pimobendan

[Simon]

First off I want to thank anyone in advance for any information and help. I’ve have never posted here before just registered today, so this will be my first time to ask a question here.

I was wondering if anyone here has ever used pimobendan on a squirrel? I have a red/fox squirrel Mel 6 1/2 years old weighing about 2 pounds that has been struggling with a respiratory condition for about six months, he has been mouth breathing and aspirating whenever trying to eat or drink, he’s been given everything under the sun, including Lasix antibiotics, breathing treatments, oxygen, saline, nebulizer, etc.
he has been x-rayed to ensure he does not have any teeth issues Causing the congestion Nothing was found. His diet consist of fruits, vegetables, leafy greens, nuts, seeds rodent block, etc. he is on a calcium supplement because he refuses to eat rodent block and I have tried many different kinds including Henry’s block he will not eat any of it.

The vet has now prescribed this medication
Wanted to check if anyone else has ever had experience with this and if it was safe to try

[CritterMom]

I have never heard of this so I did some quick browsing and it is used for congestive heart failure in dogs. Is this what your vet thinks is going on?

I assume that he has been worked up for fungal/viral/bacterial issues already?

[Simon]

Hello, thank you for your response. Yes, the doctor thought it was possible. This problem could be caused by congestive heart failure. We’ve already tried antibiotics in case it was something fungal, viral, etc.. antibiotics did not seem to help, the other issue is the veterinarian I was able to take him to is a very long ways away several hour drive one way, so I cannot continue to take him for continuous checkups where I live veterinarians will not see him here so I have to drive pretty far to get any help

[CritterMom]

OK, I just flagged one of our members who is way, WAY more qualified to answer this than I am. Hopefully he will be able to respond.

[Simon]

Thank you so much. I appreciate that. I will keep checking back in to see if there’s any more responses.

[SamtheSquirrel2018]

First off I want to thank anyone in advance for any information and help. I’ve have never posted here before just registered today, so this will be my first time to ask a question here.

I was wondering if anyone here has ever used pimobendan on a squirrel? I have a red/fox squirrel Mel 6 1/2 years old weighing about 2 pounds that has been struggling with a respiratory condition for about six months, he has been mouth breathing and aspirating whenever trying to eat or drink, he’s been given everything under the sun, including Lasix antibiotics, breathing treatments, oxygen, saline, nebulizer, etc.
he has been x-rayed to ensure he does not have any teeth issues Causing the congestion Nothing was found. His diet consist of fruits, vegetables, leafy greens, nuts, seeds rodent block, etc. he is on a calcium supplement because he refuses to eat rodent block and I have tried many different kinds including Henry’s block he will not eat any of it.

The vet has now prescribed this medication
Wanted to check if anyone else has ever had experience with this and if it was safe to try

Hi Simon and welcome to The Squirrel Board! I am so sorry to hear about Mel's breathing difficulties! First off, I am not a Veterinarian and you should know that but I will make some comments anyway but these comments are my own humble non-Vet opinions!

Squirrels like human infants and many other rodent species are what is termed Obligate Nose Breathers. They normally breath through there noses and cannot easily change up and breath through there mouths and just as easily go back and forth from nose and mouth breathing as we can as adult humans. So---when a Squirrel breaths through his mouth, it is ALWAYS abnormal and of course you recognize this even if you didn't know about the obligate nose breather "thing!" The point though is the most common cause of mouth breathing for a Squirrel is "simply" not being able to breath through the nose. One of the most common causes of this are dental issues involving the upper teeth. This can include dental abscess (which ordinarily do NOT show up on standard plain film x-ray studies) and the very common dental associated tumor called an odontoma. Odontomas are not cancer. They are tumors made up of normal but disorganized dental tissues and they almost without exceptions DO show up on x-ray studies!

Another less common cause of nose breathing is from diminished effectiveness of gas transfer (taking in oxygen and releasing carbon dioxide) in the lungs which can be from a pneumonia or other lung disease, restriction in the breathing tubes from swelling or a foreign body and other causes!

