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Specialist Nystatin - dose, organs, weight loss

Little Ones

Little Ones

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Hi all.
I do sort of have a thread related to this issue which I have linked so if it’s necessary for them to be merged then I understand. My main reason for starting a new thread is to get a direct answer for my concerns rather than members sifting through an investigative story, if that makes sense.
Little has been having some issues at the minute, he’s had bad poos for a while so we got a stool sample done (to sum up the thread I linked above). The results came back positive for saccharomyces guttulus. He was also on bio lapis probiotic a week prior to having the stool sample, if that is relevant.
After being diagnosed with this, Little ran into another health issue where he stopped eating and drinking due to holding his pee in. Simon managed to sort this out, however.
Due to this (and a delay in the order of medication for the yeast), we are only just getting round to giving the yeast medication.
Since receiving the yeast overgrowth diagnosis, Little’s poos have suddenly been the best they’ve been for a long time so I was on the fence about giving the medication.
Anyway, what has been prescribed is the Nystan nystatin:
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The dose is 1.2ml twice a day.
My other concern is that out of nowhere, Little is now losing 40 grams per day. He is 6 and a half. At the time the medication was calculated, he weighed about 150 grams more than he does now and now falls at 970 grams. Is the dose still correct given his weight?
My other concern is that the weight loss could be attributed to an organ issue given his age. I’m not sure if the yeast overgrowth could be causing this significant and sudden drop in weight? I have read that nystatin is quite harsh on the liver and kidneys which makes me cautious to use it in case we are also looking at an organ problem. Is this right?
Does the yeast even need to be treated? I’ve read that it can overall be unharmful but I’m not sure if that’s correct?
My other thought was to get in contact with Simon, he saw Little about a week and a half ago and also saw his notes related to the yeast overgrowth. I know Simon is happy to prescribe itrafungal to people which my vet is not, would this be better than the nystatin? And is it worth asking if Simon can give a prescription of this to a vet locally to us?
We are looking for places around us that offer a blood test via cutting a nail too short to see if there is an organ issue too as this is Little’s third problem (the weight loss) in only a few weeks. Tomorrow we are expecting phone calls back regarding this.
Anyway, my main concerns right now are about the nystatin and whether I should give it. Any advice is appreciated as I’m feeling a bit stuck, along with being worried about Little non stop at the minute.
Thanks in advance.
 
furryfriends (TEAS) said:
I’ve heard of it being used for guinea pigs but have no experience of dosage etc. We’ve always used Itrafungol.
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The lack of information I can find about it is really off putting, I don’t want to do the wrong thing. Not when he’s already in a fragile state at the moment too. I think we will try to get a phone appointment with Simon tomorrow to see if he can clear things up for us. I have only ever seen people using itrafungol so have nothing to go off.

All it says on guinea lynx is this:
Oral Dosage: no dose is listed for guinea pigs in Carpenter's Formulary. However, dosages for other species are listed. Depending on species, dosage varies from 22,000 Units/kg/day to 500,000 IU/kg twice daily. For example, the cat dosage is 100,000Units POq6h.

I probably would’ve given the medication had 1.2ml not been the prescribed amount. It just seems like a lot to me. The nystatin holds 100,000 units per ml. Whether any of that actually equates to a lot is completely beyond me.
 
I remember being given Nystatin for oral thrush when I was on a high dosage of steroids, I have thrown the remains out now it was 6 years ago, but it is given to humans. Sorry can’t be more helpful. Thinking if you and Little, I would see if you can get a script from Simon
 
Bill & Ted said:
I remember being given Nystatin for oral thrush when I was on a high dosage of steroids, I have thrown the remains out now it was 6 years ago, but it is given to humans. Sorry can’t be more helpful. Thinking if you and Little, I would see if you can get a script from Simon
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Just called c&r actually and they said Simon will ring us between 6 and 7pm if he has the time. The weight loss is really worrying me, no idea if it could be related to the yeast overgrowth or if it could be an organ starting to go. Little’s poos have been fine though which leads me to believe the yeast isn’t causing an issue but what do I know. The weight loss seems extreme to me at 40 grams a day, it’s really sad but we’re preparing for him not to be here much longer
 
