Managing adequate pain relief for 7 year old sow with arthritis?

[Dilly's Piggies]

My girl Delilah turned 7 in November and suffers with confirmed heart disease (enlarged heart) and arthritis. She's currently on 1/4 tablet Cardisure, 0.5ml Frusol (diuretic) and 0.2ml cat strength metacam twice per day. It was initially once per day, I actually had to push my vet to let me give it twice as they were unwilling due to apparent liver side effects, they're very stingy with metacam even though I see people on this forum giving their pigs like 0.6ml twice regularly of even dog strength.

The problem is that was fine for a while, but now she seems to really be struggling, she's laid out stretched/pancaked most of the time and is even getting bald patches of hair on her belly and legs, pressure points rubbing the hair off from laying that way so much. She doesn't walk normally either, very stiff. Sometimes, not all the time her rear legs are weak and bend to the side and sometimes she can even stumble/flop over. She is also starting to sit in a hunched rabbit like posture a lot with her back feet so far under that they almost touch her fronts with them splayed out to the side.

Another issue is her breathing, she used to start breathing harder like this whenever she had too much fluid in her chest, but she is already on the diuretic permanently to prevent this and was doing really well, her follow up scans after starting heart medication showed huge improvement so it does work for her. I'm wondering if this heavy breathing now is arthritic pain related since she seems in a lot of pain with her legs right now. She is eating fine, sometimes she doesn't finish all her veggies though when she's having a bad day, but has never turned down a vitamin C biscuit no matter how bad it is. She takes her medication in the cage willingly. Of course she isn't very mobile and prefers to sit in one spot, but I still see her out at the hay, water and pellets often, she pokes her head out of the hidey whenever I go in, expecting a treat.

I have experienced arthritic piggies before, one was really bad to the point she became paralysed and couldn't stand for days, of course we tried absolutely everything to help her, even laser treatment which actually got her back on her feet most of the time. We tried Vetergesic (opiate) for her too but it made her super sedated to the point where she wouldn't even eat, ended up with liver failure and had to be PTS, she was on an entire cocktail of meds too including this same dose of metacam and my vet thinks that's what caused her liver issue. This seriously broke my heart and she was my special pig, I tried absolutely everything but still lost.

I see many owners giving arthritic piggies stronger opiate meds like this with good results, I want to trial it with Delilah, even a low dose to see but I worry it'll do the same to her. Metacam just doesn't seem strong enough, but I don't want her to be zonked out either, can anyone help with suggestions of what we could try here? She already has a heat pad as I know that can help in these cold winter months but she hates it and makes a point of sleeping OUTSIDE the hidey lol. I just feel so, so bad for her, I don't know what to try or whether higher metacam will even do anything if I did persuade my vet. I have no idea what level of pain relief or treatment is adequate here. Any help is much appreciated. To be clear she can still walk and move, albeit stiffly.

Just a quick example of Delilah eating her prized vitamin C biscuit while sitting weirdly.

 

[PigglePuggle]

Elderly arthritic piggies are a struggle, I lost one age 6 a few months ago who had a lot of pain, and now I have another who is almost 7 and luckily doesnt have much pain yet but has some partial paralysis in her hips and back legs sometimes.
Given that age 7 is very senior, anything we do at this point is essentially buying extra happy days, and I would really try to persuade the vet to up the metacam- research studies show 1ml of cat metacam daily is safe for piggies over a 3 month study, and many vets prescribe more than this by giving dog metacam which is 3x stronger. Realistically 3 months is a lot of extra life which might otherwise be spent in pain. I see the vet may be cautious when piggy also has other health issues and takes other medicines, some vets are not always great with end-of-life palliative pain relief in small furries because they have little experience of it.
Gabapentin, and buprenorphine, are both well tolerated by piggies and commonly prescribed for severe arthritis.
My old girl Clover never liked the buprenorphine zonked feeling- but sometimes, a good nights rest after a dose of buprenorphine made her much perkier for the next few days afterwards, and bought her some extra time.
Sending hugs- sadly there are no right or wrong answers here, geriatric veterinary care for most animals is still not very widely researched or taught, and nowadays with good care piggies are living well past there natural lifespan, double or triple what they evolved for or what was normal for pets 20 or 30 years ago, and so vets and piggy parents are still finding their way to what is best practice.
Gabapentin and buprenorphine are well worth discussing with the vet and trying though, even if only for bad days x

