No appetite 4 days after dental procedure and leg tumour

[savvy]

I'm so pleased to hear he's doing well.

They do get used to regular dental procedures over time. Has the vet put him on long term metacam?

[skittish]

Thank you savvy! Yes he's on metacam long term now.

[moletteuk]

It sounds like you and the vet are taking really good care of him. I hope you feel more settled about the leg tumour decision since getting the second opinion.

I would recommend giving a vitamin d supplement a try to see if it can lengthen the gap between dental work, some forum members have found it effective. Degus need somewhere between 12 and 25IU per day, so it depends how many pellets they eat, but you can get baby or child supplement drops and add to treats.

[skittish]

Thank you moletteuk! Yes, I feel much more reassured and especially as it hasn't noticeably increased in size since we first discovered it, I really hope that he can live with it comfortably for a long time.

Thank you for the information on the Vitamin D supplements. I'll have a read of the vit d posts/threads on here to get some more info and also have a chat with our vet (he's very knowledgeable and supportive of us) at our follow up appointment after Christmas. They also have a UV light above the enclosure

[moletteuk]

That's great news that it hasn't increased in size much.

If they have a suitable UV light then the suplements shouldn't be necessary, although bouncy had a better result from the supplements than a UV light. There isn't really enough good info out there.

[deguconvert]

I'm so sorry that he had another sizeable spur and needed a dental again in such a short time. It is quite astonishing how quickly spurs will grow at times. I am thrilled with your news of his much better recovery this time!

Perhaps you could PM Bouncy and chat with her about her experiences with Vit. D supplements. She works very closely with her vet as well.

[skittish]

We're struggling with his weight at the moment. He's now at 239g even with additional food

For a timeline: At the beginning of November he was 300g. This decreased over 4 days to 286g - he had a dental and subsequent loss of appetite during which he decreased to 269g. Appetite returned and he stayed at around 269g until mid December then over course of a few days decreased to 255g - had a second dental but regained appetite quickly and he is eating, but weight is still decreasing and now at 239g.

He's bright but a bit more subdued than his normal self and his weight just keeps dropping.

We have a vet appointment on Thursday.

[teemu]

When my Posso was losing weight due to dental issues, I was able to curtail it until things could be sorted out by really making sure she'd eat as much as possible. I'd take her out of the cage and let her eat all the sunflower seeds she wanted, multiple times a day. That worked so that she did not drop any lower for the time being. It's not optimal, and not super healthy, but it's also not going to be actively detrimental, especially in a situation like this where keeping hold of weight is better than perfect nutrients.

In the long term, that really depends on what the vet visit reveals. If there's still dental problems, those can be seen to, but if it's not that, then it's possible that the tumor is causing him pain or discomfort or otherwise sapping his health. It's impossible to say yet. Hopefully tomorrow will tell.

Sending you my best wishes!

[moletteuk]

It's worrying that he is still losing weight in the period when he should have recovered from the dental and before his teeth become an issue again. Have you tried giving him nuts, seeds and grains and possibly Critical Care supplement with a fairly free hand to see if that helps and if it tells you anything about his appetite or pain when eating?
I think the possibilities could be ongoing pain or more to the dental problem or more to do with the lump, but the vet is certainly the right person to help at this stage.

[skittish]

Thank you all. Yes, we're giving him liberal access to lots of fattening food but he just takes them and buries them instead of eating them. I try to feed him by breaking up food into small bite size pieces. He is willingly eating hay and leaves when left to his own devices. We're giving cc supplement with nut butter and baby food as well.

[skittish]

I should also mention that he is happy to chew on wood and toys. Right now he's gnawing on a wooden log bridge with gusto. He especially likes shredding lolly pop sticks.

[moletteuk]

OK. I think I would ask the vet to have a good feel over the abdomen, see if they can tell if there is something up in that region.

[skittish]

Attended the vet appointment this morning. The vet could see the tooth is overgrown again (not as severely as last time) but he could still see it without using a scope. At the rate it's growing Monty will need another dental in a week-10 days. He's not eating enough fibrous stuff to wear it down. The vet doesn't think that this is related to his suppressed appetite, as he should still be wanting to take soft food, which he isn't, and it's not yet at a height that it will be causing discomfort in eating (although it will be). The tooth is very firmly fixed into the jaw (the vet checked during his last dental in case it was possible to remove it), so it would be an invasive procedure to remove it.

The vet can feel Monty's hip bones and spine so he's lost muscle mass, would class him as 'very lean'.

The tumour could be increasing metabolic rate and he's not eating enough to maintain his weight. But we would expect to see him eating a lot more, which he's not. He isn't taking the CC supplement willingly (he will tolerate me feeding him but won't take it independently). The lump isn't increasing in size. The vet theorises that it's possibly paraneoplastic syndrome which is causing changes in the body which is suppressing his appetite.

Options are: take bloods to check for liver and kidney function, remove the lump (and possibly the leg) which we've previously discussed, remove the tooth (but it wouldn't solve appetite as this isn't the cause, just the symptom of not eating enough to wear it down), euthanasia.

