Heart Issues Enlarged Heart: Medication Question

[RubysMama]

So, my Ruby had lost a bit of weight and then started to sound congested and was breathing quickly. We zipped her off to our vet, who did some tests and diagnosed Ruby with heart disease (her heart was enlarged), and she has some fluid on her lungs. She was prescribed Enalapril and Furosemide, in tablet form (1/4 table of the Enal once a day, and 1/4 tablet of Furosemide twice a day). The vet seemed very concerned about Ruby, and I am to weigh her daily and record her respiratory rate daily because if she gets any worse in those regards, she's going to be in critical condition.

She takes the meds just fine, I just pop the quarter tabs into a piece of watermelon and it goes down the hatch pretty quickly! Ha!

My question is this (and I do have a call in to the vet, but I think she's out of the office today so I may have to wait until after the weekend before I hear back) - the tablet form is what they had on hand, so it's what we're using. I think she mentioned it also comes in liquid form which I can get through the pharmacy if we find she's responding to these meds but she wanted Ruby starting the meds ASAP.

The problem is, my pill cutter is not able to cut the Furosemide tabs cleanly into quarters. I did a few last night and each quarter is either a bit small or a bit big. The tablets are wee tiny things. I got the Furosemide at the vet's, and got the Enal at the pharmacy (it was cheaper, probably 1/3 of the vet's price). The pharmacy split the tabs into quarters FOR me, which was so great.

I am worried that giving Ruby the wonky quarter tabs of Furosemide will be bad for her. She's quite ill, and I am almost considering just getting a new rx for the Furosemide so I can bring it to the pharmacy to fill so they'll cut them for me. I'd rather not do that if it's not necessary though. I have about eight full tablets in the bottle and a bunch of almost-quarters. I might see if the pharmacy will cut the remainder of the tabs cleanly for me, even though the pharmacy didn't fill this prescription.

Any thoughts?

 

[spy9doc]

As an immediate action, why not buy a new pill cutter that works for you?

I know that lots of folks do it, but I just can't imagine trying to administer meds to a cavy if they are in pill form. By using the liquid form you can accurately calculate and administer the proper dosage AND be sure that she is actually ingesting the meds. As you may know, virtually any compounding pharmacy will compound pet meds for you. Many vet clinics simply aren't large enough to stock the wide variety of meds needed for their clients, and will provide a prescription so that you can get it filled elsewhere.

I wish you and Ruby the best. Keep us posted on her progress.

 

[RubysMama]

As an immediate action, why not buy a new pill cutter that works for you?

I know that lots of folks do it, but I just can't imagine trying to administer meds to a cavy if they are in pill form. By using the liquid form you can accurately calculate and administer the proper dosage AND be sure that she is actually ingesting the meds. As you may know, virtually any compounding pharmacy will compound pet meds for you. Many vet clinics simply aren't large enough to stock the wide variety of meds needed for their clients, and will provide a prescription so that you can get it filled elsewhere.

I wish you and Ruby the best. Keep us posted on her progress.

I am going to look for a new pill cutter. This one was almost $20 (CAD) so I thought it would be a good one.

Ruby really needed to get on the medication right away, so I just took the tablet form since they had it there at the vet's. I received enough for two weeks, and she said we should know by then if the meds are working. She did say that if Ruby responds to these meds, the best bet is to use liquid medication which will be easy to get from my pharmacy. The vet is in surgery today, but her office said she'll get in touch with me this afternoon to chat about the tablets and I may just get a new rx and take it to the pharmacy. I'll see what she says.

Ruby had no problems taking the tablet. She loves her fruit and veggie treats, so this morning I popped her tablet into a piece of watermelon and I even heard her chewing the tablet in her race to get all the watermelon in as fast as possible. I do think liquid would be easier on me in the long run, I agree with you there.

