In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT.

Protected by copyright.
Mark
Rowland
qualified from
the University
Veterinary care of guinea pigs
of Liverpool
in 1996. He
works in Maidstone, Kent
where he runs a small Background: Guinea pigs have become very popular in the pet trade and have been extensively
animal and exotic referral bred for colour and coat mutations. They should not be considered as just a children’s pet, as many
centre, taking referrals in
exotics from all over Kent,
guinea pigs presented to vets are kept by adults who have the same veterinary expectations for these
Surrey and Sussex. He is an animals as they would have for dogs and cats. Therefore, it is very important that vets have a working
RCVS-recognised advanced knowledge of guinea pig anatomy and physiology in order to expedite an appropriate diagnostic
practitioner in zoological
medicine.
and therapeutic plan. This is especially true of guinea pigs as they are capable of sudden rapid
deterioration in their clinical condition. As with all exotics, the provision of supportive care forms a
cornerstone in their rehabilitation.

Aim of the article: This article provides a guide to dealing with guinea pigs and an overview of the
common conditions they present with.

GUINEA pigs (Cavia porcellus) are medium-sized
rodents, originating from South America, and
belonging to the family Caviidae and genus Cavia.
As a species C porcellus does not exist in the wild
and is most likely a domesticated descendant of a
similar species Cavia tschudii. See Box 1 for a list of
biological data for guinea pigs.
Guinea pigs have elodont dentition with no
true anatomical root and a continually elongating
crown. Growth of the crowns is continuous to
accommodate ongoing wear, as occurs in the wild
when consuming their natural diet, which consists
almost entirely of monocotyledon plants with high
silica content and low nutritional value. This means
large quantities of food need to be ingested for hind
gut fermentation.
Guinea pigs digest fibre more efficiently that
rabbits. Fibre is essential for gastrointestinal motility
and to help to maintain the balance of microflora
in the large intestine. They perform coprophagy,
eating caecotrophs up to 200 times per day, which is
doi: 10.1136/inp.m405 essential for protein and fibre digestion.
KEY LEARNING OUTCOMES
After reading this article, you should understand:
▢▢ The physiology of the guinea pig;
▢▢ Common conditions affecting guinea pigs;
▢▢ The importance of diagnostics and how to obtain samples for
diagnosis of conditions;
▢▢ The importance of supportive care in this species and its
inclusion into a therapeutic plan;
▢▢ Appropriate therapeutics including appropriate choice of
antibiotics and the provision of pain relief.
In captivity, their diet should consist mainly of
fresh hay fed ad libitum; they ingest roughly
60 g/kg bodyweight per day and 90 per cent of this
should take the form of fresh hay. The remainder of
their diet should be made up of small amounts of
concentrate feed and fresh vegetables (eg, broccoli,
parsley, pak choi, peas). The latter components help
to provide vitamin C, of which guinea pigs need
25 g per day and 50 to 100 g per day if they are
stressed or sick. Deficiency of vitamin C occurs early
on in any disease process of guinea pigs.
Handling
Guinea pigs should be restrained carefully as they
can struggle excessively if held too firmly. Fatal
liver rupture has been known to occur following
excessive restraint. You should always use two
hands, and a towel may be used to facilitate
handling.
Sex determination
Sex determination is relatively straightforward
and is usually carried out at around seven to eight
weeks. Males (boars) will have scrotal swellings
lateral to the anus. The penile urethra forms the
cranial orifice. The caudal orifice is formed by the
opening of the perineal sac and anus (Fig 1).
In females (sows) the perineum is Y shaped. The
cranial orifice in the dip of the Y is the urethral
opening (Fig 2).
Surgical neutering
Neutering may be carried out at 12 to 16 weeks. I
prefer a bilateral flank approach for ovariectomy
in females (Figs 3, 4). This approach helps to avoid
incisions coming into contact with the ground.
Ovariectomy prevents hormonal conditions

IN PRACTICE | March 2020 91

Rowland.indd 91 27/02/2020 15:33

 In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT. Protected by copyright.
Small companion animals

BOX 1: BIOLOGICAL DATA FOR GUINEA PIGS

■■Ovulation: spontaneous ovulators; polyoestrus;
cycle 15 to 17 days
■■Gestation: 59 to 72 days (average 63 days)
■■Postpartum oestrus
■■Litter size: one to six pups
■■Guinea pigs should be bred young if possible
(before eight months old)
■■Sexual maturity: nine to 10 weeks (males), four
to six weeks (females)
■■Bodyweight: 700 to 1250 g
■■Life expectancy: four to seven years Fig 1: Male guinea pig
■■Heart rate: 230 to 300 beats per minute
■■Respiratory rate: 75 to 150 breaths per minute

