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Is anybody awake? I think piggy had too much buprenorphine!

LunaticPoodle

LunaticPoodle

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Hi, I was at the emergency room today with Geezer, he had a bad flare up of his UT problems and his penis looked very swollen so I took him there.
Had a bunch of tests, then they gave him 3 injections (Borgal 0.10, cat Metacam 0.3, and Buprenorphine 0.4 ml). He screamed bloody murder. We came home around 22.30, now it's 2.54 am and I spent the last 2 hours trying to feed him vegs and recovery food. He's catathonic, stares into the void, has barely any strength to chew. Put him back into his cage and he was quiet for a moment, then started to run for his life even bumping into the coroplast and trying to jump out of the cage!
I am scared to death that they gave him too much, I read that the dose should be 0.01 to 0.05 ml (might be wrong tho, can't remember) and according to the papers I got he had 0.4!
I'd take him to the emergency room but... You see my dilemma here.
Any ideas?
 
Oh my goodness! I can't speak about that drug (I did look it up), maybe he is pretty high? But it sounds like it normally knocks them out. I could only find these two threads that talk about it.

Emergency - Opioids in piggies
Vetergesic

I would contact the vet and see what they say. Is there any way you can call them?
 
He is definitely high out of his mind. I am super uncomfortable with this, he went from being near unresponsive in my lap to panicked running around the cage (scared the living heck out of the others too) and he still hasn't eaten any hay by himself. It's like he suddenly doesn't recognize us, his cagemate, and where he is!
I could call them, but they're the ones who gave him the thing and there's no exotic vet available afterhours anyway, otherwise I'd have taken him there...
This is the only ER in the region unfortunately, and they were swamped with several poorly dogs already when I left.
Thank you, I'll read those and then hand feed him some more around 4am. If he doesn't improve, I'll take a deep breath and call them (I'll try not to yell...;)
 
Good luck! Hopefully your piggy will calm down and feel better soon. I'm sure in the morning someone else will be able to give better advice.
 
Update: so far I've got some food and water into him- about 10ml of water plus some he drank from the bottle, recovery food as much as he would take, I'd say around 15 ml but very diluted, otherwise he'd spit it out as he can't seem to be able to control his chewing too well.
I gave up and gave him a dose of activated charcoal, and after that he started to at least chew and seems a bit more present after eating a bit. He also had a little bell pepper, but he's still not eating hay and staring into the void.
 
0.4mls buprenorphine dors sound quite a high dose, 0.1mls is more usual- but it also depends on weight, is he a big pig?
Opioids will make any animal woozy and zonked, that in itself is no cause for alarm. A directly fatal overdose would be fatal within minutes/half an hour at most- so if he was ok 3 hours later, its very likely he is fine. Let him sleep it off, just keep checking he is breathing.
You could query the dosage with the vet if you are very concerned- but if he was in a lot of pain, maybe he needed that much?
 
I am at a cross roads as I am a MD and a PhD and yet I can't talk about dosages on this.

Talk to your vet is the only thing I'm allowed to say, sadly. I think I'm allowed to post studies, so here goes:

Clinical Management of Pain in Rodents
 
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Thank you all. He's a bit chonky, usually he's over 1.3 kg, but he's been steadily losing weight and lost over 50g in the last 2 days, and as of yesterday he was 1.215, two nights ago he was crying and screaming louder than he ever has, and his pee has been mostly blood for 2 days. A home test revealed extremely high proteins in his pee. Doubling his glucosamine helped, but he was still miserable. So I just took him to the ER.

I have read that study and some others and nowhere I have found such a high dose for a piggy. I only noticed the amount when I came home. At first he was just funny and sleepy, but then it became terrifying.

He is a little more reactive but has no full control of his body yet. Has enough fight to refuse the syringe at least. He's in my lap wrapped in a blanket right now.
 
I hope he's ok once the drugs wear off. Such a worry though.
 
I went to pile up firewood and when I came back I found he's moved out of the blanket pile and now he came out for veggies and he's eating by himself. I managed to get a few strands of hay in him earlier, but he had trouble remembering how to chew. I'll keep hand feeding him until I'm sure he's back to normal. Might have to *cough cough* call in sick to work but there's no way in hell I'm leaving for 10 hours when he's in this state.
I'm so tempted to say a few choice words to the vet who treated him yesterday, but I do need that place for quick prescriptions at least, and it's the only ER. 🤬
 
A friend of mine found herself in your situation once, she continued to give food and water via syringe, it took about 12 hours for him to stop acting "drugged" unfortunately this can happen with bupe, and that definitely seems a high dose, when my Leonard was on it he only got 0.1ml twice a day, 0.4 in one go is huge. It may have been necessary at the time based on their opinion of his pain though, but they should have absolutely warned you this may happen and possibly kept him in if you didn't feel able to cope with him being so spaced out, like they do post op, they don't just immediately send them home.