Ruby was my first piggy (we have four), and she's my sidekick and I love her to pieces. I just want her to get better. I'll definitely update as we go on with her treatment. She started her meds last night, and had her second dose this morning. Her breathing seems to be much clearer already, I don't hear the "pneumonia breathing" hardly at all since we got up this morning. So, fingers crossed, that we are on the right path.

 

[bpatters]

Even with a good pill cutter, it's hard to cut small pills evenly, especially when you're cutting them into quarters.

I'd try to get hold of the liquid med. With a heart pig, you often have to tweak the medicines very slightly, and your current pill cutter is tweaking in ways you can't control.

I'm just glad you found a vet who's willing to treat her heart condition. So many aren't, or don't have a clue what they're doing.

Look at the index and the records collection over at Guinea Lynx -- I think there are heart threads in both places.

 

[RubysMama]

Even with a good pill cutter, it's hard to cut small pills evenly, especially when you're cutting them into quarters.

I'd try to get hold of the liquid med. With a heart pig, you often have to tweak the medicines very slightly, and your current pill cutter is tweaking in ways you can't control.

I'm just glad you found a vet who's willing to treat her heart condition. So many aren't, or don't have a clue what they're doing.

Look at the index and the records collection over at Guinea Lynx -- I think there are heart threads in both places.

Our vet is fantastic! She is also the only one in our area who treats guinea pigs, and she is really great with our piggies. Ruby's weight had dropped quite a lot, and she saw a lot of fluid on her lungs in the xray, so she just wanted the meds in her as soon as possible before things got more critical.

I do think when she calls me back this afternoon I'll ask her about the liquid format. The pharmacy's cutter seems to cut them pretty perfectly, but the liquid sounds like it will be easier for me to control.

Thanks!

 

[ItsaZoo]

I agree with others that liquid would be easier. I have a similar situation with my dog. He gets 1/4 of a famotidine morning and night - 2.5 mg. The pills are small and 10 mg. I paid a lot for a quality pill cutter from the pharmacy and it wouldn’t even cut the pills in half evenly, much less in quarters. I saw one at Dollar Tree that looked pretty simple and that’s the one I’ve been using. Much more accurate, no sliding blade guards or adjustable cutting area. It simply splits the pills. Crazy.

 

[RubysMama]

I spoke to my vet on Friday afternoon (yesterday). She said if the 1/4 tabs are just a bit off in either direction, it's not a big danger to Ruby. She did say that once we see how she's responding to the meds, she'd move Ruby to the liquid format.

Ruby does seem to be responding to the meds, thankfully! Before we went to the vet on Thursday, the rattling and clicking in her breathing was terrifying. The night before, I actually went to bed thinking she might not make it to even see the vet, her breathing was so loud. Anyway, we started both her new meds on the night we got home from the vet. Yesterday, her breathing was already a lot quieter, and by last night I didn't hear any worrisome sounds coming from her.

I had a bit of a panic attack cuz I heard a noise while I was on the other side of the room - - went running over to listen closer, and I realized it was Ruby. Except, she was puttering around the cage making those adorable little chatty squeaks while she walked around. I hadn't heard her make those sounds for so long, I didn't recognize it when it was first happening!

Today, she seems a bit peppier. Her resting respiratory rate has dropped considerably and even when I take her out and she's a bit more active, her respiratory rate is much lower already than it was the day we went to the vet. I got hold of a very precise kitchen scale (mine was okay but I wanted to make sure we were able to catch any weight loss/gain even if it was just a gram or two). This afternoon she weighed in 2 grams heavier than she was on Thursday at the vet - not much, but I'm glad its moving in the right direction. I'll take any gains we can get right now. She even is responding much more like her old self, when we say her name and call her over - she comes running, and she even tried wheeking today!! It was weak, and raspy sounding, but she was going for it. I am not gonna lie, I got a bit teary eyed when I said her name and she came running to where I was and gave me her funny little wheek.

I was devastated at the vet's on Thursday. She said if Ruby didn't respond to heart meds, or if her lungs didn't clear up, we'd need to consider 'other options'. But I'm feeling much more positive today. I don't know that she's totally out of the woods yet, the vet was really concerned about her weight loss, but I think it might work out. We are going to do everything we can to get this lil bub healthy and happy again.

