miketudor88 shared his experiences treating his guinea pig Mili.
See original topic:
https://www.guinealynx.info/forums/view ... hp?t=78461
Summary (TL;DR): stage C heart failure treatment by constantly adjusting doses of Furosemide, Torasemide, Spironolactone, Benazepril, Cardiac Supplement & Potassium Chloride (electrolytes)
Hello all,
This post goes out to everyone who has a guinea pig struggling due to cardiac hypertrophy leading to cardiac insufficiency / heart failure. My guinea pig Mili, who passed away at around 5 years and 7 months old on January 10th 2023, struggled with heart issues for the last almost 2 years of her life. She passed away due to a ruptured ovarian cyst, so this post will not focus on her death, but rather on how we managed to prolong her life by addressing her cardiac issues.
Back in February 2021 Mili became more lethargic, sitting in one place for long periods of time and by May she had “on and off” laboured breathing. We managed to keep this at bay with Benazepril on the long term and Furosemide only for 2-3 days at a time when her breathing became off, until she stabilized again.
All however came crashing down when she started to breathe in a severely laboured way in January 2022, having to spend one night in an oxygen chamber and getting Furosemide injections every 8 hours to become stable. Following an echocardiogram (heart ultrasound) and chest x-ray, she was diagnosed with stage C heart failure.
What helped her after this incident was the following treatment (her weight was 1250 g at the time):
Benazepril 1 mg/ml - 0.65 ml every 12 hours
Furosemide 2 mg/ml - 1.25 ml every 12 hours
Torasemide 0.2 mg/ml - 1.25 ml once per day, together with the evening Furosemide.
We also introduced a Cardiac Supplement here: http://www.exoticpetvet.com/heart-suppl ... rmula.html, that you can discuss with your vet.
When her breathing would again become laboured we would initially double the morning Furosemide dose. Once she stabilised, we would go back to the treatment above. If doubling the morning Furosemide dose didn’t help, we would double the evening Furosemide dose as well and when that didn’t help we would introduce Torasemide in the morning, basically giving it twice a day together with the Furosemide. Whenever we could, once she became stable, we would try to bring the dosages down to a place where her breathing was fine.
Due to so many diuretics, blood work showed very low potassium and also low sodium (but not far below the limit). Therefore, we had to give her electrolytes (e.g. Pedialyte), but soon noticed that the sodium in the electrolytes made her drink more water and her breathing became again laboured, so I got my pharmacy to produce only Potassium Chloride 0.3 mg/ml that didn’t cause her to retain water and therefore did not affect her breathing. This was given to her in cycles of 5 days once per day 0.5 ml, after which came 10 days of break and then the cycle would be repeated.
Also due to the many diuretics she developed urinary sludge (litiasis) so she was receiving Gabapentin and Meloxicam for pain management, as well as Urinary supplements (Rodicare Uro 0,5 ml x 4 times a day).
Summer came and because of the higher temperatures she started drinking more water which caused again more fluid retention, so we had to introduce Spironolactone 10 mg/ml 0,2 ml every 12 h together with Furosemide and Torasemide. We moved her to the room with AC which made her drink less water and therefore reduced water retention, so she felt better during August and September.
Eventually in October her breathing worsened again so she eventually ended up having pericardiocentesis towards the end of October, because she accumulated a “band” of more than 0.6 cm of fluid around her heart that would not go away even with Furosemide every 4 hours. This procedure means pericardial fluid extraction via a needle, under gas sedation.
After this procedure, Mili remained stable from a cardiac and breathing perspective until she passed away almost 2.5 months later due to her ovarian cyst rupturing. Her heart treatment during these 2.5 months:
Furosemide 10 mg/ml - 0,5 ml every 6 hours
Torasemide 1 mg/ml - 0,4 ml every 12 hours together with Furosemide
Spironolactone 10 mg/ml - 0,4 ml every 8 hours
Benazepril 1 mg/ml - 0,65 ml every 12 hours
Cardiac Supplement (as described above)
Potassium Chloride 0,3 mg/ml - 0,5 ml once per day for 5 consecutive days following by 10 days break and repeat the cycle
Gabapentin and Meloxicam for pain management and Rodicare Uro urinary supplement to help manage the urinary sludge from all the diuretics
FYI I asked my vet about Vetmedin (Pimobendan) multiple times during the course of Mili’s final year but considering her heart ultrasound results he always said this medication might do her more harm than good.