such as cystic ovarian disease in sows and is a

straightforward technique.
The male inguinal ring is permanently open and
should be closed during castration if the scrotal
approach is used. Some people suggest an abdominal
approach for guinea pig castration is best to avoid
scrotal fat abscessation and inflammation, which can
occur with the scrotal approach. However, I have not
experienced this complication with any regularity
when using the scrotal approach. Castration at
an early age is thought to reduce the incidence
of ‘cloacal’ impaction with faeces in later life and
prevents fighting in same sex groups.
Diagnostics and supportive care
Anaesthesia is required for most diagnostic
tests. I prefer premedication with an opioid
(eg, butorphanol or methadone) followed by
induction with sevoflurane delivered into an
induction chamber. Many guinea pigs urinate
during induction of anaesthesia. Collecting this or
obtaining a urine sample is a useful tip as one can
quickly assess metabolic status (ie, if a guinea pig is
ketotic) by using a dipstick (Fig 5).
Fig 2: Female guinea pig
There are many protocols available in the
literature for anaesthesia (eg, BSAVA’s publications).
Some people advocate the use of atropine as a
drying agent in cases of excessive salivation, but
I do not regularly use this as I have not found
excessive salivation to be a significant issue.
However, it is important to evacuate oral contents
using a cotton bud before induction of anaesthesia,
as guinea pigs hold food in their mouth.
Whole body radiography under anaesthesia is
recommended. Further radiographs of the skull
are required to evaluate dental disease, which is
common in this species. Radiographs should extend

Fig 4: Landmarks for ovariectomy. Vertical line depicts where

Fig 3: Flank ovariectomy in a female guinea pig. Arrow shows the last rib is situated and the horizontal line depicts the
the ovary spine

92 March 2020 | IN PRACTICE

Rowland.indd 92 27/02/2020 15:33


Fig 5: Ketosis evidenced on a urine dipstick, depicted by the
dark red band
as far as the urinary tract because uroliths are also
common in guinea pigs.
Blood may be collected under anaesthesia. My
preferred site is the cranial vena cava, as larger
volumes may be harvested with this approach
(Fig 6). Because this is a blind stick (ie, the
vessel cannot be visualised), correct positioning
is essential to ensure the vessel falls within the
manubrium and the first rib landmarks. The animal
should be placed in dorsal recumbency with the
forelimbs pulled caudally and parallel. The needle
is inserted mid way in front of the first rib at a 45
degree angle, aiming towards the opposite elbow.
The blood volume of guinea pigs is 75 ml/kg and it
is safe to take 1 per cent bodyweight in a healthy
guinea pig (ie, up to 7.5 ml/kg). In sick guinea pigs,
5 ml/kg is the recommended maximum volume.
A good video of the procedure can be found on
YouTube (Trinity CPD 2012), as well as on the
smartphone app Veterinary Care of Exotic Pets.
Very small volumes may be collected from the
cephalic and saphenous veins without sedation.
Careful handling of the patient should be exhibited
and the procedure abandoned if the patient is
struggling excessively.
Fluids and supportive feeding
Fluid therapy is essential in the hospitalised guinea
pig. For fluid requirements I use 70 to 100 ml/kg/day
for maintenance and administer 1.5 to two times the
maintenance volume to correct dehydration. There
are a few available routes, discussed below.
Oral
For syringe feeding I administer 50 ml/kg/day in
divided doses with a maximum of 10 ml per feed (Fig
7). This can be in combination with subcutaneous
fluids.
Subcutaneous
Guinea pigs resist injections of large volumes so the
IN PRACTICE | March 2020
Rowland.indd 93
In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT. Protected by copyright.
Small companion animals
Fig 6: Sampling from the
cranial vena cava in an
anaesthetised guinea pig
dose needs to be divided throughout the day. Single
doses of up to 30 ml/kg may be administered for two
to three doses.
Intravenous
The intravenous route (eg, via intravenous catheter
placement) is difficult to achieve and maintain, and
so I generally avoid this route.
Intraosseous
For critically ill guinea pigs the intraosseous
route may be used and provides a route for rapid
fluid replacement. A syringe pump is required for
continuous infusion. For placement either regional
analgesia or general anaesthesia is required. My
preferred site is the proximal femur, as the greater
trochanter of the femur is easy to access, making
catheter placement easier (Fig 8).
Intraperitoneal
Although bolus volumes of fluids may be given by
the intraperitoneal route, there is significant risk
of organ puncture so this route is not generally
recommended.
It is important to understand that after a short
period of anorexia, metabolic changes associated
with fat mobilisation will result in hepatic lipidosis
and ketosis. Practically this means that most
anorexic guinea pigs require aggressive supportive
care at an early stage. Treatment of gastrointestinal
stasis is discussed further below.
Fig 7: Syringe feeding a
guinea pig to administer
fluid therapy
93
27/02/2020 15:33

