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Specialist Possible Vestibular Episode?

Almostmad

Almostmad

Junior Guinea Pig
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Hi there, my teeny tiny (420g) 1 year old female guinea pig (who also has Congestive Heart Failure) suddenly presented with a neurological episode this morning at 4am - she was found on her side and scrambling panicking! We took her to our emergency vets (in Northern Ireland) and they've said that it's most likely a vestibular episode - but could also be a tumor or given her CHF, a blood clot on the vestibular bulb. We've decided to take her home for supportive care as she's still her fiesty self despite not being able to right herself at all. She's going to the toilet and taking syringe feeds no problem and even munching on cucumber enthusiastically.
The medication she's on is 1/4 Vetmedin 1.25mg tablet twice daily - 0.2mls Frusomide twice daily - We've now added in 0.1ml Baytril twice daily and 0.4mls cat metacam twice daily - she also had an injection of Vetergesic (Bupronorphine) just before she left the vets this morning.
I'm looking for some advise with regards to vestibular - if it's common to recover and also how much time is ethically right to give them in your opinion as we don't want her to suffer unnecessarily.
Many thanks in advance.
 
Hi!

Sorry, I don't have the necessary medical training to answer your question.
@Abi_nurse

At the moment, your girl seems to have enough will of live and is able to express normal behaviour so on those grounds I would judge that her time has not come yet. It is however always upsetting when you come face to face with the fact that you may have to make that decision soon and you want to get it right.
Here is our guide about caring for terminally or critically ill piggies that will hopefully help you: A Practical and Sensitive Guide to Dying, Terminal Illness and Euthanasia in Guinea Pigs
 
It might be worth asking your vet about giving metoclopramide/emaprid as well. Although commonly used as a gut motility drug my vet also uses it in cases of acute head tilt, etc sorry I can't explain the science but I think it can help in some way with regaining a sense of balance.

on a personal note I once had I piggy I saw collapse in front of me, suddenly crying and scrabbling on his side and floppy too. I rushed him to the vet expecting pts but was given meds. He could wee and poop ok but was unable to eat for himself for several days, just had syringe food but he slowly improved until back to normal except left with a head tilt and lived on for many more months. I don't know if his condition was vestibular or something in his brain.

I would be inclined to give your piggy at least a few days to see if she improves.
 
I can’t comment on your exact issue, however I had a pig who had liver disease and recurrent respiratory problems. One morning I woke up to find he’d had some kind of stroke or something as it was very clear something wasn’t right neurologically. He couldn’t walk properly, when he tried he would just stumble around the cage, he couldn’t drink and he couldn’t eat. He couldn’t lift his head right or use his mouth to bite, he desperately wanted to eat cucumber but his body wouldn’t let him. I could see that he so badly wanted to live, he was moving the best he could and trying to eat/drink but physically could not. I’m not sure if he was weeing/pooing as we just acted quickly and got him to the vets and he was PTS.

So in regards to when the time is right, I think you’ll just know. For me, my first instinct was to stop him suffering as soon as I possibly could. Right now, your pig can still control her mouth - as you said she’s munching cucumber and her bowels are still functioning. To me, I think those are the two most important things. If she’s munching cucumber, in a few days she may then be able to slowly start eating hay again. It seems like her condition is not causing her any distress. Whereas, for my pig he was distressed because he couldn’t control his body the way he needed to, even though he wanted to live it was unfair to leave him trapped and confused in a body that wouldn’t allow him to.
If you feel like she’s becoming distressed, or if she withdraws, or if you look at her and just think she’s suffering then maybe putting her to sleep is on the cards. But since you’re questioning if the time is right, perhaps it’s worth hanging on and reassessing the situation every few hours. Like I said when the time is right you’ll know it within yourself
 
Thank you to everyone who has replied - we're syringing her a mix of fine grind critical care and crushed nuggets every hour as well as syringing her water mixed with probiotic and vitamin c. We give as much as she will take, usually about 10mls mush and 5ml water (she is very tiny), she's also been eating veggies in between these feeds. She takes these like an expectant baby bird bless her.
My husband and I have agreed that whilst she's still fighting, we will too. She is relaxing and snoozing in between feeds - has pee'd a couple of times but only produced a single poop which is concerning me!
We're just taking it an hour at a time. I do feel that she has improved since the 4am episode this morning - however she's no where near 'right' again bless her!
I've never encountered a piggy who wants to live so much in my life!
Will keep this updated - thank you for the support! ♥️
 
