Help for mild cystitis

[Char.wilson]

Hi everyone,

I posted a while back about Dougie seeming to strain doing his business and I’m now looking to get some advice from more experienced owners about treatment for sterile cystitis.

He has been mildly straining to do his business maybe 2-3 times a day (not constant and no squeaks) and his urine has been darker (told it’s dye rather than blood). He was on Baytril and metacam for two weeks and improved (his urine pH went back to normal as did his protein levels). I was then told to take him off the meds and bring him back is he got worse.

So far his weight has been constant (phew) and his urine is looking slightly less dark but he seems to have stalled there in his recovery. He is still active and eating and drinking as normal but I’m starting to think it may be sterile cystitis which i have only recently found out about. As such I was hoping to get opinions on how long I should leave him to “recover” before taking him back to vets to suggest cystitis and what the treatment plans are ranging from mild to severe cases (I know it varies between piggies but hoping to find a baseline).

Any advice would be really appreciated as he is my first piggie and my absolute world so I want him to be as happy and healthy as possible.

P.S. I did also get him an ultrasound and X-rays about 3 weeks ago when problem started which all came back negative for stones. He has also had an extra sediment test since then which was negative.

 

[Wiebke]

Hi everyone,

I posted a while back about Dougie seeming to strain doing his business and I’m now looking to get some advice from more experienced owners about treatment for sterile cystitis.

He has been mildly straining to do his business maybe 2-3 times a day (not constant and no squeaks) and his urine has been darker (told it’s dye rather than blood). He was on Baytril and metacam for two weeks and improved (his urine pH went back to normal as did his protein levels). I was then told to take him off the meds and bring him back is he got worse.

So far his weight has been constant (phew) and his urine is looking slightly less dark but he seems to have stalled there in his recovery. He is still active and eating and drinking as normal but I’m starting to think it may be sterile cystitis which i have only recently found out about. As such I was hoping to get opinions on how long I should leave him to “recover” before taking him back to vets to suggest cystitis and what the treatment plans are ranging from mild to severe cases (I know it varies between piggies but hoping to find a baseline).

Any advice would be really appreciated as he is my first piggie and my absolute world so I want him to be as happy and healthy as possible.

P.S. I did also get him an ultrasound and X-rays about 3 weeks ago when problem started which all came back negative for stones. He has also had an extra sediment test since then which was negative.

Hi

Key to treating sterile instersitial cystitis (IC) is glucosamine because sterile cystitis seems to very much attack the natural glucosamine coating of the urinary tract walls that prevents highly corrosive urine from coming into painful and infectious contact with raw tissue.

It is classed as a food supplement and not as a prescription medication, so you have to get it yourself online. Google for Feliway cystease cat bladder capsules. Empty one capsule and mix the powder with in a little medication bottle with 2 ml of water; shake well and shake before use. You can give the mix every 24 hours or give 1 ml of the solution twice daily (morning and evening). You need to make the mix fresh every day; at least with the capsule you won't have to do any daily pill cutting and grinding.
You can up the dosage to two capsules a day for 2-3 days to get on top of the occasional flares that characterise sterile cystitis as quickly as possible. With a little luck mild IC will eventually go away for good on its own with the interim between the flares gradually lengthening but you are still looking at over a year to several.

The other component is metacam to help with the inflammation in the tissue and the pain. With a bit of experimentation once you have got the IC under control you can establish which is your ideal maintenance dosage and how high you need to go to get a flare back under control.
Please speak with your vet about a prescription for dog metacam (three times stronger than cat metacam; the current dog strength UK vet brand is called rheumocam) because of the cost and the volume you will need for a daily (or during a flare twice daily) dosage. Dog metacam comes in larger bottles wheres you'll go through a bottle of cat metacam in a just over a week. Metacam is a POM in the UK (prescription-only medication.

IC comes on the whole spectrum from the very mild to the very severe; you will have to work out for yourself by trial and error just how little and how much your piggy needs.

Any antibiotics can at the best suppress mild IC temporarily but not cure it. Most guinea pigs have a small number of faecal bacteria in their urinary tract from scent marking; it is rather rare to have none. But there is not the overgrowth of those faecal bacteria in the urine that characterises a UTI.

The good news is that with the correct management, sterile IC is mainly an occasional nuisance every few months or so with some squeaking and porphyrin pees but that it doesn't shorten the life span. Healthy companions can usually fend off IC with their immune system. The problem seems to specifically affect guinea pigs with a high stress default setting. Since they experience those high stress levels as their normal in their mother's womb, there is nothing you can do bout that; it is a result of our current commercial mass breeding of pets and affects cats as much as piggies. If your vet hasn't heard of sterile cystitis in guinea pigs, then they will likely have heard of feline sterile cystitis (FSC); treatment in guinea pigs parallels it, only that guinea pigs need (and tolerate) much higher metacam levels.

