Browsing tag: Guinea Pigs

How we prepare your pet for anaesthetic.

Once you relinquish your pet to the green fairies, you may be wondering what actually happens “out the back”.

Well, wonder no more. Firstly we make sure that we have an accurate weight for your pet as this is what we use to calculate the dose of the drugs that we give your pet. Once we have this we settle them in a kennel with nice squishy blankets while we go and get everything prepared.

If you have opted for, or we have recommended, a blood sample before anaesthesia then your pet is taken to a quiet part of the practice where we can safely take the sample. To take the sample, a patch of hair is shaved over the jugular vein which runs down the side of the neck, to one side of the windpipe and a needle is inserted to collect the blood. Most animals tolerate this quite well with the gentle yet firm restraint that we green fairies have down to a fine art. Some animals on the other hand object quite vociferously and may have to have the blood sample taken once they are anaesthetised. Not ideal but better if they are getting too stressed.

Once the results have come back and been received by the veterinary surgeon, they can decide what to pre-med with and whether the use of intravenous fluids is necessary. Intravenous fluids are usually considered if there is any elevation of the liver and kidney enzymes which show that these organs need a little help during anaesthesia as that is where most of the drugs used are metabolised. Some veterinary surgeons also advocate the use of fluid therapy during routine bitch spays as a spay is a fairly major and invasive procedure and fluids help maintain blood pressure and support the body during this procedure.

There are a few ways that we can induce anaesthesia in your pet. One way is to use the anaesthetic gas and get them to breathe the gas in via a mask or an anaesthetic chamber. This way is usually used with smaller creatures such as rabbits, guinea pigs and rats and they fit into the anaesthetic chamber and can have oxygen administered in this way before the gas is turned on.

Another way is to inject an anaesthetic agent called Propofol into the vein and then maintain anaesthesia directly into the airway using an endotracheal tube which is fitted into the windpipe. This is the most commonly used induction for surgeries as induction is quick, Propofol wears off quickly and then the anaesthetic can be controlled with the gas.

The final way is to inject a combination of sedative and tranquilliser drugs into the muscle, usually the lumbar muscle or the quadriceps. This way is usually used for short, less painful and less invasive procedures such as cat castrates where the animal only needs to be asleep for a short period and is reversible with another injection.

If your pet is having surgery, the affected area will have to be shaved and cleaned to maintain the sterility of the site. This is why we advise that dogs are fairly clean when they come in so that we don’t have to spend so much time cleaning them which means they spend less time under anaesthetic.

So, that answers the question of how we prepare your pet for anaesthetic or why he has so many bald patches!

If you are worried about your pet’s surgery please talk to your vet, or check any post op symptoms with our Interactive Symptom Guide to see how urgent the problem may be.

How can you tell if your pet is in pain?

Domino-sleeping
It seems a simple enough task, to be able to tell when your pet is in pain but actually it can be a lot harder than you think. Animals have been programmed over millions of years of evolution to hide when they are sore or in discomfort, otherwise predators and competitors would pick up on the signs and target them. So, as owners, we need to be vigilant to quite subtle changes in our pet’s behaviour that could indicate they are in pain, and ensure they don’t suffer in silence.

Depression

Most of us assume that if an animal is in pain they will cry out or whine but actually the opposite is true. Chronic (low grade and continual) pain is very depressing and often animals learn to cope with it and show few outward signs of a problem, other than maybe being quieter than normal or sleeping more. The problem with is that this sort of pain is common in older pets, for example with arthritis, and this is what we expect them to do anyway. However, even in excruciating pain our pets can be very quiet and withdrawn. I once saw a cat with a very badly broken leg who had managed to drag himself home, curl up in his basket and was so calm his owner didn’t think he was in any discomfort, until she saw the x-rays! Often with this type of pain, it is not until you give your pet some pain killers, and see the difference in their behaviour, that you realise how sore they were in the first place.

Lameness

A very common sign of leg pain, from pulled muscles to arthritis, is limping. Other than this the pet can seem quite well and cheerful, and often won’t respond to the leg being moved about or felt, which can lead to their owners thinking they aren’t in any pain, when nothing could be further from the truth! Lameness is a very common problem and if it lasts more than 24 hours (even if it is intermittent) the pet should always be checked over by a vet.

Smelly Breath

All pets have smelly breath to some degree (!) but halitosis can often be the only sign, without looking in their mouths, which some pets are reluctant to let their owners do, of painful teeth problems. Often people assume if their pet is eating then they aren’t in any dental pain but this isn’t the case, as an animal’s drive to eat will always overcome any soreness. In fact, if a pet does stop eating because of mouth pain, it is likely to be excruciating and will have been there for some time. Other signs of mouth pain include tartar build up on the teeth and swollen gums. If you are concerned, most vets run free dental clinics, so give them a ring and pop along.