Small companion animals
Fig 8: Intraosseous catheter positioned in the femur of a
guinea pig
Common conditions of guinea pigs
Ophthalmic conditions
Foreign body
Guinea pigs are very prone to trauma of the eye by
foreign bodies. The most common presentation is
a grass or hay seed in the eye (Fig 9). Treatment is
straightforward. Removal of the foreign body, usually
under anaesthesia, is recommended, followed by
appropriate topical antibiotic drugs and analgesia.
Pea eye
Pea eye is the term used to describe a bulbous
protrusion of the conjunctiva, usually of the lower
eyelids (Fig 10). Usually it is of no clinical significance
but may alert the clinician to obesity issues.
Cataracts
Older guinea pigs may develop unilateral or
bilateral cataracts (Fig 11), and they are usually
progressive. Treatment is not usually initiated
unless there are other conditions affecting the eye.
Retrobulbar abscess
These abscesses cause exophthalmos. They may
be initiated by foreign bodies or may originate
Fig 10: Pea eye
in a guinea pig
94
Rowland.indd 94
In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT. Protected by copyright.
Fig 9: Grass seed in the eye of a guinea pig
as dental abscesses. Treatment in most cases is
enucleation of the eye to allow debridement of
the abscess. Appropriate antibiotic and analgesic
drugs are required in the postoperative period.
Cardiorespiratory conditions
Respiratory disease is common in guinea pigs.
Similar to rabbits, their chest size is small relative
to their body size. Pneumonia caused by Bordetella
bronchiseptica or Streptococcus pneumoniae are
common. Aggressive treatment with antibiotics,
anti-inflammatories, nebulisation (hypertonic
saline, salbutamol) and supportive care are
indicated.
In my opinion, cardiac disease is underdiagnosed
in guinea pigs. In healthy guinea pigs the heart
occupies a large percentage of the chest. However,
cardiomegaly can be identified radiographically
with associated pulmonary oedema (Figs 12, 13). As
with other species, treatment is with angiotensin-
converting enzyme (ACE) inhibitors, positive
inotropes and diuretics.
Hyperthyroidism, an emerging disease in
guinea pigs, may be a contributory factor in the
development of cardiac disease.
Fig 11: Cataract in a guinea
pig
March 2020 | IN PRACTICE
27/02/2020 15:33
 In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT. Protected by copyright.
Small companion animals

Fig 12: Cardiac enlargement and pulmonary oedema in a

guinea pig

Urinary conditions
Urinary calculi are commonly presented in guinea
pigs. The most common clinical signs include
haematuria, stranguria, pain, anorexia, ileus and
weight loss. Calculi may occur anywhere in the
urinary tract but the most common presentations
are cystic calculi and calculi within the ureters.
Renal failure (resulting from hydronephrosis) may
also occur, especially in the case of ureteral calculi.
Analyses of calculi show that the vast majority
consist of calcium carbonate, although calcium
oxalate stones have also been reported. A variety of
factors may predispose to calculus formation and
these include hereditary factors, dietary factors,
inactivity, obesity, dehydration or concurrent
disease. It is important to note that calcium salts are
a normal feature of guinea pig urine.
Cystic calculi are frequently solitary, may grow
to the size of a large pea and have a uniformly
roughened surface. Bladder sludge (calcium
deposits in the urine) may also be present. Ureteral
stones may be unilateral or bilateral. Sludge
may also appear in the ureters, blocking them
completely and resulting in hydronephrosis.
Fig 13: Postmortem
appearance of a cardiac
enlargement in a guinea pig
should be provided during surgery and any handling
of intestines kept to an absolute minimum. For solitary
cystic calculi, a caudal midline incision will expose
the thickened bladder. Cystotomy (Fig 15) may then
be performed as it would be in a dog or cat. Ureteral
stones may be ‘milked’ into the bladder for removal
through the cystotomy incision. If this is not possible,
an ureterotomy may be performed directly over the
calculus and sutured with fine absorbable suture
material. Catgut should be avoided in this species due
to the risk of granuloma formation with this material.
Solitary renal calculi or grossly affected ureters
may mean that a unilateral nephrectomy is
required (Fig 16). I prefer the use of surgical clips

Diagnosis
Diagnosis is relatively straightforward. Whole body
radiography will reveal mineralised densities in the
kidneys, ureters, urethra or bladder (Fig 14). Renal
disease, if present, may be highlighted on blood
biochemistry and an inflammatory leucogram may
be present indicating a chronic active inflammatory
process. Urinalysis may reveal calcium crystals
(although these may be present in healthy guinea
pigs), and haematuria (a pathological finding).
Ultrasonography may reveal the presence of a
thickened bladder wall, the presence of mineral
densities or ureteral distension.

Treatment
The treatment for calculi is surgical removal.
Analgesia is very important in these cases to help Fig 14: Radiograph of a guinea pig showing mineralised densities consistent with cystic
prevent postoperative ileus. Fluid therapy and warmth calculus in a guinea pig

