Reunion Day

For three nights we have had Virga and Cirrus in a separate cage in close proximity to the big cage where CB and Foehn are housed. Last night, we switched cages - CB and Foehn spent the night in the small cage, and Virga and Cirrus in the big cage. This was to get them familiar with each others scent again, because today we wanted to try and get them together for the first time since Virga and Cirrus had their surgery two weeks ago.

We wanted to reintroduce them in the bathroom again (similar to the original introductions), so after breakfast M thoroughly cleaned the bathroom and we laid an old comforter on the floor. We decided to get CB and Cirrus together first as they are the two most laid back of the four. We brought them into the bathroom along with an extra sleeping pouch, and set them free on the floor. I was standing by with a large piece of fleece in case I needed to intervene in an altercation.  However, it wasn't needed. True to their nature, CB and Cirrus crawled into a pouch together like they had never been apart! Well, that was easy. Since Cirrus and CB were successfully reunited, we thought we would try to bring in Foehn to join them. M went and fetched Foehn from the cage, and we set her on the floor in a pouch.  Cirrus wandered over and stuck her nose in the pouch, and within seconds both gliders were crabbing and Foehn grabbed Cirrus. Without thinking I tried to grab both gliders, one in each hand, and successfully got them apart, but not without Foehn chomping down hard on a finger. Both gliders were frightened, and a few additional approaches to each other resulted in more crabbing.  We collected Foehn, who seemed to be the instigator, and put her back in her cage so she and Cirrus could calm down. Once Cirrus calmed down, we brought Virga in to see if she would be OK with CB and Cirrus. She slowly approached the opening of the pouch CB and Cirrus were in, and after only a brief moment of hesitation crawled right in and curled up in the bottom. She needed her sleep and no one was going to deprive her of that!  M carried the three of them around in their sleeping pouch during the afternoon so I could clean the cages. Foehn spent the afternoon in the small cage while we tried to figure out what our next step was going to be.


4:30 p.m.

M suggested we try and get Foehn and Virga together next.  That meant fishing Virga out of the sleeping pouch she was sharing with CB and Cirrus, and she probably wasn't too happy about that. We brought Virga and Foehn into the bathroom and set them on the floor with no pouches on the floor for them to retreat to.  It took a few moments before they saw each other, and there was no immediate reaction. They eventually approached each other, and surprisingly it was Virga who took exception. She crabbed and went after Foehn, who scampered up M's leg to the safety of her shoulder. Poor Foehn was frightened and didn't know what to make of it all. It was clear this wasn't working too well, so about 15 minutes later I decided we should try getting them together in the bathtub where it is easier to contain them. Initially there was crabbing and frightened gliders. I cupped Virga beneath my hand and on a piece of fleece so she could see but not move easily (and it also provides security for her). I did the same for Foehn, and moved them closer together. After a few minutes they both seemed to relax, and best of all there was no crabbing. A few more minutes later, I placed one of the pouches in the tub and they both crawled in without incident. There was a little maneuvering and a few brief "tsks", but soon they settled in to sleep!


6:20 p.m.

I had just finished a shower after working out and was getting ready to make some dinner when M poked her out of my office and called me. Foehn had come out of the pouch to take care of "business", and when she crawled back into the pouch Virga crabbed and lunged at her. Virga continued to crab, even at me, and despite a couple of attempts and one near success, Virga was not happy having Foehn around. They are now sleeping in separate pouches, and we are trying to figure out next step.


8:30 p.m.

We thought we would try to get Foehn and Cirrus together in the same manner as we did with Virga. Interestingly, it was Foehn who went after Cirrus this time. This may be a dominance thing among the females - Virga/Foehn, and Foehn/Cirrus. At any rate, after 10 minutes or so Cirrus and Foehn were OK with each other and went into the pouch.  There was still some crabbing, so I went and got CB out of his slumber and had him join Foehn and Cirrus. That helped and they calmed down. I then went and got Virga from M and she crawled in as well.  Unfortunately, Foehn was interested in running and jumping, and not in sleep, so she came out. Virga crabbed and one in a while lunged when she tried to return to the pouch, so it appears their differences have not been worked out.


10:30 p.m.

There continues to be dust-ups between Virga and Foehn, somewhat less so with Foehn and Cirrus. For our own piece of mind and their safety, we are going to have them in separate cages tonight, and we'll see how they are during play time tomorrow.

Recovery

Virga and Cirrus had their follow-up appointment with the vet on Monday afternoon. The incisions were healing well and the ladies were freed of their e-collars before we left.  They both have lost weight the last ten days, about 8 grams each. Cirrus immediately started 30 minutes of cleaning every part of her body she could not reach while wearing the collar.  It was sort of comical in a way. You could just hear her thinking "Finally I can take a bath!"