Weight Loss
Bunnies

Our smaller pets, like rabbits and guinea pigs, are even better than cats and dogs at hiding when they are sore because, as prey animals, if they show any signs of being ill, they will be quickly singled out by predators. So their owners have to be even more vigilant to spot problems. In fact, it is not uncommon for these pets to be brought into our clinics close to death, their owners distraught that they have missed signs of a problem or thinking they have fallen ill very quickly, when it is more likely they have been poorly for a while but have managed to hide their symptoms. However, one thing which always happens if these animals are in pain or poorly is that they will lose weight, even if they appear to be eating normally. So, weighing your small pets regularly is a great way of monitoring them and any changes in a downward direction should always be taken seriously.

Our pets can’t speak for themselves and in many cases are too brave for their own good; trying to pretend that everything is fine when in fact they are in pain and suffering. So, all good owners should be alert to the small changes that could indicate a big problem and make sure they get them treatment they need and deserve.

If you are worried that your pet may be in pain, please contact your vet. If any other symptoms are present why not check the urgency of the problem by using our Interactive Symptom Guide?

Pain Part 2: Getting rid of pain

Pain and pain relief are massive topics which can – and do – fill several textbooks. It’s way beyond the scope of a blog to go into all of the detail surrounding the use of painkillers, and so all I really want to do is to outline some of the different types of pain control that we can use, both in the surgery and as day-to-day treatments.

Pain relief is one of the great success stories in medicine, and it’s no coincidence that some of my favourite drugs of all time are painkillers. Our advances mean that pain in our patients shouldn’t be accepted, and although sometimes we fail to control it, we should never stop trying.

We use a number of different types of painkiller:

  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Steroids
  • Opioids and opioid-like drugs
  • Others

NSAIDs

These are the most widely-used type of painkiller and include (for humans) aspirin, ibuprofen and paracetamol. They act by stopping inflammation.

They’re commonly prescribed for post-op pain and for joint problems and may be given for long periods of time. When you’re given painkillers to take home from the vets, they’re usually NSAIDs.

Three things to really take on board with these drugs:

  1. Human drugs are not always safe for pets, so never give anything to your pet without talking to your vet first: half a paracetamol can kill a cat, a big dose of ibuprofen can do the same to dogs and even a solitary aspirin can be a lethal overdose for a toy breed, designed as it is for a much bigger animal (us). This is why we have veterinary-licensed drugs for our patients.
  2. Increasing doses won’t give more pain relief, and may cause side effects. If they’re not working for your pet, talk to your vet about alternatives.
  3. NSAIDs are most effective when given before the inflammation starts. It might seem odd to suggest giving painkillers before the pain even begins, but this is important in treating chronic, repeated and predictable pain like arthritis.

Two of the most common drugs we use are meloxicam and carprofen. Meloxicam usually comes as a syrup, which can be dosed very accurately, and carprofen is generally in tablet form. Both drugs may be used long term as a daily dose and both have been responsible for giving patients their lives back, sometimes for years. We’re also rediscovering paracetamol as an excellent addition to treatments in dogs.

Recently, newer NSAIDs have been introduced which are labelled either as cox-2 inhibitors (e.g. firocoxib), or else dual inhibitors (tepoxalin). Essentially, these are just descriptions of which bit of the inflammatory cascade they act upon, and they’re designed to reduce some risks of side effects that we see with other NSAIDs. It’s arguable, though, as to whether they’re better at relieving pain than some of the older drugs.

More recent still is Trocoxil, an NSAID for dogs which is only given once a month. The theory is that because it acts as a persistent block to inflammation, there’s no point where the vicious cycle of pain can really take a hold. The exact ins and outs of the drug are a bit too much to go into here, but as always, speak to your vet about this medication if you’re interested in finding out more. Do understand, though, that it’s not for every patient and your vet may have good reasons not to use it on your dog.

Steroids

Steroids are very powerful anti-inflammatories, which gives them painkilling properties. However, they also affect the immune system – many patients take them for allergies and auto-immune problems – and can have major side-effects when used long-term at high doses; they also can’t be given with NSAIDs and so for practical reasons their use as painkillers is limited. You may have experience of PLT (Predno-LeucoTropin), a medicine with a steroid component which can be great for chronic pain when other drugs seem to be failing. It’s been around for a long time, and many an experienced vet will recognise its usefulness.

Opioids

Opioids are a group of drugs which act to block the passage and brain detection of pain signals. The classic drug in this group is morphine, which still forms the basis for relief of severe pain in humans. These are very powerful painkillers indeed, although the degree of pain relief depends on whether they’re what we call a full-agonist or a partial-agonist.