Does Mel ever have any time when he is not in apparent respiratory distress and seems to be breathing normally? Is the any drainage from Mel's nose. Did your Vet listen to Mel's lungs through a stethoscope? If so, what did he say about how Mel's lungs sounded? Do you have a stethoscope to enable you to listen to his lungs?

I also have some questions;
1) how do you know that Mel is aspirating?
2) What kind of calcium supplements are you using and does it contain Vitamin D? Please list the actual type of calcium and if vitamin D is part of that, what is the concentrations of vitamin D. On that note, IF you are giving Mel a human form of calcium supplement, most all of these contain Vitamin D and far more Vitamin D than a Squirrel should ever get. IF this supplement contain Vitamin D I would suggest stopping this immediately and use a Calcium supplement that does NOT contain Vitamin D or other ingredients such as pure Calcium carbonate!
3) You say in one place that Mel is getting Blocks and in another that he is not eating blocks. Please clarify and if he is eating blocks, what is the brand and how many of them does he usual eat each day?
4) What were the specific x-ray studies that your Vet performed? Did he get views of Mel's chest, his neck and his head? Most x-ray studies are made with digital technology. Do you have the x-ray studies available and if so; would please post them on this thread ASAP so that we can see them?
5) what antibiotics have been used and how long were they administered?
6) what medications were given in "breathing treatment?"
7) how long has Mel been taking the Pimobendan?


Why specifically did your Vet finally believe that Mel had Heart Failure or was this based not so much on diagnostic evidence but on the fact that nothing else that had been tried seemed to be working?

I have never used Pimobendan with Squirrels as I have never had a Squirrel in my care with Congestive Heart Failure (CHF). Diagnosing CHF in dogs is relatively straight forward and just as in humans, an echocardiogram is usually used to rule-in this diagnosis. It is a well proven medication for dogs with CHF and some great advantages in that it help both enhance the "squeeze" of the heart and decreases what is called afterload or the resistance to ejection of blood from the heart! Diagnosing CHF in Squirrels presents some challenges and we do not have any definitive evidence by which we can say what specifically might be the advantages, risks or even dosing for its use with Squirrels! The dosing information I have for use of Pimobendan with rodents is actually extrapolated from use in canines! I certainly cannot say that Mel does not have CHF and I certainly do NOT want to appear that I am trying to get between you and your Vet BUT, it IMHNVO, it would less than ideal to use this medication simply because its one of the last things not yet tried!

But with that statement just being made; have you noticed any improvement in Mel's condition or behavior since starting the Pimobendan? For that matter, have you notice any improvement (or worsening) with any of the other treatments that have been tried (oxygen, antibiotics, nebulizers, Lasix, etc)?

Please send a Private Message (PM) to me indicating the dose and frequency of dosing of the Pimobendan. We do NOT post specific dosing information or instructions on the Open Board and communicate these via PM's.

I will get back with you after reading your response. Please give Mel a gentle Squirrel hug from me and tell him that I wish him the best!

Regards,
SamtheSquirrel

[Simon]

He was also given meloxicam during this time he started experiencing bad gastrointestinal problems so I discontinued giving him this as well. During this time, I did have him on probiotics to try and help keep his stomach balanced. Only saline has been given in the nebulizer, at times. It seems to help others times I cannot tell any difference. He does not have any fluids coming out of his nose, but he sounds like he is constantly sucking snot pretty much at all time he seems to be experiencing labored breathing pretty much anytime he is up and moving around sometimes whenever he’s sleeping he seems to be better but not all the time sometimes at night. I also hear him struggling to breathe. As far as aspiration whenever he is eating or drinking, he will choke and gag and sometimes throw up liquid or food. When this happens he has an even harder time breathing. I stopped giving him dishes of water and started giving him ice cubes so that he does not aspirate on water. He seems to be able to like the ice cubes and get water without choking on it. He seems to be doing somewhat better now that I have not given him dishes of water and just the ice cubes. I have thoroughly examined his nose and cannot see or find any obstructions. I have tried different kinds of suctions for babies to try and suck anything out of his nose with no luck. His top teeth are short, but the x-rays did not show any abscesses tumors, etc.. And there is no visible lumps or signs on his face or nose that would look like an abscess or a tumor nor did anything show in the x-rays

[Simon]

I apologize. I am having a hard time using this form for whatever reason only half of my message came through to response to your reply. I will try again tomorrow to see if I am able to get my whole message through. I need to go to bed now. I have work early in the morning. Thank you again for taking the time to respond to my question about the heart failure medicine.

