Late-stage lymphoma: care advice needed - Hedgehog Central Ė Hedgehog pet care & owner forum
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Old 06-01-2016, 09:37 PM   #1 (permalink)
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Default Late-stage lymphoma: care advice needed

Hi,

Longtime reader, first-time poster here. I wish I had a happier question.

My little guy is about 4.5 years old (had him for the past 3 years), a lean running type hedgie whose healthy weight is around 350g. He's always been tiny (runt of his litter) and I feed him kitten kibble (science diet) to keep up his weight, plus regular snacks of mealworms and cooked turkey/chicken. (3-5 mealies/night or a 1-2 teaspoons of chicken)

He's seemed happy and healthy for as long as I've had him, with only one little skin issue and one scary night when he got too cold and had to be re-heated! Last week he seemed fine when I took him out for his nightly cuddles/snacks. I was away Friday-Saturday nights (roomie feeding him but not taking him out, he's mostly a one-person hedgie when it comes to cuddles) and I had a stomach bug Sunday-Monday nights, so I fed him and cleaned up his regular poops but didn't take him out to hold him. Yesterday I took him out and was shocked at how he'd suddenly become skin and bones! He ate a mealworm and then spat it out, and I realized he was also shaky on his feet. I weighed him and he had lost about 100 g since his last healthy weigh-in at a good hedgie vet. (Yes, I am kicking myself for not noticing this earlier and not doing frequent weigh-ins, but the shift from healthy-lean perky hedgie to deathly-thin happened so fast!)

He went to a vet this morning and she thinks it's lymphoma (no tests because she's not sure he'd come through anaesthesia). It was warm here last week and then got cold on the weekend but my roomie didn't put the heat on - but the vet didn't think he could deteriorate so fast because of that. I've cranked the heat back up for him anyways though. He's on a course of prednisone-by-oral-syringe, but she thinks we have a week if the prednisone doesn't work, at most a few weeks if it does and he starts eating and walking more clearly.

This is a plea for some advice making his likely last days or weeks as comfortable and happy as possible. He seems interested in food (sniffs it) but doesn't eat it. He wanders around his cage confusedly and then stops and plops down, when he's not curled up in his sleep log. If I put water near his mouth/nose he'll lick his nose to get it. Miraculously he just ate 3 mealies (about 8 hours after 1st prednisone dose) - but I had to snip them with scissors first or he couldn't seem to manage it or get them before they wiggled away.

He isn't interested in watered-down/mushed up kibbles or in wet cat food, or in chicken.

The vet said I should try to tempt him but didn't recommend syringing him broth or anything. That said, I'm in a small town where they don't see many hedgehogs so I appeal to you, the experts. Please help me help my darling hedgie
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Old 06-02-2016, 12:59 PM   #2 (permalink)
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So sorry to hear about this. If she didnít test for lymphoma, Iím wondering what part of his symptoms led her to this diagnosis. Did she mention the possibility of liver disease? Look in his mouth for any possible problems that may be causing him to not want to eat?

When they donít eat enough, or at all, they can quickly develop fatty liver disease. They will also quickly become lethargic, or unsteady on their feet. They can very quickly shed weight in a matter of days if they are not eating at all. The amount you listed is frightening though.

With that said though, first off, he has to eat. Get a high calorie food and syringe feed him if he wonít eat on his own. Call your vet and ask if they carry Hills A/D. Itís a rescue/recovery formula canned food that is high calorie, easily digestible and easy to syringe feed. Only the vet will carry this as it is a prescription food. Get yourself at least a couple of cans.

If they donít carry that, go to the pet store and find a nice high calorie variety of pate canned food. Pick a couple of different flavors and give them a try. He has to eat. If you can get the prednisone in him, the prednisone should perk up his appetite quickly as it is a side effect of that drug.

If he wonít eat but a cc or two at a time. Try again in an hour. Sometimes you have to work your way back up as they cannot handle much in their stomachs when they havenít been eating well for a bit.
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Old 06-02-2016, 10:39 PM   #3 (permalink)
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Thank you so much for the reply, Kalandra.

After I wrote this yesterday, he would eat no more mealies but did eat a tiny bit of cooked chicken, a soft dark bit. I then offered him another little scrap and instead he lunged at a much larger piece and dragged it back into his blanket. But he couldn't seem to eat it, so I dipped it in some 'gravy' from a cat food can so he could at least suck on that a bit.

This morning he took his prednisone without trouble. This evening I tried syringe feeding him and got 6ml into him before he seemed to have had enough. I've mixed some Newman's Own cat food with the gravy from the can and some water as a mixture. I will keep trying to get the food into him and will call to ask about A/D tomorrow.

Perhaps the vet didn't want me to syringe feed him because she feels it would be prolonging end of life? He doesn't seem actively in pain but is very still with rapid breathing. Every so often he perks up and adjusts position or noses in his blanket or walks a bit but it's mostly just lying down flat out.