 

[bpatters]

Just so you know, two grams means nothing. A teaspoon of water (or pee) weighs about five gram, so two grams is just a very few drops, and can easily be accounted for by whether she's just eaten, peed or pooped.

The only way you'll know about her weight is to weigh her at the same time every day, at the same time of day (preferably in the morning before breakfast). Record her weights, and see what the trend is like. Pay no attention to variations of 10 grams or less -- at any given time, you have no idea how much pee and poop you're weighing on the inside of the pig.

If she has a huge loss from one day to the next, then you can get concerned.

 

[Guinea Pig Papa]

Can't tell you how happy I am to hear your little Ruby is feeling better.

The way you described her symptoms, it sounds a lot like where my little man Sly was shortly before we had to make a very painful decision. It may have made a difference sooner, or it may not have. We'll never know.

Hopefully Ruby responds well and regains her happy little self. My best wishes to you both. Can't wait to hear more positive updates.

 

[RubysMama]

Can't tell you how happy I am to hear your little Ruby is feeling better.

The way you described her symptoms, it sounds a lot like where my little man Sly was shortly before we had to make a very painful decision. It may have made a difference sooner, or it may not have. We'll never know.

Hopefully Ruby responds well and regains her happy little self. My best wishes to you both. Can't wait to hear more positive updates.

Thank you! I'm sorry about your lil guy. I know that it's still early on into Ruby's treatment, and she is not in the clear yet. She's my lil amigo, and I know if we have to make that decision it will be really heartbreaking. Sorry you had to make that call.

When I first got her, she was 1.3kg give or take. She did slim down after she came to me, a little, thanks to getting on a better diet and getting loads of exercise time. Recently, she lost a lot of weight really rapidly and is now hovering around 800g. That was a BIG drop for her, and it happened really fast. The vet said to go back in 2 weeks and we'll see where she is at with her meds and weight and respiratory rate. She said Ruby really can't afford to drop any more weight, so we're just hoping that she continues to show progress. I'm glad the pneumonia sounds are gone, and that while her breath is still fast - it doesn't look so hard and laboured.

She seems a bit perkier still this morning. She nommed her lettuce and some shredded carrots, took her meds like a little champ (even in tablet form, she just chomps em and eats them right up), and even seemed a little more comfortable sitting on my lap. I'm just holding on to the little glimmers of progress that we can!

Will keep an eye on her, and I'll update this post when I can.

 

[Guinea Pig Papa]

Thank you! I'm sorry about your lil guy. I know that it's still early on into Ruby's treatment, and she is not in the clear yet. She's my lil amigo, and I know if we have to make that decision it will be really heartbreaking. Sorry you had to make that call.

When I first got her, she was 1.3kg give or take. She did slim down after she came to me, a little, thanks to getting on a better diet and getting loads of exercise time. Recently, she lost a lot of weight really rapidly and is now hovering around 800g. That was a BIG drop for her, and it happened really fast. The vet said to go back in 2 weeks and we'll see where she is at with her meds and weight and respiratory rate. She said Ruby really can't afford to drop any more weight, so we're just hoping that she continues to show progress. I'm glad the pneumonia sounds are gone, and that while her breath is still fast - it doesn't look so hard and laboured.

She seems a bit perkier still this morning. She nommed her lettuce and some shredded carrots, took her meds like a little champ (even in tablet form, she just chomps em and eats them right up), and even seemed a little more comfortable sitting on my lap. I'm just holding on to the little glimmers of progress that we can!

Will keep an eye on her, and I'll update this post when I can.

It does sound like she's making progress. Baby steps for sure.

I'll definitely be watching for updates.

