Malocclusion

Unlike our teeth, the teeth of a guinea pig are continually growing. The reason they usually stay the right length is because all the chewing they do as they eat (and guinea pigs spend much of their time eating!) wears them down, always keeping them in check. In addition to the four teeth you can see at the front of a guinea pig's mouth (two top, two bottom) which are called the incisors, they have another sixteen teeth at the back of their mouth called molars (the first four are called pre-molars). The molars are hidden behind the flesh of their cheeks, which gives them the important ability to chew on and taste things without necessarily ingesting them. We can't see these teeth without the use of special equipment, but a problem with these teeth overgrowing or growing in the wrong direction - a condition called malocclusion - is very serious as if their teeth aren't in good shape, or are digging in to their cheeks/ tongue and causing them pain, they can't eat properly. If they can't eat properly, they will die - it's as simple as that. Ziggy was two and a half when his dental problems occurred. This was one problem where I quickly found out the limitations of many vets who generally seem to be good with guinea pigs.

The Warning Signs

When I give the pigs their veggies, I always hang around to make sure everyone is eating okay. One evening I was watching them tuck in to some romaine, cucumber and broccoli and I noticed that Ziggy was having some trouble eating. He was dropping the food more than usual and didn't seem to be taking very vigorous nibbles at anything as he usually did, although he was getting some in. I picked him up to check him over and noticed that his front teeth were wearing at an angle. The incisors are mainly worn down by the opposing action as the guinea pig grinds its molars (not from chewing at hard objects with their front teeth) so if the front teeth aren't wearing properly it usually points to a problem with the back teeth. Both of these symptoms - the not being able to grasp food and the misaligned front teeth - are pretty compelling signs of malocclusion. I knew this was definitely one for the vet to look at immediately, and that evening I cut up Ziggy's veggies in to ribbons which meant he could get bits of food in to his mouth easily without needing to chew as much. I weighed him and found that he was a couple of ounces below his usual weight. Knowing your guinea pig's usual weight is so important for times like this - if you handle your guinea pig a lot then subtle differences of a couple of ounces lost over several days may not be obvious to you, but is a significant weight loss for them.

Vet #1

First thing the next morning I took him in to the vets - Vet #1 - to have his teeth checked out. It was a vets I had used several times before and was pretty happy with. I'd read a lot of horror stories on guinea pig message boards about vets who didn't have a clue about dental problems, and who, instead of properly correcting overgrown molars, simply clipped the incisors and sent the pig home, committing them to a death sentence. So I was naturally a little anxious that the vets who treat Ziggy not be like that. Before handing Ziggy over I asked some questions about their experience with cavy dentistry and made sure they were familiar with all the problems that can occur and whether they used buccal pad separators which greatly facilitate examination and treatment (which they did). They seemed very knowledgeable and agreed that everything was pointing to his molars being overgrown or misaligned, and I was reassured they were confident they'd be able to sort him out. They used a bit of anaesthetic gas (isoflurane: a safe gas for guinea pigs) while they were examining and treating Ziggy. The Cambridge Cavy Trust does not feel this is necessary but many vets feel that a small amount of isoflurane helps relax the piggy and makes it a less stressful experience so I was happy about it.

I picked Ziggy up later that day and spoke to the vet who said that he had checked the teeth over, made a few adjustments and was happy that he should be fine to eat now. I understood from information I had read on the internet, that their mouths could still be quite sore after dental treatment, so it could take a day or so before they really felt like eating. Something which troubled me right away was that I noticed that they had also trimmed Ziggy's front teeth slightly. Usually, because the front teeth are worn down by the opposing action when they grind their back teeth, a slight overgrowth of the incisors is left, as the guinea pig will correct it within a few hours of grinding. I'd read several things before that indicated this was something only vets who don't really have a clue about cavy dentistry do. However, I voiced this and was reassured that it was absolutely fine.

