The Ladies are Together Again

Cirrus on her favorite toy, the wheel

The day after my last post, during morning yogurt time, M mentioned that she thought Cirrus was having trouble breathing. Her breathing appeared to be a little labored, and her nose wasn't its characteristic pink, usually a sign of low oxygen in the blood.  Over the weekend she wasn't very interested in her mealworms and her energy level seemed down.  After holding her weight steady for the past four to five weeks, she was down to 57 grams at her weekly weighing yesterday, her lowest weight since she has been with us. Yesterday M carried Cirrus in a pouch inside her sweatshirt to keep her warm and Cirrus slept there content the whole day. The first thing this morning we called our vet to see if we could get her in to be checked out. Even though they were booked not only today but for the week, they gave us an appointment this morning for a half hour after I called. Off to the University of Illinois Small Animal Clinic we went with Cirrus.

We got in right away. After getting some preliminary information from us they went to put Cirrus on oxygen for a few minutes prior to her examination. Dr. W. came in, examined her, listened to her breathing and her heart, and said that there was some noise on both inhale and exhale. In addition, her heart sounded "muffled".  Dr. W. said that she felt there were three possibilities for Cirrus' distress - pneumonia, a congestive heart problem, or tumors. We decided to go ahead with an x-ray to find out what was going on. We were hoping for pneumonia. At least that would be treatable.

M holding Cirrus after she woke
from from the x-ray anesthesia,

We were expecting to wait for 20 minutes or so while the x-ray was being done, but it was only a few minutes before Dr. W. came out to talk to us - they hadn't even finished the x-ray scan yet. She said it appeared Cirrus had at least three tumors in her lungs, with a fairly large one in her right lung. Part of the reason her heart sounded "muffled" was because the tumor was blocking the heart.  Obviously the cancer had metastasized rapidly. Dr. W. said she could give medication to reduce the inflammation which would keep her more comfortable, but it was only a short term solution.There was really nothing more that could be done at this point. We made the difficult decision to let her go. We were able to spend some time with her after she woke up from her x-ray to say goodbye, and we were there with her at the end. Neither of us thought that we would be coming back home without her today.

Cirrus was a very special glider, and she was M's favorite. We are both heartbroken to have lost her, but happy that she is with her sister again and not suffering.  Cirrus and Virga will always have a special place in our hearts.

Another Visit to the Vet for Cirrus

We have been concerned about Cirrus' weight loss over the last six weeks. On November 17 she weighed 75 grams, and today she was at 61 grams. With her medical history in mind,last week we called to make an appointment with the vet to have Cirrus checked out.

Cirrus enjoying her morning yogurt last week.

Today was her appointment, and we were relieved to hear that other than the weight loss she is doing well. Her muscle tone was good as was her overall body condition. She is a very active glider. Out of all of the gliders she is the one that probably spends the most time on a wheel or the glider treadmill and she burns a lot of calories. It is probably more than a coincidence that her weight loss has occurred since we obtained Rossby and Sprite. The two attempts at introductions were stressful for all concerned, but perhaps more for Cirrus. During playtime in the office she spends much of her time "marking", which is something we have rarely seen from her before. This is even after almost two weeks of being separated from Rossby and Sprite.

Our vet does not want her weight to drop any further, and thought that reducing her anxiety might help improve her appetite. Cirrus is now on a low dose of Diazepam.  Of all the drug options for a glider, this is is probably the safest. It is often used post-surgery to keep gliders calm and prevent them from overgrooming and opening their incisions. We will see how this goes until Cirrus' next follow-up appointment sometime in February.

A "Thumbs Up" for Cirrus (and Other News)

Cirrus on M's lap just after her meal worm snack today.

Yesterday was Cirrus' follow-up visit to the vet for her eye infection and a post-surgical check for the March surgery, and we got great news. The eye issue was cleared up (which we knew) and there are no signs of any recurrence of the cancer that she had surgery for in March.  Even though she appeared to be in good shape to us, you never know and we had a little part of us holding our breath. Dr. W said that Cirrus is in great condition. Cirrus was very good during the exam as Dr. W. was explaining glider anatomy and behavior to the fourth-year vet student was was working with her that day.  Cirrus' next follow-up appointment is in six months.

