Daisy's health issues

[LilyandDaisy]

Following on from the end of this thread, I'm going to use this thread to post updates on Daisy. She has been having episodes of weakness or faintness, somewhat similar to the ones her sister Lily used to have. She takes several hours to recover from them but after appears well, just a little more tired than she used to be. But she is over 3 years old now.

This is her recovering from the latest one:

[LilyandDaisy]

Daisy had another episode this evening (that makes 3 nights in a row now). By chance I happened to be filming when it began (or soon after): www.youtube.com/watch?v=rElk1LOiNo4

For comparison, this is one of Lily's episodes: www.youtube.com/watch?v=VqutPjpNock

They're back in their usual tank now but without access to the topper (in theory anyway). I left the large tall platform in because it's hard to put it back when there's bedding in the tank but Tilly has figured out a way to climb up the wheel to get to it so I might need to take it out completely. I think it might worry Daisy if Tilly has access to areas she can't reach.

It's so strange. Lily died from heart failure but it didn't become apparent that she had this until quite near the end (when she filled up with fluid and started having breathing problems). I don't know if all her issues were caused by the heart failure from the beginning or whether there was an overarching illness that caused both the strange episodes and the eventual heart failure.

[betty]

I will certainly ask my vets when I am next in - they aren't very hot on smalls - but they might have an idea of progression of symptoms in other animals? worth an ask anyway.

[Markpd]

Sorry to hear she's having more episodes , keeping fingers crossed for both of you!

[LilyandDaisy]

Thank you both. I might take her to my vet to see if there's anything they suggest but to be honest, this kind of thing is a bit beyond them! They're fine for straightforward issues and treating symptoms. As they explained to me when I took Lily in, the only way they can really diagnose heart issues is with imaging, but I'm not going to put Daisy through that at her age.

Daisy's had one more typical episode and one that was a bit strange. I was holding her, stroking her on the top of her head and neck and noticed she had been still for an unusually long time. I checked her and she had gone quite limp. Then she started squeaking (real piercing squeaks, like when a gerbil is being very aggressively groomed) and trying to get off my hand so I put her back in her cage. She didn't have the extended recovery period that she had with the previous episodes, she just took a few moments to get her bearings and then settled down to eat. I think the squeaking might have been her trying to tell me something?

I'm fully convinced now that these episodes are the same ones as Lily used to have. There are features in common - the way they seem to have some force pushing them upwards and backwards from the chest (resulting in that strange posture Daisy had during her first episode - sitting on the base of her tail with her back legs sticking out and front paws raised), the peculiar movements of the front paws, the way they look like they're trying to walk through treacle. There are differences, which I think are down to how the individual gerbils react. Lily used to fight and thrash around more, especially in the beginning. As she got more used to them she was more inclined to try to continue with her usual activities. Daisy used to just lie down and wait for it to pass but now, she also tends to try to continue as usual. These differences are quite consistent with the gerbils' individual temperaments!

Yesterday I started giving Daisy a malt paste with added taurine. There's an accumulation of evidence to suggest that taurine may improve symptoms or slow the progression of various types of heart disease in various species, even ones that don't require dietary taurine. And I know people give malt paste to rats so I think it should be fairly safe. It seemed worth a try, and if nothing else it will make her happy since she loves the taste of it!

She seems happy in the tank with no topper and everything on one level. The best test for how she's feeling is seeing how she reacts when Tilly goes into heat. Sometimes she gets really upset when Tilly is in heat. On the one hand she'll be trying to act quite assertive (chasing and mounting Tilly) but then she also winks a lot which is usually considered a submissive gesture (and not something I have ever seen happen between gerbils before). I suspect she felt very insecure and was alternating between "I have to be super dominant and assertive now or Tilly will take advantage" and "Ok, maybe I just act really submissive, Tilly won't attack me". I'm pretty sure Tilly was never going to attack her and Daisy was just being paranoid. However Tilly is in heat tonight and Daisy is very calm, and Tilly is behaving herself and being as respectful towards Daisy as she ever was. 

[Markpd]

Interesting and curious to read, pity I can't add anything useful!
But good to hear Tilly is being nice .

[LilyandDaisy]

I took Daisy to the vet today, just for a general discussion of the options and associated risks. I also took a written summary of Lily's history for context.

The vet checked her breathing and couldn't find any evidence of fluid in her lungs. There was no cyanosis of her mucous membranes which would have indicated serious circulatory issues. She has gained about 7g but I have been feeding her more treats lately and she is quite prone to weight gain when she gets too many treats. Apart from that jump of 7g, her weight has been stable. She's not still gaining weight. It's hard to see whether she has any bloating because she's quite fluffy!

The vet offered either furosemide (a diuretic) or a trial of an NSAID (e.g Metacam).

