Cystitis

[ceciliaxdee]

Hi all, need some advice on cystitis. My two year old female piggy (grey one in the photo) has had problems since June this year. Initially presented as constant peeing very frequently with squeaking when pooping/peeing and some mild bloating. The vet has done multiple X-rays and ultrasounds and no sign of stones, she was put on a long course of Bactrim/septrin for 6 weeks or so as it wouldn’t go after the first dose of antibiotics. Then she went on flagyl for 10 days as her cage mate had a colitis and we thought it would be the same bacteria. Meloxicam was also prescribed to use whenever required. The symptoms were improving, however the squeaking when toileting is still present along with wetness on the bottom.

I put her into vegan glucosamine and took her back to the vet who tested her urine again and all levels are normal except traces of blood. Ultrasound was done again and no stones or abnormalities. They don’t think it is an infection and instead just cystitis so the vet said no more antibiotics and her bladder wall may just need time to heal. We’ve been told to continue the metacam for a bit and vegan glucosamine (100mg daily - I’ve tried up to 200mg during flare up and no issues). I have also been giving 100% unsweetened cranberry juice diluted with water 2mls a day, supplementing potassium citrate at about 12-22mg daily (10-30mg daily is the range according to vet). I’ve also been filtering the water. They told me if flares up again in 3-4 weeks to take her back for a culture/possible blood test.

Shes lost 100g of weight, and is sitting at 1070g approx. however is eating and bright. The squeaking is now mild but I’ve noticed since being on the potassium citrate, she’s been clearing a lot of sludge and gritty discharge out. Is this good? I also purchased some hydrangea root capsules, can I give this?

Thanks

 

[Scooter Pie]

Hi! I don’t have too much advice, but I do have a sow who’s had similar issues for over a year. She is on potassium citrate and hydrochlorothiazide. I'm not sure which one of the two is the diuretic....but that would make sense as it’s supposed to make them drink more, and the flushing out of sludge potentially would be a good side effect.

I'm in the US and it doesn’t seem like my local vets and their exotic specialists they consult with are as familiar with cystitis. The only glucosamine they recommended is oxbow joint support which has 90 mg. I was actually coming here to ask about Feliway capsules. Is that what you use?

 

[Wiebke]

Hi all, need some advice on cystitis. My two year old female piggy (grey one in the photo) has had problems since June this year. Initially presented as constant peeing very frequently with squeaking when pooping/peeing and some mild bloating. The vet has done multiple X-rays and ultrasounds and no sign of stones, she was put on a long course of Bactrim/septrin for 6 weeks or so as it wouldn’t go after the first dose of antibiotics. Then she went on flagyl for 10 days as her cage mate had a colitis and we thought it would be the same bacteria. Meloxicam was also prescribed to use whenever required. The symptoms were improving, however the squeaking when toileting is still present along with wetness on the bottom.

I put her into vegan glucosamine and took her back to the vet who tested her urine again and all levels are normal except traces of blood. Ultrasound was done again and no stones or abnormalities. They don’t think it is an infection and instead just cystitis so the vet said no more antibiotics and her bladder wall may just need time to heal. We’ve been told to continue the metacam for a bit and vegan glucosamine (100mg daily - I’ve tried up to 200mg during flare up and no issues). I have also been giving 100% unsweetened cranberry juice diluted with water 2mls a day, supplementing potassium citrate at about 12-22mg daily (10-30mg daily is the range according to vet). I’ve also been filtering the water. They told me if flares up again in 3-4 weeks to take her back for a culture/possible blood test.

Shes lost 100g of weight, and is sitting at 1070g approx. however is eating and bright. The squeaking is now mild but I’ve noticed since being on the potassium citrate, she’s been clearing a lot of sludge and gritty discharge out. Is this good? I also purchased some hydrangea root capsules, can I give this?

Thanks

Hi!

