GP showed signs of improvement but back to being lethargic

[Piggies&buns]

Her weight this morning is 618.5g which is a good sign!

My fear of weighing just once per day is that she's still perilously close to 600g which I've seen in a few places on the forum is apparently the point of no return - so the reason for multiple weighs is to prevent her from dipping below that.

She's not refusing any syringe feeding, but having looked into it we seem to be giving too much Dual Care for her bodyweight, so my plan is to cut her down from 3 feeds of 20ml Dual Care and 1 of 20ml pellets to 3 feeds of the former at 8ml and 2 of the latter at 15ml, one of which will be before bed (plus her veg each day) and monitor from there. It seems Excel recommend 3 feeds of 10ml per kg of bodyweight, so the 20ml could well have been too high?

Any feedback on this would be appreciated as I obviously don't want to cut out too much of the syringe feeding!

The weight first thing in the morning is the best one to use. Weighing multiple times a day just means you are picking up fluctuation throughout the day, weighing full stomachs and bladders, and actually making it inaccurate - it isn’t preventing her from dropping below anything. She is going to weigh more in an evening (due to having had a full day of eating) than she weighs in the morning (just as us humans do) - the evening weight check is effectively pointless and causing more work and stress for you.

You don’t feed a set amount for body weight - you feed as much as is needed to keep her weight stable and as much as she will take at each sitting - 60-90ml per day. I feel you may be looking too deeply into giving set amounts which is making this more stressful for you.
If her weight yesterday was around the same as today then she is eating enough, it really is as simple as that

 

[Wiebke]

Her weight this morning is 618.5g which is a good sign!

My fear of weighing just once per day is that she's still perilously close to 600g which I've seen in a few places on the forum is apparently the point of no return - so the reason for multiple weighs is to prevent her from dipping below that.

She's not refusing any syringe feeding, but having looked into it we seem to be giving too much Dual Care for her bodyweight, so my plan is to cut her down from 3 feeds of 20ml Dual Care and 1 of 20ml pellets to 3 feeds of the former at 8ml and 2 of the latter at 15ml, one of which will be before bed (plus her veg each day) and monitor from there. It seems Excel recommend 3 feeds of 10ml per kg of bodyweight, so the 20ml could well have been too high?

Any feedback on this would be appreciated as I obviously don't want to cut out too much of the syringe feeding!

Hi

You use the feedback from the scales for cutting back but in your case, you do not want to do that until you are well above 650g (ideally 700g) and your piggy is back to eating on their own. If you want to cut back with the feed, then you do a trial. If the weight is down the next day, then it means that the cut back is working. But you do not need to weigh several times per day for that because you continue to feed enough anyway for her weight to plummet.
You always start reducing little once your piggy is able to eat realiably about 15 ml per feeding session. If they are willingly take over 10 ml, then you have to persist with your feeding regime.

You cannot go by fixed numbers per feeding session. Just feed as much as your girl will accept. This will give you the added information as to whether she is ready or not to make the step. Pick up on what she is telling you and don't be obsessed with numbers.

PS: The 'line of no return' is different for any piggy. It is basically the weight of the bones, skin and major organs but with any fat and muscles gone. I've had piggies for who that line was close to a kilo and others that have gone below 600g. Please never get fixated on numbers. I currently have got two runts who on a good day in the prime of their lives just touch 600g from below; their dying weight would be somewhere around 400g or even a little less.
I also had a sow with a massive bladder stone who had her emergency operation on the Monday at 520g after being 700g on the Friday (despite feeding support) and who was back to 700g again two weeks post-op. Numbers are just relative. It's your individual piggy that is telling you when they are ready to make the step. You have to be prepared to a tester and retract if needed.

 

[KikiKaka]

The weight first thing in the morning is the best one to use. Weighing multiple times a day just means you are picking up fluctuation throughout the day, weighing full stomachs and bladders, and actually making it inaccurate - it isn’t preventing her from dropping below anything. She is going to weigh more in an evening (due to having had a full day of eating) than she weighs in the morning (just as us humans do) - the evening weight check is effectively pointless and causing more work and stress for you.

