Sterile interstitial cystitis (sterile IC) is characterised by a lack or only a low presence of bacteria in the urine but is more usually diagnosed by default after all other potential urinary tract problems have been ruled out yet symptoms persist.
It cannot be healed and needs to managed; usually by glucosamine and metacam. The glucosamine is the more important bit since sterile IC seems to particularly affect the insulating glucosamine layer on the walls of the urinary tract that prevents corrosive urine from coming into very painful contact with raw tissue. Once the issue is initially under control your piggy will experience regular flares every few weeks or months. The severity of sterile IC can vary from the really mild to the really bad. Milder to medium cases can be treated with oral glucosamine while for the more severe cases, cartrofen has now been proven to bring relief in any but the very worst cases. Milder to medium cases can go away on their own but you are looking at years rather than months.
Unfortunately, while sterile IC has become increasingly common over the last 15 years and is now more common than a UTI in indoors piggies, it is still mostly unknown outside vet circles dealing frequently with guinea pigs.
What we recommend is to tighten up our normal diet advice a bit further and to not vary as much; you are not aiming for a calcium free diet because that can cause its own problems if you miss the 'sweet spot' in your diet but to further eliminate any veg that is richer in oxalates and which can contribute to the formation of stones. Any new food, like fresh spring grass, you need to introduce even more slowly than with your other indoors piggies after a long winter break.
You CAN feed lettuce to IC piggies that are used to it (it has made frankly not made any difference for my Breila in the four years she had IC) and fresh grass as long as it is on a near daily basis. What our own experiences with IC piggies over the last years have shown that it is more of a matter of new fresh foods being introduced too quickly/too much at once that can trigger a flare. The sensitivities are rather individual than connected to specific foods.
In any case, you will still get your regular flares. It is also going to take a few weeks for the extra glucosamine to build up in the body so it is not an instant fix.
For some reason my update of this chapter has not been saved and the outdated recommendation is still there.
@Piggie&buns
@Claire W
Eventually you will have to work out how low you can get with the maintenance meds in between flares and how high you can go to get on top of an acute flare within a few days; upping the glucosamine in a flare is in my own experiments more effective than upping the metacam. Since sterile IC is on a huge sliding scale of severity, you have to do feel your own way in this in every individual case.
@Piggies&buns @Claire W