I was once in a similar situation about 12 years ago, one of mine went in for a dental and she didn't come around from the aneasthetic properly, when they closed at 6 they were just like "you'll have to take her home, we can't keep her any longer" and that was that, teenage me with no Internet had to figure out how to get poor Honey awake and eating. I did the wrong things but achieved the desired result and it was absolutely no fun.
One of the reasons I like my current vet so much, he takes the time to fully explain things.

Fingers crossed your little man is back to his old self soon!
 
One of my sows had an unexplained pain incident this summer. Our exotics vets weren’t available so she saw a general vet who took her out the back for examination. When she was brought back to me (in her carrier) she was completely “stoned” looking. I had no idea until I read her receipt that she had also been given Buprenorphine injection. She was like a zombie and very unresponsive. I found syringe feeding her was painfully slow as she would seem to be able to swallow only a tiny amount and then would space out again. She was still rather subdued the following afternoon but within 36 hours of the injection she had fully recovered from the injection.
 
Can I just reiterate though, buprenorphine is a safe and appropriate medicine for pain relief in guinea pigs, and is widely used for severe pain and post surgery by most small animal vets. It can cause the piggy to be dazed and sleepy- how much so, and for how long, varies with each individual.
The dose may be a higher than expected here, and certainly the vet could have mentioned side effects, but the vet hasnt really done anything incorrect- they have given strong and aporopriate pain relief, on label, to an animal in pain. Certainly discuss this with them, but I dont think there is anything to get angry with them about...
 
I'm so sorry you all had to go through this too, especially at a time with no internet, that is terrifying.
In all fairness I was the one proposing extra pain relief, I just did not expect the massive dose they ended up giving him. He was in extreme pain 3 nights ago, yesterday he didn't cry as loudly while going potty, but he has been crying on and off since late january. Whatever we do, tiny stones reform after less than 2 weeks. He was stone and sludge-free from his x-ray on the 5th, and by the 12th I found the first bloodstain in the cage again. By the 20th I had to start pain relief again. So yes, with a cooler head, I know they did nothing wrong, I'm just scared.
 
LunaticPoodle said:
I'm so sorry you all had to go through this too, especially at a time with no internet, that is terrifying.
In all fairness I was the one proposing extra pain relief, I just did not expect the massive dose they ended up giving him. He was in extreme pain 3 nights ago, yesterday he didn't cry as loudly while going potty, but he has been crying on and off since late january. Whatever we do, tiny stones reform after less than 2 weeks. He was stone and sludge-free from his x-ray on the 5th, and by the 12th I found the first bloodstain in the cage again. By the 20th I had to start pain relief again. So yes, with a cooler head, I know they did nothing wrong, I'm just scared.
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Of course, we all panic when our piggies are in pain, then panic again if they are not alert and eating! I remember when little Puggle was young and had acute bloat and was screaming in pain and the vet instantly gave her a big buprenorphine inject as an emergency when we first arrived, as she was in too much pain to be examined and the vet worried she might actually die of shock from the pain- she was pretty well out of it for 24 hours, but the big shot of pain relief gave her a bit of time out from suffering while the other medicines started working.
Hope your boy starts perking up soon x
 
Sick piggies do cause us stress.
If we love them, as you clearly do, then a panic reaction is normal.
Powerful painkillers can cause an ‘out of touch with the world reaction’ - in humans as well as piggies.

That’s why this forum is so good.
It’s members are understanding and supportive of each other.

Hope your boy recovers well now.
 
Yes, and that's why if in doubt I always check here first, these are my first pigs and my first pets ever even though I am a grown adult. I am still learning as I go, and have received always excellent advice from all of you.
There have been times today we thought he had crossed the rainbow bridge... He wasn't eating on his own, just had a few bites of veggies in the morning. I kept rotating critical care (different brand but same thing), probiotics, electrolytes, and hand feeding him hay. Slowly getting some food into him, but the problem is, he was very unresponsive, would stop chewing unless prompted, and wasn't pooping at all. His belly was becoming hard and bloated, he'd become incontinent, and a few times I had to lubricate his eyes cos he wasn't even blinking. He hasn't washed himself at all either.