We met the two surgeons who performed the surgery on Virga and Cirrus, and our vet  discussed the histopathology with us. Both gliders did have cancerous tumors, which wasn't surprising. However, the surprise was that Cirrus' cancer was more aggressive and there was evidence it had spread into the lymphatic system. As far as that is concerned all we can do at this point is wait and see. Both gliders have another follow-up appointment in a month.

Dr. W asked if we would mind if they published a case study of the ladies' diagnosis and treatment, and of course we immediately agreed. This would be published in one of the veterinary journals. Hopefully what Virga and Cirrus have gone through will benefit other gliders in the future. Dr. W and the staff at the University of Illinois VetMed Hospital were terrific throughout this whole ordeal.

We have two hurdles to jump before life is back to normal around here. Even though they were separated only 10 days, we will have to go through re-introducing Virga and Cirrus to CB and Foehn. A couple of nights ago night we brought Cirrus and Virga into the playroom in their small cage while Foehn and CB were running around. Foehn climbed up on the cage with Virga on the other side, and there was much crabbing and consternation. So, we have the pairs in separate cages and will begin the intro process again in earnest when the ladies have started eating normally again, Their appetite is the second hurdle.  They have been eating, but not very much, and that might be partly due to the antibiotic they were on. Tonight one of the vetmed students that works with Dr. W called to check on Virga and Cirrus. She suggested that we may want to move the cages apart on the chance that stress may be affecting their desire to eat. So, we will give that a try starting tonight.

A Rough 24 Hours

Early this week we let Virga and Cirrus have some free time in the office since they had been doing so well.  Virga was particularly happy to be out, and she kept climbing up on us and the tree to jump. We were trying not to let her jump, but she did manage to sneak in one or two longer jumps. When we were gathering them up to go back in their cage, M noticed that Virga had some blood at the bottom of her incision and found that her incision had separated a bit near the bottom. This was probably from her activity, and we now regretted letting them out. M also saw Cirrus able to get her head around to try and groom her incision, and it appeared their e-collars might be too small to prevent them from doing so. They also seemed more interested in grooming each other. That night we ended up keeping them in two separate cages so they wouldn't bother each other.  M spent time that night making two larger e-collars. The gliders were not happy with them, as it was more difficult for them to move around and get comfortable. Cirrus in particular hated her collar. She is smaller than Virga and these collars were bigger and twice the weight of the previous ones. That night Cirrus did not each much. Most of her waking time was spent struggling against the collar. When she did sleep, she was unable to sleep in the curled up position that they enjoy. Cirrus seemed generally lethargic, and I think she was also affected by that fact she was not with her sister. Virga did not like her collar either, but she seemed more resigned to dealing with it.

Cirrus sleeping in her e-collar. Gliders often like to wrap their tail
across their eyes while sleeping. Somehow Cirrus managed
to get her tail under the collar and across her eyes.

Last night we decided to put the smaller e-collar on Cirrus and to let them spend the night in one cage together. You could see the change in Cirrus' demeanor. She and Virga nuzzled each other, and Cirrus was interested in eating again, and enthusiastically ate two pieces of avocado. Both gliders were doing much better today, and there were no more problems with Virga's incision. We put her back in the smaller e-collar late this afternoon, and now both of them seem to be feeling pretty good.

Feeling Frisky

Tonight we brought Virga and Cirrus into the office and let them run around for awhile. Anytime they are awake and we walk into our bedroom (where their temporary cage is), they come to the front wanting us to take them out.  So we decided to give them a little free time tonight, just making sure they aren't taking any big jumps yet - which they want to do very badly! Their incisions are healing well, and they have got their energy and appetites back.  They are tolerating their e-collars as well as can be expected. During the day they sleep curled up in a nest of fleece M has placed in the cage for them. We aren't using a sleeping pouch because they don't have to climb and we don't want them to get hung up with their collars in it.

Virga and Cirrus asleep in their "nest" of fleece.

Their follow-up appointment with the vet is on Monday, and at that point we should be able to remove the e-collars and let them rejoin CB and Foehn as long as everything looks good.

Speaking of CB and Foehn, they have been pretty frisky the last few nights as well. Maybe it's the warm weather, but it has been nice to have them jumping and climbing around instead of snoozing in M's shirt or the sleeping pouch.

I Guess Being Fashionable Isn't Enough

Virga and Cirrus have been doing very well the last few days. They are limited in their activity by the smaller cage and can only climb, When we came into the room last night they came to the front of the cage and waited for us to take them out. We have been taking them out for periods of time and letting the climb on us and walk around on the floor for a bit.  They are both feeling pretty frisky but we don't want them to be too active until they have healed some more.  The incisions look good and appear to be healing well.