[SamtheSquirrel2018]

He was also given meloxicam during this time he started experiencing bad gastrointestinal problems so I discontinued giving him this as well. During this time, I did have him on probiotics to try and help keep his stomach balanced. Only saline has been given in the nebulizer, at times. It seems to help others times I cannot tell any difference. He does not have any fluids coming out of his nose, but he sounds like he is constantly sucking snot pretty much at all time he seems to be experiencing labored breathing pretty much anytime he is up and moving around sometimes whenever he’s sleeping he seems to be better but not all the time sometimes at night. I also hear him struggling to breathe. As far as aspiration whenever he is eating or drinking, he will choke and gag and sometimes throw up liquid or food. When this happens he has an even harder time breathing. I stopped giving him dishes of water and started giving him ice cubes so that he does not aspirate on water. He seems to be able to like the ice cubes and get water without choking on it. He seems to be doing somewhat better now that I have not given him dishes of water and just the ice cubes. I have thoroughly examined his nose and cannot see or find any obstructions. I have tried different kinds of suctions for babies to try and suck anything out of his nose with no luck. His top teeth are short, but the x-rays did not show any abscesses tumors, etc.. And there is no visible lumps or signs on his face or nose that would look like an abscess or a tumor nor did anything show in the x-rays

Thanks Simon:
Would be able to post the x-ray films? Do you have the information about the Calcium supplement your are giving?

Ice cubes can be more difficult to bite into than blocks for a Squirrel who might have tooth issues! Also, a Squirrel can become dehydrated far more quickly than many people believe and ice cubes make it very difficult to ensure adequate water ingestion as it is far more difficult than drinking. I do recognize your concern for his free drinking from a bowl and he might have more success with a hanging water bottle. It is essential that any hanging water bottle be checked at least once each day preferably more of to ensure that it is functioning as designed beccause animals ahve also become dehydrated because they cannot drink from a malfunctioning hanging water bottle!

I would suggest that even if you prefer giving ice cubes; that you also provide controlled amounts of plain water along with SEPARATE feedings of formula such as Fox Valley 20/50. Give some water and then wait maybe 20 or 30 minutes and give some some formula and do this 4 or 5 times daily depending upon the amount of fluids that Mel is consuming.

Both the plain water and formula feeding should be given as if you were nursing a young Squirrel. Formula will provide water AND nutrition and I have yet to meet the adult Squirrel who refuses formula! The likelihood of aspiration increases with the size of the syringe so to start, I would suggest using a 1cc syringe withOUT a needle and preferably with a specialized nipple such as a Miracle Nipple although just the bare end of the syringe will suffice if you do not have a nipple. You should see if Mel will suck the water or the formula from the syringe. Hold Mel upright and point the tip of the syringe toward the roof of his mouth as these steps will help prevent aspiration.

After determining that Mel is tolerating the fluids; you can let Mell have as much as he wants and let thirst will be what limits his intake (just as if he was doing this himself by drinking from the bowl). Just go slow especially at first and always have control of the the plunger of the syringe. For young Squirrels, I always recommend using a syringe no larger than 1cc but Mel is an adult and weighs almost 1Kg and the primary concern with feeding with a syringe is for prevention of aspiration but if he tolerates the syringe feeding well; transitioning to a 3cc syringe (again, preferably with one of the specialized baby animal nipples) would be fine as an adult Squirrel's normal daily total fluid intake can easily approach or even exceed 10% of his body weight so Mel could be drinking around 90cc in a 24 hour period! It is essential that Mel NOT get dehydrated!!!

We will be looking for you morning post. I too will be at work in the morning but will review your thread as soon as I am able as will others hear on TSB!