What can trigger a flare in IC piggies are new foods, so you will have to introduce fresh grass in spring very, very gradually. But IC piggies do not need a special diet in our own experience as long as ou filter your water (the UK is mainly a hard water country) and reduce your pellets to 1 tablespoon per piggy per day.

I hope that this helps you?

 

[Char.wilson]

Hi,

Thank you for the detailed run through!

I will monitor him for another week or so but if he is still no better I will ask the vet for a prescription of dog metacam.

I just have a couple of follow ups should both the metacam and the glucosamine be given daily regardless of whether he is having a flare up? I.e. he will now be on them daily for the rest of his life, or is it more a case of give him the meds when this flares up? If it’s the former and he needs them daily, is there any long term effects of extended metacam and glucosamine usage?

Also with the delivery of the glucosamine is this something to syringe “feed” him or just leave in his water bottle for the day?

Finally, you suggested increasing them if it’s a bad flare up but what’s the “max level” as, being the size of a baked potato, I imagine it’s very easy to overdose these meds which obviously I want to avoid.

Thanks again, for all your advice - I’m very new to guinea pigs so I wanna be sure I’m doing everything right for him. I’ve attached a photo of him just to add something cute to a more serious discussion

 

[Wiebke]

Hi,

Thank you for the detailed run through!

I will monitor him for another week or so but if he is still no better I will ask the vet for a prescription of dog metacam.

I just have a couple of follow ups should both the metacam and the glucosamine be given daily regardless of whether he is having a flare up? I.e. he will now be on them daily for the rest of his life, or is it more a case of give him the meds when this flares up? If it’s the former and he needs them daily, is there any long term effects of extended metacam and glucosamine usage?

Also with the delivery of the glucosamine is this something to syringe “feed” him or just leave in his water bottle for the day?

Finally, you suggested increasing them if it’s a bad flare up but what’s the “max level” as, being the size of a baked potato, I imagine it’s very easy to overdose these meds which obviously I want to avoid.

Thanks again, for all your advice - I’m very new to guinea pigs so I wanna be sure I’m doing everything right for him. I’ve attached a photo of him just to add something cute to a more serious discussion

Yes, the metacam and the glucosamine have to be given daily as a maintenance dose once the IC is under control. You and your vet have to work out how low you can go with the metacam in between flares without triggering one and then maxing it out shortly in order to bring a flare back under control quickly. But with those measures in place your boy should able to live pretty much a normal, healthy life with just the odd few days of painful pees every now and then.

My Nerys had a milder to medium sterile IC (after half a year of 'chronic UTI' - it was in the early days when IC ws only just coming onto the block) for 3 years and then lived another 3 years totally free of any bladder problems to pass away from age related issues some time after her 8th birthday; so all the dog metacam certainly didn't impact on her. Other piggies with mild IC had it for about 1 1/2 - 2 years, never to return once gone.

Please never use the water bottle for medicating guinea pigs; you cannot control the intake and it will contribute to the water going green much more quickly; you can also not ensure that only the right piggy will drink it or that they will drink enough.
It is always safest to syringe any medication in my own experience. The good news is that virtually all piggies like metacam (it has a little honey in it so it goes down when nothing else will) and that the cystease powder is also well liked so your piggies will accept the syringe.
Some members prefer to serve the capsule powder on a bit of cucumber or small bit of lettuce etc. where it sticks to the veg but this won't quite always work as I know from one or two of mine who didn't like the added taste and texture. Guinea pigs have twice the tastebuds of humans.
You can however try to train him to come for his medical syringes and a little follow up treat. I also find that associating a syringe with something positive helps with medicating and support feeding ill piggies; they are generally noticeably better behaved.
All About Syringe Feeding and Medicating Guinea Pigs with Videos and Pictures

 

[Char.wilson]

Okay, thank you so much for you response! I am so glad to hear he will be able to have a long and happy life even with this.

Just one final question about getting dosages correct - how do I “know” I have found the perfect compromise? Ie will symptoms be totally gone, or will they be very mild for example is a little straining close to his next dose okay? Will his urine go back to totally normal or is a bit of colour okay?

Thanks again!

 

[Wiebke]

Okay, thank you so much for you response! I am so glad to hear he will be able to have a long and happy life even with this.

Just one final question about getting dosages correct - how do I “know” I have found the perfect compromise? Ie will symptoms be totally gone, or will they be very mild for example is a little straining close to his next dose okay? Will his urine go back to totally normal or is a bit of colour okay?

Thanks again!

Hi

The maintenance dose is correct when symptoms completely disappear between flares; in most mild to medium cases one capsule a day seems to do the trick. Please be aware that the gluosamine takes several weeks to build up in the body; it is not an instant fix but it will stand the distance.

Any pain symptoms like straining should also disappear when you get the metacam level right.

