Help - Post bladder stone op complications

[Blue133557]

Hi,

I’m looking for some advice. My guinea pig was recently diagnosed with bladder stones and had surgery to remove them in July. He was discharged with antibiotics & pain relief & has had regular check ups since. I’ve called the vets a few times as he is still crying out in pain & hunching over when ‘trying to go’ which is pretty much the majority of the day as their bladders are so frequent. He is eating/drinking fine & seems happy in himself apart from this.

I went a week ago as his stitch hadn’t fully dissolved & they sent us away with another course of antibiotics as they thought he might have an infection. He’s finished those & is still crying frequently. The vet has now sent us away with a new prescription for Tramadol … he is now passing blood more than normal which is worrying. Any advice would be greatly appreciated

 

[WobblyPiggy]

Hi,

You could keep taking him back to the vets that you're currently at to see how it goes...alternatively you could go to a different vet and ask their opinion as they may suggest different treatment options...I had a bad vet experience myself which I believe has now lead to one of my piggies being blind in one eye after an injury...unfortunately sometimes piggies don't fully recover from surgery...if he is in constant pain and discomfort its up to you to decide how many more treatments to try...its an awful decision to make...I had to make it myself recently...thankfully I made the right call for now and chose to see a different vet and my piggy pulled round...I'm so sorry you're in the position you are its awful watching them suffer while you try desperately to help...I hope you figure out the right course of action for you and your piggy...

 

[Blue133557]

I requested another x-ray on Wednesday but they said they couldn’t do this for two weeks & to see how he goes with Tramadol. Not sure whether he’s still recovering from surgery but we’re 6 weeks post now and for him to be passing blood & crying so often is heartbreaking. He’s overly picky with his food too & is leaving most things other than cucumber.

Glad to hear all went well with yours & may try a different vet for further advice. I just need him better

 

[Wiebke]

Hi,

I’m looking for some advice. My guinea pig was recently diagnosed with bladder stones and had surgery to remove them in July. He was discharged with antibiotics & pain relief & has had regular check ups since. I’ve called the vets a few times as he is still crying out in pain & hunching over when ‘trying to go’ which is pretty much the majority of the day as their bladders are so frequent. He is eating/drinking fine & seems happy in himself apart from this.

I went a week ago as his stitch hadn’t fully dissolved & they sent us away with another course of antibiotics as they thought he might have an infection. He’s finished those & is still crying frequently. The vet has now sent us away with a new prescription for Tramadol … he is now passing blood more than normal which is worrying. Any advice would be greatly appreciated

Hi and welcome

Something is definitely not right. Unfortunately, without a hands-on examination, nobody can tell you what is going on exactly. You are welcome to see a different opinion if you feel that your vet has reached the limit as to what they can do.

Where was the stone located - in the bladder or the urethra? How is his weight? Are you weighing daily to control his actual food intake since you cannot judge the hay intake by eye, which should make around 80% of what a piggy eats in a day?

Would your vet consider glucosamine supplement (like feliway cat cystease) to help replenish the natural glucosamine coating that prevents the corrosive urine from coming into contact with raw tissue? It won't be a quick fix as it takes several weeks to build up, the same way as dietary measures like filtering the water, reducing the amount of pellets (these two are the biggest calcium sources in a diet) plus a review of the veg and herbs you are feeding will take several weeks to filter through fully.
Long Term Balanced General And Special Needs Guinea Pig Diets (see chapter on special needs diets)

Recommended Guinea Pig Vets

 

[Blue133557]

They felt his bladder a week ago & said it felt relaxed and they’re not sure what the issue is which is why i’ve asked for a further x-ray but not sure if that’s the right route to go down as this is all quite new to me.

He had two small stones - one in his bladder and the other his urethra. They had to cut into his bladder slightly. We only got him in February and he was 8 weeks old at that point. He has a good diet - i buy Excel branded pellets, good quality hay & a variety of veg. Since his op i’ve avoided any leafy greens due to calcium but don’t feel they had a high quantity of this prior. Vet said he’s a good weight & has maintained the same weight since we’ve had him.