While we were at the clinic we made appointments for a wellness and baseline checks for Rossby and Sprite, and for our son's new glider, Ghost. This will be a little more of a challenge with Rossby and Sprite. They will stay on us and aren't afraid of us, but they are not crazy about being held. On the other hand, Sunday was "spa day" and we needed to clip their nails. I was expecting a wrestling match and bites to get this done (I hold them while M trims the nails), but they both were very good about it, almost better than the others.  However, being examined is a little different. We'll be back at the vet on Friday for them.

Ghost at one month old.

Then there is Ghost, our son's new glider. He is just a little over two months old. We are taking him in for our son because his work schedule won't allow him to do it. Ghost is a white mosaic glider, with black eyes, a white coat, and faint gray splotches and a faint gray dorsal stripe. We went to pick him up last weekend. He's a little guy at this point, only 55 grams. He still needs to be neutered, but he will need to be between 65 and 70 grams before that happens.  From what we hear, at the rate he's eating he'll be in that range before too long.  If everything works out he and Case (formerly Molly) will be cage mates eventually.

Ghost sleeping on the way home last weekend.

Back to the Vet

At last weekend's weigh-in both Foehn and Cirrus had dropped four grams. They had not been eating consistently - some nights everything was eaten, and on others they picked at their food. In addition, when we woke them up to weigh them Cirrus' right eye wasn't open, and it took a few minutes before it did. This had happened a time or two before, but in light of her weight loss and prior medical history, we figured a visit to the vet was in order just to be sure she was OK. So, on Thursday we brought them all in and had Cirrus checked out. Overall she was doing well, and gained back two grams. However, Dr. W. found "debris" in her eye. They did a further exam to check for any scratches on the eye for which they had to put drops in her eye. Cirrus was pretty good about it, considering they had to do this three times. She fortunately didn't have any scratches on her eye, but as a precaution Dr. W. prescribed antibiotic drops. We have to put the drops in her eye three times a day. It really takes two of us, one to hold her (and her head) and the other to hold her eye open, if necessary, and put the drops in each eye. Cirrus is very good about it, so much so that I was able to do the morning drops by myself. M said today that she thinks Cirrus' eyes look clearer, so the drops seem to be doing the trick.

Glide Free, Virga

Virga

Yesterday was our usual weekly weigh-in for our gliders. When it was Virga's turn I placed her into the pouch we use for weighing and headed for the scale. She had been slowing down the last week and was continuing to decline. Virga looked at me from the pouch with her big eyes, and it was clear it was time for her to be free. Weighing her only confirmed it for me - she had lost 6 grams in the past five days. Last night the tremors she has experienced on awakening lasted off and on through most of play time. She spent most of the time in my hand where I rubbed her tummy, which seemed to relax her and ease the tremors. I told M that I agreed that it was time to make the call and let Virga go.

I got up this morning to give them all their morning licks of yogurt, Virga included. I made the call to the clinic and left a message. Shortly after 8:30 I received a call back - we had a 10:00 a.m. appointment.

Cirrus, Foehn, and CB accompanied Virga to the clinic with us. Dr. W came out soon after and let us know there would be a bit of a delay.  When it was time Dr. W came out to get us and brought us to the examining room.  There was a blue fleece blanket on the steel examining table - that was surprisingly somewhat comforting.  Dr. W explained to us what would occur, and Virga was put under anesthesia.  M helped by keeping the anesthesia cone over Virga's face while she was injected with the euthanizing drug, and I kept the other gliders calm (I am not good with needles). We had elected to go with a catheter into her knee bone, but the small needle would not allow the relatively thick fluid to get into her system. So, it was directly injected into her heart. When Virga had passed we placed her in the pouch with Cirrus, Foehn, and CB so they could say their goodbyes.  We were both able to hold her and say our goodbyes.  There were tears in everybody's eyes: ours, Dr. W. the vet tech, and the student helping out. Dr. W. said she would make a clay paw print for us.

Virga was nine and a half years old, but only with us for the last two and a half years (she and her sister were re-homed with us). She quickly won our hearts. We'll miss Virga being the first one up and out at night, her climbing on our arms for the ride to the play room (office), her enthusiasm for mealworms, her long runs on the wheel, and her gentle nature. We are happy she came into our lives, and know she had a happy life with Cirrus, Foehn, and CB. She had grown to be my favorite, and I think M's too.