Drugs like morphine, pethidine and fentanyl are full-agonists, and tend to be used only within the surgery. They are subject to close control and are never dispensed. Generally they’re given by injection, although fentanyl is available as a long-acting skin patch, which has been very successful for use in trauma patients like RTA cats.

Buprenorphine and butorphanol are partial-agonists and are often used as part of a pre-med before surgery. Buprenorphine is a great painkiller which is usually injected within the practice, but may occasionally be dispensed for oral, very short-term use. It is certainly useful in breaking pain cycles and allowing us to get onto more stable pain relief regimes. For in-patients where NSAIDs either don’t quite cut it, or else a combination therapy is needed, buprenorphine is an excellent drug.

A drug that we’ll often use long-term in out-patients is tramadol. This is a human drug which acts in a similar manner to opioids, and has a number of significant advantages:

  1. It’s usually pretty safe, although it can temporarily knock some patients a little flat. Your vet should tell you about this when prescribing.
  2. It’s a GOOD painkiller
  3. As it has a different way of working to NSAIDs or steroids, it can be used in conjunction with many other drugs to create a better painkilling effect

Others

Other drugs that we use act in novel ways, or else are designed for other purposes but just happen to help with pain control. These are important drugs, and whilst they’re described last they’re definitely not least in importance. In brief:

  • Local anaesthetics may be used in and around surgery, to numb the pain nerves. These tend to be injectable, although some creams are available which can be useful to pre-treat patients with needle phobias and the like.
  • Ketamine – yes, the horse tranquiliser – has been used for years in emergency medicine as a painkiller; it’s often included in battle packs for soldiers. Its use in our patients is quite specialised and confined to hospital environments.
  • Gabapentin. This is a very interesting drug indeed. It’s normally used as an anti-epileptic, but seems to have a great effect on pain of nervous origin (aka neuropathic pain), so can be useful for spinal and neurological conditions.
  • Cartrophen is an anti-arthritic drug (also sometimes used in bladder problems in cats) which has a number of effects on joints. It’s usually given as four weekly injections, followed by a variable period of remission. It can be very beneficial for some arthritis patients, but may need a little forward planning in its use, as its administration isn’t recommended at the same time as NSAIDs. It’s certainly a drug worthy of close inspection in long term arthritis cases.

Integrated methods of pain control

Whilst it’s obvious that we have some great drugs for relieving pain, reliance on drugs alone in any condition is generally a limiting approach, as adding in other treatment types – or modalities – may offer greatly increased success rates.

For example, in heart disease drugs may help to keep the cardiovascular system going, but are much less effective when used by themselves than in an overall strategy including lifestyle change, weight loss, exercise programmes, regular monitoring and support networks.

Similarly, drugs may form the heart of a pain relief strategy, but shouldn’t be used as an excuse to avoid other measures that can help – and there are even times when non-drug pain control is good enough that painkillers are not needed. Whatever the non-drug modality used, the decision on when not to use painkillers is a simple one:

  1. The pain is being completely controlled by non-drug methods.
  2. That’s it.

Remember that phrase – pain is not acceptable in our patients. If nothing else, these blogs should have explained both why pain is a bad thing in the long run, and the sheer number of drugs that fight pain. Treating pain completely without drugs is a brilliant solution, but simply taking the edge off the pain is not enough. Equally, though, finding a number of ways to help with the pain will almost certainly mean that your pet gets more relief and is happier.

Treatment modalities which can help in chronically painful conditions include:

  • Acupuncture – there’s a reasonable body of evidence for the physical effects of acupuncture and theories of how it may ‘close the gate’ on pain. It’s now widely available around the country, but must be performed by or under the direction of a vet.
  • Supplements – for joint problems, there are a number of supplements containing combinations of glucosamine, chondroitin and green-lipped mussel extract, which protect the cartilage and may even get rid of the need for painkillers in early arthritis. Additionally, essential fatty acid supplements and vitamin E are both mooted as aids to tissue repair and free-radical scavenging.
  • Herbal remedies containing Devil’s Claw are widely available, but be warned that the supplement can cause side effects and that clinical trials have produced highly variable results.
  • Weight loss – whilst it’s obvious that in arthritis, every excess ounce is another ounce of pain, recent work has suggested that body fat has a chemical pro-inflammatory effect which may exacerbate pain generally. Reducing body fat may reduce the body’s pain responses, particularly in chronic conditions.
  • Surgery – for many painful conditions, surgery is the obvious treatment to permanently remove the pain at source.
  • Physiotherapy – hydrotherapy, mobilisation, massage and PROM are all very useful in promoting recovery and dealing with chronically painful conditions. Access to these services is usually by referral from your vet, and animal physios are highly qualified professionals.
  • Mood enhancement – pain is depressing, so elevating mood helps patients to cope, and also makes new pain easier to deal with. A number of products are available, from pills (including zylkene, a natural extract, and amitryptilline) to pheromone sprays and diffusers (feliway, DAP), but equally, promotion of routine and enjoyable activities can be very successful.
  • Prevention –as the best pain relief is prevention, a word should be said about how we avoid seeing dogs with arthritis or cats with pancreas issues in the first place. Also perhaps timely, as the Animal Health Trust, in conjunction with Edinburgh Vet School, have just announced a project into genetic testing for hip and elbow dysplasias in Labradors. Being able to breed the conditions out of our patients will have a major impact on the wellbeing of future generations (so, if your Lab is KC registered and hip scored, the AHT might just want to hear from you).
  • Magnet therapy – to this day, I still don’t know if this really works, but plenty of my clients are convinced – including a large proportion of horse owners, who are about the most hard-bitten, unpersuadable people out there.

