Bladder sludge diagnosis, causes and treatment

[Apples]

Long story below with background, my actual question is in the last paragraph. I was hoping someone one here could tell me more about bladder sludge diagnosis and treatment. Yesterday I took one of my pigs to the (general) vet because I found spots of bladder sludge in the cage and he would squeak while being visibly uncomfortable peeing (often producing poops at the same time). He would do this a few times a day, and during the rest of the day seem quite happy. However, he has now lost 100 grams of weight in a week.

When I took him to the vet yesterday I was asked to collect a urine sample, which they tested and seemed fine (I think they tested for blood and infection). The vet did a quick physical examination: she checked his heartrate and felt his bladder and said she felt some sludge in there. She said this was due to a vitamin C deficiency (without asking about my feeding schedule).

I went home with cat Metacam and an over-the-counter vitamin C supplement. I have now read online that dog Metacam is better, but cat is also fine though less effective so that seems ok. But the vitamin C seems strange: to my knowledge an excess of vitamin C is associated with bladder sludge/stones, while sludge is not a symptom of vitamin C deficiency. In addition, this clinic is great with horses in my experience, but I have been to this clinic before with one of my other piggies with a skin issue for four times without result, so I am a bit suspicious about anything they say. (that piggy is fine by now, figured out the problem myself in the end, it was to do with food intolerances)

Seeing a different vet is difficult though: I have tried calling several exotic vets but most have a patient stop. One practice I called wasn’t accepting new patients, but did say that their protocol in case of sludge is to do x-rays to rule out stones and then advise a treatment protocol based on that.

What I have done now in terms of treatment/adjustments: I have started the cat Metacam twice per day, but not started the vitamin C supplement. I have made some changes in their diet: they now get bottled water (low Ca), they still get the same pellets (Selective Grain Free, about 10 grams per pig per day), 50-60 grams of veggies per pig per day (slice of bell pepper, slice of cucumber, then top up with a variety of lettuce (I used to feed coriander instead of cucumber)).

I am at a bit of a loss what to do next, should I trust my vet, or do I trust the advice of another vet? Does anyone have experience with bladder sludge problems and what treatments are usually available? What examinations should a vet usually perform so I can recognize a good/experienced vet for piggies?

Thanks so much if you took the time to read!

 

[Piggies&buns]

Sludge needs to come out but how depends on the situation. It can be felt by palpation but ultrasounds can also be used. X rays will show up stones but may not show up sludge as easily. Checking for stones would also be advisable.
It depends on how much and how tightly packed sludge is. Treatment can range from a gentle flush to a surgical procedure. If there are crystal shards as well then it can be painful and can bash against the bladder.

Excess calcium/oxalates is related to sludge and stone formation.
Encouraging plenty of urination with a wet diet and plenty of water bottles offered around the cage.
Ensuring calcium content in the diet is in balance - remembering that too low can be as bad as too high.
Changes to the diet will take several weeks to have any effect but won’t change the current situation , it will only help prevent other issues further down the line.
I don’t think a vit c supplement will do anything in this case! Vit c deficiency is rare in well kept piggies and would not be the first thing to come to my mind when considering sludge symptoms.

 

[Raymond92]

I agree - my boar has had to have 2 bladder flushes to remove the sludge and it’s the only way it can come out comfortably. Unfortunately my boar has an unusual problem with calcium and even after the flush the calcium builds back up again we’re having to consider putting him down because of it.
Once the bladder flush is done avoid any dark leafy greens, filter water and give him plenty of exercise.
The Metacam will definitely help with the irritation of the bladder.
I hope he feels better soon.

 

[Caviesavy]

Long story below with background, my actual question is in the last paragraph. I was hoping someone one here could tell me more about bladder sludge diagnosis and treatment. Yesterday I took one of my pigs to the (general) vet because I found spots of bladder sludge in the cage and he would squeak while being visibly uncomfortable peeing (often producing poops at the same time). He would do this a few times a day, and during the rest of the day seem quite happy. However, he has now lost 100 grams of weight in a week.

When I took him to the vet yesterday I was asked to collect a urine sample, which they tested and seemed fine (I think they tested for blood and infection). The vet did a quick physical examination: she checked his heartrate and felt his bladder and said she felt some sludge in there. She said this was due to a vitamin C deficiency (without asking about my feeding schedule).

I went home with cat Metacam and an over-the-counter vitamin C supplement. I have now read online that dog Metacam is better, but cat is also fine though less effective so that seems ok. But the vitamin C seems strange: to my knowledge an excess of vitamin C is associated with bladder sludge/stones, while sludge is not a symptom of vitamin C deficiency. In addition, this clinic is great with horses in my experience, but I have been to this clinic before with one of my other piggies with a skin issue for four times without result, so I am a bit suspicious about anything they say. (that piggy is fine by now, figured out the problem myself in the end, it was to do with food intolerances)

Seeing a different vet is difficult though: I have tried calling several exotic vets but most have a patient stop. One practice I called wasn’t accepting new patients, but did say that their protocol in case of sludge is to do x-rays to rule out stones and then advise a treatment protocol based on that.