*Update*
So, it's been over 12 hours since Vet visit - her head isn't as wobbly or 'bobble head' like - her eyes aren't too flickery either unless we move her to change the blanket we have her wrapped in.
She's taking syringe feeds really well, and eating peppers and cucumbers.
She's urinating frequently but she does this normally because of the diuretic she gets anyways.
Only thing is she hasn't pooped since about 2pm this afternoon - her intake of food should really be making an appearance in poop form in my opinion!
So we've done the vibration trick to see if that works. Probably every hour for about 10mins?
She's still fighting so, we're fighting along with her!
Fingers crossed my next update will be good news :)
 
Pleased to hear she is showing signs of improvement. As the flickering of her eyes reduces her balance should improve. I would speak to your vet to see if they are able to prescribe a gut motility drug such as metoclop to help move things along
 
*Update*
We have poops - so so many poops 😂 she's still eating and drinking - I would like her to get some fibre into her as the poops are very squishy and not properly formed poops.
We're still just taking it step by step!
She's getting super stinky though and keeps needing to get bathed bless her 😢 x
 
*Another Update*
She still much the same - going to the toilet OK, taking syringe feeds and eating some veg. She's lost just under 30g in 48hours which worries me (we're about 372g now) - she was so small before this and she's got no reserves to make her safe to lose some weight (I wish my other two piggies could share a few grams haha).
I offered her some dry nuggets about 20mins ago and she loved those - ate a few by herself.
She's still not up-righting herself (we've been burrito-ing her in blankets since the Vet visit and keeping her with us 24 hours) but, her eye tick is almost gone. She has a pretty severe tilt to her right which doesn't seem to be easing up at all.
I still don't know what time frame to give her realistically. I know her quality of life isn't there at the moment and obviously she can't remain how she is for the rest of her life so, it's just a case of taking it from her I guess?
For me, once guinea pigs lose interest in eating then that's a big sign for me. On that note, we're also worried about her teeth - she's not eating hay (no interest whatsoever) and we don't want her teeth to then become the issue - it's so hard with guinea pigs. People just think they're plain sailing but, if one of them becomes sick that's a whole different story!
Thanks for reading.
 
It is such a hard call to make. For my piggy who I mentioned in my previous post the sudden onset and symptoms seem just like yours. I had fully expected the vet to recommend pts but am glad he thought it worth while to give the pig a chance t recover. My boy was a big strong fella tho without other health issues so that is a big difference in our situations.
For the first few days although he wanted to eat he was not coordinated enough to be able to for himself and relied 100% on syringe feeding. But despite this he didn't end up with dental problems.
Sorry i don't remember the time scale of how soon he could stand properly, walk about, etc but could see improvements every day and remember he was able to wee and poop without getting in a mess and needing baths. It was several weeks tho before he could be reunited with his brother but eventually he was strong enough to resume his role as top pig (which was a relief to both of them). He was left with a permanent head tilt but was not bothered by it.
If he hadn't been able to wee without it soaking into his fur that would have been a big concern for me. Quality of life is so important and I agree your piggy can't remain how she is for the rest of her life but reduced quality for a short time while improving and recovering I think is ok.
If she is showing daily signs of improvement I think it is ok to continue but equally I don't think it would be wrong if you decided to let her go.
 
Pound Shilling & Pig said:
It is such a hard call to make. For my piggy who I mentioned in my previous post the sudden onset and symptoms seem just like yours. I had fully expected the vet to recommend pts but am glad he thought it worth while to give the pig a chance t recover. My boy was a big strong fella tho without other health issues so that is a big difference in our situations.
For the first few days although he wanted to eat he was not coordinated enough to be able to for himself and relied 100% on syringe feeding. But despite this he didn't end up with dental problems.
Sorry i don't remember the time scale of how soon he could stand properly, walk about, etc but could see improvements every day and remember he was able to wee and poop without getting in a mess and needing baths. It was several weeks tho before he could be reunited with his brother but eventually he was strong enough to resume his role as top pig (which was a relief to both of them). He was left with a permanent head tilt but was not bothered by it.
If he hadn't been able to wee without it soaking into his fur that would have been a big concern for me. Quality of life is so important and I agree your piggy can't remain how she is for the rest of her life but reduced quality for a short time while improving and recovering I think is ok.
If she is showing daily signs of improvement I think it is ok to continue but equally I don't think it would be wrong if you decided to let her go.
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Thank you for replying, that really helps a lot! - she's a lot cleaner today - she can sort of move away when she's gone to the toilet which also lets us know and we can change her blanket too! She is loving eating her nuggets (which was possibly her favourite part of her usual routine lol) so that's a big boost for us and her.
She has more of an appetite as the day has gone on - I was worried early this morning as she wasn't interested in eating from about 2am - 6.30am (only took about 3 feeds in that space of time) which I took as a bad sign but she must have been resting or something.
I've noticed she's trying to turn herself and stretch out her back feet when getting comfy to go for naps and she's attempting to groom herself but when she turns her head to her right to clean her side, it completely throws her off balance and her heads a bit wobbly but, she continues cleaning her face and nose.
My husband and I feel good about her as it stands as she seems to be getting hungrier since eating the nuggets. She devoured just under half a side of small pepper over the course of 20mins - I know that's really specific lol
Also, we're weirdly thankful that we're both at home due to what's happening in the world because if we both had to go to work I think we would have had to let her go!
 
