• Discussions taking place within this forum are intended for the purpose of assisting you in discussing options with your vet. Any other use of advice given here is done so at your risk, is solely your responsibility and not that of this forum or its owner. Before posting it is your responsibility you abide by this Statement

Specialist Stage C Heart Failure management with Benazepril, Furosemide, Torasemide and Spironolactone

Miketudor

New Born Pup
Joined
May 1, 2021
Messages
5
Reaction score
4
Points
135
Location
Bucharest, Romania
Summary (TL;DR): stage C heart failure treatment by constantly adjusting doses of Furosemide, Torasemide, Spironolactone, Benazepril, Cardiac Supplement & Potassium Chloride (electrolytes)

Hello all,

This post goes out to everyone who has a guinea pig struggling due to cardiac hypertrophy leading to cardiac insufficiency / heart failure. My guinea pig Mili (picture attached), who passed away at around 5 years and 7 months old on January 10th 2023, struggled with heart issues for the last almost 2 years of her life. She passed away due to a ruptured ovarian cyst, so this post will not focus on her death, but rather on how we managed to prolong her life by addressing her cardiac issues.

Back in February 2021 Mili became more lethargic, sitting in one place for long periods of time and by May she had “on and off” laboured breathing. We managed to keep this at bay with Benazepril on the long term and Furosemide only for 2-3 days at a time when her breathing became off, until she stabilized again.

All however came crashing down when she started to breathe in a severely laboured way in January 2022, having to spend one night in an oxygen chamber and getting Furosemide injections every 8 hours to become stable. Following an echocardiogram (heart ultrasound) and chest x-ray, she was diagnosed with stage C heart failure.
What helped her after this incident was the following treatment (her weight was 1250 g at the time):
  • Benazepril 1 mg/ml - 0.65 ml every 12 hours
  • Furosemide 2 mg/ml - 1.25 ml every 12 hours
  • Torasemide 0.2 mg/ml - 1.25 ml once per day, together with the evening Furosemide.
  • We also introduced a Cardiac Supplement here: Heart Supplement Formula, that you can discuss with your vet. We gave this to her once per day, 0,3 ml. The prescription (in Romanian language) is attached to this post.

When her breathing would again become laboured we would initially double the morning Furosemide dose. Once she stabilised, we would go back to the treatment above. If doubling the morning Furosemide dose didn’t help, we would double the evening Furosemide dose as well and when that didn’t help we would introduce Torasemide in the morning, basically giving it twice a day together with the Furosemide. Whenever we could, once she became stable, we would try to bring the dosages down to a place where her breathing was fine.

Due to so many diuretics, blood work showed very low potassium and also low sodium (but not far below the limit). Therefore, we had to give her electrolytes (e.g. Pedialyte), but soon noticed that the sodium in the electrolytes made her drink more water and her breathing became again laboured, so I got my pharmacy to produce only Potassium Chloride 0.3 mg/ml that didn’t cause her to retain water and therefore did not affect her breathing. This was given to her in cycles of 5 days once per day 0.5 ml, after which came 10 days of break and then the cycle would be repeated.

Also due to the many diuretics she developed urinary sludge (litiasis) so she was receiving Gabapentin and Meloxicam for pain management, as well as Urinary supplements (Rodicare Uro 0,5 ml x 4 times a day).

Summer came and because of the higher temperatures she started drinking more water which caused again more fluid retention, so we had to introduce Spironolactone 10 mg/ml 0,2 ml every 12 h together with Furosemide and Torasemide. We moved her to the room with AC which made her drink less water and therefore reduced water retention, so she felt better during August and September.

Eventually in October her breathing worsened again so she eventually ended up having pericardiocentesis towards the end of October, because she accumulated a “band” of more than 0.6 cm of fluid around her heart that would not go away even with Furosemide every 4 hours. This procedure means pericardial fluid extraction via a needle, under gas sedation.