 

[RubysMama]

Quick update. This week, Ruby's weight climbed steadily. On the advice of the vet, I was weighing her first thing in the morning before any food or breakfast or treats or her meds. I weigh her again in the evening before her PM meds. Most mornings she was over 810g, and even got as high as 822g by the end of the week. I noticed on Thursday and Friday though that her morning weights were dropping. Yesterday and today she's been below 800g, usually around 790. I know that small changes aren't a big concern, but looking at the small steady growth in her weight measures, this drop feels a bit sudden.

I heard the crunchy breathing noise again, just off and on every so often, but I did call the vet to let her know.

The vet called in a new prescription for liquid Lasix. The enalipril can be ordered in liquid but there's no compounding pharmacies nearby who will make it so it has to be ordered in from out of town on a special order and the vet said it's quite expensive. As I have lots of the enalipril tablets (and the pharmacy quartered them for me, quite neatly) I've decided to wait on the liquid enalipril.

I'm hoping yesterday was just a blip or bad day - and that we'll continue to see some steady progress. Her behaviour is definitely changed for the better - she is very active again and moving round the cage, and has been reminding her three sisters who the boss is She has been wheeking a bit more, and comes when I say her name, and even her coat seems less roughed-up lately.

The vet will give her another week or so on the liquid Lasix then she'll take her in again to give her a checkup so we can see how she's doing.

Having one sick pig, and three healthy ones, has definitely made the 'workload' of four piggies seem really overwhelming lately. I'm sure it's normal, and we'll adjust to the new care routine for Rubes, but man I feel like a worried new mom all day.

 

[Guinea Pig Papa]

I'm glad Ruby's feeling better. That "worried Mom" feeling, though, isn't going to go away. It will take adjustment on your part, but when Sly's dental issues started I was a worried dad for over a year and a half. The worst were the days he went in for surgery.

You definitely seem to be on the right track. Little gains and losses are fairly normal, and I know the losses are upsetting. As long as the losses aren't large and ongoing, she should be fine.

 

[RubysMama]

So it's Monday today, and we've just wrapped up a full two weeks with Ruby on both of her medications. This was the window of time our vet had given us to see whether the meds were helping.

This week past, I'd say between tues-thursday she seemed to be really coming around. She was moving more comfortably, her back wasn't as arched when she was being held or even when she was just standing, her weight seemed to be slowly continuing to go up (on average anyway). She seemed happier to be picked up and held (which was always her favourite thing in the world before she got sick, snuggles with her mama was always a good thing for Ruby. She'd purr and chirp and snuggle into me like a pancake piggy).

Friday came, and she seemed a bit quieter and started to look uncomfortable again - hunching a bit, not wanting any attention. Saturday was the worst day we've had yet. her breathing was really noisy, I actually at first thought the sound was a flock of geese flying over my house to the lake (spring is springin up here in the north). I realized it was actually coming from the pig cage, and it was Ruby. She let out a few hacky coughs, almost like a cat with a hairball. I grabbed my phone, and took Ruby out onto my lap. I was actually sure I was about to witness her death. She calmed down after having her back rubbed for a few mins and she snuggled for a while.

Her weight has tanked to its lowest yet. And yesterday she slept a lot. She's also walking strangely again. She walks slow, and her front paws step, step, and then the back paws she seems to draw in at the same time. Kinda like a really awkward bunny hop. She was doing this before we went to the vet, and the vet said it was likely from being in pain. It seemed to have passed, and she was doing ok - even running around in a circle with her sisters while they wait for their breakfast.

This past weekend was terrible. I know I have to call my vet, but I am honestly scared to. I'm afraid she is going to say it's time to consider our options and Ruby's quality of life.
I know bad days will come sometimes, and that she'll never get rid of the fluidy lungs. I just feel like I don't know how to make that call, if the time comes.

I have poured my everything into Ruby this past two weeks, and will keep doing so. I'm feeling really weary. The ups and downs are normal, I know, but they're so hard on my heart and on the hearts of my kids. We all noticed such an improvement in our sweet girl - and we all noticed the decline in the last few days.

Will update after I speak to the vet later today.

