Conditions Casper's Medical Thread: lesion on testicle

[bpatters]

What he really needs are motility meds, and that means a vet visit. Not all emergency vets are GP savvy, and often there's not an exotic vet available. But if you've got one, take your pig in. The longer bloat goes on, the worse the likely outcome.

The only things readily available on a weekend are massage and simethicone. Baby simethicone is good, give about 1/4 to 1/2 the dose for an infant.

If you've got something that vibrates, even a toothbrush or your clothes dryer, put him on it for 20 minutes or so at a time. Or sit with him on your lap and gently massage his tummy.

Keep him hydrated. The liquid will help loosen any material in his digestive tract and make it easier to pass.

 

[LittleSqueakers]

Got home from work a while ago and he HAS pooped some during the day, though it's very scant and misshapen. He's still bright and alert and allowing me to feed him, and even putting up a fuss when I flush his abscess. He's a brave little animal.

I've been giving him simethicone since I realized his eating was off, and my vet even told me that he could take it at a much higher dosage. I think she said 10-20 mg/kg every 8 hours? I'll go find my post-it and post when I find it. I massage his belly during his feedings. He is drinking on his own still, but I'll be sure to offer him some Pedialyte, too.

I checked with the emergency vet and they don't have an exotics vet there today. I'll support him at home overnight and take him to his regular vet tomorrow. I'm thinking he's going make it till then alright.

 

[LittleSqueakers]

Update on Casper: he started pooping more overnight and was much more active this morning. Got him in to see the vet and she prescribed metaclopramide to stimulate his gut. Of the 2 antibiotics he was taking, I'm pretty sure the metronidazole was the one causing the issue. The other antibiotic is bactrim, and he's had it before without any problems. Vet said to drop the metronidazole and start back the bactrim once he's eating again on his own. She also sent us with some betadine to mix into his solution to flush the abscess. When he got home, he actually ate a few strands of hay. He's since been quiet the rest of the day, haven't seen any more poop yet, but I'm hoping I'll see some more activity this evening. Hopefully he's on his way out of the GI issues so we can go back to treating the abscess.

 

[LittleSqueakers]

Update: Casper was very sedate last night and for a while I was worried that he was backsliding. However, he does seem to be making steady progress today. I haven't seen any poops all day, which was worrying. But at the same time, he seems more active and more willing to eat and his abdomen is starting to feel less gassy. After watching for a bit, I managed to catch him eating his own stools, so it seems he actually is pooping more than I thought!

I'm still worried that he doesn't seem to be eating enough on his own, but when I offered him some fresh clover, vetch, and grass from the yard, he gobbled it up and came looking for more. I got him to eat a little botanical hay and orchard grass as well, which are a change from his usual timothy. So clearly he WILL eat at this point, I think he's just needing a bit of encouragement. To that end, I decided to go ahead and take the risk and just put him and Poptart back together. Poptart really has turned out to be an excellent cagemate for Casper. He's rarely aggressive, but he's great at pestering Casper into doing things he doesn't always want to do - like move around and get up to eat and drink every once in a while. I'm hoping that he can keep Casper moving forward while I'm at work the next few days, but I'm still going to take a long lunch and come home to check on him and give him meds and supplemental feedings as necessary. Also, I have a webcam installed in the pigpen, so I'll be able to kind of keep an eye on them from work the next several days.

 

[LittleSqueakers]

Forgot something important! He seems to have formed a fistula from the abscess up into the floor of his mouth. When I was flushing the abscess earlier, we were BOTH surprised when the water shot out from around his lower incisors and hit me in the face. It was like being squirted by a toy from a big kids meal! I called and talked to his vet and she seemed surprised too, but not overly concerned. She says the fistula will likely close up on its own as the abscess heals, and to just try rinsing his mouth when I flush the abscess so that he doesn't wind up with food caught in it. The abscess is looking really good so far. I'm going to start him back on the bactrim soon, once I'm sure he's serious about eating on his own.

 

[LittleSqueakers]

Update: Casper's eating well on his own now, and I started him back on the sulfa last night. I noticed that his weight has dropped again this morning, but I think it might just be because I stopped feeding the critical care and he hasn't re-started eating his pellet food yet. I'll continue to monitor him closely over the weekend, but right now he's acting like his normal self and is eating hay and veggies well. If he doesn't start eating the pellet food again soon, I have the Oasis multivitamin drops I can supplement with.