After this procedure, Mili remained stable from a cardiac and breathing perspective until she passed away almost 2.5 months later due to her ovarian cyst rupturing. Her heart treatment during these 2.5 months:
  • Furosemide 10 mg/ml - 0,5 ml every 6 hours
  • Torasemide 1 mg/ml - 0,4 ml every 12 hours together with Furosemide
  • Spironolactone 10 mg/ml - 0,4 ml every 8 hours
  • Benazepril 1 mg/ml - 0,65 ml every 12 hours
  • Cardiac Supplement (prescription attached) - 0,3 ml once per day
  • Potassium Chloride 0,3 mg/ml - 0,5 ml once per day for 5 consecutive days following by 10 days break and repeat the cycle
  • Gabapentin and Meloxicam for pain management and Rodicare Uro urinary supplement to help manage the urinary sludge from all the diuretics
FYI I asked my vet about Vetmedin (Pimobendan) multiple times during the course of Mili’s final year but considering her heart ultrasound results he always said this medication might do her more harm than good.

During these entire 2 years we always managed to maintain her breathing to a point where it was barely noticeable that she had an issue. Theoughout most of this time she was a mobile pig who enjoyed her hay, pellets and especially veggies.

Unfortunately, her body was simply not worthy of her true heart and gentle soul. She had a huge cyst on her left hind leg that started oozing and had to be removed by surgery as part of the same intervention as her pericardiocentesis in October. She recovered from that in about a month due to local complications at the surgery site. Just after one week of slowly starting to walk again she developed severe arthritis at the beginning of December and once again became mainly imobile. She also had a new growth on her spleen which we first saw during an ultrasound in the summer of 2022 bit luckily seemed benign and stopped growing further. She also developed corneal dystrophy that started in one eye around August 2022 but quickly moved to her other eye as well, for which she was undergoing treatment with eye drops and ointments. We were aware of her 3 cm ovarian cyst but knew we could not remove it via surgery due to her heart issues. The vet was thinking about draining it but this involved risks (it rupturing) and would only do it if she started exhibiting ovarian cyst-specific symptoms, which she either did not or she did but we didn’t realize it, due to her many other issues. In the end, it was the rupture of her ovarian cyst that took her away from us.

I realize this was a VERY long post that took me hours to write, but I thought it might help guinea pig owners with pets in a similar situation as Mili.

I am not advising anyone to try these medications on their own piggies but it might just be worth explorong these ideas with your vet and see if anything applies to your specific situation.
 

Attachments

  • E14E22D5-6A2F-4EDE-8416-EF72D08E092A.webp
    E14E22D5-6A2F-4EDE-8416-EF72D08E092A.webp
    35.4 KB · Views: 11
  • 8075E7F1-0665-4664-AA5A-09763D917188.webp
    8075E7F1-0665-4664-AA5A-09763D917188.webp
    33.5 KB · Views: 11
So sorry that you lost your beautiful girl and thank you for sharing your experience with us.

I too lost a piggy to heart failure. There is very little research into treatment of heart conditions in piggies. So your information may be useful to someone who is in a similar position. I would certainly share it with my vet if needed.
 
So sorry that you lost your beautiful girl and thank you for sharing your experience with us.

I too lost a piggy to heart failure. There is very little research into treatment of heart conditions in piggies. So your information may be useful to someone who is in a similar position. I would certainly share it with my vet if needed.
Thank you for your kind words, YvonneBlue! I am sorry you lost your piggie due to heart failure. I know how much losing a piggie hurts, unfortunately.

Mili actually died because of a ruptured ovarian cyst, which was somewhat related to her heart condition in the sense that we knew about the cyst but could not perform a spay due to her condition, but ultimately it wasn't her heart that caused her passing away. She actually remained stable from a heart perspective in the last 2.5 months of her life and even on the day when she passed away, our vet performed a heart ultrasound and she had no fluid at all around her heart. That said, I do hope someone does indeed show my post to their vet and perhaps they can adapt the treatment to another guinea pig and are able to prolong their life.
 
Back
Top