 

[Guinea Pig Papa]

I don't envy the position you're in. I'm sorry Ruby isn't coming around the way we'd hoped.

Just remember that as painful as it may be to have to make that call, what's best for Ruby is what's paramount here. They have no sense of time, and all they know is that they are sick and miserable all the time. My vet told me once, "A month is a LONG time in the life of a guinea pig. " Those words hit home, and very hard. They definitely affected my decisions when it came to Sly.

I do hope that you find something that turns her around. The sad truth of it is that you need to be prepared if nothing does. The emotional rollercoaster is not a fun ride.

 

[bpatters]

Sorry she's had a bad spell.

Heart medicines need to be tweaked a little, one way or the other, until you hit the right combination that works. And even then, they'll need occasional tweaking every so often. I hope the vet can get her stabilized and you can keep her that way.

 

[RubysMama]

I heard back from the vet yesterday. She said it definitely sounds like she needs to have a re-check. The vet said once she hears her breathing and heartbeat, she'll be able to tell how Ruby is improving (or not) with the meds. She did say, gently, that if after 2.5 weeks she isn't showing some response to the medications and is having hacking/coughing and clicking in her breathing, a time may come when we have to discuss Ruby's quality of life. I have an appointment booked for later in the week, but the vet said to call her emerg number if Ruby shows any signs of getting worse and she'll see her right away.

She seems to be sleeping a lot, the fluid on the lungs isn't always loud. She eats on her own, drinks water, and she will walk to me if I call her name (she's my spoiled baby and almost always comes popping out of wherever she's hiding if I call out to her). She moves like she's in pain, almost a hybrid limp-bunnyhop kinda walking. I'm doing everything I can, but I still feel heartbroken that she's having to struggle through this.

She spent some time this morning with me, snuggling and nomming on a few shredded carrots after her meds. She pancake-piggied her head down onto my chest - she seems the most comfortable when the house is quiet and she's snuggling with her mama. I am one of those crazy people who got into guinea pigs not knowing quite what I was getting into. I had no idea I was going to love this little fuzzball so much.

 

[Guinea Pig Papa]

I am one of those crazy people who got into guinea pigs not knowing quite what I was getting into. I had no idea I was going to love this little fuzzball so much.

I know exactly what you mean. My son wanted a guinea pig, and I said an emphatic NO for many reasons. That was in 2010.

Now I can't imagine life without them, and losing my first two hurt far worse than I ever thought it would. For me it was akin to losing children.

I very much hope that you and your vet can find a combination that will help Ruby recover, and keep her stable.

 

[RubysMama]

Well. Today is Ruby's follow up with the vet. I am really hoping all that we need to do is adjust her medication. I cried a lot yesterday. I have a part of me that thinks she isn't going to get better and we'll have a difficult conversation to have today.




On the plus side, most of this week she has been breathing fairly clearly (by Tuesday she was down to just a few random moments where it was a bit raspy sounding) and seems active and eating. Last night, I had her out for a snuggle before bed, and my teens were laughing so hard because she had crawled right up by my right shoulder so I could pet her back. She stares at me until I sing songs to her lol. I made up a version of Baby Mine and have been singing that to her since she's been sick. I started singing it and my daughter was like "OMG she's snuggling into your neck". I just kept singing it over and over and she'd lick my cheek, nuzzle in under my chin, and do her Pancake Piggy where she lays all flat and relaxed on me. If I stopped singing, her head would pop up and she would stare at me til I sang again. Then she'd lick my cheek and go back to sleep. I swear to god, she is the sweetest freakin' animal on the planet.


I'll update when we get back from the vet later today. Fingers crossed that it's just a med tweak or change in something small that we can do to make her more comfortable. I can't imagine my days without my RubySnuggles.

 

[Guinea Pig Papa]

Fingers are crossed that everything goes better this time around. Ruby sure sounds like a little sweetheart, and the medical pigs just seem to intensify whatever bond we already have with them.

You got this Ruby!