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Ovarian Cysts Treatment

chickpea616

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For anyone who had/has a pig with ovarian cysts, can you please explain (in detail) the treatment they went through (or are going through now) and how it was definitively diagnosed. Also, if you don't mind, can you relay any of the costs?

I can get into more detail later - but I recently took one of our pigs in to an exotic specialist (who is not only handles the medical/exam type stuff, but also uses holistic medicine) and am just confused as to everything I was told and was given for her. This was just the other day, so I haven't really done anything to follow up yet - but I'm just wondering what your experiences are.

thanks so much!!
 

bpatters

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I had one pig with an ovarian cyst. The major symptom was aggressive dominance behavior, it was diagnosed with an ultrasound, and because of her age (6+ years) she was treated with hormone injections rather than surgery. The hormones were minimally effective, but before she was due for another treatment, her cage mate died. The cyst didn't seem to be bothering her, so I elected not to do any more injections.

If the cysts are large enough, they can be diagnosed because they can be felt by the vet. Smaller ones cannot, and require ultrasound. Even that isn't always definitive.

I don't know what you were told, but removal of the ovaries is the only sure cure. Some cysts will respond to hormone treatments while others do not. If they're not growing aggressively and the symptoms are not bothering the pig or the other pigs in the cage, it may be possible to get along for quite a while with no treatment. But large cysts can impinge on other abdominal structures, and can bleed severely if they rupture.
 

chickpea616

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OK, so the symptoms she has so far are indicative of ovarian cysts (Dr agrees): crusty nipples, V-shaped loss of fur, and aggressive dominance behavior (so yes, affecting the 2 other cage mates on a daily basis). However, he was not able to feel them with physical exam.

So here's my dilemma: he suggests moving forward with hormone shots (a couple, spaced weeks apart) and see how she responds. There was no CT scan done (yet) but he did take some blood samples, of which *most* came back normal, but there was a liver measurement that came back "off" and he's recommending an herbal blend for that (remember, he's holistic also).

My question would be (fully realizing that I'm simply asking opinions, and that no one here can give medical recommendations/treatment, etc): do we go along with the hormone injections and see how she responds even WITHOUT doing the CT scan (the Dr indicated he would be fine with that option), or just go ahead and get the CT scan first. One issue is cost- they are expensive! The other issue is: if he's willing to do the hormone shots without the scan, why not choose that option? It's kind of odd: he's OK with doing the shots first, yet he's "pushing" the CT "just to make sure everything else is ok". (The vet seems very knowledgeable, caring, great bedside manner, etc. - but I can't help the nagging feeling that he's trying to "sell us" more goods/services than necessary)

Fyi if it matters: her age is around 3.5; Thoughts? (again, just getting opinions)
 

bpatters

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He's pushing the CT not to make sure everything else is ok, but to make money. They're expensive for you, and he has a machine to pay for.

I'm not saying they couldn't be useful. I've just never known of one being used to diagnose uncomplicated ovarian cysts.

The hormone injections are a gamble, but it's a gamble the CT scan won't help resolve. What you need to know is what kind of cyst it is. That may or may not be possible without drawing blood, and that's problematic for guinea pigs if they need more than they can get by overclipping a nail.

I'd either go ahead with the hormone injections or I'd get another opinion.
 

chickpea616

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OK, so now some very basic questions, just so I'm clear:
1) what's the difference between a CT scan and an ultrasound (like you mentioned your pig having)?
2) he's basing his findings off of the physical exam, and my description of the behaviors - and since he can't feel any cysts, is he just assuming it's hormonal and that's why he's recommending shots? (I mean clearly she has some issues, based on what I myself saw...)

Thanks again, bpatters! Once again you provide some awesome answers and insight!
 

Soecara

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Is there any particular reason that surgery to remove the cysts/spaying her is off the table? At 3.5 i would say she is perfectly within the age range that i would personally be opting for having her spayed over hormone injections unless there are some other complicating factors.
 

bpatters

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An ultrasound is just what it sounds like -- the vet uses a wand that high frequency sound waves that the device reads as they bounce off the structures in your body. It's usually done outside the body, although some probes can be used internally.

CT stands for computerized tomography, and uses a combination of x-rays and a computer to create detailed images of the structures in your body. It gives a much clearer picture than either x-ray or ultrasound, but is usually a LOT more expensive.

Here's a link that compares the two: https://www.cardiovascularsolutions...c-ultrasound-or-ct-scan-whats-the-difference/


@Soecara makes an excellent point. Spaying is the definitive cure. You need a good exotic vet who's done many of the surgeries.
 

chickpea616

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Soecara, I think mainly because cysts are just "suspected" at this point, but not confirmed with ultrasound or any other kind of scan. Also, my understanding is that spaying is a risky option for pigs. I think they were trying to go conservative at first, especially since the vet can't feel anything by physical examination and he said that usually you can feel them (if you know what you're feeling for)....but those are just my guesses....
 

chickpea616

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Is there any reason why he would choose a CT scan OVER an ultrasound in this case, because I was quoted $350 for the CT scan but wasn't given the option for ultrasound...plus was told it's an additional $150 for a radiologist to read and interpret it.
 

Soecara

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Perhaps they don't have an ultrasound machine? Perhaps they don't feel they will get good enough imagine on an ultrasound? All we can do is speculate.

Honestly though i would opt for spaying over hormones in this case. She is young enough that surgery shouldn't be a huge risk in the hands of an experienced vet, hormones don't always work and are on ongoing expense. Hormones are a treatment, spaying is a cure. If they weren't confident enough that it was cysts they would not be progressing with any treatments, you don't just inject hormones unless you have a good reason to.

I would be discussing this with the vet though to see what their reasoning is. Did they even mention spaying or giving her an ultrasound as a options?
 

bpatters

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It could be that he's choosing the CT over the ultrasound because he makes more money off the CT and he needs to pay for his expensive machine. Color me suspicious.
 

chickpea616

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I’m taking her in for a second opinion on Monday morning. I have her blood test results and my list of questions prepared! I’ll let you guys know how it goes!


Sent from my iPhone using Tapatalk
 

sallyvh

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I've had two pigs with Ovarian Cysts over the years.

The first was 6.5 years old when she was diagnosed. At this point she didn't have a cagemate (hers had passed) and she failed to bond with other pigs, so she shared bars with another senior. On top of other medical issues, she had enlarged nipples and pronounced hairloss on her sides that led us to probe deeper for cysts. She had an ultrasound which confirmed them and she then received 3 rounds of hormone injections. Her hair grew back and was there for about 6 months before she started losing it again. I never noticed a change in her behavior and did not pursue further injections becuase of her age and she seemed comfortable.

Costs for her were around $800 I believe, with all the exams, ultrasounds and hormone treatment.

My 2nd pig came to me with a confirmed diagnosis of cysts. My local shelter where I used to work at reached out to me about a pig located at the city shelter that was at risk of being euthanized and needed medical attention. She had lots of hairloss, was very pear shaped and clearly very uncomfortable. She had an ultrasound done at that shelter at their expense so the cysts were confirmed there. She's only 3 so I had her spayed at my vet. This was in October, everything went well and she recovered perfectly. The spay was just over $500.
 
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