You are likely dealing with sterile interstitial cystitis (a non-bacterial infection of the urinary tract, which seems to particularly affect the natural glucosamine coating of the walls that prevent the highly corrosive urine from coming into direct contact with raw tissue (hence the squeaking and blood). Unfortunately, it is a condition that can be only managed but not healed until it goes away on its eventually - with is sadly more a matter of years rather than months and may never happen. Because the symptoms for all urinary tract problems are very similar, it is generally diagnosed by default after all other potential issues have been excluded.

Sterile IC has become a lot more common over the last decade but is not well known outside vet circles that deal very regularly with guinea pigs; its rise is likely connected to the massive increase in commercial mass breeding on all levels (chain pet shops as well as for sale breeders) and also to the increasing shift towards keeping guinea pigs as indoors piggies. We have at the same time seen an increase in piggies with very high stress levels as their default setting; something that has likely happened in the womb of a stressed pregnant sow and that you cannot cure unless breeding welfare is finally taken more serious and is strictly controlled.

You are doing the right thing with the glucosamine, which is the most important part in treating sterile IC (it will probably end up at some point being referred to as 'CSC' (Cavy sterile cystitis) parallel to FSC (feline sterile cystitis), whose condition and treatment is similar to that of cavies and who have experienced a similar rise in the same time.

What I would recommend is however to stop with the cranberry juice. Experience has shown that it doesn't work for sterile cystitis; it is one of a number of human treatments that have been transferred to guinea pigs for DIY home treatment that have not stood the test of time but that are still making the rounds online, being kept alive by desperate owners looking for extra home treatments and by well-meaning people in online groups without personal experience.

Feliway is a UK brand but comparable US cat bladder supplement brands will do; they are generally bit higher dosed than Oxbow. I usually aim at between 120-150 mg of glucosamine in a day and double that for the first 2-3 days of a new flare to bring the squeaking/pain down as quickly as possible with my own piggies.
Basically any glucosamine will do but capsules have the advantage that the content can be easily mixed freshly daily with 2 ml of water, shaken and syringed without lots of math for dosages needed. It is more for the convenience.
It is not vegan but the animal product used is ground up sea shells (so no meat protein), which means a better absorption. Alternatively, you can up the Oxbow supplement at the start of a flare.

What you are aiming at is working out the maintenance level between flares and how to manage the flares best with your own piggy; that will take a while to fine tune because IC can range from very mild to very strong. You will hopefully be able to work out how little you can get away with between flares and how much you need when there is a flare to get on top of acute symptoms quickly. The time between flares should gradually lengthen from a matter of weeks to a matter of years in mild to medium cases.

If that doesn't work, then cartrofen injections (it is an arthritis medication with glucosamine) have been proven to work for most guinea pigs with IC that cannot be managed orally. Your vet would however have to dig around for recent research on this.

PS: Here are our diet recommendations for guinea pigs with long term bladder problems, including sterile IC:
Long Term Balanced General And Special Needs Guinea Pig Diets

I hope that this helps you?

 

[ceciliaxdee]

Hi!

You are likely dealing with sterile interstitial cystitis (a non-bacterial infection of the urinary tract, which seems to particularly affect the natural glucosamine coating of the walls that prevent the highly corrosive urine from coming into direct contact with raw tissue (hence the squeaking and blood). Unfortunately, it is a condition that can be only managed but not healed until it goes away on its eventually - with is sadly more a matter of years rather than months and may never happen. Because the symptoms for all urinary tract problems are very similar, it is generally diagnosed by default after all other potential issues have been excluded.

Sterile IC has become a lot more common over the last decade but is not well known outside vet circles that deal very regularly with guinea pigs; its rise is likely connected to the massive increase in commercial mass breeding on all levels (chain pet shops as well as for sale breeders) and also to the increasing shift towards keeping guinea pigs as indoors piggies. We have at the same time seen an increase in piggies with very high stress levels as their default setting; something that has likely happened in the womb of a stressed pregnant sow and that you cannot cure unless breeding welfare is finally taken more serious and is strictly controlled.

