To operate or not?

[ChinMommyFL]

What a long 5 months.

5 months ago, we noticed our Mosaic, DJ, was losing weight. About a month later, he went into Stasis. Once we got that fixed, we noticed he was still gassy and breathing very heavily. When I would try to force feed him Critical Care, he would turn cyanotic, so I have not been successful in getting him to gain weight.

My husband took the little guy to another vet for a second opinion, and the vet diagnosed him with a heart murmur and took more xrays. Vet rx'd Lasix, but there still was not much of a difference in his health. He was still turning blue when he was restrained, breathing very heavy, and still gassy.

Fast forward to about 2 weeks ago, and my husband took DJ back to our original vet, without informing her of our newfound diagnosis of heart murmur and the fact that he turns blue when restrained. He told the vet DJ is still gassy, and the vet tried to "toot" him (basically, trying to shake the gas out of him, from what he described?) Well, during this, DJ started to turn blue and almost died! Vet ran with him to the treatment room to give him Oxygen and stabilizes him. Since the vet is freaked, she tells husband to return next week when all the chaos has died down.

Next week, vet refers DJ to a cardiologist for an echocardiogram. Cardiologist confirms murmur, along with an enlarged heart, and a DIAPHRAGMATIC HERNIA. Basically, DJ's stomach has prolapsed into his chest, pressing on his lungs, making it difficult to breathe. Cause of this can either be Congenital or trauma. The only treatment for this is surgery once the animal is stable.

DJ has not had any trauma as far as we know, other that maybe falling a few inches off a shelf in his cage. DJ is pretty stable now for the most part. He still breathes heavy, though.

Normally, I would agree to surgery. But, this is a chinchilla. A species not many vets are familiar with. I myself work at a vet's office, and my boss has told me he does not feel comfortable doing this surgery on a dog or cat, which is a familiar species to most, if not all, vets.

Our exotics vet told my husband and I that she has not done this surgery in a chinchilla at all, nor does she know any that has. She tried to alleviate our fears by saying she has done this surgery in ferrets and rabbits. I have searched the internet and I have not found any literature on this subject (hernia repair in chinchillas.) I am uncomfortable to be honest, since again, this is a chinchilla, which is a third the size of a ferret or rabbit. I felt like our vet just wants to do this surgery not only for the money, but for the chance to get her name out there and to have his case published in textbooks or VIN. She kept saying, "if he's going to die, I want him to die trying."

Nice choice of words there, huh?

Plus, the cardiologist made it sound like DJ would die with or without surgery. If this is truly the case, I would prefer he go peacefully in hospice at home. Obviously, I want him to live and be happy and comfortable.

I have been giving DJ Metacam in the morning to alleviate any pain he may have, and he has been responding to it very well.

I guess what I'm asking is, has anyone had this experience with any of their chins? I feel so guilty waiting this long, but this is a hard decision. My boss has told me this surgery is not easy, nor successful in dogs or cats, so I can't imagine it being as easy peacie as our exotics vet is trying to make it sound. What would you do? Would you operate? :hmm: I'm so sad and torn. :cry3: If he lives, that would be great, but if he doesn't, I'd feel like an a$$hole for investing all this time and money to make matters worse.

Thanks in advance to anyone who reads this.

 

[greychins]

It's a hard decision, that's for sure. I have no experience with this, so I'm really no help. Whatever you decide, I wish you the best of luck.

I suppose I might do the surgery in your case, I'd really have to think long and hard, but but if the surgery isn't very successful in cats or dogs, then I can't imagine it'd be a great success in chins. And even if you were to do the surgery, he may not make it.

One of my girls went in for a spay yesterday because she'd been bleeding two days after birthing kits. Spays are relatively routine at my exotic vet, and I trust the exotic vet I use very much... the vet said the surgery went well... but she didn't make it. And that was a pretty routine surgery....not something that no one around has ever done to a chin before.

Like you said, it's great if they live, but if they don't, it is a lot of money. Can't deny that. When I go to pick up her babies from the vet tomorrow, I know I'm going to cringe at the bill, which really got me nowhere other than making the best attempt I could to save her. But at least I tried. Part of what you have to consider is how you'll feel later on. If your chin was to die in a few days, would you forever wonder if you could have saved him if you'd taken him in and had the surgery done? Things like that eat at me, and despite the bill, I'm happy I took her in and know I did what I could. If that's the case for you, I say do it.