Today we thought we would put the ladies in e-jackets and remove the collars. So after their morning medications we removed Virga's collar and put her in her e-jacket.  It did not take her long to wriggle out of it, so there were a number of more tries until she finally seemed secured in the jacket. She crawled into their sleeping pouch and settled in. Cirrus was up next. She did not like this at all, and it took several tries before she was secure, or so we thought. In about five minutes she had managed to wriggle out of it. Rather than keep trying to keep her in her lime-green jacket, we put the e-collar back on. I picked up the sleeping pouch to find that Virga had wriggled halfway out of her jacket (she apparently wasn't sleeping as I thought), so we removed her jacket and returned her to the e-collar. We did not want to stress them out by repeatedly trying to get them in .the jackets. Apparently we need to work on our technique, because they should not be able to get out of the jackets.

Virga in her e-jacket

Cirrus takes off after he e-jacket was put on

Home and On the Road to Recovery

Virga and Cirrus underwent surgery at the University of Illinois Veterinary Teaching Hospital on Thursday. We brought them in around 10:00 a.m. and met with our vet. She went over what exactly was going to happen with each glider. One change from what she had thought earlier was that they would not be spayed. Since  Dr. W. felt that these tumors were possibly hormonally driven spaying them would eliminate the hormones from the equation.  However, spaying is a fairly serious procedure for sugar gliders, and she felt the risk from that surgery was too high, and we agreed. Instead, they removed the mammary glands along with the tumors, and then performed a "pouch ablation" to minimize the potential for residual mammary tissue being left behind and for abnormal cell growth to reoccur. The pouch is more or less a flap of skin, so this was a much less traumatic procedure than spaying.  It left both of them with about a one inch incision that was closed with internal sutures and externally with tissue glue.

Surgery was scheduled for early afternoon.  Virga was first, and her surgery took about an hour. The two tumors had grown together and were hard to distinguish as separate masses. When her surgery was completed, Cirrus had her surgery, which lasted about 40 minutes.  Dr. W called about 4:00 p.m. to let us know both girls had made it through surgery just fine and were awake. However, they were going to keep them overnight in ICU so they could be given injectable pain meds and watched carefully during their waking hours.

Virga and Cirrus at home in their e-collars.

We had sent along e-collars and two new e-jackets with Virga and Cirrus. The e-jackets are a relatively new device that has been successfully used with gliders to keep them from self-mutilating. On Wednesday night I practiced getting Virga into her e-jacket, but it took three tries before I got it right. After surgery they tried to get Virga in her e-jacket, but she wiggled right out of it. Rather than stress her out they went with the e-collars. One of the e-collars we have attaches with snaps and works quite well most of the time.  They tried it on Cirrus and she had it off in two seconds. The second e-collar wouldn't stay on, so the vet and vet techs made two e-collars out of old x-ray film. Not fashionable, but very effective.  The ladies had a pretty good night and cuddled up in their hospital cage. They ate a little, and apparently were loved on by the ICU staff.

I picked them up at the hospital on Friday about 11:00 a.m. The two vet med students that had been working with Dr. W and with us the last few visits explained the care needed for Virga and Cirrus. The incision site on both was a little swollen, but that was to be expected.  Otherwise both gliders looked groggy, but good.. Dr. W went into a little more detail on the surgery. To her knowledge this particular procedure has not been done before on gliders for treatment of mammary carcinoma. She was not able to find much in the veterinary literature about mammary carcinoma in gliders and the vets she spoke had heard of it but did not have much direct experience with it. So, Virga and Cirrus may end up being pioneers in glider veterinary care.

For all they have gone through, Virga and Cirrus are doing remarkably well. They ate last night, starting off with an appetizer of a few mealworms. They were mildly active in their cage last night. One of the medications they are on includes a mild sedative, and we really don't want them to be too active. We have them a a small cage in our bedroom so we can hear them in case something is wrong. The are able to climb a bit, but that's about it. They seem to be even a little more active tonight, and their incision sites look very good. They are eating and drinking.  The definitely do not like their e-collars, but seem to be a little more tolerant of them today. On Monday we will  put them in the e-jackets, which will give them more freedom of movement and make it a little easier for them to eat.

Their follow-up appointment with Dr. W is in about seven days. By that time we should have the results of the histopathology of the tissue that was removed. They should also be just about ready to rejoin CB and Foehn and normal glider activities.