You don’t feed a set amount for body weight - you feed as much as is needed to keep her weight stable and as much as she will take at each sitting - 60-90ml per day. I feel you may be looking too deeply into giving set amounts which is making this more stressful for you.
If her weight yesterday was around the same as today then she is eating enough, it really is as simple as that

Understood, thank you - the amounts I've outlined above come to roughly 54ml; looking at my spreadsheet, we've been feeding between 65ml and 70ml per day to keep her stabilised at this weight. I think my prior estimate of 4 at 20ml may have been slightly inaccurate!

Would it be okay to go ahead with this plan of 3x Dual Care @ 8ml and 2x pellets @ 15ml (for a total of 15ml)?

 

[KikiKaka]

Hi

You use the feedback from the scales for cutting back but in your case, you do not want to do that until you are well above 650g (ideally 700g) and your piggy is back to eating on their own. If you want to cut back with the feed, then you do a trial. If the weight is down the next day, then it means that the cut back is working. But you do not need to weigh several times per day for that because you continue to feed enough anyway for her weight to plummet.
You always start reducing little once your piggy is able to eat realiably about 15 ml per feeding session. If they are willingly take over 10 ml, then you have to persist with your feeding regime.

You cannot go by fixed numbers per feeding session. Just feed as much as your girl will accept. This will give you the added information as to whether she is ready or not to make the step. Pick up on what she is telling you and don't be obsessed with numbers.

PS: The 'line of no return' is different for any piggy. It is basically the weight of the bones, skin and major organs but with any fat and muscles gone. I've had piggies for who that line was close to a kilo and others that have gone below 600g. Please never get fixated on numbers. I currently have got two runts who on a good day in the prime of their lives just touch 600g from below; their dying weight would be somewhere around 400g or even a little less.
I also had a sow with a massive bladder stone who had her emergency operation on the Monday at 520g after being 700g on the Friday (despite feeding support) and who was back to 700g again two weeks post-op. Numbers are just relative. It's your individual piggy that is telling you when they are ready to make the step. You have to be prepared to a tester and retract if needed.

She's willingly taking all of the food we give her in any one session up to around 18ml - any more than that and she starts fussing slightly!

My concern is, with 4 relatively large feeding sessions per day, could mean she's effectively full from session to session, preventing her from wanting to graze? Or, considering the Dual Care instructions say to give around half of what we've been giving, could she know she's getting enough fibre so avoiding hay?

 

[Wiebke]

She's willingly taking all of the food we give her in any one session up to around 18ml - any more than that and she starts fussing slightly!

My concern is, with 4 relatively large feeding sessions per day, could mean she's effectively full from session to session, preventing her from wanting to graze? Or, considering the Dual Care instructions say to give around half of what we've been giving, could she know she's getting enough fibre so avoiding hay?

Hi

That is over 75 ml and that is a really good intake per session. - piggies need between 60-90ml but how much depends on the individual and also on the age; you are pretty much on the average. 18 ml is a very good amount; it means that her appetite is back. She will refuse when she is feeling full - that is usually somehere between 15-20 ml per session. In human terms this is the equivalent of a plate of food or a bowl of cereal.

What I would recommend is that you either start feeding the recovery mush from a bowl with some veg and hay on the side or you have a stop with feeding veg and hay on your lap after a few ml and then offer more feed once they stop eating independly. The syringe feed can trigger the appetite.
These measures will give you an insight into her independent appetite and feeding - and how much she is dipping in the different food groups. You can then start to manage the transitional process to

Please don't get stuck in the rabbit hole that is obsessive weighing and feeding by numbers. Once a day is giving you all the information that is really relevant. Your girl is not in any danger of losing weight now. You are well past the crisis and have to concentrate on managing the transition. But you get more and better feedback by just watching what she is eating and how much when left to her own devices. I usually do this on an armchair or a sofa (with an absorbent underlay) and have the syringe and water ready if needed. But I get a lot more input from how she is doing and what she is eating independently than just going by numbers.