 

[tunes]

I would contact chinvet (Angie) and ask her if she has ever heard of this type of surgery being done on a chin or if she has ever done this type of surgery herself. She may be able to talk with your vet and give them some pointers, or she may give you good reasons why to do (or not) do it.

I'm sure there are also other vets you can ask, but I recommend Angie because she's very approachable about this type of thing via email or pm, and I trust her. If you want her email, shoot me a pm and I'll give it to you.

As for your question, I personally would try it. I feel like I'm always saying this, and I don't mean to appear like some kind of goul, but everything with chins is a learning experience. I would be very hopeful that your little guy would come out on the other side of this healthy and whole, especially since she has done this type of surgery on other small critters; but either way, this information could be invaluable for treating another chin. If this is his only option, other than euthanasia, then I, personally, would give him a shot at it and hope for the best.

ETA: All surgeries are a risk with no guarantee of the outcome, even the most routine. Anything can happen, from anesthesia to recovery. It's the nature of the beast to throw money at a vet and keep your fingers crossed that all goes well.

 

[AZChins]

I agree...surgeries with chins, no matter what they are, are going to carry a risk and, most of the time, it is a very significant risk.

The type of surgery that your little guy needs is going to be difficult. But, I am going to be honest here...I'd probably let my vet do it if he recommended it or had confidence that he could do it! I only know of two vets that I would trust to do it. If either one told me that there was hope, I'd have them perform the surgery and see how it goes.

The cost may end up being prohibitive. Does the vet know what she would charge for it? Does she have a lot of experience with surgeries on little animals? You do what you think is right. Don't let anyone make you feel bad for doing or not doing. It's a hard decision. I would probably go for it, other people would be more hesitant. There's so many things to consider...and your decision will not be wrong.

From what I know about this condition it is very serious and you have to have a vet with some talent to do this type of surgery.

 

[Chintastic!]

Please forgive me if im out of line but I believe that if it were me I would probably not have the surgery. As humans we tend to look at quantity instead of quality. If he lives and recovers will his life be a good one after the surgery? In the best case senario, will he live a long and happy life if he has the surgery? I know that its harsh but I have had to ask myslef this question on several different ocassions. Am I keeping the animal alive for me or for the animals wellbeing? If he is going to be in a great deal of pain and has an extremely high rate of not surviving the operation is it worth it to you? Him?

I'm sorry to hear about your poor baby. I wish you the best in whatever you decide to do. I know you will make the best choice you can. Good Luck.

 

[ChinDaddyFL]

Well, at the moment his life consists of mostly sitting on the same shelf, sitting up (gravity pulling his stomach away from his lungs, letting him breathe easier) and moving around very little. When we let him out to dust he has to take frequent breaks. He is eating on his own and coping, but with half the lung capacity he's acting more like a 15 year old than a 5 year old.

Risks start with anesthesia--his lung capacity is compromised. The success of the surgery really depends on any complications. If the stomach or lungs have developed adhesions, the organs can be damaged and fail.

All that said, there is no other treatment...pain killers can make him more comfortable, but that's a relative thing (can't help his breathing). If the surgery is a success, he should make a reasonably full recovery--his lungs can fully inflate and he'll be able to rest lying down, start running, etc.

But...that's if he pulls through surgery. Vet says there's a 20% mortality risk...based on what I've read I'll be a bit skeptical and say 1 in 3 or 4. She's supremely confident, but its scary no matter how you look at it.

 

[addictedtochins]

Since you asked I don't think I would do the surgery. He doesn't sound strong enough. Another thought running through my head is I wish somebody would research giving chin blood to a chin in need. I have no idea but I think he would benefit from having blood donation, and I think Greychin's momma chin may have been saved with a blood donation. JMO

 

[greychins]

Since you asked I don't think I would do the surgery. He doesn't sound strong enough. Another thought running through my head is I wish somebody would research giving chin blood to a chin in need. I have no idea but I think he would benefit from having blood donation, and I think Greychin's momma chin may have been saved with a blood donation. JMO

I actually thought about that too, when the vet first said she was anemic. That for humans we have blood banks for when someone needs blood, but for my chin, she was anemic from loss of blood and there was nothing we could do about that other than wait for her body to make the new red blood cells, and she wasn't strong enough to do that. Not that it would probably be cheap to get a blood transfusion for a chin, but the option isn't even out there. It occurred to me that I don't know if that option is out there for any animals... does anyone know?

 

[menagerie]

I actually thought about that too, when the vet first said she was anemic. That for humans we have blood banks for when someone needs blood, but for my chin, she was anemic from loss of blood and there was nothing we could do about that other than wait for her body to make the new red blood cells, and she wasn't strong enough to do that. Not that it would probably be cheap to get a blood transfusion for a chin, but the option isn't even out there. It occurred to me that I don't know if that option is out there for any animals... does anyone know?