IN PRACTICE | March 2020 95

Rowland.indd 95 27/02/2020 15:33


Small companion animals
Fig 15: Intraoperative view of cystotomy in a guinea pig
for haemostasis in these cases. The affected kidney
and as much of the ureter as possible should be
removed. Histopathology of the kidney is advised.
I have encountered end-stage kidneys (kidney
failure at an irreversible point) diagnosed on
histopathology where blood biochemistry has
been normal, indicating normal function of the
contralateral kidney and illustrating the functional
reserve of renal tissue. Postoperative analgesia and
supportive care (fluids and assisted feeding) are
indicated. Antibiotics should be provided.
Prevention
Recurrence is reported to be common and these
cases can be very frustrating clinically. However,
there are some steps that may help prevent
recurrence of these calculi.
Fluid intake
Fluid intake is very important in these cases.
Washing vegetables and salad will increase fluid
intake, as some of the water will be retained on
the food. Iceberg lettuce could also be offered as it
consists mainly of water and fibre. Increasing the
number of available water bottles is also helpful,
and adding some dilute fruit juice may increase
palatability and as such water intake. Subcutaneous
fluids may be considered, owner syringing of
flavoured water may be well tolerated by guinea pigs.
Antibiotics
Following surgery antibiotics should be provided.
Bacteria that colonise the inflamed tissue of the
bladder wall may act as a nidus for repeat stone
formation. Several weeks of antibiotic and anti-
inflammatory treatment are required.
96
Rowland.indd 96
In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT. Protected by copyright.
Fig 16: Intraoperative view of nephrectomy. Note the
distension of the ureter (arrow). Hydronephrosis
was confirmed at histology
Vitamin C and calcium
Excess vitamin C may result in urinary ascorbate,
which has been shown to promote the formation
of uroliths in guinea pigs. It is advisable to cease
artificial supplementation of vitamins and calcium
minerals. Vitamin C converts to oxalate in the body,
and so calcium oxalate stones may be associated
with excess vitamin C in the diet.
Calcium intake may also be restricted by
dietary modification. Removal of concentrates
and calcium-rich plants from the diet is advised.
Timothy hay, celery, cabbage, carrots and
cucumber contain medium levels of calcium.
Higher levels are found in carrot tops, Chinese
cabbage, kale, broccoli and all concentrates.
Although dandelion is a mild diuretic, it also
contains high levels of calcium and so should be
avoided.
Addressing concurrent issues
Concurrent issues should be addressed.
Bumblefoot will result in decreased activity,
resulting in retention of the urine in the bladder.
Guinea pigs elevate their hindquarters to urinate
and pain resulting from pododermatitis or sore
hocks will decrease frequency of micturition.
Obesity or spinal diseases will have similar results.
Lack of activity may also result from inappropriate
housing facilities and reduced opportunities to
exercise.
Potassium citrate attaches to calcium in the urine
reducing the formation of uroliths. The drug is very
safe and given at a dose of 20 mg/kg orally twice a
day.
Thiazide diuretics have been advocated as they
reduce calcium excretion through the kidneys.
March 2020 | IN PRACTICE
27/02/2020 15:33

Fig 17: Abscess on the rump of a guinea pig
Skin conditions
Ectoparasites
The most common ectoparasites to affect guinea
pigs are:
■■Trixacarus caviae which causes sarcoptic mange,
■■Chirodiscoides caviae which is a fur mite,
■■Demodex caviae which also causes mange.
Diagnosis is made by skin scrape, and guinea
pigs often require sedation or light inhalational
anaesthesia for this to be undertaken. Mite
infestation can cause severe pruritus which can
even induce seizure activity in some cases. As well
as antiparasitic treatment, analgesia forms an
important part of the therapeutic plan.
Guinea pigs may also be affected by lice (Gyropus
ovalis and Gliricola porcelli). Treatment is with
topical or injectable antiparasitic agents (eg,
ivermectin). Maintaining a clean environment is
important in preventing reinfestation.
Abscesses
Abscesses (Fig 17) and bacterial pyoderma are
common. Abscesses may arise from bite wounds
from other guinea pigs.
Subcutaneous abscesses in the cervical region
may be the result of caseous lymphadenitis,
caused by Streptococcus zooepidemicus. This
organism, which is often a commensal, may
gain entry to the body in stressed, and therefore
immunocompromised, animals via abrasions in the
oral cavity or via the respiratory route. Once formed,
abscesses may burst, releasing thick pus.
Pyoderma may also occur secondary to
ectoparasitic disease, trauma or as a sequel to
systemic disease and immunocompromised
patients.
Treatment is with topical and systemic
antibiotics, ideally based on culture, and analgesic
drugs. Surgical exploration and removal of the
IN PRACTICE | March 2020
Rowland.indd 97
In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT. Protected by copyright.
Small companion animals
Fig 18: Positive
Dermatophyte culture. Note
the red colour change of the
agar gel
abscess is often required. The basic rule of abscesses
is that they will persist until the nidus of infection
producing them is debrided and treated. Surgical
excision, marsupialisation and treatment with
honey (either via honey-packed swabs or applied
directly to an open abscess) are described in
standard texts.
Fungal dermatitis
Fungal disease (ringworm) is common in guinea
pigs. The most frequent isolate is Trichophyton
mentagrophytes. Infestation causes non-pruritic
scaling and alopecia. Often the condition is
secondary to hypovitaminosis C. It is important to
realise this organism’s zoonotic potential. Diagnosis
can easily be made using hair plucks placed onto
appropriate culture medium (Fig 18).
Itraconazole is the first-line treatment. It has
pharmacokinetic benefits; it continues to be
released to the skin surface for up to four weeks
after cessation of treatment. The recommended dose
is 10 mg/kg given orally every 24 hours. Vitamin
C supplementation is essential. Treatment with
an appropriate antifungal disinfectant (eg, F10;
Meadows Animal Healthcare) of all in-contact
animals, the animal’s environment and all fomites
is recommended.
Cheilitis
Cheilitis, which can have mixed aetiology, occurs
on the lips, philtrum and nares of guinea pigs (Fig
19). There may be viral involvement or vitamin C
deficiency, which then progresses to secondary
pyoderma. The condition can be very painful and
a cause of anorexia in guinea pigs. Treatment is
with topical antibiotics (and in some cases systemic
antibiotics) and antifungals, as well as analgesics.
Ulcerative pododermatitis (bumblefoot)
Ulcerative pododermatitis is principally an
97
27/02/2020 15:33