Hope Simon can get back to you today. Sorry no experience of using it either, hope you can get some answers and get him started on some meds to help. Big hugs to you and Little xx
 
Claire W said:
I’m afraid I have no advise but I hope Little recovers soon x
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alpacasqueak said:
Hope Simon can get back to you today. Sorry no experience of using it either, hope you can get some answers and get him started on some meds to help. Big hugs to you and Little xx
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Thank you both, it’s been one thing after another with him at the minute. I know that with his age, he could be reaching the end but I’m just so worried about him passing and being left with guilt. So if I give him the meds & he passes I’ll blame myself for giving them and causing damage, and if I don’t give the meds & he passes I’ll blame myself because the meds might’ve saved him. I’m hoping Simon is able to give us some clarity and stop me from thinking the worst. Fingers crossed.
 
Little Ones said:
Thank you both, it’s been one thing after another with him at the minute. I know that with his age, he could be reaching the end but I’m just so worried about him passing and being left with guilt. So if I give him the meds & he passes I’ll blame myself for giving them and causing damage, and if I don’t give the meds & he passes I’ll blame myself because the meds might’ve saved him. I’m hoping Simon is able to give us some clarity and stop me from thinking the worst. Fingers crossed.
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Please don’t feel guilty either way, nobody could have done more for Little than you. Hopefully you will get him sorted, the weight loss is a worry though, I‘m so sorry I can’t offer any more help X
 
I'm a bit confused by this because saccharomyces is not a pathogenic fungus at all, saccharomyces is actually the beneficial yeast found in probiotics?
I cannot find any reference to a saccharomyces species called guttulus at all... not anywhere on the internet in fact... but saccharomyces is not usually a pathogen, it lives in the gut and does good things and is a main component of puggy probiotics! And beer and bread of course...
 
There is some literature suggesting 4mg per kg bodyweight of nystatin is ok for rabbits, but of course as usual no info for piggies- I believe it is mostly used as a treatment for aspergillus fungal infection in the lungs, quite a serious infection that can be picked up from mouldy hay and usually only affects immunocompromised individuals... or it could be a treatment for oral thrush, this is how it is used in humans, but the volume to give seems a bit much for that...
 
PigglePuggle said:
I'm a bit confused by this because saccharomyces is not a pathogenic fungus at all, saccharomyces is actually the beneficial yeast found in probiotics?
I cannot find any reference to a saccharomyces species called guttulus at all... not anywhere on the internet in fact... but saccharomyces is not usually a pathogen, it lives in the gut and does good things and is a main component of puggy probiotics! And beer and bread of course...
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Thank you for your response.
That was my thinking too. I know bio lapis has saccharomyces cerevisiae and because of that I did wonder if what was found wasn’t pathogenic. But then I’ve never dealt with this before so wasn’t sure if cerevisiae was different to guttulatus (think I may have spelled it wrong in my post above, apologies).
The only thing I could find related to it was this. But still the name is different to what the receptionist read out to me so I’m not 100% I’m even looking at the right thing but it’s all that came up.
Hopefully Simon is able to shed light on what is going on if he has time to call us today and whether treatment would be necessary. The stool sample was arranged because of Little having constant cow pad poos but, as I mentioned above, they’re the best they’ve been in a long time the past week or two so I don’t want to mess where it isn’t needed.
 