Unfortunately when I got Ziggy home, he was barely eating at all. I started hand feeding him a syringe feed - I used one made for small animals by Supreme Science. If you can get hold of it, Oxbow's Critical Care is the best, but unforunately I couldn't find any in the UK at the time (see Petlife International if you want to order some but you do need a referal from your vet). I alternated the syringe feed with some of his regular pellets soaked in a little warm water and liquidised with small amounts of vegetables and fruit (make small amounts as this mash will quickly spoil). I also supplemented it with Vitamin C and a probiotic, just to give him a little extra help. See Guinea Lynx's section on Hand Feeding for more information on handfeeding your guinea pig. I also offered him a wide variety of sliced veggies and grasses to tempt him to eat, but he seemed very reluctant to take anything solid and it was really hard work getting a sufficient amount of food in him. The next morning he was still the same. Even more concerned as he had deteriorated, I called the vets who said it was quite normal and he would be fine once he'd had a couple of days for the soreness to settle down.

Ziggy Gets a URI: Back To Vet #1

By the next day things got worse as not only was he still not eating and continuing to lose weight, Ziggy had also developed symptoms of the start of an upper respiratory infection (URI). He was ruttling when he breathed and was a little crusty around his nose. So he went back to the vets where he was given treatment for that - a Baytril injection there and oral Baytril to be given twice daily at home. I asked again about his teeth and the vet had a look at them with an otoscope (a camera on the end of a tube that the vet puts inside their mouths) but was told firmly that he was doing fine. He said that Ziggy had probably been coming down with a URI a few days before I noticed his teeth were uneven, so had stopped eating and that's why there'd been a problem with his teeth not getting worn down. Now he was being treated for that, everything should be fine and he expected he'd be eating again by tomorrow. I said I was concerned about how much weight he was losing, and was worried the problem with his teeth had not actually been addressed, and that the reason he'd come down with a URI because he hadn't been able to eat properly for a few days. But really, they didn't listen to me which was what convinced me to see another vet if there were no improvements that day.

Vet #2

The next morning Ziggy was still not showing any interest in food, although thankfully his respiratory infection seemed to be responding to the antibiotics. Despite me spending hours every day trying to get food in to him, Ziggy was rapidly losing weight, and I was very worried. I rang around trying to get another recommendation for a vet and phoned a local small animal rescue who gave me the number of a vet they used for their small animal dental needs, and rated highly. So I took Ziggy there and the vet - Vet #2 - gave Zigs a thorough inspection with an otoscope. He couldn't find anything wrong, and said the URI was most likely causing his appetite to diminish, but that if he wasn't at least trying to eat within a day or so, to bring him back.

Ziggy did make more effort to eat during this time, but didn't take anywhere enough food to sustain himself so I was still having to hand feed him. His URI was responding well to the antibiotics which was a relief, but he was still obviously not right. It was at this point he started getting a wet chin from time to time. This is another red flag for dental problems. It's caused by them drooling because they can't close their mouth properly due to the teeth being overgrown - that or they don't want to move their mouth around to swallow normally because it's so painful. I also noticed that the front teeth had now grown back properly and were again wearing at an angle. So I made another appointment with Vet #2. He looked over Ziggy again and said that he really couldn't find anything wrong with his teeth but there obviously was a problem that needed addressing. So he referred me to another vet, Vet #3 who was an exotics vet with a lot of experience in animal dentistry.

Vet #3

So the next morning we left Ziggy with Vet #3, who also used a small amount of isoflurane gas to sedate him during the procedure. I called up at lunchtime to check how he was doing and was told that Ziggy's mouth had been an absolute mess. He had one molar that was growing out to the side, and in to his cheek causing an ulcer. Because of the pain this was causing, Ziggy had been trying to avoid using that side of his mouth which meant other teeth had had the chance to overgrow and cause ulcerations elsewhere in his mouth and over his tongue. The poor little sausage had obviously been in a great deal of pain, but the first two vets hadn't even seen there was a problem and therefore had allowed it to get even worse. It was such a relief to hear someone confirm that something was definitely wrong and give me thorough details about it and the treatment that had been given - I'd been in limbo knowing something was desperately wrong and trying my best to do what was right by Zigs who Id have done anything for, but getting nowhere. But I was also extremely upset thinking about how Ziggy (and I) had been treated at the other vets and the fact that their incompetancy had basically risked his life. I'm just glad that I carried on fighting for him, even when I had been told by two vets that nothing was wrong with him, but that if anything was wrong, it was simply that I worried too much. Ziggy was given a Rimadyl injection, which is an anti-inflammatory and pain killer to make him more comfortable. They advised me to keep on hand feeding him until he started eating on his own, and get straight back in touch if there was no improvement within the next day or so.

