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Wiebke's Guide to Tummy Trouble

Wiebke

Wiebke

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1 Available Gut Medication
2 Mild and Medium Bloating Symptoms
- Milder bloat
- Secondary bloating
- Thickened bowel (IBS-like symptoms)
- Build-up of fluid in the body cavity
3 Severe Bloating
- Severe Bloat (Dysbiosis)
- Bloackage
- Twisted or trapped gut (volvulus and hernia)
4 GI Stasis (No Gut Movement)
- Sudden full GI stasis
- Partial GI stasis
- Heat stroke
5 Minimising the Risks


Wiebke's Guides are a series of articles I have written for Guinea Pig Magazine in 2023 and 2024.
They are there to help you understand how the body works, learn to spot what is normal and what not and what are the most common health issues connected with each particular organ or body part.


Guinea pigs are basically a gut wrapped in pretty fur and with a big wheek attached. The digestive system is by far the largest organ. In order to break down the tough but highly nutritious grass/hay fibre which is their mainstay, they need a lot of gut and two runs through it. The digestive tract starts in the mouth at one end and ends in the anus at the other end.

What makes digestive problems in cavies so difficult to treat is that the gut is actually very thin and a lot longer – think spaghetti compared to penne pasta in carnivores or humans. Operations on the gut are difficult and therefore avoided. A vet described it to me once: “It is like trying to stitch thin paper to butter.”


1 Available Gut Medication

The other problem is that the available safe medication is very limited. Steroids, which are the best drug for humans and other species with gut problems, are unfortunately a big no for guinea pigs and other rodents.
Ranitidine (the active ingredient in the old zantac in the UK) had to be taken off the market some years ago. It is now making a comeback but worldwide human demand outstrips production by far and getting hold of even a little is difficult for vets.

This leaves them with a very limited range for any problem in the digestive system:
  • metoclopramide or emeprid (gut stimulant with the same active ingredient)
  • cisapride (anti-bloating replacement for zantac) or simethicone (which tends to collect gas in one larger bubble rather than dispersing it – not ideal for spaghetti guts)
  • analgesics like meloxicam (metacam) for any pain and inflammation
  • probiotics and live microbiome transfer to support the gut microbiome
Please note that home treatments like gripe water (UK over the counter baby colic), anti-bloating herbal teas and concoctions may help with dispersing milder bloating but they do not work at all for severe bloat. They cannot cure bloat and cannot replace a vet trip. Gut stimulants and cisapride are POMs – prescription-only medication in the UK.
 
2 Mild And Medium Bloating Symptoms

Milder bloat
Milder bloating is not at all uncommon. It can be due to a mild disturbance in the gut microbiome from introducing a new food too quickly, the balance between fresh and dry foods being shifted suddenly or from fermenting food (like grass that has been damp for several days or left in the fridge after cutting). Older guinea pig guts are often more tender and no longer as working as efficiently.

The belly in mild bloating cases should be still soft to the touch and your guinea pig should be still eating and not losing weight.
Please take them off any fresh food until 48 hours after they have normalised again in order to allow the gut microbiome to stabilise again. Restart with a bit of herb like fresh coriander/cilantro or parsley and then for the next 2-3 meals add one fresh food more with each serving. Abort as soon as you notice any return or persistence of bloating. Probiotics may also help with rebalancing the gut.

See a vet for a thorough check whenever milder bloating deteriorates, persists or happens repeatedly. Especially older guinea pigs can develop a very tender digestion as their ability to process and absorb nutrition starts to fail; it can also much more rarely happen in the wake of a really bad reaction to an antibiotic (most guinea pigs do recover from an adverse reaction, though). You have to play this on a case by case scenario and go with what works and what not - and be prepared to adjust constantly.


Secondary bloating
Persistent and increasing mild to medium bloating is often the result of either pain radiating into the gut from the lower spine (arthritis), the bladder or the reproductive tract or from pressure onto the gut (large ovarian cysts or internal growths). It is necessary to find the real cause of the problem and address that since otherwise the bloating will not go away and will get worse. In this case, the gut microbiome itself is still balanced.


Thickened bowel (IBS-like symptoms)
Occasionally, guinea pigs can present with bloating flares – very short but intense bloating events – which are seen in connection with a noticeably thicker, doughier feeling of the swollen gut. The condition can affect different parts of the bowel. Constant tiny cramps in the gut cause pain and some weight loss. Long term management of the condition happens via the usual gut medication, a high level of pain medication and if needed additional top up feeding support. No dietary changes are needed.


Build-up of fluid in the body cavity
Congestive heart failure often leads to the build-up of fluid either in the lungs or in the chest cavity. In more advanced stages it can also lead to a build-up of fluid in the body cavity, which can look like a major persistent bloat with increasing loss of appetite but without the drum-tight belly.

Alternatively, a large internal growth like a cancerous tumour can cause the same symptoms. A scan or x-ray can easily tell the difference between bloating and a fluid build-up. Diuretics and other heart medication can hopefully help if the heart is the cause. In the other case it is unfortunately not good news.
 
