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View Full Version : Sick End of Life Care, and when is it time?



Rattiemom
07-26-15, 10:42 am
I believe my "heart" guinea pig, Sidney, is nearing the end of his life. I don't know how old he is because he had been abandoned when I found him three years ago, and he was an adult then. Anyway, he developed a lump on his side. I took him to the vet, and they did a biopsy, which was inconclusive. I declined to have the lump removed. A couple of months later, the lump had gone away! Then earlier this year it came back and quickly became huge, definitely too big to try to remove. It doesn't seem to bother him, and it's only been in the last week or so that he cut way back on eating and drinking. When I hold him, which I do for hours every day, he stretches out and yawns, and doesn't seem to be in any pain. Another thing is that twice I've observed what I think were seizures while I was holding him. His body would kind of vibrate and his eyes would roll up. It would last several seconds, and then he would open his eyes, yawn a couple of times, and act just fine. So with the lump growing and the fact that he's barely eating or drinking, and now these seizures, I know I might lose him soon.

I'm sorry this is so lengthy, but I wanted you to know everything that might affect your advice! After all that background, my question is, how can I tell if he's suffering and it would be kinder to have him put to sleep? Of course I would prefer to keep him going as long as possible and hopefully be holding him when he passes, but making sure he's pain free is the most important thing. Thank you.

Rocky5
07-26-15, 11:50 am
Awww :( I recommend the video How to Know When to Euthanize a Rabbit https://www.youtube.com/watch?v=wE3NMY0YtjM It is about rabbits however I apply it to all my animals. They use 3 criteria; Appetite, Affection, and Attitude. The video explains it all but I will do my best to give you advice based on your information. So the 1st point is Appetite. If we based off of appetite alone, then I would say put him down :( However, he seems to love affection so he must be happy. Is he curious? Does he like to bask in sunlight or wheek for veggies or explore during floortime? If he just stays in 1 spot during floortime and doesn't even look anywhere, then I think you should put him down. If he likes to explore, however, then I think he is happy. It all just depends on his quality of life. I hope this helps.

Rattiemom
07-26-15, 01:33 pm
Awww :( I recommend the video How to Know When to Euthanize a Rabbit https://www.youtube.com/watch?v=wE3NMY0YtjM It is about rabbits however I apply it to all my animals. They use 3 criteria; Appetite, Affection, and Attitude. The video explains it all but I will do my best to give you advice based on your information. So the 1st point is Appetite. If we based off of appetite alone, then I would say put him down :( However, he seems to love affection so he must be happy. Is he curious? Does he like to bask in sunlight or wheek for veggies or explore during floortime? If he just stays in 1 spot during floortime and doesn't even look anywhere, then I think you should put him down. If he likes to explore, however, then I think he is happy. It all just depends on his quality of life. I hope this helps.

Rattiemom
07-26-15, 01:41 pm
This is a helpful video, thanks! Are you saying that if an animal has some of each of these three things, that he's probably not in pain? Sidney eats a little, is affectionate, wheeks sometimes. He doesn't move around a lot, and I think that's because of the tumor being so big, but he doesn't just sit in one spot all of the time. Since I don't really know what's going on with him internally, my fear is that he's experiencing pain but hiding it, as animals instinctively do. I have heard that teeth grinding is sign of pain. He does that once in a while, but it seems more like impatience, "you've been holding me long enough. I want to go back to my hiding house now"! I have rats too, and I know for sure that bruxing can just as often be a sign of contentment with them. Sidney doesn't make any unhappy or whimpering noises, even when I gently poke around his body looking for lumps. So what do guinea pigs do when they're in pain?

spy9doc
07-26-15, 02:14 pm
I don't recall having seen you previously post about Sidney? Questions: 1) have you obtained an opinion from more than one vet? 2) How do you know that the "tumor" is malignant? 3) If the answer to the first two qyestion is "yes", then 3) Is he currently on any pain meds?

My Chester has severe malocclusion and it i a matter of time until monthly dental work can no longer control it. His behavior seems directly related to the dental pain.....he picks up his favorite foods.......and drops them. He eats few or no pellets. Most of all, he loudly and vigorously gnashes his teeth. Between episodes, he is his usual happy, spunky self and eats voraciously.

On Friday, we noticed he had begun to gnash his teeth and by yesterday, he was hardly eating. We unfortunately can't get him to see the vet (one out of three) until Tuesday afternoon for his dental work. In the meantime, it's Critical Care 3x/day, double up on the pain meds, and try to detach from it a bit. I was so upset by the teeth gnashing last night that I simply had to skip lap time. It's a helpless feeling when I can't help him.......nor myself. I had major surgery on Tuesday......and we both were in pain.

On a positive note, it seemed as though it was his time some two months ago, but he bounced back after some dental work. I'm soooo happy that I waited!