Small companion animals
Fig 19: Chelitis on the philtrum and nares of a guinea pig
environmental condition associated with poor
hygiene, which causes erosive lesions of the feet
and hocks of guinea pigs (Fig 20). In cases that don’t
appear to have been caused by a poor environment,
other factors, such as obesity, may play a role.
The lesions may be deep and painful and extend
to bone tissue or joints, with the latter being
diagnosed by radiography of the affected feet. The
whole body, but especially the vertebral column,
should also be radiographed to assess for any other
lesions that may cause a change in posture and
increased pressure on the feet.
Treatment is challenging. The basic rule is that
these lesions should be covered until there is skin
integrity. This means that foot bandages, often with
adhesive primary dressings such as Allevyn Thin
(Smith-Nephew) need to be applied and regularly
changed. I have also found laser therapy to be
helpful in these cases.
Analgesia and broad-spectrum antibiotics (ideally
based on culture) are also required. The prognosis is
guarded. Regularly providing soft clean bedding is
also helpful.
Gastrointestinal conditions
Gut stasis (Ileus)
Gut stasis is one of the most common reasons for
presentation of guinea pigs to the vets. A healthy
guinea pig will hold food in its mouth, so the
observation of an empty mouth is highly significant
and is a true indicator of anorexia. There are a host of
conditions that predispose to ileus and investigation
of the underlying cause is indicated in all cases. If left
untreated, the condition can cause greater morbidity
than the underlying cause. Clinical signs include:
■■Small-sized, hard faeces;
■■Abdominal bloat/distension;
98
Rowland.indd 98
In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT. Protected by copyright.
Fig 20: Pododermatitis in a
guinea pig
■■Tooth grinding;
■■Depression;
■■Anorexia.
Physiological effects include mobilisation of fat
reserves and fat metabolism, which results in
ketosis. In addition, gastrointestinal tympany
resulting from hypomotility causes stimulation of
pain stretch receptors. Pain is an important cause of
ileus and will worsen the condition.
Treatment of ileus in guinea pigs is multimodal
and aggressive. Guinea pigs can exhibit sudden and
rapid deterioration of their clinical condition, so
supportive care is essential in these cases. Treatment
usually requires hospitalisation and includes:
■■Fluid therapy (to counter ketosis);
■■Analgesia (to treat underlying conditions and
gastrointestinal tympany);
■■Assisted feeding (to provide energy and
stimulating gut motility and appetite);
■■Prokinetics (to stimulate intestinal motility).
There is some debate about the use of prokinetics.
I prefer to use oral cisapride, but it should be
noted that the single best prokinetic is food, so
oral syringe feeding by support staff is often the
difference between success and failure in these
cases. Some clinicians prefer to use ranitidine, but
I don’t regularly use this due to the potential acid
reduction and pancreatic enzyme reduction effects
of this drug, and therefore the potential to allow
microbes that would not normally pass through the
stomach and populate the lower intestinal tract.
Dental disease
Guinea pigs have 20 teeth – two sets of incisors 1/1,
canines 0/0, premolars 1/1, molars 3/3. Premolars
March 2020 | IN PRACTICE
27/02/2020 15:34
 In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT. Protected by copyright.
Small companion animals

Fig 21: Normal guinea pig skull. Note the convergence of the yellow lines rostrally Fig 22. Overgrown tooth roots causing divergence of the yellow lines
as the mouth is forced open. Note also that this has resulted in incisor
elongation, which is often the sign most commonly noticed by owners

and molars are anatomically identical and are potential for massive fluid and electrolyte loss is
referred to as cheek teeth (Fig 21). great and aggressive supportive therapy is required.
Dental disease is very common in guinea pigs. Enterotoxaemia may be the result of inappropriate
Clinical signs include weight loss, anorexia, antibiotic selection resulting in dysbiosis. Other
ptyalism, ileus and depression. In almost all causes of diarrhoea include viral (Coronavirus),
cases the cause of dental disease in guinea pigs is bacterial (Clostridia, Salmonella species) and
inappropriate feeding practices. parasitic enteritis. Coccidiosis is a disease of young
The two most common presentations are molar guinea pigs and will result in wasting anorexia and
root overgrowth and tongue entrapment. death.
In cases of molar root overgrowth the presenting Hypovitaminosis C may result in intestinal
sign that owners most commonly notice is incisor bleeding and secondary bacterial infection leading
overgrowth. In this scenario the teeth are growing to diarrhoea.
backwards into the skull and essentially forcing Treatment of diarrhoea/soft stools involves
the mouth open (Fig 22). Treatment by burring the investigation of the underlying cause via faecal
incisors alone is contraindicated as it removes the examination, blood biochemistry and haematology,
ability of the animal to prehend food and therefore and radiography of the intestinal tract. Fluid
makes the condition worse. Skull radiography and replacement and analgesia are indicated along with
burring of the molars is required, as well as syringe
feeding and analgesia. The owners should be made
aware that the procedure will need to be repeated
as significant masticatory muscle atrophy has often
occurred due to disuse and this may take several
weeks to correct. Cheek tooth elongation may lead to
jaw abscessation.
Tongue entrapment (Fig 23) is a common dental
condition seen in guinea pigs. Affected animals
cannot ingest food normally and exhibit weight
loss and anorexia. Burring of the teeth under
anaesthesia, combined with analgesia and dietary
correction are required.
Anaesthesia is required for all detailed oral
examinations of guinea pigs. Lay people with no
qualification (so-called rodentologists) treating this
species and performing conscious dental treatment
of guinea pigs is a practice that should be rejected
by the veterinary profession.
Fig 23: Tongue
Diarrhoea/soft stools entrapment in a
Diarrhoea should be addressed quickly. The guinea pig