You are doing the right thing with the glucosamine, which is the most important part in treating sterile IC (it will probably end up at some point being referred to as 'CSC' (Cavy sterile cystitis) parallel to FSC (feline sterile cystitis), whose condition and treatment is similar to that of cavies and who have experienced a similar rise in the same time.

What I would recommend is however to stop with the cranberry juice. Experience has shown that it doesn't work for sterile cystitis; it is one of a number of human treatments that have been transferred to guinea pigs for DIY home treatment that have not stood the test of time but that are still making the rounds online, being kept alive by desperate owners looking for extra home treatments and by well-meaning people in online groups without personal experience.

Feliway is a UK brand but comparable US cat bladder supplement brands will do; they are generally bit higher dosed than Oxbow. I usually aim at between 120-150 mg of glucosamine in a day and double that for the first 2-3 days of a new flare to bring the squeaking/pain down as quickly as possible with my own piggies.
Basically any glucosamine will do but capsules have the advantage that the content can be easily mixed freshly daily with 2 ml of water, shaken and syringed without lots of math for dosages needed. It is more for the convenience.
It is not vegan but the animal product used is ground up sea shells (so no meat protein), which means a better absorption. Alternatively, you can up the Oxbow supplement at the start of a flare.

What you are aiming at is working out the maintenance level between flares and how to manage the flares best with your own piggy; that will take a while to fine tune because IC can range from very mild to very strong. You will hopefully be able to work out how little you can get away with between flares and how much you need when there is a flare to get on top of acute symptoms quickly. The time between flares should gradually lengthen from a matter of weeks to a matter of years in mild to medium cases.

If that doesn't work, then cartrofen injections (it is an arthritis medication with glucosamine) have been proven to work for most guinea pigs with IC that cannot be managed orally. Your vet would however have to dig around for recent research on this.

PS: Here are our diet recommendations for guinea pigs with long term bladder problems, including sterile IC:
Long Term Balanced General And Special Needs Guinea Pig Diets

I hope that this helps you?

This is very helpful thank you! I am in Australia so I have not been able to get ahold of the UK products recommended. I did pick up some cystophan but my vet advised not to give as it has the artificial chicken flavouring and is not formulated for herbivores.
I am using these vegan glucosamine capsules (600mg glucosamine hydrochloride): Wagner Vegan Glucosamine 60 Capsules
Added 6ml filtered water each time so that’s very 1ml is 100mg. Thanks the vet recommended cranberries, but I will stop this. She is slowly getting better, so I will keep up the vegan glucosamine. If there is crystals in the urine, does the potassium citrate help clear this?

 

[Scooter Pie]

My piggie was put on the potassium chloride when her bladder looked like a "snow globe" on ultrasound. After a few weeks it was much much better. She's staying on it forever.

 

[ceciliaxdee]

My piggie was put on the potassium chloride when her bladder looked like a "snow globe" on ultrasound. After a few weeks it was much much better. She's staying on it forever.

Thank you! Yes I did some research and as she had some crystals in the urine I tried it with the vet approving the dose. It’s been a week and her urine isn’t gritty anymore. Did you find it cleared out sludge when your piggie was on it?

 

[Scooter Pie]

It seems like it did...she still has some, but the vet was really pleased with the results after like I said, she compared her bladder to a snow globe with all the crystals. She thought it worked so well, she didnt want to take her off of it. She definitely drinks more now which in theory would flush the bladder out more.

 

[ceciliaxdee]

Hi! I don’t have too much advice, but I do have a sow who’s had similar issues for over a year. She is on potassium citrate and hydrochlorothiazide. I'm not sure which one of the two is the diuretic....but that would make sense as it’s supposed to make them drink more, and the flushing out of sludge potentially would be a good side effect.