Thank you for advice - will speak to the vet re a glucosamine supplement to see what they think. Our vets have been brilliant with him but i now feel we’re being sent home with different meds each time & now more pain relief which will surely just mask the pain

 

[Wiebke]

They felt his bladder a week ago & said it felt relaxed and they’re not sure what the issue is which is why i’ve asked for a further x-ray but not sure if that’s the right route to go down as this is all quite new to me.

He had two small stones - one in his bladder and the other his urethra. They had to cut into his bladder slightly. We only got him in February and he was 8 weeks old at that point. He has a good diet - i buy Excel branded pellets, good quality hay & a variety of veg. Since his op i’ve avoided any leafy greens due to calcium but don’t feel they had a high quantity of this prior. Vet said he’s a good weight & has maintained the same weight since we’ve had him.

Thank you for advice - will speak to the vet re a glucosamine supplement to see what they think. Our vets have been brilliant with him but i now feel we’re being sent home with different meds each time & now more pain relief which will surely just mask the pain

Please don't go too low calcium, either. It is very likely that other factors are in play than just diet. Calcium absorption is a very complex process and a lot can go wrong with it, including a genetic disposition or something with the process.

It could be that your boy has developed sterile interstitial cystitis (or sterile IC) - i.e. a non-bacterial (=can't be healed by antibiotics) recurring cystitis, which seems to specifically affect the glucosamine lining of the urinary tract. it is characterised by intense red pees (which are mostly porphyrine coloured, which is a natural dye; and not blood although blood is in most but not all cases present. Treatment for IC is mainly glucosamine and anti-inflammatories/painkiller. Typically is a low bacterial count in the urine. In milder cases oral glucosamine is sufficient. For worse cases, recent research has shown that cartrofen can help - it is a glucosamine-based arthritis drug. Sterile IC in guinea pigs is not at all uncommon these days but it is not much known outside vet circles that are seeing guinea pigs very regularly. For this reason, it is generally only diagnosed by default once any other problem has been excluded. IC cannot be healed, only managed but it should in most cases slowly fade over a longer space of time - more of a matter of years than months.

In any case, glucosamine will help with a stone operation recovery, too. The oral glucosamine is classed as a food supplement and not as a medication and is widely available online but not necessarily stocked by vets. Cats are the other species that are prone to urinary tract trouble and suffer from a very similar complaint - FSC (feline sterile cystitis). Treatment of guinea pigs with sterile cystitis is pretty similar to that of cats.

 

[Blue133557]

Please don't go too low calcium, either. It is very likely that other factors are in play than just diet. Calcium absorption is a very complex process and a lot can go wrong with it, including a genetic disposition or something with the process.

It could be that your boy has developed sterile interstitial cystitis (or sterile IC) - i.e. a non-bacterial (=can't be healed by antibiotics) recurring cystitis, which seems to specifically affect the glucosamine lining of the urinary tract. it is characterised by intense red pees (which are mostly porphyrine coloured, which is a natural dye; and not blood although blood is in most but not all cases present. Treatment for IC is mainly glucosamine and anti-inflammatories/painkiller. Typically is a low bacterial count in the urine. In milder cases oral glucosamine is sufficient. For worse cases, recent research has shown that cartrofen can help - it is a glucosamine-based arthritis drug. Sterile IC in guinea pigs is not at all uncommon these days but it is not much known outside vet circles that are seeing guinea pigs very regularly. For this reason, it is generally only diagnosed by default once any other problem has been excluded. IC cannot be healed, only managed but it should in most cases slowly fade over a longer space of time - more of a matter of years than months.

In any case, glucosamine will help with a stone operation recovery, too. The oral glucosamine is classed as a food supplement and not as a medication and is widely available online but not necessarily stocked by vets. Cats are the other species that are prone to urinary tract trouble and suffer from a very similar complaint - FSC (feline sterile cystitis). Treatment of guinea pigs with sterile cystitis is pretty similar to that of cats.