Ziggy didn't really try to eat that night, but the next day he was trying to eat by himself which was lovely to see. He was obviously still a bit sore, but he was evidently feeling more comfortable. Over the next few days things kept on improving and he was soon tucking in to his grub in the enthusiastic way he usually did. I can't tell you the relief to see him back to his usual self and tucking in to his food properly. By this stage I had also got him some Oral Gel from Galen's Garden which is a homeopathic remedy containing aloe vera for sore/ infected mouths. From the fact his appetite always increased after I'd put some of this inside his mouth, I'm sure it really helped soothe his sores. I continued supplementing him with hand feeds for several days after he started eating by himself to make sure he was getting enough food in and speed up the weight gain.

The vet warned me that it was possible Ziggy may need to have his teeth trimmed every 4-6 weeks for the rest of his life. Sometimes not eating properly for a couple of days because of another illness is enough to let the molars grow too much and impede eating. But sometimes it's a genetic condition (made more likely by inbreeding which Ziggy was) and once it occurs, they may need help for the rest of their life. Luckily Ziggy's problem was a one off. He did have the tooth which grew in the wrong direction, and the x-ray showed that it didn't have as much of a root as the other molars. For some reason it had managed to grow too much, although Ziggy usually had no problem with it at all. Perhaps he did have a URI brewing which put him off his food a little bit, but so little that I didn't notice. But he never needed dental treatment again after this point, although I did have a few paranoid moments where I had them checked out by the vet to be absolutely sure. It's far better to be safe than sorry.

Dietary Considerations

I read around a lot on malocclusion incase it was going to be a recurring problem. I found that you can make adjustments to the diet which mean their teeth are kept busier and therefore more likely to be kept in check naturally. I switched the pigs from an alfalfa based food to a timothy based one (Oxbow's Cavy Cuisine). Timothy hay is a much lower energy food than alfalfa and therefore means they will need to eat more of it to satisfy their appetite than they would of an alfalfa based feed. I restricted fruits and high energy veggies like carrots and corn anyway, but I made more of an effort to really limit these and instead give more low energy veggies and grasses so Zigs would have to eat more to get the same amount of energy, so constantly keep his teeth moving and wearing down. I'll never know if it was just a one off problem, or of these measures did help keep his teeth in good shape, but it was certainly worth it, and was also healthier for all the pigs anyway! Alfalfa based feeds are also high in calcium which is possibly related to the formation of bladder and kidney stones, so it seemed like a good idea to get them all off alfalfa based pellets from that perspective.

The CCT

The Cambridge Cavy Trust (CCT) in the UK trains rodentologists to undertake dental work, and they do so without the use of anaesthetic. If you have any problems with your vet, or would prefer your guinea pig to be treated without anaesthetic, contact them for details of your nearest rodentologist.

Complaining

Remember that if you receive care from a vet that you consider negligent or in any way harmful to the health or recovery to your pet, it is important to complain. If you don't complain then there's no way they're going to find out about the mistakes that they have made, or for individual vets to be put in a position where they have to do something about it. It may fall on deaf ears, but put it in writing to them and at least you know you've done your bit to stop another animal suffering the same fate at their hands. Always trust your own intuition if you have an ill pet and don't feel the care you are receiving is good enough - no one knows them better than you and no one else can stand up for them. If your guinea pig is ill, it's a great idea to visit Guinea Lynx and post there about the problems your pig is having and your vet's responses. This way you can benefit from many other people's knowledge and experience and may well receive advice that could save the life of your guinea pig.

Ziggy's Dental Problems (Malocclusion)

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