I'm a little concerned about the situation with flushing the abscess with the fistula in the floor of his mouth. Every time I flush through the hole the vet lanced in his throat area, he starts chewing and drinking the water that comes out through his mouth and I also catch a whiff of this evil odor that tells me the pus just flushed through the fistula into his mouth. I know I need to keep the external lanced hole open to drain the abscess, but I don't want to keep flushing through the fistula or it may not close up. I guess I'm going to try my vet's suggestion and just gently rinse the lanced hole to keep it open without flushing with a lot of force. I'm hoping that after a few days of antibiotics and backing off on the forceful flushing, the fistula will have had some time to close up. Let's hope we get lucky, too, that the sulfa just happens to be the right drug to kill whatever bug is living in the abscess. I'll keep posting regular updates in the hopes that maybe this experience will prove useful to someone else who may be dealing with a similar problem one day. Wish us luck!

 

[LittleSqueakers]

Update on Casper: He took his final dose of bactrim this morning and seems to be doing great. However, he still hasn't re-started eating his pellet food, and his weight has been up and down according to how much/often I've been able to feed him critical care. I know that pigs can do just fine without pellet food as long they are properly supplemented with a multivitamin, but the weight loss just still has me on edge. How am I supposed to know if it's just from not eating pellets or if he's actually getting sick again? The abscess itself it closed, but I can still feel a little knot of tissue under the skin. I'm pretty sure it's healed for now, but I still have a feeling that it's probably going to end up causing issues again at some point.

 

[LittleSqueakers]

Update: Casper finally started eating his pellet food again Friday night after I posted. His weight this morning is up 10 grams from yesterday and 20 grams from the day before that. So he's gaining slowly, but headed in the right direction. I can still feel the lump where the abscess is/was, but it doesn't seem to be changing, so I'm crossing my fingers and hoping it's just healing tissue. The only thing is that Casper screams when I touch it, so I'm not sure whether it's actually still painful, or if he's just reacting because he's expecting it to hurt. Idk. I'll continue to monitor it and if it seems to be growing or changing again, we'll go back to the vet.

 

[LittleSqueakers]

Update: It's not healing tissue. I palpated the abscess this morning and it felt slightly bigger, but then as I pressed on it, I smelled pus express into his mouth through the fistula. As I examined him a little more closely, I saw a little blood around his lower incisors, so the fistula into his mouth is definitely still open and the abscess is not yet healed. I wonder if 7 days of antibiotics wasn't long enough? It was getting better, but apparently didn't go completely away. I'll call his vet when they open to see if I can get him in today or tomorrow for a recheck. He seems fine as long as I'm not messing with the abscess, but he does appear to have stopped eating his pellet food again, so I think the abscess may be making that difficult/painful. More updates to come.

 

[LittleSqueakers]

Update: Casper went back to the vet for a recheck on Tuesday. A different vet saw him this time, and bumped up his dose of bactrim by 50%, and he's going to take it for 2 weeks this time instead of 1. Vet did mention possibility of this being a tooth root abscess, but thinks it unlikely at this point. He was doing fine until yesterday morning, when I noticed he had lost a big chunk of weight and hadn't eaten his food pellets again. When I got home from work yesterday evening, he was sitting puffed up and puny, and clearly hadn't eaten much that day. So, back to hand-feeding CC, and I started him on simethicone and reglan again. My working theory is that maybe a 50% dose increase of bactrim is a little more than he can handle, so I've dropped the dose back down to the lower dose the first vet prescribed. The abscess had been showing improvement on the lower dose, and he wasn't bothered by the meds, so I'm hoping that doing it for 2 weeks will be enough. He's looking a bit better today, and he's showing some interest in munching hay and lettuce, so I think I hopefully noticed quickly enough that he was having a problem that he can bounce back quickly, too.

 

[LittleSqueakers]

Update on Casper: Shoot. I really thought we had this problem with the abscess licked.

Palpated his chin last Saturday and the abscess was coming back, along with that awful, smelly breath from draining pus. He saw the vet on Wednesday, and it's not good news. Vet is now sure that what he has is a tooth root abscess in one of his lower incisors. The pus is probably just draining from around the tooth. The vet said he could try his best himself there in the office, but he knows he doesn't have the best equipment or expertise for the procedure. I accepted his advice to be referred out to the vet school in Knoxville. Casper has an appointment on 9/6.

Thankfully, he seems to be feeling pretty good right now. He's eating well and not losing weight, and he's already on metacam long-term for joint pain.

From what I've read of other owners' experiences here on this forum, we could be in for a real rough ride. I can't say that I'll be able to afford to do everything the specialist recommends - there was mention of a possible CT, and I definitely can't shovel out the money for that - and I'm concerned about the recovery process as I work 12-hr shifts and have an irregular work schedule and there's no one else who can take care of him for me. I'm really worried that things may not work out for Casper piggy... Still, I'm not ready to write him off just yet. I want to see what the specialist says and go from there. As always, my first priority is to all my pets is protect them from suffering. More updates to come.