I'm in the US and it doesn’t seem like my local vets and their exotic specialists they consult with are as familiar with cystitis. The only glucosamine they recommended is oxbow joint support which has 90 mg. I was actually coming here to ask about Feliway capsules. Is that what you use?

Sorry for the late response - I just saw your other post. No I looked up vegan glucosamine tablets in my country (I’m in Australia) and found some that are in a capsule that I can open up and mix with filtered water. Does your sow still squeak when toileting or does the squeaking go away over time?

 

[Scooter Pie]

It usually only lasts a few days and settles down. She was on long courses of antibiotics for a year, when we started the glucosamine daily and meloxicam for flares. Maybe 4 days on meloxicam till it starts to go away.

Right now I'm hoping it's gone again. The past week she's been squeaking and there's been some pink urine on and off.

I just got the Feliway capsules to try. 125 mg glucosamine each....need to go look back on dosage recommendations.

How is your piggie doing?

 

[ceciliaxdee]

It usually only lasts a few days and settles down. She was on long courses of antibiotics for a year, when we started the glucosamine daily and meloxicam for flares. Maybe 4 days on meloxicam till it starts to go away.

Right now I'm hoping it's gone again. The past week she's been squeaking and there's been some pink urine on and off.

I just got the Feliway capsules to try. 125 mg glucosamine each....need to go look back on dosage recommendations.

How is your piggie doing?

Piggie was doing okay but it is flaring up again. I was just about to post to ask if you ever have pink urine/blood in urine during flare ups as I’ve noticed pink urine also

 

[ceciliaxdee]

New update: I had her urine cultured last week and the results have come back as sterile. No infection was found so the vet has diagnosed her with sterile cystitis. She’s doing better, but the squeaking comes and goes. Vet said the outlook isn’t bad but we just need to make sure her comfort and pain are managed during flare ups.
We are offering supplements: glucosamine, tumeric/circumin, cranberry (unsweetened) juice, protexin probiotic, meloxicam as required during flare ups. I’ve just been recommended to try cold pressed flaxseed oil as she’s lost a little weight. Also chamomile, peppermint and dandelion teas were also recommended. @Scooter Pie may help your piggie also.

 

[Wiebke]

New update: I had her urine cultured last week and the results have come back as sterile. No infection was found so the vet has diagnosed her with sterile cystitis. She’s doing better, but the squeaking comes and goes. Vet said the outlook isn’t bad but we just need to make sure her comfort and pain are managed during flare ups.
We are offering supplements: glucosamine, tumeric/circumin, cranberry (unsweetened) juice, protexin probiotic, meloxicam as required during flare ups. I’ve just been recommended to try cold pressed flaxseed oil as she’s lost a little weight. Also chamomile, peppermint and dandelion teas were also recommended. @Scooter Pie may help your piggie also.

Hi!

Please leave the cranberry off and also the turmerin. They are alternative DIY treatments for humans and not for rodents with a very different metabolism.
We have tried cranberry juice in its time (about a decade ago) when IC (or as it was then, a seemingly resistant form of UTI) started to come on the scene, and we have all found that it doesn't make one bit of a difference in terms of easing IC symptoms apart from adding a load of sugar to the diet - even the unsweetened one, which in fact still contains plenty of natural sugar. Which can then contribute to dysbiosis (overgrowth of the wrong kind of gut bacteria, making your piggy more likely to suffer severe bloat on persistent digestive problems) if it is used in the longer term...

PLEASE be careful with all the speculative home treatments and always be careful re. instinctively wanting to throw the kitchen sink at your piggy without knowing the potential (and really not researched) side effects they can have on rodents for the long term. You also do not know how they interact with the medication your piggy is on - whether it is prescribed medication or seemingly harmless non-medication home treatments, they are in fact all complex chemical compounds that will interact and can interfere with each other in ways you cannot necessarily foresee. Panicking and overdoing things can it its own way can be just as bad and in some cases as potentially life-shortening as undertreating.