In the end I decided against the diuretic because as the vet explained, there's a risk of kidney damage. Also the dosage would have 0.1ml twice a day, which is actually quite a lot for a gerbil. The liquid furosemide tastes awful to gerbils. It contains ethanol and an artificial cherry flavouring. Lily despised taking it! I'm unwilling to make Daisy take large doses of something that tastes disgusting, which might damage her kidneys, when there doesn't seem to be a great need for it yet. She doesn't seem to be retaining much fluid, if any. If she gains weight again I might reconsider. I'm also trying to be pragmatic that she is an old gerbil, and all gerbils have to die of something. Some things might extend their life slightly but not without costs and risks.

I also opted against the NSAID because I doubt it would help and it could also cause kidney damage.

So the plan for now is just to monitor her and take her back to the vet if I decide to try the medications.

At the moment, when Daisy is active she's pretty much herself, but then she has these extended periods of fatigue. Her appetite is still good.

[LilyandDaisy]

If you look at page 5 of Lily's thread linked above, you'll find that Lily used to occasionally have a second type of episode that I called "thrashing" episodes.

Well, this morning Daisy had one of those. Just as with Lily, I heard the banging and initially thought they were fighting but it was just Daisy, thrashing and barging her way around the tank, banging into the walls on her way. She eventually stopped in a corner and just sat there drumming her feet for ages. The drumming made me wonder if this type of episode could be brought on by some kind of sudden terror, dread or panic?
After she stopped drumming, she started doing laps of the tank, not thrashing around this time but she did seem disoriented and like she was looking for somewhere she couldn't find. I even wondered if she couldn't see, which if it came on suddenly might account for the terror. After a while I put her in a carrier and covered it with a coat, because I thought a dark, restricted space might help her calm down.

This is all so... eerie. The similarity of symptoms between the gerbils is uncanny, but Daisy's course seems to be progressing much faster.

[betty]

I am assuming that you are leaning towards perhaps a more neurological condition (either alone or brought on/exacerbated by the potential heart condition) which could explain the confusion?

I haven't been to the vets yet (forgot I booked the weekend off) but pawing, freezing and lethargy/confusion are often associated with seizures and some seizures are almost micro seizures - like just face twitching and 'freezing'. Perhaps there are other nerve-related conditions that could display in a similar way?

[LilyandDaisy]

Sadly Daisy died this afternoon. I took her to the vet to be put to sleep. She didn't recover from that fit this morning, but continued to be disoriented and scared. She would alternate between running laps of the cage and collapsing in exhaustion. I believe she was confused or delirious as her behaviour was very repetitive, and not purposeful. She also didn't want to eat and she was holding herself in a way that suggested she might be having breathing problems. I think she might have had a stroke because one of her eyes was half-closed and she tended to run in circles.

It wasn't an easy decision to make, and I initially wanted to wait until tomorrow to see if she was better, but I knew that even she was better tomorrow she would be bad again soon. This thing has progressed so fast. Daisy was having episodes every day, and every one took her several hours to recover from. I don't think she could have had much longer to live, and a large part of the time she did have left wouldn't have been pleasant for her. Lily had this amazing ability to bounce back from things, which Daisy didn't seem to have.

I feel really sad to have lost Daisy but also relieved that this is over for her and for me. It was emotionally exhausting watching Lily decline, and then Daisy, and not knowing what was wrong.

[Markpd]

I'm so sorry to hear that she's passed already , but at least you can both rest peacefully now (in different ways of course!).

[betty]

Oh no, I'm so sorry.

[LilyandDaisy]

Thank you. I'd still be interested in hearing what your vets have to say betty. It does seem like there was a neurological component. Perhaps it was blood clots or heart arrhythmias causing brain ischaemia. Or a disease that damaged the brain/nervous system and heart separately. I only wish I knew for sure.

[catnut]

Soo sorry to hear about Daisy, may she rest in peace with her sister. It's hard when we don't have answers to why but it did seem like something with her brain. I lost my Theo to a stroke last July, it only showed up about 10 hours before he passed away so at least he didn't suffer long from it ( i couldn't get a vet appt. or i would've had him put down), but know how seeing your pets' not well is very draining. take great care and know you gave her a good life.

[betty]

The vet I was working with on my last two shifts isn't really conducive to small animal questions - so we didn't get very far - even when I tried to extrapolate out to other animal groups - so I have widened my questioning to other areas - but haven't yet had any decisive conclusions.

There are different vets in next week after the holidays that I can question - and I will certainly keep trying outside of work too - and hopefully not annoying too many people over the bank holiday weekend. Like you - I like to have an answer on these things. There must be something that is more likely than other conditions - even if there is no way now to know for sure - I like to have justified the answer as 'most likely' then I can switch off and accept it.