A necropsy is being done, and we should have the results in a few weeks. What they learn from Virga and Cirrus will eventually be published in the exotic animal veterinary journal so perhaps other gliders can be helped. As Dr. W. was briefly examining Virga she found new tumors, one of which appeared to be in her lymph nodes.

We can't say enough about the staff at the University of Illinois Vet Med Exotics Dept. for their efforts and care the last six months. Everyone from the receptionist who checked us in today (she knew why we were there and quietly offered to escort us back early), to Dr. W., Kim, and the vet med students we met were caring, compassionate, and professional.  We feel very fortunate to have access to the level of care and caring our gliders have received.

Virga

Virga and Cirrus had another follow-up appointment today with our vet. The last week or so Virga has seemed to be slowing down, and after a period where the tremors had lessened, they returned with more frequency.  She also has been overgrooming her abdomen to the point where she has little fur.  Virga still has been spending time on the wheel, but doesn't run as long and quite as hard. It's been two months since the cancer returned and in the back of my mind I knew that she wasn't feeling well, but I've tried to be optimistic. So, it was hard to hear that her body is in decline and the tumors had grown. Although her weight has been stable, she has lost muscle and fat to the growth of the tumors. The vet says she probably is having a little trouble breathing as well. She is on a medication to reduce inflammation and any pain or discomfort.

We don't want her to suffer or to progress to the point where she is unable to function, and she is not at that stage yet.  I was not ready to say goodbye today, and I don't think she was either.  Our hearts are with Cirrus as well, because they are so bonded and Cirrus will have a tough time without her sister.  Cirrus, by the way, came though the exam with flying colors, so there was some good news today.  However, that only slightly tempered the fact that sometime soon we are going to have to make a difficult decision and make our last trip to the vet with Virga.

This is a photo of Cirrus and Virga after their exam, asleep
in their pouch. Virga is on the bottom, and Cirrus is laying
on top of her with her arm on Virga's head

Back at the Vet

We were back to visit our vet today, but this was a routine visit.  It was time for the annual wellness check for CB and Foehn.  Dr. W came into the room with an entourage today - the vetmed student who initially greeted us and took history info, a new resident, and a visiting resident from Japan. In addition to our four gliders we had our grandson with us as well, so it was quite a crowd.

CB, our laid back glider, "Mr. Chill", pitched a fit today during the exam.  He did not want anything to do with Dr. W or the exam. When she placed him in a container to weigh him he was crabbing as loud as he could. He even managed to push aside the weighted lid of the container and escape briefly before Dr. W gathered him up in the towel. He was fine once the exam was complete and he could go back in the pouch with the others.  His reaction was uncharacteristic for him, and he's been examined several times before and never reacted like this. Foehn did just fine during her exam. She crabbed a bit, which is to be expected, but was pretty settled down for her.

We did discuss Virga and Cirrus a bit. According to the oncologist there is apparently no "good" chemotherapy to treat them without making them miserable and lower their quality of life. The evaluation of the CT scan by the radiologist wasn't available yet, so we don't quite know all we are dealing with yet.

The CT Scan

Virga and Cirrus had their CT scans on Thursday. The procedure went well. It was done under anesthesia, and the radiologist had to inject them with a contrasting dye to get the images, which had some risks.

The results were heartbreaking, though. Virga has metastatic cancer that has spread to her lungs. They don't think the spots on her liver are anything and that was a bit of good news. Our vet said that she may only have another month or two (three at the outside) before she starts to rapidly deteriorate. The vet had tears in her eyes and gave M a hug when she told her the news. I was at work for a bit and just missed getting back to the hospital when M was called back. There were also a couple of small spots on Cirrus' scan that are suspicious on first look, and the radiologist will further analyze the scan to see what is going on. Our vet is going to talk to their veterinary oncologist and see if there is an oral, inexpensive, and somewhat effective chemo med that we can treat Virga and Cirrus with. It won't cure them, but it it may slow things down and give Virga few more months. If Cirrus is in the very early stages, she's hoping that with treatment it has a chance to go into remission.She was careful to inform us that chemo for animals is more for quality of life, and if the cancer goes into remission it's a bonus. We'll get a report and a copy of the CT images this week.

