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My beautiful Buttercup (UTI again)

Scooter Pie

Scooter Pie

Teenage Guinea Pig
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Buttercup is about 4, Ive had her for 2 years and she's my first piggie (along with her sister Nutmeg who departed last April)

She's got blood in her urine again. It's been 4 weeks since she finished her last antibiotics. This has been going on since June. 4-6 weeks of antibiotics at a time and it returns after 3-4 weeks.

Last time this happened she had some ulcerations on her vulva. Silver cream took care of it. That seems to be returning too.

Anyway, she goes to the vet tomorrow. I'm just sad for her.

On top of it she's losing fur on her sides. Ive suspected ovarian troubles for a while (crusty nipples and always in season, climbs on her little cage mate daily). Ive told the vet this and she couldn't feel anything on exam. The fur loss is new.

Anyone have a sow on antibiotcs permanently? She is on potassium citrate and hydrochlorothiazide twice a day for life now. 292B922B-F0E4-4011-960C-B26FFD1C6009.webp
 
I’m sorry it’s returning. I would push for the vet to scan and check for the cysts. give she’s being more ‘moody’ and losing hair and has crusty nipples. I hope you come away with a decent treatment plan.

On the UTI, what antibiotics has she been prescribed the previous times?
 
So ultrasound is how they find the cysts? Usually they "take a peek" at her bladder to see where she's at with crystals. I will ask about it tomorrow for sure.

Antibiotics. The one that has worked is SMZ TMP. googled: Trimethoprim / Sulfamethoxazole, Bactrim DS, Sulfatrim, Bactrim

After it returned the first time, they tried a round of Baytril and the bacteria level was even worse then. Usually she's much better within a day or two on the SMZ TMP.

Luckily they give her metacam too.

They mentioned her urethra is a bit inverted which adds to the problem.
 
I think sometimes they can be felt but a scan/x ray is also used.
 
Hi!

Have your vets considered that your piggy may have a sterile (i.e. non-bacterial) interstitial (i.e. recurring) cystitis? This cystitis cannot be healed by antibiotics. In its milder form, antibiotics can temporarily suppress it while in the more severe form, it won't respond to them at all.
Sterile IC has become a lot more common in guinea pigs over the last decade but is not well known outside vet circles that do not deal with guinea pigs on a very regular basis.

Sterile IC can only be managed but not healed; it can eventually disappear on its own but you are looking more at years than months.
Key to treatment is glucosamine (which is not a medication but classed as a food supplement) to support the affected natural glucosamine coating of the walls of the urinary tract that prevents the corrosive urine from coming into painful contact with raw tissue plus an analgesic especially during the regular flares. This treatment follows Feline Sterile Cystitis since cats are the other species that seems to increasingly suffer from the same problem.
We recommend for milder cases a glucosamine based cat bladder supplement in capsule form (easiest for dosage - dissolve the powder in the capsules in 2 ml of water, always shake well before use and either give 1 ml every 12 hours or 2 ml every 24 hours. In a bad flare you can give 1 capsule every 12 hours; I am doing this with my own persistent IC piggy.
For severe cases, recent research in Europe has shown that cartrofen (a glucosamine based arthritis medication) does also work for guinea pigs but this is currently still being trialled by exotics vets in the UK on an ad-hoc basis, so a standard way has not yet been established.
Your vet may want to look into this. The good news is that sterile IC in its milder forms does not shorten the life expectancy or cause bladders stones although we recommend to switch to a lower (but NOT calcium-free) diet.
My Nerys, the large piggy in my avatar had sterile IC for 3 years and then lived free of any urinary tract problems for another 3 years before dying at the respectable age of 8 years in 2016 from age related issues.

