Back from the vet.........again

[mishellyshel]

I took Richie today to his regular vet as a follow up to the Animal Hospital I took him to a few weeks ago to get Digital X-rays
see this thread: http://chins-n-hedgies.com/forums/showthread.php?t=5360

I also posted yesterday that he has been on Baytril, Metacam & Cisapride for over 3 weeks! Everyone agreed way too long, especially on the Baytril!

I took him off Baytril today and my Dr agreed. We are also going to reduce the Metacam.......to once a day for the next 3 days and than once a day every other day.
She also put him on something that I havent heard mentioned here, so I would like some feedback. It is called Torbugesic. It is mixed with grenedine and I am to give .13 cc 3 times per day for both pain management & appetite stimulant.
She feels that maybe he is in pain and that is why he isnt even trying to eat his pellets and that the baytril is also killing his appetite.

She is going to consult with another Dr in either NYC or CA regarding his x-rays.............but he definitely has tooth root issues.

Of course the only good news is that he is still gaining weight and seems feisty enough. She is also going to evaluate his diet over the weekend to let me know if what I am feeding him is suffcient.
She spent a good amount of time with me listening and discussing options so I will see how it goes over the next month and see if being off baytril and being on torbugesic makes any difference.
Thanks for listening.

 

[lauralynne]

Thanks for keeping us posted, Michelle. I wish you and little Richie the best!

 

[AZChins]

You will have to let us know if the appetite stimulant works. I'd love to have something to give chins that have been sick to get them to eat on their own. So many times I end up hand feeding for weeks and weeks until finally the chin decides it's time to eat pellets again. My Meega did that to me recently, but she finally started eating last week...so yay!

Being off the Baytril will help with appetite for sure. Pain is something that is even worse. A chin in pain often just won't eat. If those two things can be eliminated, Richie will go back to eating pellets, or at least he should.

I hope the little dude makes a full recovery. He's been through so much, he's obviously a fighter.

 

[tunes]

I know what Torbugesic is, but I have not personally used it on chins. I know it's used on rabbits and ferrets though. It seems like there are quite a few similarities between rabbits and chins, medication wise and in various treatments, so I would assume this would also be okay.

I was digging around on the internet one day trying to find alternative pain meds for someone's chin with kidney issues, and found this link that was interesting: http://www.urmc.rochester.edu/ucar/manual/table1.htm. They don't even mention Metacam for chins, and yet it's pretty much the pain drug of choice from any vet I've ever seen or any chinchilla experienced person I've spoken with.

 

[AZChins]

It's strange that morphine would be used with a chin. I always thought that that was a very hard core drug to use for pain.

That's a good link to keep just in case dosages are needed. Is there another drug name for Metacam?

 

[Kalandra]

Meloxicam. Brand names are Metacam, Mobic, Mobicox

 

[tunes]

I believe generic Metacam would be meloxicam Susan.

In thinking on this, I'm wondering why you would want him on two forms of analgesia. I'm not second guessing your vet, I'm thinking out loud. It would seem that two forms of pain killers is a bit of overkill, except that you mentioned the Torbugesic was for appetite stimulant. Julie looked it up on line, and one of the side effects of Torbugesic is appetite suppression, not stimulation.

 

[ticklechin]

If opiods (morphine, buprenex) are used, motility drugs need to be used also.

 

[Claire D]

I took him off Baytril today and my Dr agreed. We are also going to reduce the Metacam.......to once a day for the next 3 days and than once a day every other day.

So you are effectively switching him to the opioid?
He will just be on the Torbugesic?
Did you vet tell you why she wants him switched to an opioid and what benefits there are in that change?

She also put him on something that I havent heard mentioned here, so I would like some feedback. It is called Torbugesic. It is mixed with grenedine and I am to give .13 cc 3 times per day for both pain management & appetite stimulant.
She feels that maybe he is in pain and that is why he isnt even trying to eat his pellets and that the baytril is also killing his appetite.

Sorry but I have to agree with the others - opioids can reduce appetite and can also slow gut function - is your chin still going to remain on Cisapride?
Do you know why is the Torbugesic mixed with Grenadine?
Grenadine is basically sugar syrup and fruit flavouring - it's the last thing your chin needs if her gut does not contain beneficial bacteria and is possibly slower than normal. I know it is a small amount but even so .........

She is going to consult with another Dr in either NYC or CA regarding his x-rays.............but he definitely has tooth root issues.

Of course the only good news is that he is still gaining weight and seems feisty enough.

Please take this next bit in the spirit with which it is written.

You are trying really hard for your chinny but I am concerned that your vet is saying there are tooth root issues and that the chin is in pain which is why he is not eating.

I have to throw this in - 3 weeks down the line from a dental procedure, your chin should not require opioid analgesic and continued syringe feeding.
By now he should be back on a (relatively) normal diet and if any pain relief were necessary it should be a minimal (1 drop) dose of Metacam once a day.
If a chin of mine were in a similar situation then I would want to know if there was more going on in his mouth than first discovered (e.g. spurs, a mouth ulcer, an abscess etc). If there was no apparent problem then I would have to seriously consider the chin's chances of a meaningful recovery and his quality of life.

I wish you all the very best with your chin.

 

[mishellyshel]

from the way the vet explained to me today, the metacam is more of an anti-imflamatory kinda like motrin, where as it does reduce the pain by minimizing the inflamation. the Torbugesic was to be used for pain, but she did mention that it would also stimulate his appetite, so i will have to ask her on this.

she wanted me to keep him on the metacam but reduce it from 2x per day to 1x per day just for the next 2 days and then reduce it to 1x every other day.

he is off the baytril completely.

he is on the cisapride still 3 - 4 times a day (i work pretty much full time, so i can really only do 3x a day except on the weekend).

i dont know much about the Torbugesic and i am not sure why it is mixed with the grenadine, perhaps to "sweeten" the taste?? that is why i asked about it here, so i can present her with some questions.

claire--im not sure if you read my other link........but my richie has malo and had filing and a tooth removed at his visit about 3 weeks ago. i went to the original vet today to have her go over his records and basically to see if she agreed with the treatment and to "officially" give me the word to get him off the baytril.
when she looked in his mouth today she said his tounge looked to be red, but that is on the side i syringe feed him but his teeth did not seem to grow any points (which i figured since it was only 3 weeks ago!)
i think she was trying the new meds for a week or so and being off the baytril she was hoping to get him to start eating on his own again.
I am currently handfeeding him 3 times a day and get about 60 ccs in him a day. he has steadily gained weight. June 1 he only weighed 615 and today he weighs 644.

but i understand what you are all saying, i am concerned with his quality of life. So i will try this new treatment and see where it takes us............

on a good note, he still has a lot of life in him, still plays during playtime, not with the enthusiasm as he once did, but he is still hoppin. I dont want to give up on him just yet.

And i really do appreciate any & all advice. The vet was generous enough to give me her personal e-mail and said i can email her anytime with any questions. So i will definitely start my list of questions!
Any other advice on getting him to eat on his own would be greatly appreciated!