We honestly weren't expecting to hear that everything was good, but to hear Virga might not have much time left hit us hard.


To top it all off, Virga has had some sort of tremors when she first wakes up. The odd thing about them is that they cease as soon as she is up and around. We informed our vet about it and she will be checking with their new neurologist.  I've been trying to get video of it to show them, but it seemed every time I turned on the camera she would stop! I was finally able to get about 30 seconds the night before last and will be sharing that with them on Tuesday. That's when we'll be back at the vet for the regular wellness checks for CB and Foehn.


Right now Virga seems to be herself, perhaps moving a bit slower. She is still one of the first out at night, loves her mealworms, and is spending a lot of time on her wheel during "office" time.

Update on Virga

The call we were waiting for on Monday from our vet didn't come until Tuesday morning, and it wasn't good news.  Virga has another mammary tumor.  They are not sure what the spots on her lungs and liver are and would like to do a CT scan. This would be expensive ($600-$700) and it's possible we would not gain much new information.  There was some good news to come, though. Since our vet, the surgeon, and the radiologist are so interested in Virga's case, the CT scan will be paid for by a research grant. Cirrus will also be imaged  as a "control" subject, which will further add to any information they can obtain. M asked the vet how Virga could have gotten another mammary tumor since the surgery in March was supposed to remove all mammary tissue. She said that based on all the information available to them, they were sure they had removed it all. However, it could be that gliders have mammary tissue similar to rodents, that is, it extends to their back. The one thing that worries us is that they may need to inject a contrast dye through a catheter to improve the imaging. They are so small that this may be difficult to do.

So, the CT scan is scheduled for July 19.  We're hoping the CT scan will help determine the best course of action. Our vet really does not want to put Virga through another surgery. I guess we'll evaluate all the options after we know where things stand. In the meantime Virga is doing well, eating normally and is pretty active, all things considered.

Unexpected Bad News

Virga and Cirrus went in for their four-month follow up visit with the vet yesterday. Just in the last few days M had noticed a small nodule on Virga's abdomen, so the timing of the appointment was perfect. There was good news - both Cirrus and Virga have returned to their normal weights. Cirrus is 88 grams, I think the most she has weighed, and Virga was at 92 grams. They both have been active, although Virga has slowed down some. The vet was concerned about the nodule, which seemed on her hip bone, and wanted to do an x-ray, ultrasound, and needle aspiration. So, our 9:00 a.m. appointment turned into a six-hour affair since the first opening for the ultrasound was at 1:00 p.m. We left Cirrus with Virga  to keep her company at the vet's and went to run some errands. About 2:00 the vet came out and brought us back to the examining room to show us the x-rays and ultrasound. She had several concerns, but cautioned us that the x-rays and ultrasound had yet to be seen by the radiologist. The nodule was subcutaneous, right below the skin, and to her it didn't feel like it was the type of lump to be concerned about. What was more troubling were two spots on her liver evident in the ultrasound, which may be just cell regeneration, and some clouding evident on the x-ray in Virga's lungs. These might mean her cancer has metastasized.

Our vet called tonight, but we were gone at the time. She left a message that she wanted to discuss the cytology report with us, and will call us on Monday. However, the message was disheartening for what it didn't say. If the pathology was negative, I assume the message would have been something along the lines of "Everything's negative and there's nothing to worry about now".

In addition to this, Virga has been having some sort of spasm or tremors when she wakes up in the pouch. As she's having one she makes an noise similar to the noise they make if they are annoyed with each other. The first couple of time we heard it we thought one of them was bothering someone and the one being bothered was expressing their displeasure. The strange thing about it is it stops as soon as she is out of the pouch, and we have never heard it at any other time.

It will be a long weekend.

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.

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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Update on Virga

It's been a week since we had Cirrus and Virga in for their checkups and our vet found two masses near Virga's pouch. She has has been on an antibiotic and an anti-inflammatory to treat her for mastitis, and there seems to be improvement.  She is back to her usual self in the morning, being the first (or quick second) out of the pouch for her yogurt. While the others are napping in my shirt during night play time, Virga runs on the wheel.  M has been checking the masses and says they seem to be getting smaller. Virga has been very good about taking her medications. I use a small syringe to give her just 0.2 ml of her meds, and it requires holding her so she can't squirm and can't bite, though she hasn't tried to nip me. I think she is sort of resigned to the fact that we have to do this twice a day, and just like a kid she gets a treat after taking her medicine.