 

[KikiKaka]

Hi

That is over 75 ml and that is a really good intake per session. What I would recommend is that you either start feeding the recovery mush from a bowl with some veg and hay on the side or you have a stop with feeding veg and hay on your lap after a few ml and then offer more feed once they stop eating independly. The syringe feed can trigger the appetite. These measures will give you an insight into her independent appetite and feeding - and how much she is dipping in the different food groups.

18 ml is a very good amount; it means that her appetite is back. She will refuse when she is feeling full - that is usually between 15-20 ml.

She definitely wouldn't take it from a bowl by herself unfortunately, but I'll try alternating with veg and hay when we do her next feeds! Would it be okay to cut it down as mentioned above, or would you recommend we continue with the higher amounts of 65-70ml per day? I think my estimate of 75ml may have been slightly off based on my spreadsheet.

 

[Wiebke]

She definitely wouldn't take it from a bowl by herself unfortunately, but I'll try alternating with veg and hay when we do her next feeds! Would it be okay to cut it down as mentioned above, or would you recommend we continue with the higher amounts of 65-70ml per day? I think my estimate of 75ml may have been slightly off based on my spreadsheet.

See how she is doing with veg and hay first. You need to create your own data base on what she is eating on her own befor planning any changes.

 

[KikiKaka]

See how she is doing with veg and hay first. You need to create your own data base on what she is eating on her own befor planning any changes.

Will do, thank you! She seems to willingly take around 25g of veg when given them once per day now, which is lower than I'd like but I think given how much she's being syringe fed, it makes sense that she'd be full.

One thing I did notice is that around the time we stopped Metacam was also around the time she stopped eating hay - could the two be related? I would imagine not considering she's still perky when taken out of the cage and still willingly eating veg, but I thought I'd ask to be sure.

 

[Piggies&buns]

When a piggy is in pain hay is usually the thing that gets dropped first. If she has gone downhill since the pain meds stopped then it would be a good idea to have a chat with the vet

 

[Wiebke]

Will do, thank you! She seems to willingly take around 25g of veg when given them once per day now, which is lower than I'd like but I think given how much she's being syringe fed, it makes sense that she'd be full.

One thing I did notice is that around the time we stopped Metacam was also around the time she stopped eating hay - could the two be related? I would imagine not considering she's still perky when taken out of the cage and still willingly eating veg, but I thought I'd ask to be sure.

Hi

Plese be aware that hay makes around 80% of the daily food intake.

Veg, fresh and dry forage, pellets and any treat all together are basically one second food group that fills the supplementary role that fresh forage used to have.

Unfortunately, you cannot control the hay intake by eye but pain can diminish the appetite and that generally translates into a reduced hay intake. What your recovery formula does is to replace first and foremost the all important hay intake, not the veg or pellet intake.

Please speak to the vet if there is a remaining pain issue which is impacting on her appetite/hay intake.

 

[KikiKaka]

When a piggy is in pain hay is usually the thing that gets dropped first. If she has gone downhill since the pain meds stopped then it would be a good idea to have a chat with the vet

Would this definitely or likely suggest that she's in pain or could it just be one of many possibilities? She seems mostly fine in herself - lazing around a lot in the cage (which she always does) but very upbeat when she's taken out.

 

[Piggies&buns]

Would this definitely or likely suggest that she's in pain or could it just be one of many possibilities? She seems mostly fine in herself - lazing around a lot in the cage (which she always does) but very upbeat when she's taken out.

It would be ringing alarm bells for me - the fact you say she stopped eating hay at the same time the pain meds stopped would be something I’d want investigated - it’s for the vet to say what the possibilities are

 

[KikiKaka]

More bad news... have just checked in her cage and the poops are back to being both small and slightly clumpy (spoiler-tagged picture below). I've spoken to our vet who has advised giving it a couple of days for everything to pass through her system and carry on with syringe feeding as before - if there's no sign of uptick in a couple of days, or if there are any major concerns in that time, then he's recommended we take her back. Does this seem like an okay course of action?

 

[KikiKaka]

We've taken her out for a feed and while she still isn't interested in fresh hay (we got her Excel Timothy hay with dandelion and marigold), she's currently grazing on a hay block we have while between mouthfuls of syringe feeding which gives me some hope - is this a good sign?