There is a reason that most vet hospitals have resident dogs and cats. They are often used for blood transfusions. I would imagine that if you needed to do a blood transfusion on a chin or other small animal, you would have to provide your own donor animal. Some cities also have dog blood banks, I believe San Diego has one.

 

[Essentia]

Do animals have blood types like humans do? Like, could any chinchilla give another a blood transfusion?

 

[greychins]

There is a reason that most vet hospitals have resident dogs and cats. They are often used for blood transfusions. I would imagine that if you needed to do a blood transfusion on a chin or other small animal, you would have to provide your own donor animal. Some cities also have dog blood banks, I believe San Diego has one.

I did not know that. This may be a stupid question, but if you're providing your own chin (another one) for the blood transfusion... I mean.... how feasible is this, like in reality? They're small, they can't have all that much blood... could a chinchilla blood transfusion maybe only be done if the sick chin needed just a little blood? Because I would think taking too much from the healthy one might amount to sacrificing one for the sake of the other?

Like in my case they said she lost a "lot of blood" - well, if you were to take "a lot of blood" from a healthy chin to put in the sick anemic one, surely it would put that healthy chin in the same anemic state the sick one was in? Maybe not, I don't know. Any thoughts on this are welcome.

 

[Bostongirl'sChin75]

Personally, I am on the fence about this one. If I had a vet that had done the surgery before and knew what she/he was doing, then I would probably have it done. But if I had a vet telling me she/he had never done it before than I would be more hesitant to have it done.
I guess it all comes down to trusting your gut and going with what you think is best for you and your fur baby. If your gut is sending you warning signs about the vet and her maybe wanting to make a name for herself, than maybe you should get a second or even a third opinion. What could it hurt? If your gut is telling you to trust what she says, than go that route. It all comes down to trusting that gut instinct.

Either way, I wish you and your fur kid all the best and that something can be down to alleviate any pain he may be in.

 

[tunes]

A chin to chin blood transfusion would be impossible. When I had to have blood drawn on chins, they get SUCH a small amount. It's a battle just to get the needle in the vein because they are so small, and then the vein collapses because it just can't take the abuse. Short of shaving a chin and trying for the jugular, which I would never allow, making a chin a blood donor would be next to impossible.

As an aside - I had a pony who needed major veterinary care (mainly her feet) due to severe abuse from the people I took her from. I took her to Ohio State. To defray costs there, which can be beyond prohibitive, they used Candy as a blood donor. She never minded a bit. She would stand there very quietly while they put the needle in and munch her hay. They actually offered to buy her from me because she was so relaxed about it.

I would assume if you follow the advice of the people advising against the surgery that your other option is to euthanize, and very soon, like today. Right now there is zero quality of life, and it almost seems cruel to even bother to try and stabilize him, just to have to euthanize him anyway if you're not doing the surgery. It's pretty obvious when they do get him stable enough for surgery, he will still face zero quality of life because without the surgery he'll never be healthy again. The biggest thing for me would be as Susan pointed out, the cost. If you're talking $3000.00 for the surgery, then no, I wouldn't do it. I love my chins, but in this economy, with people's jobs the way they are, the cost of just surviving, I not only wouldn't do it -- I couldn't do it. But if the surgery was within my reach money wise, then yes, I would.

ETA: You know, you might talk to the vet about this. Explain that since she is using this as a learning situation, and that there is not even a remotely guaranteed outcome, would she defer some of the cost?

 

[pamszoo]

Since you wanted opinions here is mine: If this was my chin I would not have the surgery done. From his turning blue episodes just with restraint he may be dead before the surgery would even start. He may never be "stable" enough to even attempt the surgery.

And if you did consider the surgery I would not have a vet do it who has never done it before. Remember vets can't fix everything, there is no guarantee to the outcome. Sometimes euthanasia is best even if we don't want to hear it.

 

[ticklechin]

When I considered surgery on D.J. who has a intestinal tumor the vet told me there was a 5% chance of survival, to me 5% might as well have been zero percent. 20% chance of recovery, I would do it since the chin could have a good quality of life.

