Gut stasis - 1 Week in

[Deleted member 151640]

Hi everyone, hope you’re doing well and staying warm in this cold weather.

My 5 year old boar was taken to the vets last saturday with very bad lethargy and not eating and was diagnosed with gut stasis. The vet could hear a little movement so we were prescribed 0.75ml twice a day of Emeprid (probiotic) and 0.45ml once daily of Loxicom (painkiller).
At the time i wasn’t aware we weren’t prescribed a gut stimulant. We were also given critical care to step in with support feeding, there was obvious improvement hours within him first meds i assume the painkillers kicked in. From Saturday to Wednesday he was on 30-50ml of critical care and just in the past few days weaning down to 25-10 since he has been eating on his own since the start (getting much better as the week went on)

On his recovery on tuesday i noticed signs of bloat so phoned up the vet and got more critical care, more Emeprid and more Loxicom as well as Cisapride 0.12ml once every 8-12 hours (twice daily).
Since then he has been back and forth on the poop front, around 2 of the 4 past days i’ve seen majorly reduced poops and then the next day it’s fine.
Today is one of the reduced poop days, and i noticed yesterday he was showing signs of discomfort - Sitting in his favourite hide in the corner, hunched up, fluff put up and not wanting to move much - But he was still eating and i just kept an eye on him. When i cleaned them this morning in his area i found very few tiny poops and bottleneck poops.

This morning he weighed 1105g whereas the rest of the week he stayed between 1130-1140g which i know is technically between the normal fluctuation but it’s strange as his stomach feels full (not particularly hard, just like he hasn’t pooped in a while) which i assumed would increase his weight which makes me worry perhaps he was lost more weight just not showing because he hasn’t pooped.
I am reluctant to step in with increased critical care as this is his first time losing since the start of the week and i want to see if it’s genuinly just fluctuation or if he needs more help.

My plan generally is to get an in clinic check up at the start of this coming week, so we can check up on how he’s doing and perhaps plan forward where we want to go with this.

As i’m typing this he’s eating his hay and having a drink.
For people who have dealt with this before, we have maybe a couple days left of medication, do i need more?
Is this medication working for him?
Is such a fluctuation in improvement normal?

I’m just keeping a close eye on him for now, i plan to give him 10ml of critical care at 8pm which is the same as he got yesterday. (Alongside his meds, obviously)

Any advice is welcome and appreciated, thanks

 

[Siikibam]

I’m sorry your boy is unwell. I’ve no experience of gut stasis but would say you should offer him as much syringe feed as he will take. I wouldn’t wean him off yet given he’s lost weight.

I hope he gets better soon. Sending lots of healing wheeks.

 

[Wiebke]

Hi everyone, hope you’re doing well and staying warm in this cold weather.

My 5 year old boar was taken to the vets last saturday with very bad lethargy and not eating and was diagnosed with gut stasis. The vet could hear a little movement so we were prescribed 0.75ml twice a day of Emeprid (probiotic) and 0.45ml once daily of Loxicom (painkiller).
At the time i wasn’t aware we weren’t prescribed a gut stimulant. We were also given critical care to step in with support feeding, there was obvious improvement hours within him first meds i assume the painkillers kicked in. From Saturday to Wednesday he was on 30-50ml of critical care and just in the past few days weaning down to 25-10 since he has been eating on his own since the start (getting much better as the week went on)

On his recovery on tuesday i noticed signs of bloat so phoned up the vet and got more critical care, more Emeprid and more Loxicom as well as Cisapride 0.12ml once every 8-12 hours (twice daily).
Since then he has been back and forth on the poop front, around 2 of the 4 past days i’ve seen majorly reduced poops and then the next day it’s fine.
Today is one of the reduced poop days, and i noticed yesterday he was showing signs of discomfort - Sitting in his favourite hide in the corner, hunched up, fluff put up and not wanting to move much - But he was still eating and i just kept an eye on him. When i cleaned them this morning in his area i found very few tiny poops and bottleneck poops.

