Walter Acute Renal Failure - Full Write-up

Walter was a perfect young skinny pig (hairless guinea pig) with an adorable fuzzy-face and a heart-wrenching life story.
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Arrival:

Walter's previous owner was looking for someone who could provide their beloved guinea pig with a better life - hopefully, with a friend, too. 
We decided to offer Walter a sanctuary spot so we could improve his lifestyle. 
Walter was 16 months/1.4 years old and in good health. All he needed was a larger living space and a boar-friend.

New home:

Thanks to the workers, and frequent donors at Alpha and Street Legal Tyres LTD, Walter had a new Piggy-pad built within no time.



Meeting Wilfred:

Walter also found companionship with a young neglected Guinea pig, Wilfred.


Walter's life was perfect. It genuinely couldn't have been any better for him. He was a happy and healthy soul.

Acute Renal Failure:

Walter started selective eating and was rapidly losing weight. He was administered 1mg:1kg QD Metacam/Meloxicam (NSAID) and introduced to frequent syringed feeds of Oxbow 'Critical Care' for herbivores. Once the pain-relief had kicked in, Walter had started eating hay again, which suggested he was feeling discomfort. We booked him in for clinical investigation in the morning.
Most of Walter's Critical Care ended up on me.

In the clinic, Walter's mouth was full of CC, and the vet was unable to get a clear view of his molars with their otoscope. They attempted to swab his mouth clean, but Walter needed his mouth flushing clean. Walter was admitted for flushing, radiographs, and further work if required.


Lateral X-Rays were reassuring. No significant abnormalities were visible. Walter had mild spurring of his molars but no damage to his mouth. The vet was able to file the spurring down under general anaesthetic. We hoped the molar spurring was a primary issue, but Walter was sent home with Metoclopramide Syrup (GI Prokinetic) and continued with non-steroidals and syringed feeds.

If Walter didn't improve or worsened, a blood test and DV X-Rays were advised. 
Walter was still doped on Ketamine, but he managed to enjoy some parsley.
We obtained urinalysis over the weekend.
Results:
  • Glucose: Negative
  • Bilirubin: Negative
  • Specific Gravity: 1.015
  • Blood: Negative
  • pH: 8.5
  • Protein: 100/1/++
  • Urobilinogen: Normal
  • Nitrates: Normal
  • Leucocytes: Normal
Results were suggestive of kidney issues.

Walter lost 400g within 48hrs despite eating independently and assisted feeds. He was readmitted for blood tests and radiographs.
We were confident his molar-spurring was a secondary issue. Given the abnormal urinalysis reading, specifically protein and low specific gravity, we were concerned about a renal illness. 
DV X-Rays showed small amounts of gas in his abdomen, but nothing drastic. Blood tests were sent to the phlebotomists for analysis. 
Walter's pain-levels were also drastically and rapidly increasing. 
The exotic specialists were also concerned about a possible infection, silent heart failure, or hyperthyroidism.
Walter was precautiously introduced to Trimethoprim-sulfamethoxazole (antibiotic) and sent home to wait for his results.

A few hours after arriving home, Walter collapsed. He was now borderline fitting due to becoming emaciated. We immediately rushed him back to the vet and after multiple debates, the kindest thing for Walter was for him to be humanely euthanised. The primary diagnosis was acute renal failure. With added support from his previous owner, we both mutually agreed on arranging a post-mortem for more insight on his sudden death.
WARNING: 
EXTREMELY GRAPHIC CONTENT THAT MAY UPSET SOME READERS! 
THEMES AND IMAGES OF AUTOPSY.

Post Mortem:

Walter's organs appeared mostly normal. This ruled out chronic organ failure and further confirmed the suspected diagnosis of acute kidney injury (AKI). There was an abnormal collection of bloody fluid which likely occurred as a reaction to organ failure.

Blood test results:

  • Low creatinine levels: Blood creatinine levels are maintained by the kidneys are considered a reliable indicator for kidney function. High blood creatinine levels are an indication of impaired function.
  • High BUN levels: Blood urea nitrogen (BUN) levels are maintained by the kidneys and are a reliable indicator for kidney function. High BUN levels are an indication of impaired function.
Our vet decided to get additional input from the phlebotomists at the laboratory - they're the experts.
"Acute kidney failure is the most likely cause of death. As organ failure occured under 3 years of age, a genetic predisposition is the most likely cause for acute kidney failure. As Walter was immunocompromised, there was nothing the owner could've done to sustain life. Another hypothesis, although unlikely, is internal parasites" - Phlebotomist.
The vet mentioned that parasites were unlikely as Wilfy, Walter's companion, was in perfect health. Phlebotomy input further confirmed the primary diagnosis of AKI.


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