 

[Piggies&buns]

We've taken her out for a feed and while she still isn't interested in fresh hay (we got her Excel Timothy hay with dandelion and marigold), she's currently grazing on a hay block we have while between mouthfuls of syringe feeding which gives me some hope - is this a good sign?

It shows she has an interest but it’s not the same thing as eating hay and can’t be included as any hay intake

 

[KikiKaka]

More bad news... have just checked in her cage and the poops are back to being both small and slightly clumpy (spoiler-tagged picture below). I've spoken to our vet who has advised giving it a couple of days for everything to pass through her system and carry on with syringe feeding as before - if there's no sign of uptick in a couple of days, or if there are any major concerns in that time, then he's recommended we take her back. Does this seem like an okay course of action?


View attachment 252784

Just to follow up on this, it seems like she's straining to poop as well - she's not in any audible pain and doesn't seem uncomfortable, but she lifts her butt up when pooping and it takes a while for it to come out. Could this be a sign of sterile IC? If so, is there anything we can request the vet do to deal with it? And would taking her off the Metacam and having her go downhill be explained by sterile IC?

 

[KikiKaka]

In addition to the clumped poops, some of them are quite wet and very "poop" smelling - is this indicative of anything? We're taking her back off fresh veg, but unsure if this might point to anything?

 

[Piggies&buns]

Just to follow up on this, it seems like she's straining to poop as well - she's not in any audible pain and doesn't seem uncomfortable, but she lifts her butt up when pooping and it takes a while for it to come out. Could this be a sign of sterile IC? If so, is there anything we can request the vet do to deal with it? And would taking her off the Metacam and having her go downhill be explained by sterile IC?

Sterile IC is never the first thing that would be checked for - it presents as a repeated urinary tract infection. Every other bladder related issue would be checked first as IC is a process of elimination.

Coming off metacam and then going downhill can be as a result of any pain issue of any cause.

Poop issues are a result of any digestive issue or lack of fibre intake
Wiebke's Guide to Poops

 

[KikiKaka]

Sterile IC is never the first thing that would be checked for - it presents as a repeated urinary tract infection. Every other bladder related issue would be checked first as IC is a process of elimination.

Coming off metacam and then going downhill can be as a result of any pain issue of any cause.

Poop issues are a result of any digestive issue or lack of fibre intake
Wiebke's Guide to Poops

Thank you - can bladder issues also impact pooping?

 

[Piggies&buns]

Thank you - can bladder issues also impact pooping?

As Wiebke said in her first post to you, sterile IC could be a one off incident as well as the stasis being caused by an underlying health issue. So they are secondary to an underlying health issue.
So it’s about finding out what is her issue.
You, as far as I can see, haven’t mentioned any bladder related symptoms other than the first incident of porphyrin?

The poops in the picture are looking, to me anyway, a bit like poops as a result of stasis

 

[KikiKaka]

As Wiebke said in her first post to you, sterile IC could be a one off incident as well as the stasis being caused by an underlying health issue. So they are secondary to an underlying health issue.
So it’s about finding out what is her issue.
You, as far as I can see, haven’t mentioned any bladder related symptoms other than the first incident of porphyrin?

The poops in the picture are looking, to me anyway, a bit like poops as a result of stasis

There haven't been any other bladder-related symptoms, that's right - when you say they look like they're as a result of stasis, do you mean that she seems like she's currently in a state of gut stasis, or do you mean that they can be symptomatic of having been through a bout of it?

I've attached two more photos to this post of other poops she's done this morning - in the photo where it's attached to the stick, there are two healthy poops from her sister that have stuck onto it due to its consistency - those aren't hers!

 

[Wiebke]

There haven't been any other bladder-related symptoms, that's right - when you say they look like they're as a result of stasis, do you mean that she seems like she's currently in a state of gut stasis, or do you mean that they can be symptomatic of having been through a bout of it?

I've attached two more photos to this post of other poops she's done this morning - in the photo where it's attached to the stick, there are two healthy poops from her sister that have stuck onto it due to its consistency - those aren't hers!