Our diet guide contains some tips which foods you may want to leave out of an IC diet in addition of filtering water and not feeding more than 1 tablespoon of pellets: Long Term Balanced General And Special Needs Guinea Pig Diets (see chapter special needs diets)
Here is some information on IC: Links - Interstitial Cystitis - Guinea Lynx Records
On this forum, sterile IC enquiries have by far overtaken UTI ones because more guinea pigs are now being kept indoors. Like in cats, sterile cystitis seems to affect particularly individuals with a very stress level as their default setting. Due to the worldwide mass breeding of pets whether that is commercial pet shop supply breeders or private for sale breeders, this has unfortunately become a lot more common over the last decade.
As to ovarian cysts: they are best found by scan. Balding sides and symptoms that resemble a nonstop season are a very strong pointer towards relatively small but growing hormonal cysts; which seem to be more common typically around ages 2-4. The most common variant of ovarian cysts are the large fluid-filled non-hormonal ones that can grow rather large and cause problems because of pushing on other organs especially in older sows of 4 years plus.
You can find more information on ovarian cysts and possible treatments in this guide here: Sows: Behaviour and female health problems (including ovarian cysts)

Cystitis and ovarian cysts are unrelated health issues.

I hope that this helps you?
 
I will definitely look into this and mention to the vet! Sadly this vet has replaced my amazing exotic vet who retired. She is just learning about piggies. She had one appointment with Buttercup along side the old vet before she left.

IC...they are seeing bacteria in the urinalysis. So could it still be that? There were times they were just checking the urine for calcium crystals and saw the infection without Buttercup showing symptoms.

Glucosamine. We are big fans of the stuff here. Can I get cat version over the counter? Would it be harmful to try it without a diagnosis?
 
Wiebke said:
Hi!

Have your vets considered that your piggy may have a sterile (i.e. non-bacterial) interstitial (i.e. recurring) cystitis? This cystitis cannot be healed by antibiotics. In its milder form, antibiotics can temporarily suppress it while in the more severe form, it won't respond to them at all.
Sterile IC has become a lot more common in guinea pigs over the last decade but is not well known outside vet circles that do not deal with guinea pigs on a very regular basis.

Sterile IC can only be managed but not healed; it can eventually disappear on its own but you are looking more at years than months.
Key to treatment is glucosamine (which is not a medication but classed as a food supplement) to support the affected natural glucosamine coating of the walls of the urinary tract that prevents the corrosive urine from coming into painful contact with raw tissue plus an analgesic especially during the regular flares. This treatment follows Feline Sterile Cystitis since cats are the other species that seems to increasingly suffer from the same problem.
We recommend for milder cases a glucosamine based cat bladder supplement in capsule form (easiest for dosage - dissolve the powder in the capsules in 2 ml of water, always shake well before use and either give 1 ml every 12 hours or 2 ml every 24 hours. In a bad flare you can give 1 capsule every 12 hours; I am doing this with my own persistent IC piggy.
For severe cases, recent research in Europe has shown that cartrofen (a glucosamine based arthritis medication) does also work for guinea pigs but this is currently still being trialled by exotics vets in the UK on an ad-hoc basis, so a standard way has not yet been established.
Your vet may want to look into this. The good news is that sterile IC in its milder forms does not shorten the life expectancy or cause bladders stones although we recommend to switch to a lower (but NOT calcium-free) diet.
My Nerys, the large piggy in my avatar had sterile IC for 3 years and then lived free of any urinary tract problems for another 3 years before dying at the respectable age of 8 years in 2016 from age related issues.

Our diet guide contains some tips which foods you may want to leave out of an IC diet in addition of filtering water and not feeding more than 1 tablespoon of pellets: Long Term Balanced General And Special Needs Guinea Pig Diets (see chapter special needs diets)
Here is some information on IC: Links - Interstitial Cystitis - Guinea Lynx Records

As to ovarian cysts: they are best found by scan. Balding sides and symptoms that resemble a nonstop season are a very strong pointer towards relatively small but growing hormonal cysts; which seem to be more common typically around ages 2-4. The most common variant of ovarian cysts are the large fluid-filled non-hormonal ones that can grow rather large and cause problems because of pushing on other organs especially in older sows of 4 years plus.
You can find more information on ovarian cysts and possible treatments in this guide here: Sows: Behaviour and female health problems (including ovarian cysts)

Cystitis and ovarian cysts are unrelated health issues.