Regards,
SamtheSquirrel

[SamtheSquirrel2018]

Another less common cause of nose breathing is from diminished effectiveness of gas transfer (taking in oxygen and releasing carbon dioxide) in the lungs which can be from a pneumonia or other lung disease, restriction in the breathing tubes from swelling or a foreign body and other causes!

Hello Simon:
How is Mel doing?

With the possibility of Mel having partially swallowed something that may be impeding swallowing and breathing; have you or the Vet looked in Mel's mouth to see if there may be some foreign material visible? The presence of some foreign material (or a tumor or swelling from some undefined cause) would explain Mel's apparent breathing difficulties (especially when he is active and breathing rate and depth increases) AND his regurgitation of food and fluids! Ideally, a thorough examination such as this is best accomplished by a Veterinarian who can administer a sedation level of inhaled anesthesia gas.

**PLEASE make certain that Mel has adequate fluid intake as only ice cubes and no other available fluids seems IMHO to be an almost certainty for dehydration to result which in itself is a disaster and can easily end very sadly! DEHYDRATION MUST BE PREVENTED!! I would again like to encourage you to try a hanging water bottle and ask that you use a syringe as mentioned in one of my prior posts for assisting with keeping Mel hydrated! IF Mel truly can NOT drink fluids; this is extremely critical! Those of us dealing with ill or injured animals are trained in using other methods for ensuring hydration such as sub-cutaneous fluid administration if the animal is unable to truly drink fluids. I am not certain that Mel is actually at this point and I would like to encourage you to try any reasonable means such as a hanging water bottle or even controlled return of his water bowl! Dehydration is a huge risk in itself, no matter what the other issues may be!**

Regards,
SamtheSquirrel

[Simon]

Good morning and thank you for getting back with me, Simon is a male squirrel. Sorry I think there is confusion about his name. His name is Simon not Mel lol I have periodically offered him formula. He will eat it. I did that to ensure he was getting proper nutrition whenever he was having a really hard time eating as of now he is able to eat food. It’s just not as easy for him as it should be I have offered him a water bottle often as well and I do keep a very small dish of water and Pedialyte along with the ice cubes. he seems to prefer the ice cubes. The calcium supplement I give him is designed for squirrels. It does not have vitamin D in it. It does have magnesium added. I have thoroughly examined the inside of his mouth and as much down his throat as possible while he is sleeping, I have taken a light and magnifying glass to try to find anything so far no luck everything looks as it should. I also held him and opened his mouth for the veterinarian to look inside they did not see anything either no obvious obstructions.

Also, he has not been given the congestive heart failure medicine. I was trying to gather more information before I gave it a try. This was something the veterinarian wanted to try because she felt it was possible His heart was enlarged, but she was not a squirrel specialist, so I am hesitant on trying something without knowing How it could affect him in a bad way.

[Simon]

Also, I do use miracle nipples, and the O-ring syringes. I have helped for many years in animal rehabilitation so I do know some basics on care just letting you know a little bit about myself.

[Simon]

Also, I did forget to mention the veterinarian did not think it was safe to put him under because she thinks he could possibly have a heart condition, she thought it would probably kill him by putting him under for her to do a more thorough examination.

[SamtheSquirrel2018]

I have a red/fox squirrel Mel 6 1/2 years old weighing about 2 pounds --->

Hi! Simon Squirrel; I apologize for calling you "Mel" and the above is where this misconception on my part originated! I now realize that this was a typo and that you must have meant to type "male!" By the way, I am the long standing Squirrel Board Typo Champ! Please don't threaten my only claim to fame!

Thanks for the updates on your experience as a Rehabber and what more has gone on with Simon, your clarifications on food, drink and calcium supplements, as well as examinations performed by you and your Vet! Just once more; if it may have slipped by; do you have the digital x-ray films and if so, would you be willing to post them in your thread? There are some members on TSB with interest in radiographic studies and I am certain that Simon's films would be interesting to view and if you might want a "second read," I'm sure that this too, could be forthcoming! Thank you for continuing to update Simon's thread!
Regards,
SamtheSquirrel

[Simon]

Thank you so much lol I’m not here to take your claim to fame ha ha I can try to request the x-rays I do not have them and they did not send me any. I can call the clinic and see if they can forward them to me, I would love a second opinion this has been an ongoing thing for quite some time now trying about everything under the sun to remedy whatever is wrong with him. I am very interested if anyone has used this congestive heart failure medicine pimobendan and what their experience was.