[skittish]

Hi moletteuk, sorry didn't see you had posted (I have this thread bookmarked but it's not alerting me to new posts). He had a feel of abdomen today but couldn't feel any irregularities and Monty is not showing discomfort when he's the area is touched or has pressure applied to it

We've discussed CT scans (during his last dental), but they are not sure they will get good images - has anyone had experiences of CT scans in degus? Apparently (apologies if i get some of this incorrect I am recalling this information) they take two images. After the first image they put in dye for contrast and take a second image. The dye has to go into a vein (?) and it's an irritant so if it goes outside it will inflame the area. Without the dye the images will be very blurry and inconclusive. I'm not sure how well I am remembering this.

[skittish]

Here's how the vet described the options

1) Takings blood for testing. Would need to take blood from the jugular vein which is quite deep as they don't have a suitable superficial vein to draw from. Possible risk of damaging other blood vessels near the heart. If the vein ruptures it is catastrophic and there is no recovery. Would normally take 5 days for results, but with bank holidays and postal strikes could be 10 days (this was how long the vet's last test results took) - at which point he will need another dental and another anaesthetic.
2) CT scan - would likely get very little from CT imaging without contrast. Risk of contrast is making sure it goes into a vein otherwise it is a severe irritant if it ends up under the skin. Vet said if he didn't think he could get a good catheter in then he wouldn't attempt it all and we would just have the non-contrast imaging. Also risk of allergic reaction to dye even if injected successfully. Images need to be sent to an interpreter.
3) Removing lump / leg = as described earlier in this thread
4) Tooth extraction - very complex and high risk given how well rooted it is.

If we were doing above then he would burr the tooth down at the same time (rather than attempt extraction this time) otherwise he will need to have another dental in a week.

If we opted for above, it could be done tomorrow or next Thursday.

At this point I am thinking that euthanasia would be kindest, rather than put him through a bunch of invasive procedures that might not have any conclusive results and in the meantime he continues to lose weight and muscle mass. At least he would be comfortable. The worst thing would be to push him until it's too late and he's spent his last days and weeks in pain. But I feel like I'm giving up. The vet says he will do any of the options above if we wished, but I feel like he is cautioning us against them with the risk/possible complications outweighing the benefits. He is an experienced exotics vet so I don't feel like he's saying this lightly.

[moletteuk]

I'm sorry Skittish, what a difficult position to be in.

Was the vet willing to say what he thought was the best option? Or did you infer that euthanasia was what he essentially recommended?

I can share some forum experience on some of your options if that would help a little. I can confirm that taking blood is fairly difficult and risky and is not commonly done. At least two or three members have had CT scans done, but one of those was at Edinburgh Vet hospital so the best of facilities, I don't remember contrast being mentioned. Would removing the lump/leg solve paraneoplastic syndrome? I suppose this would be impossible to say as you won't know if it has metastasized. I can confirm that tooth extractions that are well rooted can break or damage the jawbone or damage the hinge mechanism if they need to overextend the jaw for access.

Would it be worth asking the vet what the chances of finding something treatable with the blood test or CT scan would be? It may be that a large percentage of things would still end in euthanasia.

I think weight loss aside, dental treatments at less than 4 week intervals are very hard.

I think any of your options are valid and it's entirely a personal decision which you chose, we will support you in any of them. It's always difficult to figure out what is for the best because there is always a push and pull between easing your conscience by doing everything you can and easing suffering when the chances of interventions being successful are doubtful. Easing suffering can sometimes feel like giving up or taking the easy option when really I think it is sometimes the bravest choice. In complex cases like this I think most of us when looking back later wish we had ended things sooner.

[skittish]

Thank you for taking the time to respond and your comforting words. He didn't say which would be best option but I think he is doubtful that any of them will return a prognosis that would be treatable, which I think essentially means that euthanasia is our only option to us because ongoing dental treatments at such short intervals would be very taxing on Monty and if we can't diagnose and treat the cause for the weight loss then it would not be in his best interest to keep having them, especially as he loses weight after each dental. The vet has already said, with regards to the blood tests, that while it would would rule out (or confirm) kidney or liver failure, there is not necessarily treatment for it. Likewise if they could get suitable images the CT might show whether the tumour has metastasised significantly (in which case there would be little point attempting to remove it), but if the CT images aren't precise (which he says will likely be the case with no contrast) then it's not to say that it hasn't spread, only that the images don't show it. As you say, neither of these necessarily leads to anything treatable in the long term. We have another appointment tomorrow so I will ask if he can explain further the likelihood that the tests might reveal something that would be treatable

[teemu]

I'm sorry to hear that you and Monty are having such a tough time. It's a hard call. It's impossible to say how any one option would play out. Like Molette says, any choice at this point seems like a valid one, just depending on how you feel about things and what you think is best for him.

Sorry if this was answered already, but how old is Monty? His age is an additional factor that should be considered with this. Even a young animal would be under a lot of stress if they'd have to go through many operations quickly, and with an older one the risks will be much greater...

[skittish]

Hi Teemu, we think he is possibly 5-6 years old. We adopted him from a rescue which didn't have much background information on him. We've had him for 2.5 years.

[teemu]

5-6 years is not exactly young any more, and depending on things might be getting to be somewhat old already. Unfortunately, I can't really give any definite advice about what should be done right now. It does sound like this might be a situation where test results might not really help with a treatment, especially since the vet sounded skeptical about treatments. It seems rather likely that the tumor is messing with him somehow, ultimately.

Have you had the other appointment yet? Did it shed any extra light on things?