Help with Long Term UTI

[AvatarKorra]

Pig Background
My pig Smores is an almost 5 year old female who weighs 879 grams. At the end of May, I noticed blood in her urine and that she was a little less active than usual, so I took her to the vet. The vet believes she has a UTI. However, the UTI does not seem to be going away. I was wondering if anyone could give me advice on the situation and answer some questions I had.

Exam Results
Urine Analysis -
Cocci, rods, 0-2 wbc/40x, 0-4 rbc/40x
Protein trace
Leukocytes +/-
Bilirubin, urobilinogen, ketones, nitrite, glucose are all negative/normal
X-ray - No stones or hormonal issues were found

S'mores was put on .4 ml of Bactrim 48mg/ml and .13 ml of Meloxicam for 2 weeks every 12 hours. I also gave Benebac probiotic 1-2 hours before or after her antibiotics and added an Oxbow urinary support tab to her daily diet. A few days into the antibiotics, I did not see any more blood. After two weeks, I took a urine sample to the vet and they discovered more bacteria:
Ca oxalate TNTC, cocci 2++
Protein trace
Leukocytes 1+
Bilirubin, urobilinogen, ketones, nitrite, glucose are all negative/normal

Smores was put on the same dose of Bactrim for another two weeks. Not even a week after this course had finished, I noticed blood in Smores urine again. I took another sample to the vet and got the following results:
Occasional cocci and red blood cells
Protein 3
Leukocytes +_
Bilirubin, urobilinogen, ketones, nitrite, glucose are all negative/normal

The vet told us we can either do another two weeks of Bactrim or get a urine culture. However, Smores does not tolerate Baytril and the vet said other antibiotics could damage her organs. Because of this, I opted for another two weeks of Bactrim.

A few weeks after this dose finished, I noticed Smores had been drinking a lot more water than usual. Her pee also seemed to smell a bit. Soon enough, I noticed the blood again. Smores went back to the vet and got the bacteria culture done. It found a greater than 100,000 CFU/ML of Acinetobacter Lwoffi and 10,000-50,000 CFU/ML of Escherichia Coli. Protein was at .3 and Leukocytes was ++. My vet said Bactrim was still the best antibiotic for this bacteria and said she did not know why the infection was not going away. Smores got put back on the .4 Bactrim and .13 Metaloxicam dose for two weeks. I know it is helping her because she is a lot happier now and is even doing zoomies around her cage but we are 1.5 weeks into the 2-week course and I still see blood spots. She is also still drinking a lot more water than normal. I would appreciate any advice from someone who has also experienced a UTI going on this long. I also have a few questions if anyone could answer:

1.) Dosage and timespan of antibiotics
Is .4 ml of Bactrim a good dosage for this issue or should she have been put on a higher dose since the infection was not going away? I am also concerned about how we only get meds in two-week courses. My vet's office told me to do the urine test 24 hours after Smores finishes her meds. Then we have to wait at least a few days for results. This means Smores is always at least half a week off antibiotics between each two-week course. Wouldn't the antibiotics be more effective if she was just put on a long-term course without all these breaks?

2.) Ultrasound
Is there any other illness that causes bacteria in urine? My vet mentioned an ultrasound but also said it could be useless because it is hard to do on guinea pigs. I thought ultrasounds were more so for looking for hormonal issues or masses but would either of those cause bacteria in her urine?

3.) Long term antibiotics
If this infection never goes away, can she stay long-term on antibiotics? My vet said that is not good because they can become resistant but I am not sure what else to do if the infection does not go away.

 

[Bradshaw Piggies]

So sorry to hear of your piggy's UTI problems. I'm sure our health advisors will be along to help soon.

When one of mine had recurring UTIs and IC, I found cystease to be a real help. He was much more comfortable within a couple of weeks.

Hope you get some answers and get on top of his problems soon. Sending love!

 

[Dilly's Piggies]

I'm sorry you're having this issue, UTI's can be very stubborn sometimes! The dosage for bactrim sounds correct, but when my piggies have been prescribed it for a UTI usually they have it for at least 4 weeks, sometimes longer. Perhaps this is something you can discuss with your vet, as it sounds like the medication works but then when finished the infection comes back, a longer course may knock it out.

I would recommend an ultrasound for your piggie also, xrays are good for detecting stones/sludge etc, but ultrasounds are better for looking at soft tissues, it will show whether your piggie has inflammation or damage etc that could be causing it. It will help give your vet more information. Many of my piggies have had ultrasounds, one just had one yesterday (found she has ovarian cysts) and it was no issue for the vet to do and I've had a bladder pig have one before, it picked up that she had a thickened bladder wall.

Your pig could also be one who has interstitial cystitis which antibiotics won't help, this condition can only be managed with metacam and dietary changes.

Another thing to look at is bedding and being extra clean with your piggies cage, one of my piggies in the past kept getting UTI's, she would always lay in one spot in her mess and a bedding change and keeping things even cleaner than I thought it needed to be kept things under control. She was also long haired so keeping her bottom hair as short as possible with regular bottom baths helped.

I hope this helps, I'm not a professional, this is just some things I've learned having gone through it. I hope your piggie gets better soon ❤