 

[Guinea Pig Papa]

Man, I was really hoping it wouldn't come to this. I know you'll do what you need to, and I also know that sometimes some things just aren't possible. I went through this with Punkin but his was an upper incisor. You are right, it did not go well.

Fingers crossed that everything works out.

 

[LittleSqueakers]

Update on Casper: His appointment with the exotic specialist at the vet school is this coming Tuesday. I was initially really concerned about waiting so long after the vet diagnosed a tooth root abscess, but actually... He seems to be doing just fine. Almost indifferent in fact, which is perplexing.

His weight is stable, he's eating and drinking and active. He was even running laps last week, which he rarely does to begin with because of his chronic joint pain. The only thing I've noticed different is that he does seem to be unable to gnaw carrots apart now and a little slow on gnawing hunks off his other large veggie chunks, so I've been cutting everything into matchsticks for him. But then I saw him devote several hours on Friday to gnawing on hay cubes! The abscess itself seems to have shrunk down for the time being, though I can still palpate it. I guess it's draining well so it isn't getting bigger. But at this point, I'm actually starting to wonder if the abscess is actually in a tooth root at all?... Idk. Certainly, I'm not a vet, but this problem just doesn't seem to be presenting how I would expect. I guess I was assuming it would cause progressively more pain and difficulty eating the longer he had it.

I called the vet school last week and asked about pricing for a CT scan, and was surprised to find out that it was not going to cost the many thousands of dollars that I have learned to expect working in human healthcare. It's still a big chunk of my vet budget, but I'm starting to think I MIGHT just go for it. It sounds like it's going to be the best option to get to the bottom of what exactly the problem is. I'm hoping against hope that maybe, just MAYBE, this problem might be easier to fix than I was anticipating. He's a brave little animal, and he gives me hope. Wish us luck, friends. More news soon.

 

[Guinea Pig Papa]

Best of luck to little Casper, and to you. Really hoping for some better news. Please keep us up to date.

 

[LittleSqueakers]

A long-overdue update on Casper's abscess: he saw the exotic specialist at the vet school on 9/6. The day before we went, I made a startling discovery: he had lost his right-lower incisor. I pointed this out to the vet when we were there, and she said that because the tooth was missing, she wouldn't be able to pull it (assuming that's what was needed) until it had grown back. However, she was cautiously optimistic that the abscess might still be healed with the right antibiotic.

We held off on the CT scan since we were holding off on surgery. She sedated him and opened up the abscess to drain it and get a culture. Finally, she prescribed chloramphenicol. When I asked her about home care (ie flushing the abscess), she seemed to think this was unnecessary and that the chloramphenicol would take care of the abscess. She recommended just cleaning the exterior of the wound. I was suspicious of this advice, as everything I have ever heard or read regarding abscesses in guinea pigs emphasizes that it is critical to flush the abscess to keep it open and draining so it can heal from the inside out. But...I chose to follow the vet's advice.

Well, he's now been on chloramphenicol for about 6 weeks. He's tolerating the medicine well, but the healing progress seems to have reached a plateau. I took him to his regular vet 2 weeks ago for a recheck. I expressed my concern that the abscess was still not healed and no longer seemed to be making progress. He now has a pinhead-sized opening where they opened it on 9/6, where I can still express out some small amount of pus daily (much to Casper's outrage). His vet has been trying to get the sensitivity from the vet school - she received his culture results in his records, but somehow the sensitivity isn't there? Idk. I'll probably call the vet school myself, but I don't know that I'll have much more luck.

When she called me this past weekend to give me an update, she mentioned the possibility of doing a marsupialization surgery, or possibly implanting antibiotic pellets (but she would need the sensitivity panel results). If the abscess turns out to have bony involvement, antibiotic pellets would be the best bet. She doesn't recommend bony surgery or tooth extraction as the outcomes for guinea pigs are generally very poor, and I agreed that if it comes to that, I will have him euthanized rather than put him through it.

Has anyone ever had any experience with the antibiotic pellets? Or marsupialization surgery?

 

[omgitspiggies]

Well, I've had my little men 2 months and we've already run into our first medical issue.

Last Thursday, I noticed that Casper (formerly Avery) was having significant redness and a little swelling in his left testicle. At the time, it just looked like irritation, like it might have been an abrasion or something and he wasn't showing any sign of pain, so I made a vet appointment for the following day and decided to monitor until then. We went to the vet last Friday and by then it looked like there was possibly an abscess or something forming in the scrotum surrounding the testicle. The vet put him on SMZ and metacam to see how he did over the weekend and told me to bring him back Monday for a recheck.