Almostmad said:
*Another Update*
She still much the same - going to the toilet OK, taking syringe feeds and eating some veg. She's lost just under 30g in 48hours which worries me (we're about 372g now) - she was so small before this and she's got no reserves to make her safe to lose some weight (I wish my other two piggies could share a few grams haha).
I offered her some dry nuggets about 20mins ago and she loved those - ate a few by herself.
She's still not up-righting herself (we've been burrito-ing her in blankets since the Vet visit and keeping her with us 24 hours) but, her eye tick is almost gone. She has a pretty severe tilt to her right which doesn't seem to be easing up at all.
I still don't know what time frame to give her realistically. I know her quality of life isn't there at the moment and obviously she can't remain how she is for the rest of her life so, it's just a case of taking it from her I guess?
For me, once guinea pigs lose interest in eating then that's a big sign for me. On that note, we're also worried about her teeth - she's not eating hay (no interest whatsoever) and we don't want her teeth to then become the issue - it's so hard with guinea pigs. People just think they're plain sailing but, if one of them becomes sick that's a whole different story!
Thanks for reading.
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A Guinea pigs weight fluctuates about 50 grams a day, and it can even be the weight of a big wee if I’m thinking correctly, so I wouldn’t worry about a 30 gram weight loss over a 2 day span, I’d only worry if her weight was significantly deteriorating each day. Like if she lost around 50 one day and then lost 50 the next day and so didn’t make any of it back up.
Just a thought in case you haven’t already mentioned it, have you tried her with grass? Grass wears the teeth down and guinea pigs with dental issues appreciate this as they can eat it with ease. She may find this a lot easier than eating hay right now and it would lesser the chance of a dental problem if she recovers.
Obviously, we can’t see what she’s like so it’s up to you to judge her based on quality of life, whether she’s suffering, and chance of her improving in your eyes. From what you’ve said, I’d give it a few more days just to see if she perks up or if chances of improving are slim, but again it’s 100% your choice as you can judge her for what she is. If she isn’t deteriorating then that’s a good sign and I’d take it day by day, if there’s no improvement at all in the next few days then I’d definitely be considering euthanasia as then it really is just prolonging a difficult life with little chance of recovery.
 
Almostmad said:
Thank you for replying, that really helps a lot! - she's a lot cleaner today - she can sort of move away when she's gone to the toilet which also lets us know and we can change her blanket too! She is loving eating her nuggets (which was possibly her favourite part of her usual routine lol) so that's a big boost for us and her.
She has more of an appetite as the day has gone on - I was worried early this morning as she wasn't interested in eating from about 2am - 6.30am (only took about 3 feeds in that space of time) which I took as a bad sign but she must have been resting or something.
I've noticed she's trying to turn herself and stretch out her back feet when getting comfy to go for naps and she's attempting to groom herself but when she turns her head to her right to clean her side, it completely throws her off balance and her heads a bit wobbly but, she continues cleaning her face and nose.
My husband and I feel good about her as it stands as she seems to be getting hungrier since eating the nuggets. She devoured just under half a side of small pepper over the course of 20mins - I know that's really specific lol
Also, we're weirdly thankful that we're both at home due to what's happening in the world because if we both had to go to work I think we would have had to let her go!
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That all sounds very hopeful
 
Forgot to mention as well, porridge oats are really good for keeping the weight up. I use jumbo porridge oats to keep Little’s weight up as he is suffering with dental problems at the moment so not eating as much as he should be. I’d definitely try them with your girl.
 
*another update*
Good news! I don't want to jinx it but - we're back up to 395g - I know it can be maybe the difference between a big pee but, we're so happy to see she's gaining today.
Still good appetite, pooping (poops getting more formed and firm) and pee-ing.
She's now able to right herself so she can settle and rest like 'normal' instead of leaning on her side.
She's a bit more sleepy today but we think she's tired from all the eating she did last night/this morning haha!
Posting on this is a good way of keeping me sane through this and thank you to everyone who's replying. I know we're not out of the woods and still have a long way to go but, just to see her improve every day is such a relief that for now we're doing the right thing for her at the moment!
 