I hope that this helps you?
Click to expand...

Regarding diet. We do filtered water, NO parsley, daily cucumber, cilantro (coriander) peppers, occasional carrot, green and red lettuce, just a "sprinkle" of pellets scattered around the cage for them to forage for 2x a day, equalling no more than 1tbs.
 
Scooter Pie said:
Regarding diet. We do filtered water, NO parsley, daily cucumber, cilantro (coriander) peppers, occasional carrot, green and red lettuce, just a "sprinkle" of pellets scattered around the cage for them to forage for 2x a day, equalling no more than 1tbs.
Click to expand...

Thank you for clearing up that point. Please accept that we want to make sure with everybody with recurring urinary tract issue since this

Unlike bladder stones where the wrong diet can be a contributor to the formation of stones (although there are usually other contributing factors beyond ou control), diet does NOT cause or contribute to sterile IC but dietary changes can sometimes cause a flare in some guinea pigs and the alkalinity of the urine or calcium levels seem to swing a bit, especially just before a flare ('unprovoked' calcium pees can be more common for a few days beforehand) so it is best to check the diet. Unlike other posters we see over the same problem, you are clued up; which makes a nice change. ;)
 
Scooter Pie said:
I will definitely look into this and mention to the vet! Sadly this vet has replaced my amazing exotic vet who retired. She is just learning about piggies. She had one appointment with Buttercup along side the old vet before she left.

IC...they are seeing bacteria in the urinalysis. So could it still be that? There were times they were just checking the urine for calcium crystals and saw the infection without Buttercup showing symptoms.

Glucosamine. We are big fans of the stuff here. Can I get cat version over the counter? Would it be harmful to try it without a diagnosis?
Click to expand...

You should be able to find the cat version either over the counter or via online order. Glucosamine is helpful with any urinary tract issue but it it takes several weeks to build up. It is classed as a food supplement. If you have concerns, please discuss them with your vet. What a pity that you have lost your old vet! :(

It depends on the bacteria levels; bacteria can still be present in smaller quantities in an IC (most piggies have some faecal bacteria in their bladder due to the scent gland being located just in front of the genitial, so the bum is wiped on the ground regularly by both genders) . If you have higher levels, then you could be dealing with a UTI that has not been treated for long enough. Sometimes it can take at least 3-4 weeks of treatment or longer to get on top of bacterial UTI or cystitis. IC is usually diagnosed by default after any other potential issue has been excluded rather than positively to be honest.
 
Sadly we've been doing long courses of abx. After 10 days of smz, then a course of baytril, original vet consulted with a specialist and we did 6 weeks of SMZ...and at that time added the potassium citrate and hydrochlorothiazide. The latter two helped her crystals and sludge very much. But after less than 3 weeks infection returned. So back on them for 4 weeks.

And now it's back again after a month off.

The bactertia was a common one, from fecal matter.

I try to keep her cage really clean. I sweep poop 2-3x a day, change absorbant cushions where they sleep the most every 1-2 days, and entire fleece floor is changed once a week.
 
Does anyone know about Metacam (I believe it's "dog" because there's sticker on the bottle that says do not use on cats). I have some leftover from ? At the very most it's from a year ago or much shorter. Would it be harmful to give? I know they will dispense more tomorrow.

As usual, pee is alternating between nice and clear (gave her a big piece of cuke today and the watery white ribs of lettuce) and finding drops of pink around. Last time I saw her go it was clear and a lot of it...but at the end she definitely raised her butt up a few times :(
 
These symptoms - porphyrine coloured pees alternating with clear ones (either may or may not test for the presence of blood, by the way, as urine can carry quite a lot of blood while still clear; I've got all possible t-shirts on that aspect by now) - are also typical for the onset of an IC flare. I would recommend to discuss the possibility of a sterile recurring cystitis at the bottom of it all and the advisability of starting glucosamine in order cover that angle; it won't interfere with any other medication so your vet can still prescribe another round of antibiotics if they feel happier with it.