During these entire 2 years we always managed to maintain her breathing to a point where it was barely noticeable that she had an issue. Theoughout most of this time she was a mobile pig who enjoyed her hay, pellets and especially veggies.
Unfortunately, her body was simply not worthy of her true heart and gentle soul. She had a huge cyst on her left hind leg that started oozing and had to be removed by surgery as part of the same intervention as her pericardiocentesis in October. She recovered from that in about a month due to local complications at the surgery site. Just after one week of slowly starting to walk again she developed severe arthritis at the beginning of December and once again became mainly imobile. She also had a new growth on her spleen which we first saw during an ultrasound in the summer of 2022 bit luckily seemed benign and stopped growing further. She also developed corneal dystrophy that started in one eye around August 2022 but quickly moved to her other eye as well, for which she was undergoing treatment with eye drops and ointments. We were aware of her 3 cm ovarian cyst but knew we could not remove it via surgery due to her heart issues. The vet was thinking about draining it but this involved risks (it rupturing) and would only do it if she started exhibiting ovarian cyst-specific symptoms, which she either did not or she did but we didn’t realize it, due to her many other issues. In the end, it was the rupture of her ovarian cyst that took her away from us.
I realize this was a VERY long post that took me hours to write, but I thought it might help guinea pig owners with pets in a similar situation as Mili.
I am not advising anyone to try these medications on their own piggies but it might just be worth explorong these ideas with your vet and see if anything applies to your specific situation.
Lynx notes:
Spironolactone is "a potassium-sparing diuretic".
https://www.merckvetmanual.com/pharmaco ... /diuretics
Torsemide is also a diuretic, more potent than furosemide:
https://www.merckvetmanual.com/pharmaco ... #v23640174
See original topic:
https://www.guinealynx.info/forums/view ... hp?t=78461
Summary (TL;DR): stage C heart failure treatment by constantly adjusting doses of Furosemide, Torasemide, Spironolactone, Benazepril, Cardiac Supplement & Potassium Chloride (electrolytes)
Hello all,
This post goes out to everyone who has a guinea pig struggling due to cardiac hypertrophy leading to cardiac insufficiency / heart failure. My guinea pig Mili, who passed away at around 5 years and 7 months old on January 10th 2023, struggled with heart issues for the last almost 2 years of her life. She passed away due to a ruptured ovarian cyst, so this post will not focus on her death, but rather on how we managed to prolong her life by addressing her cardiac issues.
Back in February 2021 Mili became more lethargic, sitting in one place for long periods of time and by May she had “on and off” laboured breathing. We managed to keep this at bay with Benazepril on the long term and Furosemide only for 2-3 days at a time when her breathing became off, until she stabilized again.
All however came crashing down when she started to breathe in a severely laboured way in January 2022, having to spend one night in an oxygen chamber and getting Furosemide injections every 8 hours to become stable. Following an echocardiogram (heart ultrasound) and chest x-ray, she was diagnosed with stage C heart failure.
What helped her after this incident was the following treatment (her weight was 1250 g at the time):
Benazepril 1 mg/ml - 0.65 ml every 12 hours
Furosemide 2 mg/ml - 1.25 ml every 12 hours
Torasemide 0.2 mg/ml - 1.25 ml once per day, together with the evening Furosemide.
We also introduced a Cardiac Supplement here: http://www.exoticpetvet.com/heart-suppl ... rmula.html, that you can discuss with your vet.
When her breathing would again become laboured we would initially double the morning Furosemide dose. Once she stabilised, we would go back to the treatment above. If doubling the morning Furosemide dose didn’t help, we would double the evening Furosemide dose as well and when that didn’t help we would introduce Torasemide in the morning, basically giving it twice a day together with the Furosemide. Whenever we could, once she became stable, we would try to bring the dosages down to a place where her breathing was fine.