It's so hard to know what to do.....and for how long. When he has no more quality of life, then it's probably time. On a slightly humorous note, one of the last times I was waiting at the Vet for Chester to be ready, I watched this man with something in a box waiting for meds to be prepared. When I asked him what was in the box, he said "a gecko". The little green man had a tumor and they were waiting for some tramadol to be prepared. Apparently the gecko was doing o.k. with his pain meds for now and that was good enough for his owner.

Rocky5
07-26-15, 02:26 pm
I believe he is still enjoying life. But if his quality of life deteriorates to the point where he is unhappy then you would put him down. This is just my advice it is completely your choice obviously.

Rattiemom
07-26-15, 02:31 pm
I don't recall having seen you previously post about Sidney? Questions: 1) have you obtained an opinion from more than one vet? 2) How do you know that the "tumor" is malignant? 3) If the answer to the first two qyestion is "yes", then 3) Is he currently on any pain meds?

My Chester has severe malocclusion and it i a matter of time until monthly dental work can no longer control it. His behavior seems directly related to the dental pain.....he picks up his favorite foods.......and drops them. He eats few or no pellets. Most of all, he loudly and vigorously gnashes his teeth. Between episodes, he is his usual happy, spunky self and eats voraciously.

On Friday, we noticed he had begun to gnash his teeth and by yesterday, he was hardly eating. We unfortunately can't get him to see the vet (one out of three) until Tuesday afternoon for his dental work. In the meantime, it's Critical Care 3x/day, double up on the pain meds, and try to detach from it a bit. I was so upset by the teeth gnashing last night that I simply had to skip lap time. It's a helpless feeling when I can't help him.......nor myself. I had major surgery on Tuesday......and we both were in pain.

On a positive note, it seemed as though it was his time some two months ago, but he bounced back after some dental work. I'm soooo happy that I waited!

It's so hard to know what to do.....and for how long. When he has no more quality of life, then it's probably time. On a slightly humorous note, one of the last times I was waiting at the Vet for Chester to be ready, I watched this man with something in a box waiting for meds to be prepared. When I asked him what was in the box, he said "a gecko". The little green man had a tumor and they were waiting for some tramadol to be prepared. Apparently the gecko was doing o.k. with his pain meds for now and that was good enough for his owner.

Rattiemom
07-26-15, 02:38 pm
My vet consulted with a second exotics vet regarding Sidney's tumor, so I guess that's two opinions! I don't believe it's malignant, it's just the size of it that is hard to deal with. It's probably about the size of a plum and is kind of behind his left "arm pit." He is not on any meds now. I do have Metacam prescribed for him, but have not given him any. I requested that we be given something in case he suddenly got much worse and we couldn't get him immediate medical care. Sidney does like to eat the tough, hard base of a stalk of celery, so I guess at least his teeth are working properly, when he feels like eating! Sidney has gotten me through some hard times, as I'm sure Chester has done for you, and I want to return the favor now if I can!

My very best wishes to you and Chester.

spy9doc
07-26-15, 03:12 pm
I do have Metacam prescribed for him, but have not given him any. Sidney has gotten me through some hard times, as I'm sure Chester has done for you.

Metacam is an antiflammatory and is often prescribed for both pain and inflammation. However, if the issue is pain, then Tramadol may be more effective. Chester gets Tramadol b.i.d (2x/day). During the periods when he seems to be symptom and pain free, then I give him only Metacam.

Chester most definitely has seen me through some hard times in our 4.5 yrs. together. I can't imagine a more perfect piggy for me. I often say that I would love to have him cloned......minus the apparently genetically bad teeth.

One other question....is the tumor solid, or perhaps fluid-filled? If fluid-filled, then it would be worth a try to aspirate the contents.

Rattiemom
07-26-15, 03:28 pm
When the tumor was biopsied, it was solid, not fluid-filled. I'm assuming it's the same thing now, but it's probably worth checking. The speed at which it grew this time might indicate fluid. I'll check with my vet tomorrow. Thanks!

foggycreekcavy
07-27-15, 05:34 pm
I would have had it removed when it was smallish and easier to remove. I would still have it removed, depending on the condition of the guinea pig.

Rattiemom
07-28-15, 08:10 am
Since originally the bump appeared and then eventually went away on its own, I was hoping for the same thing to happen when it reappeared. Unfortunately, his overall health and age make surgery risky. He's really doing okay with it though. We visited our vet yesterday, and he felt that Sidney still has reasonably good quality of life. I'm just blessed every day I have him!

PandaPiggle
07-28-15, 09:27 am
I went through the same thing recently with my very first piggie, Agnes. She had a large solid mass in her abdomen, and the vet explained that surgery was very risky, and it was quite likely I'd lose her on the table, if not afterwards, but we could do it if I wanted. The vet said otherwise she would have bad days sometimes and then at some point there would be more bad days than good and when it got bad then it would be kindest put her down. I decided that I'd rather just spend what time she had left loving and spoiling her like crazy.

