Euthanasia

[jadielin]

Hi everyone,

I’m just wondering if anyone else has been through this and I also need to vent (again).

One of my girls (Evie - around 4.5 yrs) has been fighting with a painful bladder and blood in her urine for the past 6 months. At first, it was an infection which we cleared up with antibiotics for a few weeks but then it returned. Since then, the blood in her urine seems to return every 3-6 weeks.

I have ruled out bladder stones and uterine tumours twice now via X-ray and ultrasounds, along with around 5 urine samples to rule out infection.

She has been on and off metacam for the last 6 months and she has lost about 200 grams since August. The metacam does not seem to relieve her pain anymore. The vet gave her an shot of a slow release opioid that is supposed to work for 72 hours, paired with the metacam- but nothing seems to be taking away her pain. I tried a different antibiotic but it gave her diarrhea.

I have changed her diet even more over the last 2 months - purified water, only wet veg (leaf lettuce 1-2 times a week, cucumber daily) to try to get rid of the sludge that keeps happening. That seemed to work for a while, but again - the blood came back.

She is in so much pain and is straining when she’s urinating, crying out. I’ve started cystease to see if that will help but I’m not sure if I can see her in this much pain for much longer as I know that cystease can take a long time to work (if this is sterile cystitis).

She is just not her usual self, she is constantly arguing with her sister and very lethargic. I’m just so heartbroken and unsure of what the next steps should be. I know I’ve read on here that sterile cystitis is becoming common, but I don’t know how I can keep her comfortable until it improves.

I’m just wondering what anyone else would do in this situation. My family doesn’t understand how much these little animals mean to me and they think I’ve spent way too much money on them. But at this point if I could cut my own arm off to take away her pain I’d do it.

Thank you in advance,

 

[Qualcast&Flymo]

Sorry your poor piggy is suffering so badly with cystitis. I've no personal experience, but have read on other threads here that Cartrophen can help in some more severe cases of cystitis. You could search for threads mentioning it to find out more, and see if your vet can prescribe it for your little one.

 

[Wiebke]

Hi everyone,

I’m just wondering if anyone else has been through this and I also need to vent (again).

One of my girls (Evie - around 4.5 yrs) has been fighting with a painful bladder and blood in her urine for the past 6 months. At first, it was an infection which we cleared up with antibiotics for a few weeks but then it returned. Since then, the blood in her urine seems to return every 3-6 weeks.

I have ruled out bladder stones and uterine tumours twice now via X-ray and ultrasounds, along with around 5 urine samples to rule out infection.

She has been on and off metacam for the last 6 months and she has lost about 200 grams since August. The metacam does not seem to relieve her pain anymore. The vet gave her an shot of a slow release opioid that is supposed to work for 72 hours, paired with the metacam- but nothing seems to be taking away her pain. I tried a different antibiotic but it gave her diarrhea.

I have changed her diet even more over the last 2 months - purified water, only wet veg (leaf lettuce 1-2 times a week, cucumber daily) to try to get rid of the sludge that keeps happening. That seemed to work for a while, but again - the blood came back.

She is in so much pain and is straining when she’s urinating, crying out. I’ve started cystease to see if that will help but I’m not sure if I can see her in this much pain for much longer as I know that cystease can take a long time to work (if this is sterile cystitis).

She is just not her usual self, she is constantly arguing with her sister and very lethargic. I’m just so heartbroken and unsure of what the next steps should be. I know I’ve read on here that sterile cystitis is becoming common, but I don’t know how I can keep her comfortable until it improves.

I’m just wondering what anyone else would do in this situation. My family doesn’t understand how much these little animals mean to me and they think I’ve spent way too much money on them. But at this point if I could cut my own arm off to take away her pain I’d do it.

Thank you in advance,

Hi

Have you and your vet considered sterile cystitis (you may find more information under its older name, interstitial cystitis or IC). The condition is now by far more common in indoors guinea pigs than the bacterial urine infection that is behind UTI. Unlike UTI, sterile cystitis cannot be healed by antibiotics (the 'sterile' bit refers to a no or rather low count of faecal bacteria in the urinary tract); it can at the very best only be temporarily suppressed by antibiotics.
It is however characterised by regular flare ups every few weeks (that is what is referred to by 'interstitial', i.e. recurring at regular intervals) and that is the big fat clue in your information for me.

The condition is linked to commercial mass breeding and some embryos taking their mothers' high stress levels as their own default normal setting before they are even born. Cats have a very similar condition calles feline sterile cystitis (FSC). Treatment in guinea pigs mirrors FSC treatment without the hormonal bits if your vet is unsure.

It generally affects the natural insulating glucosamine layer of the walls of the urinary tract, which prevents the highly corrosive, stinging urine from coming into painful direct contact with raw tissue. Hence the pain during the flares.