Little Ones said:
Thank you for your response.
That was my thinking too. I know bio lapis has saccharomyces cerevisiae and because of that I did wonder if what was found wasn’t pathogenic. But then I’ve never dealt with this before so wasn’t sure if cerevisiae was different to guttulatus (think I may have spelled it wrong in my post above, apologies).
The only thing I could find related to it was this. But still the name is different to what the receptionist read out to me so I’m not 100% I’m even looking at the right thing but it’s all that came up.
Hopefully Simon is able to shed light on what is going on if he has time to call us today and whether treatment would be necessary. The stool sample was arranged because of Little having constant cow pad poos but, as I mentioned above, they’re the best they’ve been in a long time the past week or two so I don’t want to mess where it isn’t needed.
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I still think that paper is referring to beneficial gut microbes, and I think nystatin is most likely for oral thrush in a piggy with weight loss- the mouth would be sore... certainly Simon knows his stuff, I'm sure anything he prescribes will be spot on correct! But it might be you need a probiotic with the nystatin as you would with antibiotics, to replenish the good yeasts in the gut and prevent the diarrhoea coming back X
 
PigglePuggle said:
I still think that paper is referring to beneficial gut microbes, and I think nystatin is most likely for oral thrush in a piggy with weight loss- the mouth would be sore... certainly Simon knows his stuff, I'm sure anything he prescribes will be spot on correct! But it might be you need a probiotic with the nystatin as you would with antibiotics, to replenish the good yeasts in the gut and prevent the diarrhoea coming back X
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I really hope it ends up being good bacteria, or nothing harmful anyway. I think I’m doing the right thing by talking to Simon about it. I’m not comfortable giving the medication without doing so the more I’ve thought about it. Especially if there’s a chance it may not need treating at all. I wish I could trust the vets local to me, but it’s hard to tell if they fully know what they’re doing or if there’s some guess work going on at times.
Simon also gave him a good check over almost 2 weeks ago when he saw him for another issue and also burred his teeth (we had just received the diagnosis of yeast overgrowth a few days before then by our local vet).
I will definitely make sure to give a probiotic if we’re advised to give any sort of medication too.
 
After closely watching Little yesterday and today, we’ve noticed he’s being very selective on what hay he wants to eat. Seems to mess with it rather than eating it too. We added pellets and oats to his cage Wednesday night along with giving top up syringed pellets. Since then he’s got some weight back on him, about 60 grams. He’s definitely being selective though with his hay. He wants to eat it and sits in it but then after a few minutes goes over to the pellets/oats. This could be why he’s losing weight, which I suppose gives a more positive outlook as the only thing I thought it could be was organ related. But now it seems like he just isn’t eating his hay right. When Simon saw him on the 1st he checked his mouth then as Little wasn’t eating or drinking but the cause wasn’t mouth related but because he was holding his pee in. But anyway, Simon thought his mouth was fine, couldn’t feel or see anything amiss. Little is definitely being selective though.
Little has his top incisors burred every three weeks due to not having an bottom incisors, we are able to have this done at the local vet. Sometimes they’re cut angled/with grooves but most of the time they’re cut straight across. Simon burred his incisors when he saw him but cut them very nicely as he does, with grooves. Is it possible that Little is used to picking hay up with straightly cut incisors and is finding it difficult now that they’re shaped? He’s very skilled at yanking hay about with only his top incisors, would it be possible that he’s just finding it more difficult now they’re a different shape? He is still eating some hay, some thin bits and some thick bits so there’s no preference. Maybe it’s just more effort for him? Once he gets a piece he does yank it about but I’m just wondering if he’s struggling to actually pick pieces up? I’ve no idea if this could be the cause though, just a passing thought I had.
 