 

[YvonneBlue]

I have three older piggies with arthritis (aged 6.5 years and 5.5 years). All three are currently on 0.6ml of dog Metacam twice daily and one is also on Gabapentin. We also give 0.4ml of 4Joints once a day, this was recommend by Debbie from The Excellent Adventure Sanctuary (TEAS) a rescue that cares for guinea pigs with serious health problems.

Before taking these meds Ginger Pig was dragging his back legs as though they were paralysed and he is now walking normally again. Peggy was chewing off her fur because of the pain and is now much more mobile and no longer barbering herself. Mavis has been on Metacam for at least 3 years (she had other health issues before the arthritis) and there have been no noticeable side effects. I would definitely speak to your vet about a higher dose of Metacam and possibly Gabapentin too, at this age quality of life is far more important then length of life.

One thing our vet did advise was that we encourage the older piggies to move around as this helps with mobility. So we make a point of moving hay piles around and scatter feeding veggies and nuggets so that they have to walk around little.

 

[Qualcast&Flymo]

My sow Winifred is 6+ too, and is in a similar situation. In the spring she was diagnosed with arthritis after she started losing weight. She was put on 0.2ml dog metacam twice daily by my local vet. After about 3 months I noticed that she was losing hair on the inside of her back legs, and also the fur on her bum was matted and dirty, so we went back. The vet agreed that she needed something else in addition, we tried buprenorphine but it didn't seem to help, so she is now on 0.58ml Tralieve (tramadol) suspension twice a day. The vet says she is moving better since adding the tramadol, she is also cleaning herself better at the back end.

To try to build her up a bit I give my 2 a tablespoon or two a day of critical care in which I mix a cystease capsule for the glucosamine. I also have Joint Support biscuits for them, but W seems to have gone off them. I'm thinking of trying 4joints or one of the other supplements that have been mentioned elsewhere too.

I hope you can get some more medicine that will help your girl be more comfortable x

 

[Dilly's Piggies]

Thank you so much everyone, I forgot to mention she also get the oxbow joint support supplement for the glucosamine but I doubt it does much, she loves them so I guess even if it doesn't help it's at least it's a nice treat.

My past piggie Lottie with the horrible arthritis was on gabapentin too and a liver supplement called Nutramed which was multi action and also covered joints too. We also did aquatherapy and physiotherapy. I'm not sure if it helped but at this point I think it is worth trying for Delilah. With Lottie we had no idea she even had arthritis, she had only just turned 5, never showed symptoms but suddenly became paralysed overnight, it was only after investigation and xrays that we found arthritis was the cause. That situation was just heart breaking so I'm a bit anxious with Delilah now too, I don't want her to go through it, but she has never lost the use of her legs, she can just stumble sometimes when she hasn't moved for a while.

I have heard good things about 4joints too, I'm going to make an appointment and discuss all of this with my vet as we are at the point where she needs more support. She has done fantastic to get to such a big age and I don't want the time she has left here to be spent in pain. Hopefully me and the vet can come to an agreement with the metacam, she definitely needs a higher dose, and perhaps trial vetergesic for very bad days. Will start laser treatment too as honestly thats what worked the most for Lottie, she'd go in paralysed and come out standing it was that good, its just heartbreaking that her liver had problems or she'd still be here I think.

Thanks everyone, I hope your piggies do well too❤

 

[Josie_lg]

My girl is on gabapentin for her bladder issues! And my vet said she has been treating a piggie with spinal disease with gabapentin. We tried buprenorphine for my girl but it made her quite unwell and very “high”.
I hope the vets can give her something else to help manage her pain. Big hugs xx