This morning he weighed 1105g whereas the rest of the week he stayed between 1130-1140g which i know is technically between the normal fluctuation but it’s strange as his stomach feels full (not particularly hard, just like he hasn’t pooped in a while) which i assumed would increase his weight which makes me worry perhaps he was lost more weight just not showing because he hasn’t pooped.
I am reluctant to step in with increased critical care as this is his first time losing since the start of the week and i want to see if it’s genuinly just fluctuation or if he needs more help.

My plan generally is to get an in clinic check up at the start of this coming week, so we can check up on how he’s doing and perhaps plan forward where we want to go with this.

As i’m typing this he’s eating his hay and having a drink.
For people who have dealt with this before, we have maybe a couple days left of medication, do i need more?
Is this medication working for him?
Is such a fluctuation in improvement normal?

I’m just keeping a close eye on him for now, i plan to give him 10ml of critical care at 8pm which is the same as he got yesterday. (Alongside his meds, obviously)

Any advice is welcome and appreciated, thanks

Hi
Please get more meds and keep on support feeding with daily weigh-ins first thing in the morning for as long as it takes; right now he is not stable and is not eating enough hay yet. If he has enough appetite, you can see whether switching to feeding from a bowl outside the cage twice daily will take some of the pressure off you; if he isn't clearing his bowl, you need to syringe feed the rest over the course of the day/evening.
Digestive Disorders: Not Eating - Diarrhea - Bloat - GI Stasis (No Gut Movement)

You do compute the level of support feed for the day according to the weight; the poo output will tell you with the usual delay whether things are going in the right direction or not. In my own experience, weighing first thing in the morning when the daily weight swing is at its lowest gives you the best day-to-day comparison and also the clearest feedback where your piggy stands.
The poo output reflects the food intake from 1-2 days before with the stasis showing up as a clear gap on the internal conveyor belt. After a stasis, the gut can sometimes be sluggish and slow moving for longer.
Digestive Disorders: Not Eating - Diarrhea - Bloat - GI Stasis (No Gut Movement)

It is likely that there is an underlying issue that is causing the stasis and the bloating. One-off stasis usually happens out of the blue but the piggy will usually bounce back to normal within two days.

My own Pili Pala retained off and on mild bloating/digestive issues and an up and down weight in the wake of her own 4 day gut stasis with a thickened lower bowel and IBS like symptoms (especially little cramps and off and on mild to medium bloating); this was diagnosed about 5 weeks after the stasis event when she failed to fully stabilise.
A few months later added to by suspected hyperthyroidism causing more weight loss before she died from acute heart failure about a year later; coming up to her 6th birthday. She had that extra blessed year but it was not an easy one since she required her daily top up feed and gut meds cocktail. My vet preferred not to treat for the hyperthyroidism in view of Pili Pala's gut cocktail and there not yet being a reliable medication for the hyperthyroidism at the time.
I can of course not say whether Pili's story has any direct relevance to your story but it shows that stasis is not always a quickie experience that never repeats again. Pili took about a full week for the stasis event to be over the worst but she took longer to recover from it. Please Send Your Vibes To Pili Pala!

 

[Deleted member 151640]

Hi
Please get more meds and keep on support feeding with daily weigh-ins first thing in the morning for as long as it takes; right now he is not stable and is not eating enough hay yet. If he has enough appetite, you can see whether switching to feeding from a bowl outside the cage twice daily will take some of the pressure off you; if he isn't clearing his bowl, you need to syringe feed the rest over the course of the day/evening.
Digestive Disorders: Not Eating - Diarrhea - Bloat - GI Stasis (No Gut Movement)

You do compute the level of support feed for the day according to the weight; the poo output will tell you with the usual delay whether things are going in the right direction or not. In my own experience, weighing first thing in the morning when the daily weight swing is at its lowest gives you the best day-to-day comparison and also the clearest feedback where your piggy stands.
The poo output reflects the food intake from 1-2 days before with the stasis showing up as a clear gap on the internal conveyor belt. After a stasis, the gut can sometimes be sluggish and slow moving for longer.
Digestive Disorders: Not Eating - Diarrhea - Bloat - GI Stasis (No Gut Movement)

It is likely that there is an underlying issue that is causing the stasis and the bloating. One-off stasis usually happens out of the blue but the piggy will usually bounce back to normal within two days.