That’s so lovely to hear and has brightened my day a little!
Whether it’s a big wee or not, any weight gain is good regardless. It’s a step in the right direction to not have lost anything since the last weighing. It also tells you she’s eating enough to sustain herself, especially if her poos are gradually becoming more normal.
She seems to be improving every day, so whilst you may not be out of the woods, the consideration of euthanasia can be put on the back-burner which is a nice position to be in. I have every thing crossed she continues to improve.
 
*Update*
Good news again! We're now able to keep ourselves standing and move around a little bit! She's still wobbly and certain movements can throw her off balance but, it's such a vast improvement to what she was like Saturday morning!
We weighed her this morning and she was 387g so a little loss but, I'm not too worried.
We're so pleased she's looking to be on the mend bless her ♥️ she's been through a lot in the past 5 days haha!
 
*Update*
So we were doing great up until this morning when she had another episode. Although not as severe as the first one, we've still taken steps back. She's like how she was on Monday/Tuesday so, very wobbly. The tilt is now on her left side and she has the eye tick back in that eye now.
Been prescribed another course of Baytril and were advised if it was an inner ear infection we should see an improvement with her within 48 hours. We were also discussing that this episode could be purely idiopathic (they don't know the reason why) - so we're happy covering all bases.
Her weight has dropped again to 381g and we're becoming more concerned about that she might not be able to re-gain her weight and that will be more of the issue than this strange episode!
She' s still interested in eating and is going to the toilet - her personality is still there. We're happy to continue for now but, another comment was that if this is neurological like a brain lesion or something like that, these episodes will be more frequent and no improvement at all.
Just thought I'd post again because we're a bit knocked today as we were making plans to set up her own rehabilitation enclosure this weekend but that doesn't look likely now!
 
That’s such a shame. I had hoped it was a one-off for her, it makes it so much more complicated if it’s a recurrent thing which is what it seems like if it’s happened again, especially in quite a short space of time since the first episode.
I’ve got no advice, other than to keep us updated. I really hope she improves.
 
Sending healing vibes to your little piggie, can’t offer any advice but just hang in there x
 
*another update*
Her weight today was 373g (she was 369g yesterday) - she's so skeletal at this point, the only way you can't tell is because she's so fluffy. We think she's very tired bless her but, we've added ground oats to her ground nuggets/crit care mix to try and get more calories into her - which she loves! Piggy porridge!
My biggest issue now is trying to get her to eat hay. She point blank refuses to eat it. She wasn't a massive hay eater to begin with (she's obsessed with nuggets) but she won't even bite it now. I've gone out and bought 3 different types of Timothy hay for her as I'm really worried about her teeth.
Her incisors are a little crooked now, there's a point on her right side on the lower one's and just a slight diagonal slant to the top and lower ones.
I've read that to get pigs to eat hay, you cut down on nuggets and veg but, I feel as though we can't because of her weight!
Is eating grass more of less the same as eating hay? That might be a silly question but in terms of fibre/roughage and grinding teeth? I know its probably not as good as it's not dry.
I'd need to go to a park to get some as we don't have a garden!
 
Her back teeth could be becoming overgrown - sometimes you can look at the front teeth and see there’s a problem with the back. Guinea pigs instinctually eat hay, the nuggets and veg aren’t the thing that will be stopping her and to cut back on them could mean she goes hungry.
Grass is very good to give, hay is generally better but grass is perfectly fine. Some guinea pigs with dental problems will live off grass as hay becomes difficult if there is a dental issue. It will wear the teeth down the same as hay. So yes, porridge oats and grass are definitely the way to go.
I believe if you collect grass from the park, you’ll need to wash it as it could have been weed on which isn’t good. I’ve personally never collected it anywhere but my garden so I can’t give solid advice where that’s concerned
 
Little Ones said:
Her back teeth could be becoming overgrown - sometimes you can look at the front teeth and see there’s a problem with the back. Guinea pigs instinctually eat hay, the nuggets and veg aren’t the thing that will be stopping her and to cut back on them could mean she goes hungry.
Grass is very good to give, hay is generally better but grass is perfectly fine. Some guinea pigs with dental problems will live off grass as hay becomes difficult if there is a dental issue. It will wear the teeth down the same as hay. So yes, porridge oats and grass are definitely the way to go.
I believe if you collect grass from the park, you’ll need to wash it as it could have been weed on which isn’t good. I’ve personally never collected it anywhere but my garden so I can’t give solid advice where that’s concerned
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Okay that's great - I know I really hope that her molars aren't overgrown and trapping her tongue or something coz we can't put her through a dental the way she is, she'll just die!
I'm gonna head out here and get some - there's a resovoir that has some good long grass so I'll try there! Thank you!
 