This is great advice - thank you so much. Will speak to my vet again & see what they think. Just want him pain free & happy. He has been through so much and to still be in pain 2 months later is hard to see. Lots of tlc in the meantime

 

[Wiebke]

PS: Please look at the water angle and the 1 tablespoon of pellets per piggy per day, too. It has really made the difference between stones and none for many a member.

All the best!

 

[Blue133557]

They have x-rayed again and unfortunately found a further stone. He has underwent further surgery, however, it was more complicated this time as they said he had a lot of adhesions they asked if i wanted him put to sleep or to try to operate.

He seems to be limping now and will not drink so we’re trying to give him water via a syringe. His eyes have looked glazed over the past few days, however, he actually seems a little brighter tonight. He has been eating & moved a little more but still not drinking . Our other guinea pig has been amazing and not bothered him but slept close … i think he must sense he isn’t himself

 

[Wiebke]

They have x-rayed again and unfortunately found a further stone. He has underwent further surgery, however, it was more complicated this time as they said he had a lot of adhesions they asked if i wanted him put to sleep or to try to operate.

He seems to be limping now and will not drink so we’re trying to give him water via a syringe. His eyes have looked glazed over the past few days, however, he actually seems a little brighter tonight. He has been eating & moved a little more but still not drinking . Our other guinea pig has been amazing and not bothered him but slept close … i think he must sense he isn’t himself

Hi!

I am very sorry. All you can do is hang in there, support feed and hope for the best. The bladder will take some time to heal, especially when crystals and stones have become embedded in the walls.

I would recommend to discuss the use of glucosamine for general comfort in the urinary tract because a natural glucosamine coat prevents the highly corrosive urine from coming into direct contact with raw tissue. it takes a little while to build up but it helps with pain management. As it is a food supplement and not a medication, it is generally not stocked at vets but is widely available online (Feliway cast cystease capsules or similar products).

Are you weighing daily and monitoring the actual food intake this way? Keep in mind that hay makes around 80% of what a piggy eats in a day so you cannot control the food intake just by eye. Veg should be only about 15% of what a piggy eats. If your piggy gets enough water in their syringe feed and veg, they do not need to drink because they are not getting any thirstier. Only ever offer a piggy water via syringe but never force more down than they want.
Not Eating, Weight Loss And The Importance Of Syringe Feeding Fibre
Complete Syringe Feeding Guide

Unfortunately, the first weeks after a bladder stone op are the most difficult because any dietary changes take time to come through. Depending on what causes the stones, new ones can unfortunately form rather quickly before your long term measures can become fully effective. I hope that you can get him through that and also his stronger reaction to a second and longer GA, which should hopefully wear off gradually.

 

[Blue133557]

Thank you. There has been such a change in him tonight so i’m hoping he is starting to improve. Will continue with his meds & make sure he is eating plenty. His appetite is definitely improving - he showed interest & just took two bits of cucumber. He turned around & faced the wall last night … it was so worrying he obviously just wanted to be left alone.

Will definitely mention glucosamine again. Briefly mentioned it on Wednesday but then everything after the x-ray results are a bit of a blur. I’ve bought in mineral water with a low calcium carbonate content as just found out our area is considered ‘very hard’

 

[Wiebke]

Thank you. There has been such a change in him tonight so i’m hoping he is starting to improve. Will continue with his meds & make sure he is eating plenty. His appetite has definitely improving - he showed interest & just took two bits of cucumber. He turned round & faced the wall last night … it was so worrying he obviously just wanted to be left alone.

Will definitely mention glucosamine again. Briefly mentioned it on Wednesday but then everything after the x-ray results are a bit of a blur. I’ve bought in mineral water with a low calcium carbonate content as just found out our area is considered ‘very hard’

You will find that the change in water is the best and most effective part of the dietary changes you can make but working the calcium out takes unfortunately several weeks. Been there myself...

 

[Blue133557]

Thank you. Will take it day by day with him & see how he goss