My own Pili Pala retained off and on mild bloating/digestive issues and an up and down weight in the wake of her own 4 day gut stasis with a thickened lower bowel and IBS like symptoms (especially little cramps and off and on mild to medium bloating); this was diagnosed about 5 weeks after the stasis event when she failed to fully stabilise.
A few months later added to by suspected hyperthyroidism causing more weight loss before she died from acute heart failure about a year later; coming up to her 6th birthday. She had that extra blessed year but it was not an easy one since she required her daily top up feed and gut meds cocktail. My vet preferred not to treat for the hyperthyroidism in view of Pili Pala's gut cocktail and there not yet being a reliable medication for the hyperthyroidism at the time.
I can of course not say whether Pili's story has any direct relevance to your story but it shows that stasis is not always a quickie experience that never repeats again. Pili took about a full week for the stasis event to be over the worst but she took longer to recover from it. Please Send Your Vibes To Pili Pala!

Thanks for your reply, I've found it very helpful.

So I should take him straight back up to 30-40mls and continue that? He was stable and looking better but then the bloat came and now a couple days later hes acting like hes in discomfort and not pooing correctly. He is eating hay, veggies and nuggets but as i said he has lost a little weight and as he hasn't pooped i believe this could be lifted more because of that.
I was going to wait till tomorrow to see if he continued to lose weight but thinking about it again seems to have more cons than pros, so i will step in now with support feeding, I was just weaning as our vet (who isn't an exotic vet but she is very caring and kind and actually takes my concerns seriously) said that realistically syringe feeding is for guinea pigs who aren't/cant eat. I have tried in the bowl as hes now wanting to eat the critical care but he wants it straight into his mouth apparently, he even lets me know when hes ready by putting his mouth on the syringe.

I also had a thought the stasis was caused by an underlying issue, since that's the main cause. Would it be worth trying to find that? or is it uncommon to find it. I fear my boy my have the same year that your girl had, but I'm not going to give up on him this easy.
Will he be on these meds for ages? - Is there alternative meds that would be an option? - Am i doing the best for him right now?

Sorry for all the questions but I want the best for him and even after years of owning guinea pigs this is my first ill health that isn't an easy medication then fixed issue. Thanks again

 

[Wiebke]

Thanks for your reply, I've found it very helpful.

So I should take him straight back up to 30-40mls and continue that? He was stable and looking better but then the bloat came and now a couple days later hes acting like hes in discomfort and not pooing correctly. He is eating hay, veggies and nuggets but as i said he has lost a little weight and as he hasn't pooped i believe this could be lifted more because of that.
I was going to wait till tomorrow to see if he continued to lose weight but thinking about it again seems to have more cons than pros, so i will step in now with support feeding, I was just weaning as our vet (who isn't an exotic vet but she is very caring and kind and actually takes my concerns seriously) said that realistically syringe feeding is for guinea pigs who aren't/cant eat. I have tried in the bowl as hes now wanting to eat the critical care but he wants it straight into his mouth apparently, he even lets me know when hes ready by putting his mouth on the syringe.

I also had a thought the stasis was caused by an underlying issue, since that's the main cause. Would it be worth trying to find that? or is it uncommon to find it. I fear my boy my have the same year that your girl had, but I'm not going to give up on him this easy.
Will he be on these meds for ages? - Is there alternative meds that would be an option? - Am i doing the best for him right now?

Sorry for all the questions but I want the best for him and even after years of owning guinea pigs this is my first ill health that isn't an easy medication then fixed issue. Thanks again

Hi

Please continue with the topping up level on which he has been stable and please use your kitchen scales as a daily health monitor; unlike with the poo output, you get an up to date feedback and can react much more quickly. When dealing with a long term problem, it becomes more about management and reacting to the inevitable ups and downs.