Metacam and any other medication should not be used past 6 months of the date on it. If your girl is seeing the vet tomorrow, she should keep until then. Symptoms are only at the very start yet.
 
I can't thank you enough. Glucosamine sounds promising. Unfortunately I'm not sure the new vet will have a lot of info, but hopefully she can learn fast.

I dont want to get into a "dont ask, dont tell" situation. If she doesnt know a lot about this, she may advise against glucosamine...but hopefully it's in the "dont know if it will help but can't hurt" food suppliment category.

Her little buddy is staying close by. She's fluffy today but eating/begging/asserting dominance is all normal level. FCF9E6F1-9168-436E-B66E-0682CE27A8F6.webp
 
Glucosamine is in that category; you may mention that treatment is similar to FSC (feline sterile cystitis), which she may have come across before. ;)
 
Update. Large amount of white cells in urine sample, sending out culture, back on antibiotics and metacam...and the verdict is in on the fur loss.

Large ovarian cysts, one side bigger than her bladder :( Waiting to schedule drain and lupron injection within the next week or so.

Spay really isn't going to be an option for her.

I mentioned the glucosamine and she didn't know the guinea pig dosage. Hopefully she'll look into it for me, and I'm going to see what more I can find here.

Now on to read more about cysts!
 
Scooter Pie said:
Update. Large amount of white cells in urine sample, sending out culture, back on antibiotics and metacam...and the verdict is in on the fur loss.

Large ovarian cysts, one side bigger than her bladder :( Waiting to schedule drain and lupron injection within the next week or so.

Spay really isn't going to be an option for her.

I mentioned the glucosamine and she didn't know the guinea pig dosage. Hopefully she'll look into it for me, and I'm going to see what more I can find here.

Now on to read more about cysts!
Click to expand...

The usual glucosamine dose on here is the contents of one cat cystease capsule per day.

All the best - it looks like an infection. All the best with the cysts.
 
Wiebke said:
The usual glucosamine dose on here is the contents of one cat cystease capsule per day.

All the best - it looks like an infection. All the best with the cysts.
Click to expand...
Thanks.

Sounds like the glucosamine could help keep her more comfortable, even though it's caused by an infection. Might still try it.
 
Scooter Pie said:
Thanks.

Sounds like the glucosamine could help keep her more comfortable, even though it's caused by an infection. Might still try it.
Click to expand...

Like an exotics vet specialising in guinea pigs told me once, glucosamine was never amiss with any urinary tract problem, whether it was infection or a stone; it is like an extra coat of protective paint on a scratched and flaky iron spike to prevent it from rusting. ;)
 
I just realized something.

This fall, Buttercup had a cystocentisis to get a sterile urine sample, for her UTI/crystals/sludge issue.

The vet called me a few hours later and wanted to get a new sample, because the sample the lab had was "totally different than what her urine usually looks like, way too clear" and they redid it, noting the new sample looked right and they must have drawn some fluid from her abdomen the first time.

Now I have to wonder if they actually drained a cyst at that time. If they saw a dark circle on the ultrasound and mistook it for her bladder.

And at another appointment not long after that, when I was asking about cysts because of her crusty nipples and constant season, the vet didnt feel anything, and she had not yet lost fur so she said no (but did say if it ever did show up we'd do drain and lupron as her spays didn't have good outcomes).

Thinking out loud here.
 
Update.

Calling the vet today, Buttercup is showing signs of blood in her urine again despite being on antibiotics for close to 4 weeks again.

Same antibiotic (SMZ TMP) she's been on for the better part of 7 months now. 4-6 weeks on, off for 3-4 weeks before it returns again.

I guess this is the point where they stop working. Baytril was tried once a while back with no success.

She has been taking a glucosamine suppliment since her lupron injection 2 weeks ago. At the time they tried to drain ovarian cysts with not much success without sedation.

Sigh.
 
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