What I have done now in terms of treatment/adjustments: I have started the cat Metacam twice per day, but not started the vitamin C supplement. I have made some changes in their diet: they now get bottled water (low Ca), they still get the same pellets (Selective Grain Free, about 10 grams per pig per day), 50-60 grams of veggies per pig per day (slice of bell pepper, slice of cucumber, then top up with a variety of lettuce (I used to feed coriander instead of cucumber)).

I am at a bit of a loss what to do next, should I trust my vet, or do I trust the advice of another vet? Does anyone have experience with bladder sludge problems and what treatments are usually available? What examinations should a vet usually perform so I can recognize a good/experienced vet for piggies?

Thanks so much if you took the time to read!

This all sounds quite similar to the symptoms my guinea pig has been having. Please can we have an update on how things are going, if possible?

 

[Raymond92]

This all sounds quite similar to the symptoms my guinea pig has been having. Please can we have an update on how things are going, if possible?

Hi Cavysavy, Raymond very quickly went downhill after I posted. In the last 24 hours he was crying regularly. I had a feel of his bladder and it was the size of a golf ball.
We took him to the vets, they did an x-Ray and confirmed that his bladder had filled back up with Calcium again worse than ever. As we’d only done a bladder flush 2 weeks prior we were left with no other option than to put him to sleep.
If you piggie if having problems I would recommend talking to your vet about an x-Ray. The initial bladder flush we did in Jan was successful so it might be that your pig needs a bladder flush, low calcium diet and filtered water and it might fix his problem. But sadly for Raymond there was nothing we could do.
I hope your piggie is ok

 

[Caviesavy]

Hi Cavysavy, Raymond very quickly went downhill after I posted. In the last 24 hours he was crying regularly. I had a feel of his bladder and it was the size of a golf ball.
We took him to the vets, they did an x-Ray and confirmed that his bladder had filled back up with Calcium again worse than ever. As we’d only done a bladder flush 2 weeks prior we were left with no other option than to put him to sleep.
If you piggie if having problems I would recommend talking to your vet about an x-Ray. The initial bladder flush we did in Jan was successful so it might be that your pig needs a bladder flush, low calcium diet and filtered water and it might fix his problem. But sadly for Raymond there was nothing we could do.
I hope your piggie is ok

So sorry to hear this about Raymond, it sounds like you did all you could and he was lucky to have yourself as his caretaker.

Thank you for being so kind and sharing this update despite the circumstances. I have an x-ray booked after pushing for this with the vet and he is on a low calcium diet plus filtered water. Fingers crossed, as he is intermittently squeaking!

 

[Raymond92]

So sorry to hear this about Raymond, it sounds like you did all you could and he was lucky to have yourself as his caretaker.

Thank you for being so kind and sharing this update despite the circumstances. I have an x-ray booked after pushing for this with the vet and he is on a low calcium diet plus filtered water. Fingers crossed, as he is intermittently squeaking!

aww poor thing. And sorry you had to push your vet.
I wonder if it’s a stone that’s causing irritation.
Because Raymond was susceptible to sludge and calcium he had regular medication of gabapentin (I think it was a painkiller), Metacam (painkiller) and phenoxybenzamine which dilated his urethra and allowed things to pass more comfortably. He was actually able to pass a small stone with the phenoxybenzamine so definitely worth talking to your vet about depending on the outcome of the xray.
Good luck. I hope it goes well.
And thank you for your kind words on Raymond. He was such a lovely boy and I miss him dearly

 

[Apples]

I'm sorry to hear about poor Raymond!

I was able to get an appointment with a piggy-savvy vet and my wonderful parents were willing to take him there as I was unable to go myself due to work. They were able to rule out stones through an ultrasound; and at a later visit did an x-ray to make sure they hadn't missed anything. But they did find a UTI. The sludge must have come out by itself for a large part by the time we had this appointment with this vet, as there was no excess sludge visible on the scan and I found much less sludge around the cage.

This vet gave some feeding advice as well which was in line with what piggies&buns said: oxalates should be kept low. Aside from feeding only 10-20grams of pellets per pig max, she recommended some veggies like tomatoes, cucumber, carrot (+tops), cauliflower (+leaves), bell pepper, chicory as low-oxalate and low calcium veggies.

Dumpty didn't deal very well with the medication (antibiotics and painkiller) so bloat and later a course of nystatin followed. He lost nearly 250 grams, but both his UTI and a problem with yeasts in his gut caused by the antibiotics have cleared up now. I was able to stop all medication earlier this week. He needs to put a lot of weight back on, but he is back to his happy, popcorning self!

I hope things will be alright for your piggy as well Caviesavy!

 

[Raymond92]

Thank you Apples! That’s amazing news about your piggie - I’m really happy to hear he’s better and great news about changing his diet - that should hopefully keep any complicated urine troubles at bay.