Gut medication for guinea pigs is unfortunately very limited and not ideal.
You have basically metoclopramide/Emeprid and cisapride. Zantac/ranitidine has been withdrawn from the market some years ago; it is produced again but due to huge human use demand not exactly available. Steroids for things like IBS like issues are a no no for rodents unless it is for terminal care where short-term benefits outweigh longer term concerns.
You can find more information on medication in the bloating/GI stasis care guide link in my first post. I would recommend to please take the time and read the links. You should find them helpful.

Unfortunately for you, I would need a crystal ball to answer your questions re. future developments and what is exactly going on. I can't do sight unseen what your vet may struggle to do hands-on and with access to other diagnostics. That is the tiger you have to ride with most serious or chronic illnesses as they develop and unfold; there are no roadmaps, shortcuts or travel time schedules and arrival predictions.

But if things are not stabilising, please see your vet again some time next week.

 

[Deleted member 151640]

Hi

Please continue with the topping up level on which he has been stable and please use your kitchen scales as a daily health monitor; unlike with the poo output, you get an up to date feedback and can react much more quickly. When dealing with a long term problem, it becomes more about management and reacting to the inevitable ups and downs.

Gut medication for guinea pigs is unfortunately very limited and not ideal.
You have basically metoclopramide/Emeprid and cisapride. Zantac/ranitidine has been withdrawn from the market some years ago; it is produced again but due to huge human use demand not exactly available. Steroids for things like IBS like issues are a no no for rodents unless it is for terminal care where short-term benefits outweigh longer term concerns.
You can find more information on medication in the bloating/GI stasis care guide link in my first post. I would recommend to please take the time and read the links. You should find them helpful.

Unfortunately for you, I would need a crystal ball to answer your questions re. future developments and what is exactly going on. I can't do sight unseen what your vet may struggle to do hands-on and with access to other diagnostics. That is the tiger you have to ride with most serious or chronic illnesses as they develop and unfold; there are no roadmaps, shortcuts or travel time schedules and arrival predictions.

But if things are not stabilising, please see your vet again some time next week.

Thanks, he does get weighed every morning and i have been writing it down to let the vet know.
I’ve had a read of that specific link a couple times in the past but forgot it existed so i have just read over it to refresh my mind.

I do understand how no one can predict what will happen so i apologise if i put you in a uncomfortable situation. I'm just keeping a close eye and my fingers crossed.
I appreciate all your insight and knowledge.

 

[Wiebke]

Thanks, he does get weighed every morning and i have been writing it down to let the vet know.
I’ve had a read of that specific link a couple times in the past but forgot it existed so i have just read over it to refresh my mind.

I do understand how no one can predict what will happen so i apologise if i put you in a uncomfortable situation. I'm just keeping a close eye and my fingers crossed.
I appreciate all your insight and knowledge.

I get asked regularly about the outcome; it comes with the territory. It can get a bit frustrating at times, especially when I have to ride my own tigers into unchartered territory just like everybody else.
Of course, we all wish to be reassured of the possibility of a happy ending but that is the one thing nobody can give us.

We can provide ongoing practical and moral support to help you ride the tiger as best as you can in terms of making the most of your home support care and your individual veterinary access; but we cannot tell you exactly what tiger you are riding or where it will take you. Every journey is different; even more so once you get past the routine stuff.

Right now, all you can do is hanging in there, keeping up with medicating and feeding as much as you can get into him.

 

[Deleted member 151640]

I get asked regularly about the outcome; it comes with the territory. It can get a bit frustrating at times, especially when I have to ride my own tigers into unchartered territory just like everybody else.
Of course, we all wish to be reassured of the possibility of a happy ending but that is the one thing nobody can give us.

We can provide ongoing practical and moral support to help you riding the tiger as best as you can in terms of making the most of your home support care and your individual veterinary access; but we cannot tell you exactly what tiger you are riding or where it will take you. Every journey is different; even more so once you get past the routine stuff.

Right now, all you can do is hanging in there and keeping up with medicating and feeding as much as you can get into him.

Ofcourse you’re also just a human (if not a smart one) and you still don’t possess these powers we all wish we had especially when’s dealing with a sick pet. And you have your own gorgeous piggies!