IN PRACTICE | March 2020 99

Rowland.indd 99 27/02/2020 15:34


Small companion animals
Fig 24: Large cystic ovary in a guinea pig. This was removed
via ovariectomy
supportive feeding. Probiotics may be indicated,
and vitamin C supplementation may also aid
recovery.
Gastric bloat
Like rabbits, guinea pigs are unable to vomit and
so gastric tympany constitutes an emergency.
Decompression may partially be achieved by
passage of a rubber tube into the stomach. However,
surgery may be indicated for some cases and the
prognosis is usually poor.
Liver conditions
Even short periods of anorexia will lead to the
onset of hepatic lipidosis. The liver cells become
non-functional as lipid droplets peripherise the
hepatocyte’s machinery. The condition is reversible
if the fibrous integrity of the liver remains intact.
Supportive feeding and liver supplementation is
useful in these cases.
Liver torsion and rupture may occur through
blunt trauma or inappropriate handling techniques,
and catastrophic haemorrhage may result. This
condition is usually fatal.
Faecal impaction
Faecal impaction is mainly seen in older, entire
male guinea pigs. The ‘cloaca’ becomes impacted
with faecal material, usually requiring manual
evacuation, which often needs to be repeated. Work
up of these cases should include spinal radiography
to rule out spondylosis, which may result in a
reduction in coprophagy leading to impaction.
Increasing fibre in the diet and analgesia may help.
The condition appears to be less common in guinea
pigs that are castrated at an early age.
100
Rowland.indd 100
In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT. Protected by copyright.
Fig 25: Abdominal
enlargement in a guinea pig
with cystic ovarian disease
Reproductive conditions
Cystic ovarian disease
Middle-aged entire sows show a high incidence (80
per cent) of cystic change within the ovaries. These
cysts may grow to a large size (Fig 24) and are easily
palpated in the abdomen (Fig 25) in often clinically
normal animals. Broadly, the cysts fall into two
groups: non-functional and functional.
Non-functional cysts
Non-functional cysts tend to grow to a large size
and cause no significant clinical signs unless
their size causes distension of the abdomen and/
or causes discomfort by putting pressure on other
abdominal organs. These cysts are often multiple
and bilateral.
Functional cysts
Functional cysts are less common than non-
functional cysts. Clinical signs include crusting of
the teats and non-pruritic bilateral truncal alopecia
(Fig 26). Other changes may also be present within
the reproductive tract such as cystic endometrial
hyperplasia, endometriosis and mucometra.
Neoplastic change (eg, fibroleiomyoma) may also be
seen.
Treatment options for cystic ovarian disease
include:
■■Human chorionic gonadotropin injections (1000
iu), repeated after seven days. These injections
may reduce the size of the cysts but are limited
in reliability and the volume to be injected
intramuscularly is very large and uncomfortable
for the animal;
■■Percutaneous drainage. However, I don’t
March 2020 | IN PRACTICE
27/02/2020 15:34

Fig 26: Truncal alopecia in a guinea pig with cystic ovarian
disease
recommend this in most cases because of risks
associated with organ puncture;
■■Deslorelin implants – a synthetic gonadotropin-
releasing hormone. However, these have been
shown to be ineffective at reducing cyst size;
■■Ovariectomy/ovariohysterectomy is considered
the treatment of choice for cystic ovarian disease.
Ovariectomy via a flank approach is indicated
where there are no uterine changes. If uterine
changes are present, ovariohysterectomy should
be performed. In cases where uterine changes are
observed, affected tissues should be submitted for
histopathology.
Elective flank ovariectomy, which is a
straightforward procedure, can prevent cystic
ovarian disease from occurring.
Pregnancy toxaemia
In the final 14 days of pregnancy the fetuses have
a high energy demand which can be greater than
the energy intake of the sow. This negative energy
balance causes fat mobilisation in the sow. The end
products of fat metabolism are ketones. Therefore,
the sow is at risk of developing life-threatening
ketosis and acidosis in this stage of gestation.
The sow may present depressed, collapsed
or uncoordinated. Hypotension may be severe.
Hyperkalemia and hypoglycaemia will be evident on
clinical chemistry. Intravenous or interosseous fluid
therapy is required. In addition, oral glucose and
injectable calcium gluconate should be considered.
Corticosteroids (normally contraindicated in this
IN PRACTICE | March 2020
Rowland.indd 101
In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT. Protected by copyright.
Small companion animals
species) may be required as an aid to treating shock.
The prognosis is guarded to poor.
In addition, the heavily gravid uterus may
compress blood vessels and nerves to other parts of
the body, particularly the hindlimbs. Hypertension
may result from compression of the renal blood
supply. Caesarean without delay is the treatment of
choice in these cases.
Dystocia
Sows should be bred at younger than six months
of age if breeding is to be carried out. This will
prevent fusion of the pelvic symphysis, which
occurs at six to eight months of age. Breeding
sows after the pelvic symphysis has fused risks
the fetus not being able to pass through the
pelvic canal and resulting in dystocia. Caesarean
may be required in these cases. In practice I
have experienced several occasions where sows
older than one year of age have been bred and
gone on to produce young without any issues, so
observation and caution is recommended before
embarking on a caesarean.
Other uterine/vaginal disorders
Vaginitis, pyometra, mucometra, uterine torsion
and leiomyoma are all reported. Ovariohysterectomy
is indicated for gross uterine disease.
Mammary glands
Sows may develop mastitis. This species has
short legs and so the ventral abdomen is in
close contact with substrate. Soiled substrate
can act as a source of contamination leading
to mammary gland infections. Treatment
with antibiotics, ideally based on culture of
secretions, is recommended.
Mammary gland neoplasia is a common
condition and is as common in males as it is
in females. Surgical excision is indicated with
histopathology.
Paraphimosis
Penile prolapse may be seen in older boars.
There may be a spinal lesion causing paresis or
the presence of a urethral plug. The condition
may also occur as a result of excess straining
from urinary tract disease. A urine sample may
help to differentiate a urinary tract lesion from a
neurological issue. Radiography will also be useful
in establishing the presence or absence of uroliths
or spinal lesions.
Orthopaedic conditions
Fractures
Guinea pigs are relatively frail pets and can be
involved in traumatic events such as being stepped
on or dropped. Spinal fractures and fractures of the
tibia are common. Treatment and prognosis depends
on the individual lesion and its clinical effects.
101
27/02/2020 15:34