[SamtheSquirrel2018]

Thank you so much lol I’m not here to take your claim to fame ha ha I can try to request the x-rays I do not have them and they did not send me any. I can call the clinic and see if they can forward them to me, I would love a second opinion this has been an ongoing thing for quite some time now trying about everything under the sun to remedy whatever is wrong with him. I am very interested if anyone has used this congestive heart failure medicine pimobendan and what their experience was.

Hi Simon: I too would like to hear about any uses of Pimobendan with Squirrels or even pet rats! It is important to recognize that with any medication; the recognized benefits for one species (or adverse effects as well) may not and are actually unlikely to to the same across all species. Pimobendan was actually first investigated for humans and it was found that while it showed potential advantages, it actually increased morbidity when used by humans. There has been considerable positive evidence for its use in dogs, however and it offers considerable benefits for dogs when used appropriately. It is even associated with delaying or preventing the development of true heart failure in dogs with conditions such as mitral valve prolapse that can and subsequent left atrial enlargement.

Again, I cannot tell you that Pimobendan is potentially beneficial for Squirrels in the event of heart failure or those with conditions that may lead to heart failure or compromised cardiac functioning. IMHNVO, I would recommend that any Squirrel or pet Rat that is truly suspected to have a heart condition; have a Cardiac Ultrasound (Echocardiography) study performed. This is not as far fetched as it may seem as Echocardiograph has been performed on Rats very successfully! In fact there was a paper published fairly recently where this was discussed and while the authors obviously could not say that information contained in the paper would definitely be able to be used cross-species in other closely related small mammals, they felt that there may indeed be some potential for utilizing their Rat protocols for other small mammals.

I do hope that you will be able to post the x-ray films! I still believe that some sort of dental issue such as an odontoma is at a significant factor in what is gong on with Simon! It would be good, regardless of what I might think, to be able to review the actual films! Hopefully these include views of the chest and head and even the neck!

Regards,
SamtheSquirrel

[Simon]

Thank you for the info. I did reach out to the clinic today to request copies of the x-rays. Hopefully, I will get them in the next few days. It would be good to have them looked over for a second opinion for sure, I did find a post on a thread here on the squirrel board where someone was using this medication on a squirrel named Lucky. I read the content, but nothing was really said about the reaction or affects of using this congestive heart failure medication that I could see.

[SamtheSquirrel2018]

Thank you for the info. I did reach out to the clinic today to request copies of the x-rays. Hopefully, I will get them in the next few days. It would be good to have them looked over for a second opinion for sure, I did find a post on a thread here on the squirrel board where someone was using this medication on a squirrel named Lucky. I read the content, but nothing was really said about the reaction or affects of using this congestive heart failure medication that I could see.

Thanks; I went to that thread (which I had not read previously) and it sounds as if the Vet prescribed Pimobendan based only upon an empiric diagnosis (some type of heart condition) without any testing performed as the poster stated that an ultrasound of Lucky's heart had not yet been arranged but was being scheduled and the thread left off before the procedure had been performed but apparently it had apparently finally been scheduled. Also, the actual dose of Pimobendan was not defined as the amount given was expressed in volume of a liquid (0.05ml) and that could volume contain any of a relatively wide range of concentrations of Pimobendan! I believe that my opinion is aligned with yours and that is this thread does NOT help to define a rationale for usage of Pimobendan with Squirrels, does NOT give any hint as to what dose was that was chosen or more to the point; HOW the particular dose was derived such as evidence based upon studies of some sort, use in Rats, dogs or other animals or even anecdotal evidence from others to name some possibilities.

Thanks for checking on the x-ray films! Please keep on with updates about Simon!

Regards,
SamtheSquirrel