Thanks for everything you do

 

[Merab]

Just offering support

 

[Deleted member 151640]

Just offering support

 

[Little Ones]

I hope he recovers soon bloat can be quite hard to shift. Simon, our best and most recommend Guinea pig vet here in England, used prescribe us up to 1ml of emperid twice a day (this was for our 1040 grams piggy but we also received the same guidance for our 1400 gram piggy) so it may be worth raising the dose? I found that any lower of a dose could never entirely clear the bloat, it would kind of linger. However once I upped the emperid to 1ml twice a day, after a couple of days I would notice a resolution.
I would also strongly advise the use of a probiotic if you aren’t already. When it comes to bloat, I’ve found it to be a massive help however the only probiotic I’ve ever had success with is fibreplex. The ones I’ve been given at previous vets never worked whereas fibreplex made a massive difference when I was dealing with a frequently bloated senior pig. It also helped his poops out massively.

 

[Deleted member 151640]

I hope he recovers soon bloat can be quite hard to shift. Simon, our best and most recommend Guinea pig vet here in England, used prescribe us up to 1ml of emperid twice a day (this was for our 1040 grams piggy but we also received the same guidance for our 1400 gram piggy) so it may be worth raising the dose? I found that any lower of a dose could never entirely clear the bloat, it would kind of linger. However once I upped the emperid to 1ml twice a day, after a couple of days I would notice a resolution.
I would also strongly advise the use of a probiotic if you aren’t already. When it comes to bloat, I’ve found it to be a massive help however the only probiotic I’ve ever had success with is fibreplex. The ones I’ve been given at previous vets never worked whereas fibreplex made a massive difference when I was dealing with a frequently bloated senior pig. It also helped his poops out massively.

That’s helpful, thanks.
Is fibreplex a vet prescribed thing? If not where would i get this and should i consult my vet beforehand.
Also my boy is eating critical care, 30-40mls a day now after being weaned the past few days which I was also told contained probiotics alongside all the nutrients a non eating guinea pig would need.

About the emeprid, i assume i would have to ask my vets advice before changing anything? Also my vet told us that emeprid was a probiotic.
Either way he will be booked into the vets at the start of this coming week.

Thanks!

 

[Wiebke]

That’s helpful, thanks.
Is fibreplex a vet prescribed thing? If not where would i get this and should i consult my vet beforehand.
Also my boy is eating critical care, 30-40mls a day now after being weaned the past few days which I was also told contained probiotics alongside all the nutrients a non eating guinea pig would need.

About the emeprid, i assume i would have to ask my vets advice before changing anything? Also my vet told us that emeprid was a probiotic.
Either way he will be booked into the vets at the start of this coming week.

Thanks!

Fibreplex you can easily find and order online from places like amazon and vet supplies websites. It is not classed as a prescription-only medication (POM). Emeprid is a POM but guinea pigs tolerate more than other species.

 

[Free Ranger]

I have tried in the bowl as hes now wanting to eat the critical care but he wants it straight into his mouth apparently, he even lets me know when hes ready by putting his mouth on the syringe.

I've got one of those! George thinks this 'new' way of eating started about the same time as he started feeling better so it must be good food
He might actually get bored of the syringing eventually and want to eat different things on his own.

 

[Deleted member 151640]

Poop picture one week post medication start.
This is what he is producing every second day (the other day he does no poops and shows signs of discomfort and not wanting to do much but still eats and moves around. I mean like not lethargy but staying in one place more often)

I really am just stressed, this isn’t my only sick animal i have a 10 year old dog on half a ton of steroids and she keeps throwing up, unrelated but it’s all a lot right now.

I really just want him to start feeling better, he’s still eating hay and his veg and drinking from what i can see. Today he’s had 30ml of critical care (with struggle as after around 5ml he’s either bored or full) and all his medication as prescribed. His belly is down a bit but the cage is filled with these tiny orange ish poops.