Small companion animals
Fig 27: Fibrous osteodystrophy in a guinea pig. Arrows show
lytic lesions in the bone
Hypovitaminosis C
Vitamin C deficiency results in a disruption of blood
supply to the epiphyses of long bones and the
costochondral junctions. Joint swelling results from
these pathological changes. This causes lameness
and pain in the joints. Young guinea pigs are more
severely affected. Appropriate supplementation and
analgesia are required.
Fibrous osteodystrophy
Fibrous osteodystrophy is a genetic condition
affecting satin guinea pigs. Those animals that
have the condition but are not phenotypically
satin guinea pigs are thought to have satin genes.
It is a progressive, incurable condition affecting
all bones and causing lameness, anorexia and
dental disease. Radiographically there is osteolytic
activity and sclerosis of all bones (Fig 27), including
the mandible. Palliative treatment (multimodal
analgesia) along with supportive care is indicated
but the prognosis is poor.
Neurological conditions
Heat stress
Guinea pigs are particularly susceptible to the
effects of increased environmental temperature.
At temperatures of 25 to 28°C affected animals may
show signs of hypersalivation, incoordination and
increased respiratory rate. Coma and death will
result if the condition is not rapidly treated.
Therapy involves cooling the patient with cool
mists and baths. Alcohol may be applied to the
patient’s skin to increase the rate of evaporative
heat loss and they should also be given appropriate
aggressive supportive care. The prognosis is fair if
treated early.
102
Rowland.indd 102
In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT. Protected by copyright.
Otitis media
Infection of the middle ear can cause head tilt and
circling in guinea pigs. Isolated bacteria include
Bordetella and Streptococcus species. Medical
treatment is usually indicated. Anti-inflammatory
and antibiotic drugs are used with variable success.
Antivertigo drugs, such as prochlorperazine or
meclizine, have also been used. Bulla osteotomy is
not well described.
Miscellaneous conditions
Hyperthyroidism
Hyperthyroidism is an emerging condition of
middle-aged to older guinea pigs. Affected animals
present with weight loss even though they still have
a normal appetite and skin/coat changes (often
thinning of hair) (Fig 28). Clinical examination
often reveals an enlarged thyroid gland. Blood
biochemistry shows an increase in T4 (thyroxine)
levels (over 50 nmol/l). Calcification of the thyroid
gland is often a feature so radiography may help in
the diagnosis (Fig 29).
Patients can be treated with antithyroid drugs
(methimazole 2 to 3 mg/kg every 24 hours) and
possibly thyroidectomy; however, this is challenging
so most cases are treated medically. Radioactive
iodine is also a treatment option.
Cavian leukaemia
Lymphosarcoma is the most common neoplasm
encountered in guinea pigs. A type C retrovirus
is involved in the aetiology. Lymphoblastic
leukaemia may occur and carries a grave
prognosis. Lymphadenopathy may also occur
with enlargement of the peripheral lymph nodes,
spleen and liver. Progression of the disease is
rapid. I have tried chemotherapy in some of
these cases but with little success. Euthanasia
should be considered in these cases if palliative
Fig 28: Weight loss and coat
changes in a guinea pig with
hyperthyroidism
March 2020 | IN PRACTICE
27/02/2020 15:34
 In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT. Protected by copyright.
Small companion animals