Update:
So we’ve spoke to Simon.
He’s never used nystatin so doesn’t know what dose etc to give. He looked through his medicine book and found no information on it.
He thinks Little’s issue could be bladder related so a stone for example. To which if that’s the case I feel awful about, Little only ever had a few pellets syringed a week or two from February until November. When we adopted BB, we told the rescue Little was unable to eat pellets due to his teeth (but also Little’s previous cage mate had IC so we didn’t use pellets) - which was what I believed. The rescue gave him pellets and said he managed. From then on (since Nov 7), we gave Little pellets daily along with his oats. Then when we adopted Digby, his owner brought with him the Science Selective pellets. So Little had been having those. I’m kicking myself because I didn’t think to check the ingredients and didn’t know they were made with alfalfa. If I had known, I wouldn’t have bothered :( If Little does have stones, I’m going to be so upset with myself. He’s only been having pellets properly since the start of November and now look where we are.
Simon wants to run xrays under sedation to see for any stones.
However, he thinks it would be worth trying the nystatin first but to drop the dose on the label due to the weight loss before we do an X-ray. He thought it would be the lesser of two evils. If there’s still weight loss and no improvement, then to have the xray done.
I’m just really kicking myself :( I so hope there’s no bladder issue.
Simon mentioned that it’s possible the yeast could’ve been transferred to the mouth through poos since last he saw him. Which could be a possibility as Little was unable to eat his poos due to them being cow pat like BUT he has been able to eat them since pretty much the day he saw Simon.
He said it’s hard to tell whether the yeast found is pathogenic or non pathogenic.
As Little would be losing weight without the extra food, we should give him the nystatin before having an X-ray as a lesser of two evils to rule out that before looking into something more serious.
I’m relieved to have spoken to Simon and feel better about it all. We will start giving 1ml twice a day of the nystatin tonight and see if things improve.
 
Oh also, Simon said we should find a good grass based pellet to syringe feed Little with. Does anyone know a decent brand for this?
 
This is the nugget comparison chart Nugget Comparison Chart. It shows which ones are grass based, but you’ll also want to check them individually on their websites because they may also contain other you want to avoid - eg burgess pellets are grass based but they also contain alfalfa (under its alternative name of Lucerne In the ingredients)

Haybox pellets are grass only but as cold pressed pellets I’m not sure how well they would soak and go through a syringe. The only other thing I can think of using a proper recovery feed rather than pellets
 
Piggies&buns said:
This is the nugget comparison chart Nugget Comparison Chart. It shows which ones are grass based, but you’ll also want to check them individually on their websites because they may also contain other you want to avoid - eg burgess pellets are grass based but they also contain alfalfa (under its alternative name of Lucerne In the ingredients)

Haybox pellets are grass only but as cold pressed pellets I’m not sure how well they would soak and go through a syringe. The only other thing I can think of using a proper recovery feed rather than pellets
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Thank you. I’ll have a look.
We have critical care but he avoids it like the plague. When we’ve been giving him top up food, we give him about 50ml and he takes it all happily and could easily eat more. Whereas with critical care, he doesn’t even want a single syringe. I don’t want to make him not want to eat even more if that makes sense.
Hopefully we find some decent pellets
 
Think I will get some hay box ones ordered anyway in the meantime and if I’m able to find something else then get those too. He stills needs pellets in his cage right now too so they can at least go there.
Simon also said that usually in this situation, he’d recommend feeding watery veg but they’re empty calories and the main thing is to keep him bulked up given the weight he is losing daily
 
Have you tried Little with the Emeraid CC? Ted hated all CC’s apart from the Emeraid Sustain, he didn’t mind that at all. I get it on eBay and they delivery very fast, you can get it on Amazon too. Glad you feel a bit better after speaking to Simon, don’t blame yourself about the pellets, he may not have stones anyway, but it certainly not your fault x

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Bill & Ted said:
Have you tried Little with the Emeraid CC? Ted hated all CC’s apart from the Emeraid Sustain, he didn’t mind that at all. I get it on eBay and they delivery very fast, you can get it on Amazon too. Glad you feel a bit better after speaking to Simon, don’t blame yourself about the pellets, he may not have stones anyway, but it certainly not your fault x

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I haven’t actually, I’ll get some ordered now. Thank you! The last thing I want to do is put him off being syringe fed when it’s the one thing bringing us peace of mind, just to know he’s definitely had something is reassuring.
I know, it’s just hard not to blame yourself :( the funny thing is I had actually read the nugget comparison chart when Digby came back with the science selective but I couldn’t find it on the list. I could only see the grain free version which is Timothy hay based so I assumed the regular would be something similar. It’s only when I’ve revisited the chart now that I actually saw the normal science selective is at the top of the list :doh: it was a silly mistake. We’ve binned the bag now though.
 
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