I’ve added an additional photo of him about a year ago, a look at our patient. They generally live in a hutch in my garage, they used to be on sawdust but can’t be as my other boy is prone to URIs and changing to bath mats was the best option. I am aware of the risks with dampness but it’s been a while and during winter particularly i am on top of it. For these past almost 5 months now they’ve been inside as it started as a -9 week in november and now it’s march and it’s snowing so they aren’t going out for atleast a little while.
Hoping to get a vet appointment monday where i will ask about fiberplex, i understand i could go ahead and buy it but he’s already on three different medications i would like to speak to the vet first.
Hoping tomorrow his weights up again.

P.S I have reason to believe the healthy looking black one is his cage mates, but i technically cant say for certain

 

[Little Ones]

That’s helpful, thanks.
Is fibreplex a vet prescribed thing? If not where would i get this and should i consult my vet beforehand.
Also my boy is eating critical care, 30-40mls a day now after being weaned the past few days which I was also told contained probiotics alongside all the nutrients a non eating guinea pig would need.

About the emeprid, i assume i would have to ask my vets advice before changing anything? Also my vet told us that emeprid was a probiotic.
Either way he will be booked into the vets at the start of this coming week.

Thanks!

You can buy fibreplex online, I usually get it from animeddirect and choose the fastest shipping option. Emperid isn’t a probiotic, it’s a gut stimulant, so it keep things moving. Cisapride is also a gut stimulant.
You could ask your vet before upping the dose of emperid if you feel more comfortable to, if you decide not to then just don’t exceed the 1ml twice daily dose. If they aren’t Guinea pig experts then their information may fall flat in some areas however.
If piggy is passing a very small number of poops, of which aren’t ‘normal’, upping that dose and getting fibreplex would be my personal call to action

 

[Deleted member 151640]

Hi all, happy Sunday.
My boy has been doing okay this morning, he weighed in at 1105g again today meaning hes still down 30g, hes had his medication and 10ml of critical care. He is still losing interest after the first 5ml but I'm making him take it as hes still not stable.

I've ordered fibreplex online and should be here Tuesday, hopefully Monday if amazon comes early to me like it normally does.
Instead of getting a real life consultation I am planning on getting a phone consultation to update my vet on his progress and let them know that I plan to feed him fibreplex. They may recommend I come in and if so I will book but if they are happy to allow me to continue with how we are going along with the fibreplex I will continue as, then if I am not seeing improvements in around another couple days I will book an in-vet appointment.

I am still not sure about upping the medication without consulting the vet first so will continue with the .75ml until I can hopefully get a phone call tomorrow. (The vet is closed Sunday)

I have attached an image of my boys poops this morning, a lot more normal. Fingers crossed he continues on this way and doesn't get backed up again.

 

[Free Ranger]

He's an older boy - I'm assuming he doesn't get impaction...? That can lead to erratic pooping. Those are some fine looking poops!

The Fibreplex instructions involve feeding directly from the syringe a few ml a day. I normally make up the day's CC and mix in a ml of so. It's yeasts, so it grows in there anyway... you'll see if you ever leave the leftovers out overnight on the sideboard that it's gone a bit bubbly (and probably tastes yeasty by that point!) Mine won't have it straight from the syringe but anything mixed into papaya CC seems quite acceptable.

 

[Deleted member 151640]

He's an older boy - I'm assuming he doesn't get impaction...? That can lead to erratic pooping. Those are some fine looking poops!

The Fibreplex instructions involve feeding directly from the syringe a few ml a day. I normally make up the day's CC and mix in a ml of so. It's yeasts, so it grows in there anyway... you'll see if you ever leave the leftovers out overnight on the sideboard that it's gone a bit bubbly (and probably tastes yeasty by that point!) Mine won't have it straight from the syringe but anything mixed into papaya CC seems quite acceptable.

Sorry i’ve just seen this now, no he doesn’t that i know of aside from some issues when he first went to the vet for stasis. (In terms of impaction)
The fibre plex should hopefully be coming some time today.
Of course as i order it he gets a lot better on his own, haha.

I’m still going to give it a try as long as i’m still support feeding him until he stabilises, good tip about the mixing it in, thanks!