There are, of course, countless other integrated therapies, like Reiki or Homeopathy, and each will have their champions and detractors. The important factors with any of these are choice and inclusivity – it’s fine to explore all of the possibilities, but not to the detriment of the patient. As a general rule, the vet who prescribes you meloxicam won’t demand that you stay off the Reiki during treatment, and this should work both ways.

The mainstay of pain relief will always be drug therapy, but its effectiveness can be massively enhanced by looking at integrated treatments. Pain is such a debilitating problem that anything which can help to remove it has got to be worth exploring. If you feel that your pet may be in pain, especially if you’re already giving treatment, then speak to your vet about what you can do – there are so many ways to target pain that there’s bound to be something to help.

And do remember that phrase: pain is not acceptable in our patients.

If you are worried about your pet’s health, talk to your vet or use our Interactive Symptom Guide to help assess how urgent the problem may be.

In praise of the Guinea Pig

guinea_pigI love Guinea Pigs, I think they are fabulous little creatures, friendly, full of character and very easy to keep.  I recently did some work for a vets based at the back of a large pet store and one of the highlights of my day was walking past the Guinea Pigs and watching them all running about!

Guinea Pigs make great pets but are particularly good for children. They are easy to handle and calm when held, in contrast to rabbits, who although very cute to look at, can cause nasty scratches if they wriggle in your arms.  They are easy to tame and rarely bite, unlike hamsters, who can nip if they are disturbed and are not used to being handled.  Guinea Pigs are also great pets to do things for; make them a little house from an up-turned shoebox and they will be straight in there; pop in a couple of toilet rolls and they will get to work shredding them immediately, another reason why I think they are so good for children, who will be delighted their efforts are well received.

Guinea Pigs are very sociable creatures and will soon learn to ‘talk’ to you when you appear with their dinner!  They should be kept with at least one other of their own kind and watching them play is a great distraction.  However, although Guinea Pigs and Rabbits are often kept together, it is not an ideal pairing.  Not only are their dietary requirements different but rabbits can often bully the Pigs and sometimes cause nasty bites.  Also, rabbits can carry a bacteria which doesn’t affect them but can cause flu like symptoms in guinea pigs.

Guinea Pigs are easy, and cheap, to keep and, as long as they are looked after well, tend to be relatively healthy.  They should be fed a diet consisting of a majority of good quality hay, a small amount of pelleted Guinea Pig food and a daily amount of fresh vegetables.  These, and the Guinea Pig food, are particularly important as, like humans, they cannot make Vitamin C in their bodies.  They cope equally well outdoors or indoors but they should always have enough room to have a good run about and be provided with different toys to keep their interest.  They should be handled and played with everyday as they thrive on human contact and interaction.

I don’t see many Pigs in my consultations (much to my disappointment!), particularly not for the number of them there are out there.  The biggest issues they have are fur mites, which can make them very itchy, or dental problems.  It is difficult to prevent the mites and some pigs are very sensitive to them (it is quite common to see two together where one is badly affected and the other is fine).  However, they are easily treated with medications and anti-mite spot-ons (just like the kind used for cats and dogs) from your vet and these spot-on products can be used to ward off infestations, which can be a good idea for those Pigs who are vulnerable.  The majority of dental problems are caused by over-grown teeth; Guinea Pig’s teeth grow continually and can develop nasty spikes if they are not fed correctly.  A Pigs diet should consist of at least 80% hay, the tough woody stems help to keep the teeth ground down and the correct shape.

So, if you are looking for a new pet who will be a great companion without being too much trouble, who will be less wriggly than a Rabbit, more handle-able than a Hamster and less giddy than a Gerbil, why not try a Guinea pig?!

Cat is the resident vet at Pet Street

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