you don’t need to use pellets as well. Mushed pellets is the emergency alternative to a recovery feed. Recovery feed being higher in fibre content.

You can offer a normal diet alongside syringe feeding to see if she will eat independently. The more independent hay eating which takes place the less syringe feed is needed.
 
By normal feed, yep, he means mushed pellets.

I guess the main thing I'm struggling with is: what ratio should I be doing of mushed pellets to Emeraid? Should I follow the vet's advice of a couple of ml of Emeraid every few hours followed by syringe feeding as normal? Or should I just feed her the Emeraid and see if she eats by herself? And if it's the latter but she doesn't eat by herself, how long should I allow before I start syringe feeding the mushed pellets?
 
She doesn’t need mushed pellets if she is having emeraid. Emeraid is a recovery feed, it replaces lost hay intake. Emeraid is ‘syringe feed as normal’ - it’s not instead of.
Mushed pellets is the emergency alternative if you didn’t have a recovery feed, nothing more.

She will eat by herself if she is well enough to do so.
It’s not that she is having emeraid but she isn’t eating hay independently so she also needs mushed pellets. Emeraid is making up for lack of hay intake perfectly well on its own.
 
Okay, so is it okay to feed the Emeraid initially in the quantity the vet said (a couple of ml every couple of hours), and then we should up that intake if she's not eating of her own volition?
 
KikiKaka said:
Okay, so is it okay to feed the Emeraid initially in the quantity the vet said (a couple of ml every couple of hours), and then we should up that intake if she's not eating of her own volition?
Click to expand...

No, you feed as much right now as she needs to keep her weight stable each day. If she isn’t eating on her own now, then she needs 60-90ml of syringe feed now.
As she starts to get better and eats more on her own then you reduce the amount of syringe feeds or rather she will start to refuse syringe feeds as she doesn’t want them due to being full from independent hay eating.
 
Update: she's still fighting on but I could do with some more advice please!

We took her to the vet again today as her appetite was gone again, despite her playing with her sister and eating her food yesterday. He said her body temperature was 36.4C (97.5F) and put her in a Bair Hugger for 2 hours to bring her up - when we left, she was at 38. He said it was imperative that we keep her warm or her appetite will go again.

We already have a Snugglesafe in her cage, but she only sits on or near it half the time - the other half, she's out in the open. The room itself is around 18-20C which should be fine for her, but I'm very conscious of the fact that we need to keep her as warm as possible. She also has snuggle sacks and tunnels to rest in, but still she sits in the open.

Is there anything we can do to bring up the ambient temperature in the cage? We have a 5x2 CNC from Kavee with a loft. I was thinking of putting some thick/heavy blankets on top but wasn't sure if that was advisable or if it would help.
 
I would cover the cage with blankets, stuff hides and boxes with plenty of hay. I would actually throw lots of hay loose into the cage everywhere out in the open also as it’s a great insulator and if she burrows into it if she doesn’t want to be in a hide, it will hopefully help. Obviously still keep snugglesafes etc

Have the vets been able to find out/made suggestions if further checks to find out what is wrong with her/and her temp is dropping?
 
Lots of hay in the cage too, forgot to mention that!

They haven't suggested or offered any further checks unfortunately - is there anything I could be recommending or requesting?

The other thing I forgot to mention, there were some poops in the cage last night that were attached seemingly by a sticky/stretchy piece of string - apparently this is common for gut stasis but thought I should mention it anyway - there's a picture here (spoiler-tagged for the squeamish!):
https://imgur.com/FGazW1m
 
Any advice at all here would be greatly appreciated - the vet is at a loss as to what could be causing her poops to be stringy like this, and I'm finding surprisingly little info about them online!
 