Mostly it was the rapid weight loss (I know, it is such a shocking number) that made her think lymphoma. I can check out his mouth though. No mention of liver disease. He was perky up until at least last Thursday and his last poop that I remember was Tuesday evening.
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Old 06-03-2016, 02:52 AM   #4 (permalink)
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Update:

After the 6ml of Newman's Chicken + Liver, he ate a further 3ml of straight pate (different brand) a few minutes later, then another 6+2ml 3 hours later. So 17ml of food, most of it pate with no dilution, all through a syringe. I only fed him when he was licking at the syringe or otherwise seemed willing to swallow.

I'm now letting him sleep for a few hours. I will wake up tonight and try again.

He seems a bit more lively, or at least no worse, today. He had one small poo at second feeding, dark and sticky with a bit of gooey blood, about the size of a pea.

I have a warm-mist humidifier near his cage to help (or at least not hurt) with the dehydration too.
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Old 06-03-2016, 09:40 AM   #5 (permalink)
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Sounds like you made some progress. I don't know why a vet wouldn't recommend syringe feeding. Hedgehogs are one of those funny creatures that if they don't feel well they sometimes will just stop eating and starve themselves. Doing so is bad because their bodies don't process fat very well and then they get fatty liver, which makes them more sick. If you get a moment, do a search of Lilysmommy threads for Pancakes health update. Pancake is a rescue she adopted who has/had fatty liver disease. She posts the symptoms that Pancake had and updates on what was tried and what seems to have worked to try to help her fight.

I had a girl who lived a long time, I think it was 10 months with a lymphoma that we were given a couple of weeks left diagnosis. Her lymphoma caused a node in her throat to swell drastically and she couldn't eat. The prednisone reduced its size. Even when it started to grow again, she syringe fed and was fine for a long time. She just had trouble chewing and swallowing chunky foods.

Keep at it. With the prednisone and force feeding you may see some good improvements.

Also check to see if he is dehydrated. Did the vet check? Pinch a bit of his back quills together and see how quickly they return to normal. If the skin stays pinched for very long, he is dehydrated. You will have to increase water intake, but if you can, call the vet and ask about have a sub-q injection of fluids. Sub-qs are the fastest way to combat dehydration when they are sick. Dehydration can further promote the lethargy, and lack of appetite.

I'm a little concerned about the mention of blood in your last post. Is the stool black, and tarry? Does it smell horrendous? If it does, call your vet and give him an update. Black tarry stools indicate bleeding in the upper GI or stomach. This can be bad if he has a bleeding ulcer, but it could also be a symptom of something else that is still treatable.
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Old 06-03-2016, 04:42 PM   #6 (permalink)
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Update:
At 4am he ate 5ml pate, 1ml water. At 8 am he ate his prednisone and then 6ml pate, 3ml water.

The vet is fully booked today but she had time to give him sub-cutaneous fluids. She said she gave him as much as she calculated his system could handle. That was around 10am.

At lunchtime I could only get him to take 4ml of food. He's on A/D food now and resting in his cage. I have to go back to work but will try more food as soon as I get back at 5pm, and see how he's doing behaviour-wise.

I'm booking another appt. for as soon as possible to ask about the stool (which was quite tarry - no more yet and I didn't get a chance to sniff it) and in case he needs more fluids.

Thank you again for the advice!
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Old 06-05-2016, 11:56 AM   #7 (permalink)
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Update:
On Friday he went to the vets and got as much sub-Q fluids as they could give him. After that he ate really well, to a total of 51 ml (A/D with some water) that day. He even licked his nose! Saturday wasn't so great, he ate a total of 31 ml. Today he took 8 ml after his meds at 8am, and did 2 nose licks!

Apart from the nose licks, he seems still sleepy and weak. He'll take 1 ml of food, swallow it, then another, then need a little break. In total he's managing 2 to 8 ml of food per session, every few hours. I'll see how he goes next session today. I try to pop the syringe in his mouth whenever he opens his mouth or shows any interest/activity in it.

No stools yet.

His paws are a little discoloured and his legs overall seem not to be doing what he wants them to do very fast. Sometimes his paws droop a little like he's leaving them behind. He goes slowly into his log house when I put him to bed and I find him there when I wake him up. Except this morning he was lying just outside the log.

I have to be out for 5 hours today but I will weigh and feed him as soon as I get back. poor little fella. I have a vet appt. booked for tomorrow at 8:30.
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Old 06-05-2016, 11:59 AM   #8 (permalink)
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Also, his breathing seemed fast and shallow yesterday, while today it's a bit more defined - short and sharp. Neither seems great, I don't think he is very comfortable. He does seem animated when I start to put him in his cage, and then he goes into his log and just plops right down.
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