View attachment 252785View attachment 252786

It means that the stasis and the persistent gut problems could be caused by a problem outside of the gut that is impacting on it (usually either via radiating pain or pressure on the gut). In this case, we are talking about your problems being secondary complications. It is an angle that should be kept in mind.

Your poos are reflecting a minor tummy upset.
Wiebke's Guide to Poops

I am very sorry that it is still one step forward, one step back for you.

 

[KikiKaka]

It means that the stasis and the persistent gut problems could be caused by a problem outside of the gut that is impacting on it (usually either via radiating pain or pressure on the gut). In this case, we are talking about your problems being secondary complications. It is an angle that should be kept in mind.

Your poos are reflecting a minor tummy upset.
Wiebke's Guide to Poops

I am very sorry that it is still one step forward, one step back for you.

We did give her some veg the past couple of nights as they seemed to have gone back to normal (cucumber, lettuce, and herbs) - and I've read that the water content of cucumber and lettuce could potentially be enough to make things bad again? Keeping my fingers crossed it's nothing too serious!

 

[Wiebke]

We did give her some veg the past couple of nights as they seemed to have gone back to normal (cucumber, lettuce, and herbs) - and I've read that the water content of cucumber and lettuce could potentially be enough to make things bad again? Keeping my fingers crossed it's nothing too serious!

If you have re-introduced veg too quickly, then the gut doesn't have the time to scale up the digestive bacteria responsible for the processing of veg after weeks on just support feed.

Give the gut some days off veg to normalise again.

The rules for re-introducing veg very slowly are:
- Start with just a little fresh herb like coriander or parsley for the first two meals.
- Serve the herb and just a very little cucumber (half a small slice) for the next two meals.
- Serve the herb, the cucumber (normal slice) for two meals.
- Add a little pepper next.
- Then add a small amount of lettuce.
- Then introduce any other veg.

Stop as soon as the tummy struggles again.

 

[KikiKaka]

If you have re-introduced veg too quickly, then the gut doesn't have the time to scale up the digestive bacteria responsible for the processing of veg after weeks on just support feed.

Give the gut some days off veg to normalise again.

The rules for re-introducing veg very slowly are:
- Start with just a little fresh herb like coriander or parsley for the first two meals.
- Serve the herb and just a very little cucumber (half a small slice) for the next two meals.
- Serve the herb, the cucumber (normal slice) for two meals.
- Add a little pepper next.
- Then add a small amount of lettuce.
- Then introduce any other veg.

Stop as soon as the tummy struggles again.

If this is the case, would it also explain the lethargy and lack of grazing? I would imagine so but confirmation would be nice!

 

[Wiebke]

If this is the case, would it also explain the lethargy and lack of grazing? I would imagine so but confirmation would be nice!

A tummy upset in a frail piggy could cause these symptoms if she is feeling a bit sick and nauseous.

See how she is by tomorrow evening and contact your vet first thing on Monday morning if there hasn't been any improvement in the poos (firming up again at lest partially) by then.

 

[KikiKaka]

It looks like the poops are continuing, sadly (more pictures below, sorry!) - I obviously don't expect them to clear up instantly, but if we're continuing with regular syringe feeding should we be immediately going to an emergency vet, or should we see how she is in the morning?

 

[Wiebke]

It looks like the poops are continuing, sadly (more pictures below, sorry!) - I obviously don't expect them to clear up instantly, but if we're continuing with regular syringe feeding should we be immediately going to an emergency vet, or should we see how she is in the morning?

Hi

Just continue with the full-on feeding support. This isn't a life or death emergency.

 

[KikiKaka]

Hi

Just continue with the full-on feeding support. This isn't a life or death emergency.

Sorry, me again... she's just done this in her snuggle sack - still okay to continue supplementing with syringe feeding or should we be going to an emergency vet? I'm assuming she's partially squashed it down by sitting on it, but still not good.

 

[KikiKaka]

Would it be advisable to give her some Metacam to see if that helps alleviate the potential inflammation causing this? We have dog Metacam from a recent vet visit with some teeth issues for our dog, so it's not prescribed for her but I'm really at a loss as to what else I can do.