So, we're hopeful that there is continued improvement and things go well next week on her next visit to the vet.

3 Hours at the Vet

Today we had an appointment for Virga and Cirrus for their annual wellness check.  They are now almost nine years old.  We also had another reason for taking them to the vet. She and Cirrus have had a brown discharge around their pouch, and it seems to have been bothering Virga some.  She will frequently spend several minutes grooming and cleaning her pouch. We had taken her in for this before, and the vet indicated it was the result of glandular discharge related to hormonal activity and was fairly common and not usually a problem. So, we were expecting much the same result today.  Cirrus, always curious about what is going on around her, was active and awake once we got into the exam room, so she was first up for her checkup.  She is doing great and weighed in at 79 grams.

Virga was sleeping comfortably in the pouch when I had to scoop her out for her exam. Both she and Cirrus did pretty well with Dr. Whitington, squirming as they usually do but overall being well-behaved all things considered.  As part of their exam the vet took a swab from their pouch to check for anything unusual.  When Dr. Whitington took the swab from Virga, we were all surprised to see blood on the swab. She was a little concerned about it, but indicated that the blood was likely the result of the swabbing but also said there was some irritation. As she continued the examination, she found two masses near the middle and side of the pouch. Dr. Whitington indicted they seemed to be mammary in origin and wanted to examine Virga's pouch and the masses more closely. This would require general anesthesia and about an hour to complete, including lab analysis.  We told her to go ahead and headed out to wait with a very unhappy Cirrus.  She did not want to be in the bonding pouch, especially by herself. For most of the hour she kept trying to push through the mesh, to the point her normally pink nose was red.

About an hour and 15 minutes later Dr. Whitington brought a now awake Virga out to us and filled us in on what she found. Virga's pouch was irritated and inflamed, and she could see one mass through the pouch. The other wasn't easy to see. Dr. Whitington suspects the inflammation and masses may be due to mastitis.  Virga is on an antibiotic (Trimethoprim-sulfa) and an anti-inflammatory (Metacam) for 14 days, and then she goes in to be checked. If the medication doesn't help, then the next step will be to do a biopsy and go from there.

Needless to say, we were pretty bummed out by the news.  In hindsight we could note some small changes in her behavior.  She is normally the first out of the pouch when it's yogurt or mealworm time, and lately she has been slower to come out.  However her appetite has been good, her weight has been stable, and she has been active (spends a lot of time on the wheel). On a positive note, the vet said that Virga is in otherwise great shape.

Virga came though the whole exam very well and curled up to sleep in the bonding pouch once she was brought out. Cirrus was pretty stressed out the whole time, but finally relaxed on the way home.  She is spending most of play time tonight napping in a fleece blanket.

Checking Out the Ladies

M contacted me at work this morning after she had returned the gliders to their cage after their morning time together. She noticed that both Virga and Cirrus, our 8-year old gliders, both seemed to have something wrong with their pouches. The color was not the pink healthy color they should have been, and seemed to have some dried discharge. We were concerned that their pouches might be infected, and called the university small animal clinic for an appointment.

There was nothing else to  indicate that something might be wrong. Virga has had some loose poops at times, but otherwise seemed OK. All four gliders have been really active, and in fact last night as one of their most active nights. However, sugar gliders often try and hide their illnesses or injuries as a matter of self-preservation. In the wild a sick or injured glider is more susceptible to predators. Sometimes by the time you notice a glider is in distress it is too late. So, with all of this in mind, and the fact that the ladies were due for their annual checkup in a month, off to the vet we went.

Cirrus and Virga did very well during the exam, considering they were being handled by a stranger and their normal sleep time was being disrupted. The vet, who we had not been to before, was very thorough with the exam. She swabbed their pouches to check for infection or other problems. They also ran tests to check for parasites or other digestive issues (giardia can be a serious problem in gliders). After about 30 minutes the vet came in to give us the news.  There was no sign of infection in their pouches and the coloration and small secretion was normal. The tests and exam for parasites were negative. We were relieved that there were no problems and both Virga and Cirrus were healthy.

We really liked this vet, and we'll be making an appointment to take Foehn and CB in for their annual exam in the near future.