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Blood / calcium sludge / need for hysterectomy?

Covaya

New Born Pup
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Hello! Our 4-year-old sow, Flequita, has long had issues with calcium sludge and making pained/strained noises while pooing. The noises are something she's done her whole life, but it's on-and-off. It never seems to affect her energy, appetite, weight, or the shape of poops. Sometimes it happens when there's a lot of poops or calcium buildup, but other times there's no evident cause.

About a month ago, we noticed some very small red spots next to some poops after she was making this noise. We took her to the vet, where they did an ultrasound. They said that they didn't see anything immediately concerning - no masses that appeared cancermous and no major buildup in the bladder.

They did note that there was (note: I'm translating from Spanish) - "cystic enometrial hyperplasia, endometrial thickening 6 ml [I think this was a typo and is mm]". They suggested a hysterectomy, something they have suggested since she was very young as a prophylactic measure. They said it's not entirely clear that the hyperplasia would be causing the blood spot, but they didn't see anything else to cause it. They also said we could do a repeat ultrasound this month to see if there was any change that might inform the necessity/urgency of an operation.

Today, we noticed another blood spot on her blanket, which you can see in the attached photo. You can also see a small calcium spot on the poop itself (other poops often have multiple of these calcium spots).

We've tried tons of things over the years to reduce the calcium buildup (adjusting veggies, encouraging water intake, etc.), but while it's gotten better, it's never gone away.

We'd like to avoid the operation if possible because we worry about the recovery process, especially since she otherwise shows no signs of being ill. But we'd love to get any insight from folks here about what to make of the situation.

One specific question we have is admittedly kind of weird...but, is it possible that the blood spots come from passing poops that are larger because of the calcium buildup? In other words, could it be from an external source (the anus) as opposed to an internal issue? Is that a thing that can happen with guinea pigs (like hemerrhoids in people)?

Thank you in advance for any information you can share with us.
 

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