Table 1: Drugs used to treat guinea pigs

Drug Dose Notes
Antibacterial
Ciprofloxacin 10 mg/kg given orally every 24 hours
Enrofloxacin 10 to 25 mg/kg given orally every 24 hours
Doxycycline 2.5 mg/kg given orally every 12 hours
Marbofloxacin 10 mg/kg given every 24 hours
Metronidazole 20 mg/kg given orally every 12 hours
Trimethoprim/ 30 mg/kg given orally every 12 hours
sulfamethoxazole
Antifungal
Itraconazole 20 mg/kg given orally every 24 hours
Analgesics
Meloxicam 0.2 mg (given on day 1) I have used 0.5 mg/
(licensed product) 0.1 mg/kg given orally every 24 hours kg given orally every
(maintenance dose) 12 hours with no
Discretionary use of 0.5 mg/kg orally every observed ill effects
24 hours
Butorphanol 1 mg/kg given subcutaneously every eight
hours
Fig 29: Calcification of the thyroid gland (arrow) Buprenorphine 0.05 mg/kg given subcutaneously every
eight to 12 hours
Tramadol 2 mg/kg given orally or subcutaneously
care (supportive feeding and analgesia) are every 12 hours
unsuccessful. Quality of life assessments should Methadone 0.5 mg/kg given subcutaneously every
be frequently made. eight hours
Antiparasitics
Lipoma
Ivermectin 0.2 mg/kg given subcutaneously every
I have seen several cases of lipoma in guinea seven days
pigs. On palpation the masses are in the subcutis
Selamectin 6 mg/kg applied topically
and are flattened and discoid in shape. Multiple
lipomata may be presented on the same animal. Praziquantel 7 mg/kg given subcutaneously
Diagnosis is by biopsy and excision may be Miscellaneous
indicated. Calcium gluconate 100 mg/kg given intramuscularly
Dexamethasone 0.5 mg/kg given intramuscularly Used in cases of
Therapeutics
pregnancy toxaemia
Table 1 lists some of the drugs I use when treating
guinea pigs. Furosemide 1 to 4 mg/kg given subcutaneously or orally
every 12 hours
Caution should be exercised with antibiotic
selection. Many antibiotic drugs (eg, β-lactams and Cisapride 0.5 mg/kg given orally every 12 hours
macrolides) are known to result in antibiotic-related Metoclopramide 0.5 mg/kg given subcutaneously or orally
enterotoxaemia in this species. Overgrowth of gram- every 12 hours
negative bacteria, including Clostridium difficile, Potassium citrate 10 to 30 mg/kg given orally every 12 hours Used in cases of
results in the production of powerful exotoxins that urolithiasis
cause diarrhoea and typhlitis. Ranitidine 4 mg/kg given orally every 12 hours
Enterotoxaemia requires aggressive supportive
Human chorionic 1000 iu/guinea pig given intramuscularly Used in cases of cystic
care to counteract fluid loss and shock, appropriate gonadotropin every seven days ovarian disease
analgesics and the use of probiotics, which may be
obtained by transfaunation of caecotrophs from
Vitamin C 10 to 30 mg/kg given orally (maintenance
other guinea pigs. The prognosis is guarded. dose)
50 to 100 mg/kg given subcutaneously or
Summary orally (in cases of deficiency)
Guinea pigs are popular pets and form an
important part of the pet-owning demographic.
It is essential to have a working knowledge of the forgetting to provide supportive care which is
common conditions affecting this species, and how an essential part of any therapeutic plan for this
to approach diagnostics and treatment without species.

IN PRACTICE | March 2020 103

Rowland.indd 103 27/02/2020 15:34

 In Practice: first published as 10.1136/inp.m405 on 5 March 2020. Downloaded from http://inpractice.bmj.com/ on March 6, 2020 at UNIVERSITY LIBRARY UTRECHT. Protected by copyright.
Small companion animals

Reference Species: Structure and Function of Mammals, Birds, Reptiles and

TRINITY CPD (2012) Guinea pig blood sample. www.youtube.com/
watch?v=tD9BpT-xqDw. Accessed 6 February, 2020
Further reading
CARPENTER, J. W. (2005) Exotic Animal Formulary. 3rd edn. Elsevier
Saunders
O’MALLEY, B. (2005) Clinical Anatomy and Physiology of Exotic
Amphibians. Elsevier Saunders
MAYAR, J. & DONNELLY, T. M. (2013) Clinical Veterinary Advisor: Birds
and Exotic Pets. Saunders
VIN (2020) Veterinary Information Network. www.vin.com/vin/.
Accessed 7 February 2020
KEEBLE, E. & MEREDITH A. (2009) BSAVA Manual of Rodents and
Ferrets. BSAVA
QUESENBERRY, K. & CARPENTER, J. (2011) Ferrets, Rabbits and
Rodents: Clinical Medicine and Surgery. 3rd edn. Elsevier

SELF-ASSESSMENT: VETERINARY CARE OF GUINEA PIGS

In Practice partners with BMJ OnExamination to host self-assessment quizzes for each clinical article. These can be
completed online at inpractice.bmj.com

1. At what lower age can sex determination be c)  Streptococcus intermedius

carried out in guinea pigs? d)  Streptococcus zooepideimicus
a)  Two to three weeks
b)  Seven to eight weeks 4. What is the incidence ratio of mammary
c)  12 to 13 weeks neoplasia between male and female guinea
d)  24 to 25 weeks pigs?
a)  Males 0 per cent: Females 100 per cent
2. What is the most common constituent of b)  Males 25 per cent: Females 75 per cent
guinea pig cystic calculi? c)  Males 50 per cent: Females 50 per cent
a)  Calcium carbonate d)  Males 75 per cent: Females 25 per cent
b)  Ammonium urate
c)  Calcium oxalate 5. At what lower temperature could signs of heat
d)  Potassium citrate stress in guinea pigs be noticed?
a)  28oC
3. Caseous lymphadenitis is caused by: b)  30oC
a)  Staphylococcus aureus c)  35oC
b)  Escherichia coli d)  40oC

Answers: (1) b, (2) a, (3) d, (4) c, (5) a

Make sure you’re complying

with waste regulations
Download the BVA guide to handling veterinary
waste from www.bva.co.uk/guides

104 March 2020 | IN PRACTICE

Rowland.indd 104 27/02/2020 15:34