It cannot be cured but the milder to medium ranges can be managed with metacam and either - in the milder ranges with glucosamine - which you will have to get yourself since it is classed as a food supplement - or in the medium to slightly higher ranges by cartrophen (which is a proper medication). There is not yet any treatment for the highest end of the spectrum although glucosamine and cartrophen can be given in parallel, which is pushing out the boat that bit further.

The problem is that because sterile cystitis is a relatively new kid on the block, it is still not widely known outside vets that deal very regularly with guinea pigs so it is often missed or misdiagnosed.

You may find this link here helpful and may want to show it to your vet:

Thread 'Wiebke's Guide to Pees and Stones'

May 29, 2024

1 The Urinary Tract
2 Pees
- Water intake changes
- Pee discoloration
3 Infections
- Bacterial urine infection (UTI)
- Bacterial cystitis
- Sterile cystitis (interstitial cystitis or IC)
4 Stones, Sludge and Crystals
- Crystals, stones and sludge
- Stone and sludge removal
5 Kidneys...

• Wiebke
• Replies: 3
• Forum: Wiebke's Guides to the Body

Here is some US based information on sterile/interstitial cystitis:
Guinea Lynx :: UTI

But I hope that treatment for sterile cystitis will hopefully give your piggy a new lease on life. Reacting to antibiotics means that she is still in lower half of the spectrum. Please brace yourself that glucosamine takes severa weeks to build up in the body. It is not a quick fix but it is an essential part of treatment to strengthen the glucosamine layer and repair any holes in it.

Wishing you all the best and a hopefully positive outcome even if it may take a little time. Once you have got on top of symptoms, you can then work out just low you can safely go with the maintenance dosage and how much you have to up it/max it out for 2-3 days to get on top of flare quickly. Milder cases will eventually go away on their own, never to return, but you are looking at years rather than a few months. But there is yet some more life for your beloved girl.

 

[weepweeps]

Hello @jadielin. Sending you hugs and healing vibes to your piggy.

I don’t have any experience of sterile cystitis but you’ve been given great advice above.

I hope she is soon feeling more comfortable. It’s so hard seeing them in pain.

 

[jadielin]

Hello @jadielin. Sending you hugs and healing vibes to your piggy.

I don’t have any experience of sterile cystitis but you’ve been given great advice above.

I hope she is soon feeling more comfortable. It’s so hard seeing them in pain.

Hi everyone,

Thank you for your replies! I will try to give the cystease some more time to hopefully work and try the other painkiller as well.

I was having some trouble getting her to take it but a mashed raspberry seemed to do the trick

 

[Wiebke]

Hi everyone,

Thank you for your replies! I will try to give the cystease some more time to hopefully work and try the other painkiller as well.

I was having some trouble getting her to take it but a mashed raspberry seemed to do the trick

The other option would be likely stones in the kidneys and downwards from there.

Can you try and double the cystease you give for a week (i.e. a capsule every 12 hours)? And max out the painkiller?
What dosage and concentration is she exactly on?

 

[jadielin]

The other option would be likely stones in the kidneys and downwards from there.

Can you try and double the cystease you give for a week (i.e. a capsule every 12 hours)? And max out the painkiller?
What dosage and concentration is she exactly on?

She’s on 0.4 of metacam every 24 hours!

Yeah, I will double the cystease for sure!

Thank you, Wiebke.

 

[Piggies&buns]

I’m sorry to hear this

Is that cat (0.5mg/ml) or dog (1.5 mg/ml) version of metacam?

There sounds to be room for increasing her dosage though with your vets approval.

If it is cat then it is a lower end dose with room for raising it; and it can be given twice a day.
Dog version is stronger in its concentration so a smaller volume packs more of a punch but it can still be given twice a day.

 

[jadielin]

I’m sorry to hear this

Is that cat (0.5mg/ml) or dog (1.5 mg/ml) version of metacam?

There sounds to be room for increasing her dosage though with your vets approval.

If it is cat then it is a lower end dose with room for raising it; and it can be given twice a day.
Dog version is stronger in its concentration so a smaller volume packs more of a punch but it can still be given twice a day.

It is dog metacam - 1.5mg

I may try to do 0.2 and 0.2 every 12 hours and see if that changes anything.

Thank you!

 

[Merab]

Just want to offer my support for you.

 

[Wiebke]

It is dog metacam - 1.5mg

I may try to do 0.2 and 0.2 every 12 hours and see if that changes anything.

Thank you!

Hi

You can give safely up to 0.4 ml twice daily to a 1 kg guinea pig (that is 1.2 ml cat metacam) and adjust the weight from there but we have seen higher dosages than that prescribed on here for short term acute pain with no ill effects on the piggies. Guinea pigs metabolise metacam differently to other pet species.