I split the cage when I got home from the vet. Friday night, Casper clearly wasn't himself. Saturday morning, I saw that he hadn't eaten as much as I would have liked overnight, so I gave him a serving of critical care with his morning meds. When I got home from work Saturday afternoon, he seemed to be feeling a lot better. I picked him up to check him over, and the area on the testicle seemed to have ruptured and was draining a little. Over the weekend, the swelling and redness decreased and I thought I could see a small pus-pocket inside the abscessed area.

Monday evening, we went back to the vet for a recheck. Dr. Huong agreed that the inflammation looked better, but was concerned that this was not a typical abscess. She sent pictures to the clinic's other exotic veterinarian, Dr. Ashley, and a few colleagues, and they all agreed that this thing -- whatever it is -- doesn't look normal and it needs to come off. So Casper's scheduled for a neuter with a scrotal ablation tomorrow.

So here we are. At present, Casper seems to be feeling really good overall. I split the cage last Friday after we got home from the first vet visit and I'm keeping it split for the time being. He's still on SMZ twice daily, followed by a "poop soup" probiotic, courtesy of his cagemate, Poptart (formerly Andrew). I've saving the rest of the metacam for after the surgery since he doesn't seem to be in any pain at present. I'm supplementing an extra 25mg vitamin C daily. I'm also supplementing a small serving of critical care twice a day to go with his meds. Although he's eating normally on his own and his stools are plentiful and normal, Casper's been underweight and struggled to gain weight since I brought him home. He's been gaining weight since last Friday since I've split the cage and been feeding CC, so I decided to keep at it to try and get him into good health status in the days leading up to the surgery.

I guess the two questions I have right now are these:

1.) The vets strongly recommend that we send off for a biopsy, but it's a huge chunk of the cost of the surgery. Can anyone with any experience in the area of having mysterious lesions removed tell me if a biopsy is worth the cost?

2.) Should I feed him his CC with his meds the morning of the surgery? Or would it be better that he doesn't have too much food in him when he's under anesthesia? (Don't worry; I know not to withhold food entirely from a guinea pig.)

I wish I could see it, however it sounds like a sebaceous cyst that popped. That’s common if it is.

 

[LittleSqueakers]

Hi everyone! Well, it's been a while since I've been on the forums, and I never did actually post about the conclusion of Casper's tooth abscess saga. Long story short: we were finally able to heal the abscess without surgery using azithromycin. After 6 months of fighting the horrid thing, he's been abcess-free since Thanksgiving. The lower incisor he lost during the infection never did grow back; I guess the tooth root was too badly damaged. But with his one remaining lower incisor he's been able to pick up food and feed himself without any trouble - I just have to dice up his veggies so he can pick them up.

Fast forward to last week: he suddenly started looking very puny, not eating well, and losing weight. Didn't see any signs of sickness, and the rapid onset made think that something might be hurting him. I started feeding him critical care over the weekend and he's really perked back up now. Vet visit on Monday revealed some minor tooth spurs on his back molars that might be causing some problems, so I brought him back in today for sedation and tooth trimming. He'll be at the vet today until I pick him up after work.

So, I got a call from the vet, and she says that his remaining lower incisor is pretty loose. She thinks this might be what's bothering him more than the molar spurs. Likely due to the long battle against the tooth root abscess, the surrounding bone tissue has probably experienced a fair bit of degradation, leading to loosening of the neighboring incisor.

There's obviously no reason to pull the incisor, as he'll have nothing left in the bottom to pick up food. The vet says she'll have to do some research to come up with specific recommendations, but now I'm really concerned. What does long-term management of something like this look like? How can I help manage the pain this seems to be causing? What if he eventually loses his one remaining lower incisor? Is this even something that I can help him cope with long-term, or is this more than likely "the beginning of the end"? Looking for any advice or experience related to this matter.

Thanks everyone, and happy St Patrick's Day!

 

[Guinea Pig Papa]

We had a similar issue with Sly, regarding his ongoing dental issues. I must say that it was his molars that had gotten loose, and that it was very close to the end of his time with us. We ended up making the decision to send him across the rainbow bridge when he had to choose between breathing and eating, and his little body couldn't handle another dental surgery. If his remaining incisor falls out, you are correct in that he will have no way to pick up food. At that point you'd have to decide whether or not you want to keep him going with Critical Care feedings, or let him go. It's a lousy position to be in.