From Bad to Worse

Virga is scheduled for surgery on Thursday to remove the two masses on either side of her pouch, so we are in the process of making preparations for her care after surgery. In the meantime, yesterday morning M observed Cirrus aggressively grooming her pouch  during the gliders' morning yogurt time. When she checked Cirrus' pouch she found it raw and irritated around the outside of the pouch from overgrooming. Back to the vet we went today. Dr. W immediately noticed that her pouch was worse than two weeks ago and wanted a better look. So, off went Cirrus to go under general anesthesia so they could get a closer examination. When Dr. W came back into the room with a camera we knew the news couldn't be good. The photo showed Cirrus had a growth about the size of a pea on one of her mammary glands. Dr. W wanted to do a needle aspiration for a cytology and of course we said go ahead. The results were supposed to be available late today.  The phone rang around 7:00 p.m.and M took the call. The news was not good. While Cirrus' mass is much smaller than Virga's two, it is definitely cancer (while Virga's may be pre-cancerous). Dr. W called another well-known glider vet to consult with him, and he said he had never encountered a glider with breast cancer, let alone two. Our vet will be calling other vets she knows with glider experience to see what light they might shed on all of this, but it looks like we could be forging new territory.

It's very possible Cirrus may be joining Virga in the surgical suite on Thursday if they can swing it.  It will be a little crazy for us for a few days caring for two recovering gliders but it will probably be better for them not only from a medical standpoint but also for their social well-being.

Our two ladies just turned 9 years old this month (we've had them two years) and they are pretty special to us. Not much of a birthday for them, but hopefully Thursday's outcome will mean more birthdays to come.

Headed for Surgery

Our vet called this morning with the results of the diagnostic procedures Virga went through. The news was not good.  The cytology indicated abnormal cells. Dr. W said if we decide to have surgery, she recommended it be done as soon as possible. When M called me with the news, we didn't have a lot of time to talk since I was in the middle of something at work. Dr. W said to take the weekend to think about it, but we both knew our decision without either of us actually saying it. We will be calling first thing on Monday to schedule Virga for surgery at the University of Illinois Veterinary Teaching Hospital. Dr. W said that the surgeon was ready and waiting, and has had experience with surgery on gliders. He apparently also has a soft spot for gliders and enjoys dealing with them (in contrast, I guess, to some who don't like dealing with small exotic pets).  Dr. W has been doing some background research and is going to be contacting another vet who has experience with this type of carcinoma for more information.

There was some good news in all of this. The x-ray confirmed that the suspected cancer has not spread. Virga's blood workup showed her liver was in great shape (this would be the next organ likely to be affected if the cancer spreads), and that overall she was in great systemic health. She feels that Virga should come through this fine and live out a normal healthy life.

And right now, Virga is getting her evening run in on the wheel.  No wonder she is great general health with all the exercise she gets!

Another Long Vet Visit

Today was Virga's follow-up appointment with our vet after two weeks on meds to treat possible mastitis. The good news was that the pouch opening was smaller and appeared to be better, but on closer examination the lining was still red and inflamed. And, the two masses were still there.

Rather than going to a biopsy, our vet Dr. W decided it would be best to do a fine needle aspiration of the masses for a cytology. This, of course requires Virga to have general anesthesia, so this visit was shaping up to be like the last one. I brought Virga in by myself today. M had to stay home with our grandson who had a tonsillectomy and adenoidectomy on Monday and is staying with us for the week.

After the examination Virga was placed in a plastic container while I signed the consent form.  Bright lights and strange smells were taking the place of her normal sleep time and she had none of the things she was secure with. As Dr. W finished briefing me on what was going to happen, Virga was watching me and the look on her face seemed to be saying "What is going on and why are you leaving me here?" She was obviously scared and not sure of what was going on. 

Prior to Virga going in for the procedure, Dr. W consulted with a vet surgeon about Virga's case and checked related pathology reports. The surgeon said that if and when there was a biopsy it would be prudent just to remove the masses rather than subject Virga to two surgeries. Prior to putting Virga under Dr. W called me and said she would like to do a full body x-ray and draw some blood since Virga would already be under. This would save another step if further treatment is needed.

The procedure was supposed to take an hour, but at two hours I still hadn't heard anything and was getting worried. I checked at the desk and they told me they had just finished. Turns out Dr. W had a "hamster emergency" and they got a late start on Virga.

Dr. W brought Virga out and sat down with me to explain what she knew at this point. We will have to wait for the x-ray to be read by the radiologist and for the cytology and blood work to be completed before we know anything for sure. She said she did take a look at the x-ray and she didn't see signs of anything spreading, so that was good to hear. On the other hand, the mass on the left side that was not visible through the pouch two weeks ago is visible now.

Dr. W said that mammary adenocarcinoma has been reported as the most common mammary cancer in sugar gliders, representing about 4 percent of all cancers in sugar gliders. We should learn the results of the diagnostic testing tomorrow, and are keeping our fingers crossed that the masses are benign.

When I got home around 2:00 p.m. from our 10:00 a.m. appointment, M scooped Virga out of her travel pouch and Virga spent the rest of the day sleeping in M's sweater.

Virga enjoys a mealworm snack this evening from the comfort of M's sweater

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