I have usually doubled/maxed out my metacam and glucosamine initially and during spikes to get on top of them as quickly as I could (if that was possible) with my own sterile cystitis piggies. It has often made a difference.

The suggestion to double the cystease initially for a week is also a vet's recommendation, by the way. It did finally get on top of my Nerys's 'chronic UTI' in early days well over a decade ago when sterile cystitis was slowly starting to become more common. Under her placid demeanor big Nerys in my avatar picture on the left was always a very nervous piggy. I adopted her and sister because they had been surrendered to rescue as not fit for handling with still having very short razors sharp baby nails at 10 months and being extremely skittish.
Nerys had 3 years with sterile IC and then another 3 years without it and lived to 8 years before old age caught up with her.

I wish you all the best with throwing the kitchen sink at your girl before considering euthanasia. Think about it from that perspective: What have you got to lose?

 

[jadielin]

Hi

You can give safely up to 0.4 ml twice daily to a 1 kg guinea pig (that is 1.2 ml cat metacam) and adjust the weight from there but we have seen higher dosages than that prescribed on here for short term acute pain with no ill effects on the piggies. Guinea pigs metabolise metacam differently to other pet species.

I have usually doubled/maxed out my metacam and glucosamine initially and during spikes to get on top of them as quickly as I could (if that was possible) with my own sterile cystitis piggies. It has often made a difference.

The suggestion to double the cystease initially for a week is also a vet's recommendation, by the way. It did finally get on top of my Nerys's 'chronic UTI' in early days well over a decade ago when sterile cystitis was slowly starting to become more common. Under her placid demeanor big Nerys in my avatar picture on the left was always a very nervous piggy. I adopted her and sister because they had been surrendered to rescue as not fit for handling with still having very short razors sharp baby nails at 10 months and being extremely skittish.
Nerys had 3 years with sterile IC and then another 3 years without it and lived to 8 years before old age caught up with her.

I wish you all the best with throwing the kitchen sink at your girl before considering euthanasia. Think about it from that perspective: What have you got to lose?

Hi Wiebke,

Thank you for your reply. I’m definitely wanting to try everything to see if I can fix her

The vet said exactly what you’ve said regarding the painkillers.

She has also agreed to try the cartrophen shot as well. We may also try a bit of Baytril as this seems to clear her symptoms relatively quickly, just until we get the rest under control.

I really appreciate your help.

 

[Wiebke]

Hi Wiebke,

Thank you for your reply. I’m definitely wanting to try everything to see if I can fix her

The vet said exactly what you’ve said regarding the painkillers.

She has also agreed to try the cartrophen shot as well. We may also try a bit of Baytril as this seems to clear her symptoms relatively quickly, just until we get the rest under control.

I really appreciate your help.

My fingers are very firmly crossed! I sincerely hope that throwing the kitchen at it is going to do the trick.

 

[jadielin]

My fingers are very firmly crossed! I sincerely hope that throwing the kitchen at it is going to do the trick.

Hi Wiebke,

Thank you!

I’m struggling to get her pain under control - even though we’ve doubled the dose of the metacam it does not seem to be working at all. Do you have any experience with gabapentin in Guinea pigs? Did it have any bad effects?

Thanks again.

 

[Wiebke]

Hi Wiebke,

Thank you!

I’m struggling to get her pain under control - even though we’ve doubled the dose of the metacam it does not seem to be working at all. Do you have any experience with gabapentin in Guinea pigs? Did it have any bad effects?

Thanks again.

Hi

HUGS

I am very sorry.

Others have more experience but gabapentin has less side effects and doesn't space out piggies as badly as tramadol. What you cannot do is to stop all at once; it has to be phased out over several days - your vet can advise you on that.

 

[jadielin]

Hi

HUGS

I am very sorry.

Others have more experience but gabapentin has less side effects and doesn't space out piggies as badly as tramadol. What you cannot do is to stop all at once; it has to be phased out over several days - your vet can advise you on that.

Thank you, Wiebke!

 

[jadielin]

Just to update everyone -

She has had her first shot of the cartrophen and about 4 days later I was able to stop painkillers and she’s not crying or straining anymore (and attempting to chew on my furniture during floor time, which means she’s back to her normal self )! Looks like we’re on the right path.

The plan is to do 4 weekly shots of cartrophen and then monthly from then on.

Thank for you your help!

 

[sport_billy]

Just to update everyone -

She has had her first shot of the cartrophen and about 4 days later I was able to stop painkillers and she’s not crying or straining anymore (and attempting to chew on my furniture during floor time, which means she’s back to her normal self )! Looks like we’re on the right path.

The plan is to do 4 weekly shots of cartrophen and then monthly from then on.

Thank for you your help!

That is great news! Sending lots of love and cuddles to her

 

[CTWC]

Fantastic news