Oh that’s such a shame. Give her time, she might decide to eat it. It doesn’t look hopeful though. My only other suggestion would be readigrass. Let’s hope she suddenly starts eating the hay or grass, not sure how long realistically a guinea pig can go without eating anything like that. If she isn’t eating either then her back teeth will be growing :(
 
Little Ones said:
Oh that’s such a shame. Give her time, she might decide to eat it. It doesn’t look hopeful though. My only other suggestion would be readigrass. Let’s hope she suddenly starts eating the hay or grass, not sure how long realistically a guinea pig can go without eating anything like that. If she isn’t eating either then her back teeth will be growing :(
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We give her sprinkled ready grass in her nugget bowl which I'm not entirely sure she eats - I offered the grass to my other 2 pigs and they ate it no problem so it's not an issue with taste or anything. I think the emergency vet said they looked at her teeth and that they were fine when we were there over a week ago but, I suppose a week of not eating hay could make a difference? She still eats her dry nuggets, not in as much a quantity that she normally would, would this help her teeth a little?
I'm hoping that she'll decide she wants to eat it too 😢
 
Sadly exotic vets aren’t actually trained in guinea pig dental care, so not a lot of vets actually know what they’re looking for. In the uk, we’re fortunate to have a proper guinea pig dentist. The back teeth can definitely grow after not eating hay for a matter of days, ideally grass should be offered quickly after you notice your pig isn’t eating hay as it’s the next best thing for teeth. Nuggets don’t really do anything for the back teeth, it’s hay and grass which helps. Guinea pigs with all manner of dental problems happily eat grass as they have no problem with it, it could be that her back teeth have overgrown but even if they had, it shouldn’t affect her ability to eat grass at all. It could be that her episode has affected her ability to eat something so fine like grass or hay. I really hope she does improve, I’m just not sure what you can do with a pig which won’t eat hay or grass
 
Little Ones said:
Sadly exotic vets aren’t actually trained in guinea pig dental care, so not a lot of vets actually know what they’re looking for. In the uk, we’re fortunate to have a proper guinea pig dentist. The back teeth can definitely grow after not eating hay for a matter of days, ideally grass should be offered quickly after you notice your pig isn’t eating hay as it’s the next best thing for teeth. Nuggets don’t really do anything for the back teeth, it’s hay and grass which helps. Guinea pigs with all manner of dental problems happily eat grass as they have no problem with it, it could be that her back teeth have overgrown but even if they had, it shouldn’t affect her ability to eat grass at all. It could be that her episode has affected her ability to eat something so fine like grass or hay. I really hope she does improve, I’m just not sure what you can do with a pig which won’t eat hay or grass
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I know that's what I've started to say to my husband - she really needs to eat hay. She's very happy to get syringes and hand fed with us but, she's just sitting in this weird limbo at the moment.
She's slowly improving but, I don't know how much longer we should drag this out for her? I honestly don't know what to do - she's still her cheeky self, I think it would be an easy decision if she was fed up and not eating at all but the fact she's still going is making us hope she'll recover. She's lost the head tilt and eye twitch completely and is regaining some balance when manouvering which is good?
 
One of my boys came to me with dental problems, it seemed to have come from never being given hay in his life (he was 3/4). When they don’t eat hay both sides of the back teeth grow and create what is called a tongue pinning. It basically means the tongue is unable to move properly due to being trapped by overgrown teeth. Because of this, he was underweight as he struggled to eat nuggets for himself too. He’d only eat a very small amount of nuggets per day as he found them very difficult to move around his mouth to his back teeth and he struggled to eat veg properly too. He’d get food stuck and make uncomfortable faces trying to dislodge it. If she doesn’t begin to eat hay, this is likely what will happen, she will struggle to actually eat anything for herself. If she begins eating grass but not hay, then I’d say a dental would be needed. If not, then it seems like you would have to syringe her food for the rest of her life.
Since she’s been improving by the day, she could begin to eat grass for herself in a few days. It’d offer her grass everyday, as that’s the first and easiest step. Give her maybe another week? And if she still isn’t eating hay or grass, I’d either look into potentially having a dental treatment if her teeth have overgrown or euthanasia. It’d be such a shame to do that to her, since she’s quite content as she is but to not do it could be prolonging the inevitable :(
 
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