Key to managing sterile cystitis is and remains the glucosamine because sterile IC seems to particularly affect the natural glucosamine coating of the walls of the urinary tract. In my own experience with several IC piggies over the years (including my current one), upping the glucosamine for a few days at the start of a flare is by far the most effective and harmless way of bringing it under control quickly. It is as simple as that.

I would also not worry about some minor weight loss because that will correct itself on its own once you get your individual management of your piggy's IC under control, which may take a few weeks but it will usually happen with the mild to moderate forms of sterile IC. And all your on spec home stuff won't do anything for the severe forms whatsoever.

The less you throw at her apart from the glucosamine, the better for the long term. Just keep her on a stable normal diet and be careful with introducing new things because the changes (including re-introducing fresh grass in the warmer months of the year) can trigger a new flare.

Can I please remind our new members to be very careful about recommending unproven home treatments on spec on this forum. There are too many making the rounds online without any research into their effects on guinea pigs and too many long debunked being handed on to new people wanting to be extra good with their piggies because the people recommending them are self-nominated 'experts' without personal experience. They just read what is there in a self-reinforcing cycle without being even aware of the potential downsides of what they are doing because they lack the necessary medical background.

 

[ceciliaxdee]

Hi!

Please leave the cranberry off and also the turmerin. They are alternative DIY treatments for humans and not for rodents with a very different metabolism.
We have tried cranberry juice in its time (about a decade ago) when IC (or as it was then, a seemingly resistant form of UTI) started to come on the scene, and we have all found that it doesn't make one bit of a difference in terms of easing IC symptoms apart from adding a load of sugar to the diet - even the unsweetened one, which in fact still contains plenty of natural sugar. Which can then contribute to dysbiosis (overgrowth of the wrong kind of gut bacteria, making your piggy more likely to suffer severe bloat on persistent digestive problems) if it is used in the longer term...

PLEASE be careful with all the speculative home treatments and always be careful re. instinctively wanting to throw the kitchen sink at your piggy without knowing the potential (and really not researched) side effects they can have on rodents for the long term. You also do not know how they interact with the medication your piggy is on - whether it is prescribed medication or seemingly harmless non-medication home treatments, they are in fact all complex chemical compounds that will interact and can interfere with each other in ways you cannot necessarily foresee. Panicking and overdoing things can it its own way can be just as bad and in some cases as potentially life-shortening as undertreating.

Key to managing sterile cystitis is and remains the glucosamine because sterile IC seems to particularly affect the natural glucosamine coating of the walls of the urinary tract. In my own experience with several IC piggies over the years (including my current one), upping the glucosamine for a few days at the start of a flare is by far the most effective and harmless way of bringing it under control quickly. It is as simple as that.

I would also not worry about some minor weight loss because that will correct itself on its own once you get your individual management of your piggy's IC under control, which may take a few weeks but it will usually happen with the mild to moderate forms of sterile IC. And all your on spec home stuff won't do anything for the severe forms whatsoever.

The less you throw at her apart from the glucosamine, the better for the long term. Just keep her on a stable normal diet and be careful with introducing new things because the changes (including re-introducing fresh grass in the warmer months of the year) can trigger a new flare.

Can I please remind our new members to be very careful about recommending unproven home treatments on spec on this forum. There are too many making the rounds online without any research into their effects on guinea pigs and too many long debunked being handed on to new people wanting to be extra good with their piggies because the people recommending them are self-nominated 'experts' without personal experience. They just read what is there in a self-reinforcing cycle without being even aware of the potential downsides of what they are doing because they lack the necessary medical background.

Hi thanks so much for your response. The exotic vet actually recommended the cranberry and tumeric, however I have stopped both as the tumeric didn’t seem to help much and she is getting some bloating and diarrhoea so I figured it may be the cranberry. Do you have any advice to why she is getting larger sized mushier poops and some bloating, is this related to the sterile cystitis?