Due to so many diuretics, blood work showed very low potassium and also low sodium (but not far below the limit). Therefore, we had to give her electrolytes (e.g. Pedialyte), but soon noticed that the sodium in the electrolytes made her drink more water and her breathing became again laboured, so I got my pharmacy to produce only Potassium Chloride 0.3 mg/ml that didn’t cause her to retain water and therefore did not affect her breathing. This was given to her in cycles of 5 days once per day 0.5 ml, after which came 10 days of break and then the cycle would be repeated.
Also due to the many diuretics she developed urinary sludge (litiasis) so she was receiving Gabapentin and Meloxicam for pain management, as well as Urinary supplements (Rodicare Uro 0,5 ml x 4 times a day).
Summer came and because of the higher temperatures she started drinking more water which caused again more fluid retention, so we had to introduce Spironolactone 10 mg/ml 0,2 ml every 12 h together with Furosemide and Torasemide. We moved her to the room with AC which made her drink less water and therefore reduced water retention, so she felt better during August and September.
Eventually in October her breathing worsened again so she eventually ended up having pericardiocentesis towards the end of October, because she accumulated a “band” of more than 0.6 cm of fluid around her heart that would not go away even with Furosemide every 4 hours. This procedure means pericardial fluid extraction via a needle, under gas sedation.
After this procedure, Mili remained stable from a cardiac and breathing perspective until she passed away almost 2.5 months later due to her ovarian cyst rupturing. Her heart treatment during these 2.5 months:
Furosemide 10 mg/ml - 0,5 ml every 6 hours
Torasemide 1 mg/ml - 0,4 ml every 12 hours together with Furosemide
Spironolactone 10 mg/ml - 0,4 ml every 8 hours
Benazepril 1 mg/ml - 0,65 ml every 12 hours
Cardiac Supplement (as described above)
Potassium Chloride 0,3 mg/ml - 0,5 ml once per day for 5 consecutive days following by 10 days break and repeat the cycle
Gabapentin and Meloxicam for pain management and Rodicare Uro urinary supplement to help manage the urinary sludge from all the diuretics
FYI I asked my vet about Vetmedin (Pimobendan) multiple times during the course of Mili’s final year but considering her heart ultrasound results he always said this medication might do her more harm than good.
During these entire 2 years we always managed to maintain her breathing to a point where it was barely noticeable that she had an issue. Theoughout most of this time she was a mobile pig who enjoyed her hay, pellets and especially veggies.
Unfortunately, her body was simply not worthy of her true heart and gentle soul. She had a huge cyst on her left hind leg that started oozing and had to be removed by surgery as part of the same intervention as her pericardiocentesis in October. She recovered from that in about a month due to local complications at the surgery site. Just after one week of slowly starting to walk again she developed severe arthritis at the beginning of December and once again became mainly imobile. She also had a new growth on her spleen which we first saw during an ultrasound in the summer of 2022 bit luckily seemed benign and stopped growing further. She also developed corneal dystrophy that started in one eye around August 2022 but quickly moved to her other eye as well, for which she was undergoing treatment with eye drops and ointments. We were aware of her 3 cm ovarian cyst but knew we could not remove it via surgery due to her heart issues. The vet was thinking about draining it but this involved risks (it rupturing) and would only do it if she started exhibiting ovarian cyst-specific symptoms, which she either did not or she did but we didn’t realize it, due to her many other issues. In the end, it was the rupture of her ovarian cyst that took her away from us.
I realize this was a VERY long post that took me hours to write, but I thought it might help guinea pig owners with pets in a similar situation as Mili.
I am not advising anyone to try these medications on their own piggies but it might just be worth explorong these ideas with your vet and see if anything applies to your specific situation.
Lynx notes:
Spironolactone is "a potassium-sparing diuretic".
https://www.merckvetmanual.com/pharmaco ... /diuretics
Torsemide is also a diuretic, more potent than furosemide:
https://www.merckvetmanual.com/pharmaco ... #v23640174
Furosemide is a loop diuretic and the most commonly used diuretic to treat CHF in dogs and cats. Torsemide is another loop diuretic that is ~10 times as potent and has a longer duration of action than furosemide with a similar adverse effect profile. However, current clinical experience with torsemide is far less than that of furosemide; thus, furosemide remains the diuretic of choice in dogs and cats with CHF.
Statistics: Posted by Lynx — Tue Apr 11, 2023 8:09 pm