3 Severe Bloating

Severe bloat (dysbiosis)
Severe bloat is a potential killer disease. It often happens out of the blue and develops very quickly but it can also start off as a milder bloat caused by badly introduced fresh food which triggers the overgrowth of the wrong kind of bacteria in the gut and throws the whole finely balanced digestive gut microbiome into disorder. Every spring a number of guinea pigs die from being put out on the lawn without having been carefully introduced to fresh rich grass first.

I tend to liken severe bloat to a tsunami – the first wave may not always be the worst but later waves (sometimes hours, days or several weeks later) can occasionally be even more ferocious and fatal. You are in for a battle that will take days to get your piggy first through the crisis and then weeks rather than days to stabilise the gut microbiome again.

Symptoms
Severe bloat is characterised by a part or the whole belly feeling hard to the touch and – when you knock against it gently – making a hollow sound like a drum. Severe bloat can affect just a part of the digestive system or the whole. Bloating in just the stomach but not the rest of the gut is rare but it has happened to a guinea pig of mine.
Severe bloat is a life or death emergency. Please seek regular or out-of-hours vet care immediately at any time of the day or night. A scan or x-ray will bring clarity as to what is going on and your vet can then take any measures from there.


Vital support care at home
The pain is also increasing as the bloat develops and will impact on the appetite. Syringe feeding and watering is important to keep the gut going. Aim for 40-60 ml in 24 hours or as close as you can get with the solids; water is extra. It will become an increasingly desperate fight as the piggy is becoming weaker. You feed the more often the less you can get into a piggy in one session.

Apart from gut and pain medication, vibrating is the best help with bringing much needed relief; any vibrating massage pad or car seat etc. will do for frequent half hour sessions. Even the vibration from a car journey can sometimes help.

Signs that you are losing the battle:
  • Growing apathy/weakness. Your guinea pig will fight feeding in excess of their remaining or become too weak to swallow. Please stop feeding when this happens and contact your vet for emergency euthanasia.
  • The belly or part of it feels as hard as concrete. Any guinea pig that is grunting in pain is in extreme agony. There is no coming back from this; eventually the heart will give out. Please race your guinea pig to the vets for emergency euthanasia as quickly as possible as the kindest gift you can make them at any time of the day or night.

Blockage
Blockages in the digestive tract can happen anywhere from the back of the mouth to the anus. In the gut they can cause localised bloating symptoms from the point of blockage upwards.

The constant flow of saliva will no longer pass through and will back up through the mouth, presenting as constant dribbling and salivating. Please always ask your vet to also check the back of the mouth/throat area for a potential blockage as well as the gut there if the constant salivation is the main symptom.
Any dribbling is generally a sign that your piggy is either struggling to swallow for whatever reason (dental overgrowth, something stuck in the teeth, oral fungal thrush, heat stroke or pregnancy toxaemia or a neurological issue) or that the digestive tract is blocked at some point.

With food no longer able to pass, loss of appetite with the attendant weight loss and increasingly apathy will set in. The speed varies depending on whether you are dealing with a slowly developing blockage or a sudden one.

Bridging support feeding and a prompt vet trip are a must. If you are lucky, a blockage in the gut (often from ingested bedding) can sometimes be moved on. Otherwise the prospects are bleak and putting to sleep (pts) may be the kindest thing.


Twisted or trapped intestine (volvulus and hernia)
If a small piece of the gut gets trapped in a sling formed by another part of the gut as it moves around (volvulus) or slips through a tiny hole in the muscular wall that holds the gut in (hernia), the trapped part will swell up very quickly and become extremely painfully. It can quickly feel like concrete.

A twisted gut is very often misdiagnosed as a fast developing severe bloat. Heaving and vomiting badly in combination with bloating symptoms and severe pain (grunting) are usually the only outwards indication that you may be dealing with a twisted gut. A hernia usually shows as a soft swelling in the groin area; any other tissue slipping through the hole is painful but not fatal.
PTS (putting to sleep) as quickly as possible is sadly the only solution when a piece of gut is cut off.

More practical illness and care information:
Digestive Disorders: Not Eating - Diarrhea - Bloat - GI Stasis (No Gut Movement)

All About Syringe Feeding and Medicating Guinea Pigs with Videos and Pictures
How to Improvise Feeding Support in an Emergency

Signs of Pain in Guinea Pigs
Emergency and Crisis Care as well as Bridging Care until a Vet Appointment
A Practical and Sensitive Guide to Dying, Terminal Illness and Euthanasia in Guinea Pigs
 
4 GI Stasis (No Gut Movement)

A healthy guinea pig gut is usually happily gurgling away. A silent gut is a gut that has stopped working. This can affect the whole or just a part of the gut.

Your guinea pig will be suddenly very apathetic and will stop eating and drinking because they can no longer process any food. A quick listen to the gut will tell. Please see a vet as soon as possible. Gastro-intestinal stasis is a potential killer.


Sudden full GI stasis
Full-on GI stasis usually happens without warning. It can start with the gut shortly going into overdrive before falling eerily silent. It can also sometimes be a bad reaction to GA drugs (the vast majority of operations goes thankfully fine).

