Update: After having the spurs trimmed off his back molars 3 weeks ago, Casper was still not quite right in his eating. One of the first things I noticed after the tooth trimming - which should have been obvious to me earlier - is that his cagemate, Poptart, eats more than twice as fast as Casper is now capable of doing. So I now not only dice up his veggies really small so he can pick them up to eat, but I make sure to hand feed at dinner time so that I can play referee and make sure he gets his fair share. He's been willing enough to eat anything offered to him, but in spite of this and supplemental feedings of CC 1-3 times daily, he still was struggling to maintain his weight.
Finally, on Monday morning, the latent tooth abscess made it's appearance. I dropped him off at the vet for the day on Tuesday and boy, has the situation changed.
The vet confirmed that his remaining lower incisor was infected... and it had to go. I didn't understand this recommendation at first, as I always thought that a guinea pig simply cannot eat without any lower incisors and has to be euthanized. But the vet told me that guinea pigs can sometimes learn to adapt to feed themselves. I've been bringing my pigs to this doctor for a long time. I trust him, and he knows that I'm attentive to my animals and take good care of them. Success would largely depend on Casper.
I had originally decided that if Casper's problems ever came to the point of tooth extraction, I would have him euthanized rather than put him through it. But his vet didn't seem to think that losing the incisor was necessarily a death sentence for him. He felt that it was worth giving the tenacious little fellow a chance to see what he could manage to do. Casper has already surprised me a number of times in the years I've known him by coming back from the brink. Tuesday morning, he was still eating and begging for his vitamin; not even close to giving up. I decided to give it a try.
The vet pulled the tooth - he noted that it was black on the root end
- lanced and drained the abscess, and took a culture sample. Casper's on Bactrim for the moment until the culture results come back.
I picked him up from the vet after I got off work, and was surprised to find him bright-eyed and active in his carrier. He takes metacam daily for arthritis, and he didn't appear to be in very much pain at all. Even MORE surprising - after I got him home, fed him a meal of CC (which he eagerly gobbled up), and put him back in the pigpen with Poptart, he STARTED EATING HAY. I don't mean he TRIED to eat hay; he actually managed to pick up strands and gum at them for a few seconds until they hit his back teeth and he could pull them into his mouth. I was floored. The next morning, when the vet called to check on him, he was ecstatic to hear the news. Casper is not finished just yet.
He's continued to eat hay on his own and move around without any obvious signs of difficulty. I can tell that he does hurts some, as to be expected between the surgery and ongoing infection, but for now his pain seems to be under control with metacam alone. I'm feeding him CC 2-3 times daily right now, and he'll likely be on it long term for supplementation as it's become clear that he can no longer pick up his food pellets at all. We're working together to figure out how I can best help him to eat his veggies. Again, he has proven himself to be a lot more adept at manipulating what I hand to him than I would have ever imagined. I think he may be a bit challenged by the water bottle at present, so I put a dish of water in the cage to give him another option.
Honestly, if it had been any other pig or any other situation, I don't think I would have taken the chance. I think we were at an advantage in several ways. For one, the bad tooth was an incisor - which is easier to extract than a molar. The tooth was also already loose enough that it didn't take a lot of effort to remove. Since I have been proactive in providing supportive nutrition, he was in good condition when he underwent the surgery (ie yes, his weight has dropped, but it was holding steady with the extra feedings, so he has not been starving). And again, Casper has the spirit of a survivor.
This isn't the end of Casper's problems, not by far. The vet point-blank told me that he's becoming somewhat of "a dental nightmare." Obviously, he'll require intensive monitoring and regular work on his teeth - at least of his top incisors and quite possibly of his back teeth as well - for the remainder of his life. He'll need to have his diet modified somewhat to ensure that he can get what he needs to eat. And, of course, we still have to deal with the abscess and underlying infection that has caused the problem to begin with. Still a long road ahead, but he's not over yet.
I don't know how much longer he'll be with us in the long term. But Casper-rah has proven himself beyond doubt, and made a believer out of me. I held him in my arms and told him not to listen to any of the silly, sightless fools who are ignorant of the hidden strength of the guinea pig. Once again, I am in awe of this brave little animal, rescued from a hoarder's home.
If you read all the way to the end, thanks for hearing our story, and I will continue to post updates whenever possible. Have a great weekend everyone!
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! 
Wish us luck, friends. More news soon.