The porphyrin should only make an appearance (if any) at the start of a flare-up; as should symptoms like a cluster of calcium pees just ahead of a flare.

Ideally your boy should be perfectly symptom-free with the exception of 2-4 days every few months.

 

[Char.wilson]

Hiya,

Brilliant! Thank you for all the information and your patience.

My vet unfortunately isn't an exotic specialist but so far she has been really good with him and listening to my input so I’m feeling knowledgeable enough to go in and tackle this in order to get Dougie back to his usual, chaotic self.

 

[Wiebke]

All the best! I hope that your vet can link up via FSC (the cat version) if she has concerns and do her own research.

There is now stronger but much more expensive medication (cartrophen) available that can push treatment further out into the more severe spectrum but if Dougie is fine on just the metacam and glucosamine, then that would be great.

 

[MrsHappyH]

Thanks! This is perfect for Mario. He gets recurrent UTI ISH symptoms including darker wee (no blood) and painful wees .. goes temporarily with antibiotics but always comes back a couple of weeks later..and he has an enormous "sheath". Just wondering if this in any way related ? I'm constantly having to clean bits out of it .. luckily he doesn't suffer with much smegma, but is a pet shop piggy sadly.. I wonder if there is an operation he needs if sheath is too big and contributing to cystitis? I think I read somewhere about cauliflower sheathes but can't find a link .. thanks for your help and great advice!

 

[Wiebke]

Thanks! This is perfect for Mario. He gets recurrent UTI ISH symptoms including darker wee (no blood) and painful wees .. goes temporarily with antibiotics but always comes back a couple of weeks later..and he has an enormous "sheath". Just wondering if this in any way related ? I'm constantly having to clean bits out of it .. luckily he doesn't suffer with much smegma, but is a pet shop piggy sadly.. I wonder if there is an operation he needs if sheath is too big and contributing to cystitis? I think I read somewhere about cauliflower sheathes but can't find a link .. thanks for your help and great advice!

Hi

Here is our boar care guide. You will find the cauliflower willy in the Boar Bits chapter; the 'cauliflower' bit is actually the prolapsed lining of the penis shaft and not the penis itself. And no, there is no connection to any problem in the urinary tract.

Boar Care: Bits, Bums & Baths (with pictures)

 

[MrsHappyH]

Brill ! Thanks!

 

[MrsHappyH]

So I will take a picture of Mario's as it's bigger then the one in the picture. So are boars with this prone to infection of the skin surrounding the penis ? I sometimes use sudocrem there when things are a bit red (vets fine with that). How big is too big for prolapse ? Give me 20 I'll send a pic.

 

[MrsHappyH]

So I will take a picture of Mario's as it's bigger then the one in the picture. So are boars with this prone to infection of the skin surrounding the penis ? I sometimes use sudocrem there when things are a bit red (vets fine with that). How big is too big for prolapse ? Give me 20 I'll send a pic.

So I won't bother sending a pic as I've just realised it's not quite a prolapse. He can tuck it away but doesn't bother alot ! I completely forgot this. His sheath is very long compared to my other boars (and deceased boar) and is also very knobbly. It does catch ALOT of debris and it's difficult to express his penis due to the sheer amount of sheath. If any one has any tips on infections etc as it can get so red. anything I'm missing please let me know as the bacteria it hold I was assuming could easily create a UTI ... But apparently not. I will try the cat cystitis thing..

 

[Char.wilson]

Hi everyone,

Quick update on Dougies condition. My vet wasn’t all that knowledgeable on sterile cystitis in piggies so she referred me to an exotics vets.

The exotic vet double checked for stones or kidney issues via an X-ray and ultrasound which were both clear (phew).

Dougie was still feeling a bit tender around his bladder so the vet prescribed 0.3ml gabapentin a day as an anti inflammatory for 2 weeks. This helped massively and his urine is almost back to normal but still seeing the occasional strain. As such I mentioned the cystease to the vet who has said he is happy for me to try it alongside continuing the gabapentin indefinitely to help ease the last of the symptoms.

As a final query I know your previous answers all mentioned metacam but my vet said that gabapentin is another anti inflammatory used to help manage cystitis and so I was just wondering if there are any long term draw backs to this med I should know about.

Thanks again to everyone for the support!

 

[Char.wilson]

Hi,
I have a quick follow up as I’ve started Dougie on the Feliway cystease capsules. I’m trying the one capsule a day dissolved in 2ml of water however I’m finding it a little bit tricky to fully dissolve whereby it stays a little gritty - is this normal?
Furthermore, can a guinea pig overdose on this and how do I watch out for signs of this? I know this chain has recommended 1 capsule a day as maintenance and 2-3 during a flare up but the packet seems to suggest using less (although I am aware this is instructions for cats). Do guinea pigs just tolerate this better which is why they can have more?
I am happy to stick to a capsule a day but just want to be very careful about not giving him too much.