Pili Pala during the stasis event
1717157865709.webp

First real post-stasis poos reflecting the food intake and gut disturbance
1717157825128.webp

Pili Pala switching from needing syringe feeding support to top up feeding by herself
1717157797453.webp

Here is the link to Pili Pala's GI stasis thread (she did make a full recovery): Please Send Your Vibes To Pili Pala!



Gut meds from an emergency trip to the vets are one necessary part for getting your guinea pig through the crisis but your home syringe feeding and watering care is the other equally important role.
Think of the digestive system as one long conveyor belt. You need to keep on loading it while it stops so there is food on it as it starts up again; especially in a more protracted stasis. It is not pleasant but vital for the survival. Try to aim at 60 ml of recovery feed plus 1 ml of water for every 5 ml of solids feed over the course of 24 hours.

The conveyor belt metaphor also explains what you will see once the gut starts up again. Firstly, some normal poos appear; those are healthy ones stuck at the end of the gut when the stasis happened. They are followed by the stasis gap on the conveyor belt. Please don’t panic; the gut is moving again but it reflects the period when nothing moved. Eventually you will see small and funny poos which reflect your battle to keep your piggy going during the stasis. From now on the poos should get better and bigger as the recovery period arrives a day or two later at the far end.

A full-on GI stasis event is usually a mystery one-off event. Healthy piggies will often bounce back quickly within a couple of days never to have it again. Guinea pigs with underlying issues may however struggle or at the worst may not make it through even with the best possible veterinary and home feeding care.


Partial GI stasis
A partial GI stasis event is more commonly a secondary complication caused by an intense pain or heat event whose origin may or may not be traced.

Partial means that only the part of the digestive tract will stop working but it will also result in loss of appetite/flatness and will need the same support care and medication to get the gut back to moving again as fast as possible. A major pain event in the lower body can also lead to partial or full temporary loss of back leg mobility. Your piggy may need temporary feeding support and a vet trip.

Partial GI stasis can also be used to describe a very sluggish gut with little gurgling. Bloating and stasis can go hand in hand; the poop consistency is often also affected. The volume of poop output reflects the food intake


Heat stroke
What most owners are not aware of is the fact that heat stroke in guinea pigs will also majorly affect the gut and can lead to GI stasis. They will require gut meds and feeding and watering support in the days after as their gut won’t necessarily start up on its own again.
Guinea pigs with heat stroke can also present with dribbling or salivating as they lose the ability to swallow in the more advanced stages of a potentially fatal heat stroke. Sadly, far too many guinea pigs have died from unrecognised heat stroke complications in recent summers.

Typically, overheated guinea pigs are collapsed on their belly (pancaking) and are very apathetic. Please cool them down gently with cool but not cold damp rags in order to avoid a heart attack. See a vet as soon as possible to check the heart and gut as well if your piggy is not recovering and eating straight away.
Heat stroke symptoms and what to do
 
5 Minimising the Risks

You can never fully avoid bloating or stasis and may struggle with increasingly hot summers but here is what you can do:
  • Ensure that over three quarters of what a guinea pig eats in a day is hay/grass fibre. The digestive system is laid out for it. Your guinea pigs will be overall healthier and longer lived. A mainly pellet and veg based diet can promote dysbiosis.

  • Introduce any new foods slowly, in a small quantity as part of a mix of veg. This will allow the gut microbiome to gradually adapt. This includes fresh grass in spring for indoors guinea pigs.

  • Go easy on feeding fruits (including watermelon and carrots) as they are high in sugar and encourage the wrong kind of bacteria. Rather give your piggies a large chunk of cucumber to nibble on in your absence (which will stay cooler for longer) and refresh the water regularly in hot weather than overdoing fruity treats.

  • Ensure that you keep your guinea pigs as cool as possible inside the house during hot days. Think of keeping rooms as cool as possible and not just cages; not all tricks are expensive. Hutches and runs in full sun or in the way of a hot breeze (even in deep shade) are sadly death traps.

  • Please take the time to feel and listen to the gut with your ear against the belly now so you’ll know how a normal gut feels and sounds. Each piggy belly is a little different. Knowing how a normal gut sounds will help you assessing whether there is a problem with the gut being overactive (gassy) or underactive/silent.


Here is our Diet Guide link, which looks at diet as a whole and at all possible food and drink group in practical detail: Long Term Balanced General And Special Needs Guinea Pig Diets

This is our information on heat stroke and heat exhaustion, as well as the most comprehensive collection of tips of how you can protect your guinea pigs (and yourself) now that climate change is fully underway. Please keep in mind that just one measure may often not be enough but that a combination of low impact measures can be actually surprisingly effective.
Hot Weather Management, Heat Strokes and Fly Strike


For diarrhoea and any poop related problems please look at my Poop guide:

Wiebke

Thread 'Wiebke's Guide to Poops'

1 How the Digestive System Works
2 Poo Eating (Coprophagy)
3 Health Monitoring: Weighing vs. Poos Watching
- What does weighing do?
- What does the poop output tell you?
4 Minor Poop Issues
- How to deal with a minor tummy upset
- Funny poops: What do they mean?
- Caked on poops
5 Serious Diarrhoea
6 Impaction
7...
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