She was just fine up through the day before she passed, she even had a corneal ulcer that was treated and she recovered beautifully. One Sunday I woke up and her bottom was wet and very dirty and she wasn't moving much, so I thought she was having the first of the "bad days". I skipped church and gave her a butt bath, and cuddled her dry. Then I went to knitting group for a few hours, and when I came home I looked in the cage to make sure everyone was okay. Except she was gone. I never had to make the decision, but I would like to think that I would have made the call if she didn't slip away so quickly. Either way she's up at the rainbow bridge popcorning about now.

spy9doc
07-28-15, 09:32 am
As a healthcare professional, it's often my job to ask the hard questions. So I put on my "doctor hat" and looked at Sidney's condition from an objective standpoint.

It concerns me that Sidney may have not been properly diagnosed.......and treated. I can only go on what you have posted so I don't have benefit of having seen the Vet's reports.

The history of this lump does not suggest a malignant growth. A malignancy does not disappear on its own, only to reappear and grow rapidly. Even if it is a benign tumor, it would be unlikely for it to progress so rapidly. If it is solid or semi-solid then that suggests a fatty lipoma.

It has all the characteristics of a fluid-filled growth in which case it should (and could) be aspirated. This will often only temporarily resolve the swelling. Cysts generally have a capsule around them that may encourage the regrowth, in which case the capsule needs to be excised......also the case with a lipoma.

I would encourage you to seek a second and third opinion. I have three exotic vets available to me and I utilize all three of them. Not one of them has caught everything that has gone on with Chester and Maya. I don't think any less of them for that, but am not willing to take one opinion as gospel.

Rocky5
07-28-15, 09:37 am
I went through the same thing recently with my very first piggie, Agnes. She had a large solid mass in her abdomen, and the vet explained that surgery was very risky, and it was quite likely I'd lose her on the table, if not afterwards, but we could do it if I wanted. The vet said otherwise she would have bad days sometimes and then at some point there would be more bad days than good and when it got bad then it would be kindest put her down. I decided that I'd rather just spend what time she had left loving and spoiling her like crazy.

She was just fine up through the day before she passed, she even had a corneal ulcer that was treated and she recovered beautifully. One Sunday I woke up and her bottom was wet and very dirty and she wasn't moving much, so I thought she was having the first of the "bad days". I skipped church and gave her a butt bath, and cuddled her dry. Then I went to knitting group for a few hours, and when I came home I looked in the cage to make sure everyone was okay. Except she was gone. I never had to make the decision, but I would like to think that I would have made the call if she didn't slip away so quickly. Either way she's up at the rainbow bridge popcorning about now.

When you say gone do you mean she was missing? Like she got loose or something or was she dead? :(

spy9doc
07-28-15, 10:43 am
If you take it in context, then it means that she died. It's a phrase that is often used when someone is quite ill and in the final stages of life. One minute she's here, the next......she's gone.

Insofar as missing, haven't you ever looked in your cavy cage and at first glance someone was missing? It happened to me just yesterday when I looked into the cage to see where Chester was napping. I looked in all the usual places and no Chester. My first thought was 'did he crawl under something and die"? I then noticed that a hand towel that normally hangs over the side of the cage was out of position. Sure enough Chester had creatively made himself a new hidey.

Rocky5
07-28-15, 11:07 am
spy9doc Yes that's what I thought I just wanted to make sure. My Toro is part cuy I think and he jumps out of his cage all the time so I can't ever find him. I'm considering just making him free-range since he likes my room so much.

PandaPiggle
07-28-15, 11:23 am
Sorry for the confusion, I did use "gone" to mean dead... I had the entire sad story of coming home in my initial drafts, but I cropped it to keep it from getting too dark. All my pigs have been/are on the small side, none much bigger than 1000 g, and nobody climbs the cage at all, so I've never had anybody escape the cage before. It's been about a month so I'm mostly okay, but it's still hard to remember coming home and finding her body.

Rocky5
07-28-15, 12:15 pm
PandaPiggle That is terrible. I figured that's what you meant but it also knew it was possible she could have escaped and that was the last time you saw her or something.. That would have been way worse in my opinion :( Blake is tiny and the eldest while Toro and Snickers are huge. On April 1st, 2 of my pigs (Calvin and Cinnamon) died at the same time. I had told all my friends and they basically laughed in my face because it was April Fools day. I'm mostly ok too but it was just so terrible. Did any of your other pigs become depressed when Agnes died?

PandaPiggle
07-28-15, 12:22 pm
Everybody was pretty okay, they were a herd of five, so the loss of one was not too terrible, and they had plenty of piggie friends to lean on. I did worry about her partner a lot because they had been together for almost a year, and the rest of them had only been around for a few months, but they were all okay. I think they were kind of like "Mooooooom stop cuddling us so much we're fine!" because I was cuddling everybody a lot.

Rocky5
07-28-15, 01:19 pm
Awww :( I cuddled Blake so much after it happened. He stopped eating for a few days so I force fed him Critical Care. I brought home Gibby and they immediatly hit it off. Then I found a lump under Gib's chin so I took him back the Petsmart (sorry!) and they fixed him. About 3 weeks after I got Gib back and he became much more dominate and so he and Blake fought.