She's done more poops similar to the above - the first two images in this album are from this morning while I was massaging her tum (that's the only advice I could find for trying to relieve her from the mucous), and the ones in the last picture were done overnight. It's not hair or hay, it's a stringy, sticky substance (not boar glue). Any information at all on what could be causing this would be very helpful!

https://imgur.com/a/fduM2GD

The vet has upped her from ~0.3ml Emeprid and Metacam once a day to 0.7ml of each twice per day. Does this seem advisable?
 
KikiKaka said:
Any advice at all here would be greatly appreciated - the vet is at a loss as to what could be causing her poops to be stringy like this, and I'm finding surprisingly little info about them online!
Click to expand...

Poops on a string are indicative of a major tummy upset

Wiebke's Guide to Poops

is she on dog or cat metacam? (I'm assuming cat given the dosage)

Pain meds are needed to be given twice a day because piggies metabolise their meds in around 12 hours. Dog metacam is three times stronger than cat. So a low dose of cat metacam once a day is unlikely to be effective against pain
 
Piggies&buns said:
Poops on a string are indicative of a major tummy upset

Wiebke's Guide to Poops

is she on dog or cat metacam? (I'm assuming cat given the dosage)

Pain meds are needed to be given twice a day because piggies metabolise their meds in around 12 hours. Dog metacam is three times stronger than cat. So a low dose of cat metacam once a day is unlikely to be effective against pain
Click to expand...
She's on cat Metacam - I've read Wiebke's guide but couldn't find anything as to what the next steps should be.

She's drinking lots of water, albeit in large gaps. She'll actively take 15-20ml at a time then not touch it for a good few hours. She's still not grazing, but we're able to get her to take around 15ml of Emeraid every 5 or so hours.
 
KikiKaka said:
She's on cat Metacam - I've read Wiebke's guide but couldn't find anything as to what the next steps should be.

She's drinking lots of water, albeit in large gaps. She'll actively take 15-20ml at a time then not touch it for a good few hours. She's still not grazing, but we're able to get her to take around 15ml of Emeraid every 5 or so hours.
Click to expand...

What has today’s weight check shown you when compared to yesterday?
Poops won’t right until the stasis and issue behind the stasis is dealt with. Next steps is to continue wirh syringe feeding until she is eating for herself
 
Piggies&buns said:
What has today’s weight check shown you when compared to yesterday?
Poops won’t right until the stasis and issue behind the stasis is dealt with. Next steps is to continue wirh syringe feeding until she is eating for herself
Click to expand...
Not great at all - she was slightly higher than yesterday's weigh in when we got up (620g ish I think), but she hasn't had anything to eat of her own accord since and she's rejecting syringe feeding a lot of the time now :( I checked at 1ish out of paranoia and she was at 599g, but I know that's still in the fluctuation range despite being critically low.

Is the mucus a cause for concern or should we just keep doing what we're doing?
 
KikiKaka said:
Not great at all - she was slightly higher than yesterday's weigh in when we got up (620g ish I think), but she hasn't had anything to eat of her own accord since and she's rejecting syringe feeding a lot of the time now :( I checked at 1ish out of paranoia and she was at 599g, but I know that's still in the fluctuation range despite being critically low.

Is the mucus a cause for concern or should we just keep doing what we're doing?
Click to expand...

Your priority is just to stop day to day weight loss. She isn’t going to gain weight at any time soon.
If she was around the same as yesterday’s weight check then that’s a good thing - it means you are syringe feeding her enough for maintenance. That is all you can hope for at this stage.

The mucus isn’t good as obviously it means she is unwell. Is she on a probiotic at all?
 
She is, yes - she's currently taking:
Fibreplex - 3x a day (this is prebiotic and probiotic I believe)
Emeraid - as much as we can get her to take, ideally 4x 18ml a day according to the packet but we're struggling to get that much into her
Emeprid - 0.7ml 2x a day
Metacam Cat - 0.7ml 2x a day

I'm also offering water as regularly as she's willing to take it and have taken her off fresh veg as this seems to be the advice for stringy poop - happy to be corrected as she seems very jealous of her sister's basil and lettuce!
 
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