 

[Rickman]

I think I'd let the vet attempt the surgury only if she'd absorb the cost. After all, she'd have accomplished an 'expiremental' surgury never before done, which could help many others down the road. My biggest concern would be blood loss, as I'm unaware of any studies about how much loss is 'too much'. I'm sure it's a %, but how much blood does a chin have? Can they add other things as they can in a human during surgury? Do they make needles small enough for chin veins?
I know microsurgury has come a long way in the past few years, but far enough to make this feasable?
I'd ask about the blood loss, and with that problem solved, [and her absorbing the cost,] give my chin a chance, as small as it may be.
The alternative is final, and no one learns anything.

 

[Claire D]

I think this is a very complex situation & there are many issues interweaving - taking a step back & removing the emotional aspects of it:

Whilst it is always hard to make a decision I have to say that over the years I have watched people put their chins through dental after dental, months of syringe feeding, considerable amounts of potent pain relief - expensive, time consuming treatments with no positive outcome at the end of it. How many times do we see people advocating these chins are PTS? Not often - people are encouraged to continue with dentals, syringe feeding, & potent drugs even when there is no possible "cure". The chins are kept alive but at what cost to the little furry creature? Currently we are seeing a trend for using stronger drugs than metacam - the question I have to ask is, "to what end?" These chins often die skeletally thin because they are malnourished through lack of eating but very few people comment on that...............


This chin is clearly very sick BUT there is a chance, however small, that he could come through surgery & have a good quality of life - at least with this procedure there is a hope in Tartarus that he might recover (unlike with root root problems or malocclusion) ...............
If the surgery fails then at least a chance at a cure (rather than a palliative procedure) was tried & the chin will pass away with no pain or distress - that's got to be better than watching him gasp his last or PTS with the perpetual question being "what if?"


The clinical side of me says it's worth a try even if it fails because it's a learning curve.
The clinical side of me says it makes no difference whether the chin is PTS without trying or during the procedure ........ the chin won't know any different - he will just fall asleep.
The clinical side of me says it's worth it because I've seen seemingly hopeless situations produce that "miracle" result - the chin defies the odds.

The "soft" side of me says it's too costly (financially, emotionally & otherwise) to put an already sick chin through "experimental" surgery with a poor prognosis.

I suspect, if it was me, that my clinical head would win out & I'd go for the procedure as long as the chin was in a fit enough state to be anaesthetised & I could justify the cost (or come to an arrangement with the vet) - if he was so unwell that he could neither be stabilised or anaesthetised then I would opt to PTS - it would be pointless to put him under a procedure which had little/no chance of success - I would, however, allow the vet to necropsy or "work" on the cadaver because that's a learning experience & may help other chinchillas.


OP, I think you are in a very tough situation & I wish you & your chinchilla all the very best - whatever decision you make.

 

[fanofdmb84]

Personally, knowing he also has a heart murmur and is already so unstable, I would not do the surgery. Even in humans diaphragmatic hernias are often fatal. I know someone who lost her baby this past year to that very thing. He spent his entire life (18 months I believe) in the hospital, and he died despite it all. Its also possible that if he has two physical abnormalities (murmur and hernia) he could have more that are yet unseen.

It sounds to me like your vet is getting your hopes up just so they can perform this surgery. I would tend to believe the cardiologist over the vet on this one, since the cardiologist really has nothing to gain, his opinion is probably the least biased.

 

[ChinDaddyFL]

The murmur is fairly small--something like a category 1, maybe a 2. The cardiologist said is was something treatable, but likely not an issue for the immediate hernia problem--and it might even be less of an issue once the stomach is out of the chest and not putting additional strain on the heart and lungs.

DJ is fairly stable--he's obviously discomforted by the reduced lung capacity, and he can't have his breathing compromised via restraint without going cyanotic, but he's not in imminent danger. He will also never recover or lead a comfortable life without the surgery (which was ballparked to us at $800-1200).

I just spoke with the vet today--she said they were all prepped and ready and rehearsing for the surgery tomorrow. The main hurdle is getting him intubated/masked--if they can get that done she's fairly confident about the remainder of the procedure. Taking that with a grain of salt, but it makes sense. She also cautioned about pulmonary edemas from lung reinflation, but that's something we won't know until we get there.

We're supposed to take away pellets and hay first thing in the morning, then bring him in 4 hours before surgery to allow him to acclimate. They anticipate 2 hours for surgery, then if successful they'll be doing close watch overnight to make sure he's OK.

We're on edge here, and nervous as all ****, but its the right thing to do, I think. I hope.

 

[tunes]

Chin dad and mom - I will keep you and your little one in my thoughts and prayers tonight. I will hope for a wonderful outcome for all of you.

Please know that everyone here will be doing the same, I'm sure of it.