Tofu Eye Problems (again!)

[JaseChase]

Called the vets, no appointments today - he's booked in for 10:10am tomorrow morning and they said to keep a close eye overnight and take him to emergency vets if need be

Tofu has hay poke again! This is the fourth time he's had it, the latest was September, always his right eye. I've always been able to get him seen same-day in the past and I'm a bit anxious about leaving it overnight. What are the key signs I should be looking out for that he needs to go to the emergency vet? Redness, swelling etc?

So far, his eye doesn't look too dull, but there's visble spots in it that I can't tell if it's still a hay piece stuck or damage. I did manage to get at least one bit of hay out this morning. Last time this happened, the vet said he may have a weakness in that eye as he had quite a bad ulcer after the second hay poke (treated with isathal, then clorogen, and some metacam too). The first and third time were cleared up just with isathal + metacam. Pictures below, I'm going to try taking some better ones later once he's had time to calm down and OH is home to help me



Thanks for any help, pig tax of Tofu napping with his brother Noodle (both 3 year old boars) demonstrating why he gets hay poke so much!

 

[Wiebke]

Called the vets, no appointments today - he's booked in for 10:10am tomorrow morning and they said to keep a close eye overnight and take him to emergency vets if need be

Tofu has hay poke again! This is the fourth time he's had it, the latest was September, always his right eye. I've always been able to get him seen same-day in the past and I'm a bit anxious about leaving it overnight. What are the key signs I should be looking out for that he needs to go to the emergency vet? Redness, swelling etc?

So far, his eye doesn't look too dull, but there's visble spots in it that I can't tell if it's still a hay piece stuck or damage. I did manage to get at least one bit of hay out this morning. Last time this happened, the vet said he may have a weakness in that eye as he had quite a bad ulcer after the second hay poke (treated with isathal, then clorogen, and some metacam too). The first and third time were cleared up just with isathal + metacam. Pictures below, I'm going to try taking some better ones later once he's had time to calm down and OH is home to help me

View attachment 245069View attachment 245070View attachment 245072View attachment 245073

Thanks for any help, pig tax of Tofu napping with his brother Noodle (both 3 year old boars) demonstrating why he gets hay poke so much!

View attachment 245068

Hi

Any bleeding inside or outside the eye or any rupturing of an eye counts as an immediate emergency. The same goes for a very quickly bulging eye that is at risk of bursting before the next day.
Any other eye injuries, stuck items under a lid or any infections resulting from the injury (runny eyes and frequent blinking or greyish//bluish ulcerating gunk) as well, any one sided bulging eyes as well as any infections or problems with the conjunctiva are ideally seen within 24 hours (ask your vet clinic when best to ring up in the morning for one of their emergency slots on the following day if they cannot fit you in on the same day).

In the UK, eye injuries are prioritised when it comes to emergency slots or squeezing in because they can deteriorate so very quickly.

How are you feeding hay and how hard/spiky is it? Have you checked whether your boy is either turning his face towards the hay in a certain direction, whether he really likes to burrow his head in the hay or whether he could have a sight impedement (like a developing cataract in that side)?

Eye diagnosis with a special dye under UV light, treatment and medication is the same as for other common pets, so speed comes before specialisation in this respect - don't wait for several days for a slot with an exotics vet and see a general vet instead. Consider whether feeding soft meadow hay may be a better alternative.

How Soon Should My Guinea Pig See A Vet? - A Quick Guide

 

[JaseChase]

Thanks Wiebke, I appreciate the advice. There isn't any active bleeding or obvious ulceration yet, but I'm keeping a close eye and if it bulges or swells I'll get him seen today. The appointment booked tomorrow morning is within 24 hours

I mostly feed soft meadow hay (from dustfreehay), it's in a paper bag and then a second loose pile - I did used to put it under a cardboard box/carrot cottage but the vet said last time that might be making the hay stick up stiffly, increasing the risk of hay poke, so I don't do that anymore. I use a handful of stalkier Timothy hay (from HayBox) at the very front of their C&C cage in a loose pile

Tofu does love hay diving and is often found head-first in the meadow hay pile, but so is Noodle, and he's never had hay poke in his life. I'm very willing to change up the way I feed hay to help avoid him getting sick, but last time I went to the vets they said there wasn't much I could do. If he was having a sight problem in that eye, would the vets be able to spot it? It is weird to me that it's always been his right eye, and it's been four times within just over a year

Thank you for your time!