So I called the ER, they were swamped as usual and no exotic vet, but they agreed the situation was bad and they'd put it down as an emergency. Went there, after 2 hours they hadn't even done triage. I was still giving him electrolytes and hay, and slowly he started to perk up and pick up the hay and chew by himself, so I decided that, excuse my French, screw this and I'll take him home.
Kept up the rotation, he's eating more hay by himself, gave him gas drops and massaged his belly while husband and I watched a movie.
WE HAVE POOPS! Ugly, smelly poops but at least some poops. And he started eating some, so I think things are starting to move to the right direction...
Thank you for the moral support everyone, really. I am covered in dried critical care, pee and poop, but I feel hopeful :)
 
Well done you.
Honestly I feel your despair, but no one could have done more.
I am so pleased things seem to be slowly heading in the right direction for you and your boy.
 
Thank you 🥲 Trying my best. I have been told (not here, I mean in person) to consider pts. Hell naw. He was a normal pig yesterday, with bladder problems, sure, but otherwise playful and doing usual pig things. I don't think it's his time yet!
 
LunaticPoodle said:
Thank you 🥲 Trying my best. I have been told (not here, I mean in person) to consider pts. Hell naw. He was a normal pig yesterday, with bladder problems, sure, but otherwise playful and doing usual pig things. I don't think it's his time yet!
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Remember that you always know your own piggy best.
When Ruby was struggling with bladder issues at age 2 even the vet asked if I was sure I wanted to continue with treatment.
I knew deep down that she wasn't quite ready to let go, so we persisted and she lived another happy 4 years.

I think when you have a close bond with an animal that you love you will be guided to the right decision.
 
Swissgreys said:
Well done you.
Honestly I feel your despair, but no one could have done more.
I am so pleased things seem to be slowly heading in the right direction for you and your boy.
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:agr: You sound like a wonderful, caring and dedicated piggy slave.

Your boy is clearly in the best possible hands with you.
 
Thank you so much. There's so much I still don't know, or rather, I haven't experienced so I'm not trained to recognize the signs, that's why I often come here to check if I'm doing the right things or heading towards a major -up :)
Geezer is still sleeping a lot but he had some morning veggies, some hay (still only if offered/laid in front of his face), and some misshapen poops that he ate. He's starting to show glimpses of his usual grumpy self by shooing my hand and refusing the syringe, and I'm glad. He was so cuddly these last few days and that's soooo unlike him! Although I can't deny I have been enjoying him taking naps on me, he does that so rarely! 😂 He also seems to be regaining control of his bladder... That worried me.
He's overdue his Malaseb bath, but I really didn't want to stress him more, and I didn't start the antibiotics yet, I figure if his GI is still in shambles it cannot be good to kill that little gut flora he is trying to regain, right?
 
Just came back from a proper exotic vet. Geezer started to eat hay by himself and poop more, so basically she said he was out of danger. She gave me motility meds to keep at home just in case, but he doesn't need it right now anymore. He's now on the carpet eating hay. Belly isn't hard anymore, he perked up a lot, and he's playing with a cardboard tunnel... We are so relieved.

In the morning I called an exotic clinic in Helsinki and asked them for an opinion. Both them and this vet confirmed the dose of bupre he got was about 10 times the reccomended amount. It's a miracle he's alive. But he recovered and that's what matters. 🥳
 
I'm sorry to hear your dilema,you did all you could.I'm glad your piggie is recovering.Maybe you could have a talk with the practise manager if you feel it will h elp.:hug:
 
eileen said:
I'm sorry to hear your dilema,you did all you could.I'm glad your piggie is recovering.Maybe you could have a talk with the practise manager if you feel it will h elp.:hug:
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I think they should be informed about what happened, but the fact is, for being an ER, they only ever have one doctor on call and maybe 2 nurses. They are always full of patients and I acknowledge it must be hard for them to stay on top of everything, and errors can happen. Nevertheless, if the same had happened in a people hospital, which is just as understaffed at times, I feel it would have been taken more seriously.
 
LunaticPoodle said:
Just came back from a proper exotic vet. Geezer started to eat hay by himself and poop more, so basically she said he was out of danger. She gave me motility meds to keep at home just in case, but he doesn't need it right now anymore. He's now on the carpet eating hay. Belly isn't hard anymore, he perked up a lot, and he's playing with a cardboard tunnel... We are so relieved.

In the morning I called an exotic clinic in Helsinki and asked them for an opinion. Both them and this vet confirmed the dose of bupre he got was about 10 times the reccomended amount. It's a miracle he's alive. But he recovered and that's what matters. 🥳
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That is clearly one very tough (and lucky) piggy!
 
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