 

[JaseChase]

Tofu's been to the vets this morning and he's got isathal and metacam again for the week

The vet checked his eye with the dye and couldn't find a scratch or an ulcer, but when she pressed down above his eye he was flinching in pain. There are also a couple of odd specks/floaters in his eye that she's not sure about, so she's going to consult with someone who works at a small animal hospital who is a specialist in guinea pigs

She gave me a couple of possibilities for what could be going on because she agreed it's weird it's been the same eye four times, but she isn't sure without further investigations

1) there's a mass behind the eye making it bulge
2) an infection in an incisor (she checked his teeth and they looked fine today)
3) a floating piece of hay or something that might have got caught behind his eye

The long-term treatments for 1 and 2 would be removing the eye, she said, and 3 would flare up every now and again and be treated symptomatically with eyedrops & a painkiller. She said to treat this bout symptomatically and then if it happens again within a month or so, she'd admit him for a day for some further investigations

Is anyone familiar with eye problems like this? Not sure how concerned I should be. Tofu's weight is stable and he's eating and drinking and napping like normal, though he has been a bit fluffed up in the cage and keeping to the hideys. Noodle has also been more affectionate with him - they've been in the same hidey a few times, which isn't normal for them (though it is kinda cute) and lots of snuggling, he's also been barbering Tofu the last few weeks which is new behaviour for them

Hoping the painkiller helps him get a bit more comfortable. Here you can see the couple odd flecks in his eye near the bottom (lettuce for bribery lol)

 

[Qualcast&Flymo]

I wonder if the flecks are osseous metaplasia aka heterotopic bone formation? They aren't painful for the piggy but would presumably affect the vision.

When you mentioned that pressing the area made him flinch, I wondered about retrobulbar abscess, but I think that would make itself obvious quickly, and being painful would affect his appetite.

 

[JaseChase]

I looked up osseous metaplasia and it does look like the early stages of some of the pictures - I had a good look while giving him isathal this morning and it looks like a possibility? I'll keep an eye on it. Thank you for the suggestion!

I did wonder about an abscess as well but his weight is still stable and he's drinking and moving around fine. I can't see any swelling or obvious bulging either. That said, he's definitely perked up being on the painkiller. The vet said to go back if I think he's still uncomfortable or in pain after the week on meds, to figure out what might be causing it, as there isn't really an obvious answer at the moment. From what I read, osseous metaplasia doesn't usually cause pain? Hard to know how concerned I should be if this round of meds does clear it up and his symptoms stop - if they continue I'll definitely go back to the vet

 

[JaseChase]

Tofu has been back to the vets today - the round of meds helped initially, but since stopping them his behaviour went back to being withdrawn and irritable (he's normally a very calm piggie) and he still had the odd flecks in his eye, so I called for some advice and they booked him another appointment

Here are the odd flecks I'm talking about, as best I can get them to show up on camera:



The vet today was the more knowledgable one at my branch. She had a very good look and poke around and concluded that he likely has glaucoma in his right eye. There were a few abnormalities she could see:

1) The obvious flecks on his cornea that I had noticed, she still wasn't sure what those were but said might be damage from an old ulcer healing
2) Brown staining in the whites above his right eye
3) Some spots when she shined the torch/microsocope to look through the eye
4) He likely has little to no sight in his right eye, he wasn't reacting at all to the bright light (he did when she shone it in his left eye)

She touched above both his eyes and felt more pressure over the right one, and the right one also bulges out just slightly more, which led her to think glaucoma is probably present. She said it might have come after the time he had a bad ulcer (he's had four bouts of hay poke in this eye, the second one was the worst ulcer) or the glaucoma might have come first, it's hard to say. There are also signs his eye fluid isn't draining as well as it should

He's back on a painkiller for the long-term - dog metacam at 0.2ml per day for now, up to 0.3ml if he needs it, and if I think he's still in pain I can call to discuss raising it again. And he'll be having regular six-monthly checkups. She also said that if I spot any redness, weepiness, or swelling to take him straight back

She doesn't think it's an abcess (she did check), his teeth are fine, his weight was actually up from last time and he's eating fine. I'm hoping the painkiller will brighten him up again. I do still wonder if the corneal flecks are osseus metaplasia as was already suggested, it does look a lot like some of the earlier stage pictures I've seen online

The main thing I wonder about is if anyone has any experience with glaucoma or sight loss in guinea pigs? I wasn't super aware they could get glaucoma and I'm not sure how common or serious it is. The vet said in the long term, he might need his eye removed if it got worse, but we're a long way from that at the moment. She also advised I keep the cage layout roughly the same so he doesn't get confused with his sight loss, and that I keep to soft meadow hay, pick out any sharp bits, and stick to soft fleece hideys with no sharp corners

Both boys are back in the cage munching on their hay so I think they've recovered from the second vet trip this month! (I bring Noodle along for support)

Piggie tax xx