Red urine

[Lazw]

Hi all, my lovely 2 year old sow bramble was crying when she urinated last week so I took her straight to the vets. She's on cotrinoxazole and metacam and has been for 8 days now- 10 day course of the antibiotics has been prescribed. Our vet is very piggy savvy and noticed she was very uncomfortable in her bladder and had swolled glands. Her urine test stick indicated blood and protein. Home tests are showing a decreased amount of protein now but more blood.

Yesterday evening I noticed her wee is very red at times, it looks like blood- but she is intermittently passing urine with no red or pink tinge, this morning it was almost clear but now we're back to drops of deep red.

She's passing small amounts frequently which is unfortunately a common occurrence for us-for background she has been diagnosed with interstitial cystitis and has been on cartrophen injections for around 4 months now which has helped.

She's spayed and has been for well over a year, so it's not a reproductive issue. I have contacted the vet and I'm awaiting a response from them. She's otherwise her usual self, eating, maintaining weight and bobbing around as usual. She's also no longer crying when she weesso there obviously was an infection there. I'm so confused, what could this blood be? I'm hoping to get her in at the vet on Monday once I hear back, does this sound OK to do given its blood? I'd rather wait to hear from our good cavy savvy vet than take her elsewhere tomorrow just to get her seen sooner, if they're going to make things worse for her.
Just looking for general advice/experience really given she's otherwise fine on the outside!

 

[Free Ranger]

Poor little Bramble - the health experts will be with you shortly. Could I just ask why she was spayed... was there a different problem?

If she has also been diagnosed with sterile IC in the past how did your vet decide to treat with antibiotics this time? I don't know what the protein indicates... I've not had an SIC piggy before. I guess an SIC piggy can get a UTI just like anyone else.

When we've had bacterial cystitis and been prescribed antibiotics we have usually seen a marked improvement within a day or two (although we always complete the course). The AB starts to work straight away but needs time to knock down the numbers of bacterial so the body can start to recover. On one occasion there was no difference after 3 days and I reported back to the vet who changed the AB straight off to a second one - which behaved more as expected. Did you see any improvement between 1 and 3 days of starting your course?

The next step for my non-SIC pigs would be x-ray to check for the presence of stones/bladder sludge. When we've found stones we have usually been being treated for UTI anyway, it's not an either/or thing. Stones can make UTI more likely and can continue to prevent the bladder healing after. Sometimes they've been wedged in the urethra in the girls and have been able to be passed or extracted manually. It will be important to rule out a stone. Check that she is still able to pass urine - if you turn her over (which she won't like) and look at her tummy just 'above' her bits this is about where the bladder is. It should feel soft, not like a hard bulge of a blocked bladder. Be gentle as she's probably very tender. If she's not peeing and there's a swollen lump like a conker she may have a blockage and this would be urgent enough not to wait till Monday. Otherwise it's pain control.

How much metacam were you prescribed and what is the concentration? And how often do you give it?

 

[Lazw]

Poor little Bramble - the health experts will be with you shortly. Could I just ask why she was spayed... was there a different problem?

If she has also been diagnosed with sterile IC in the past how did your vet decide to treat with antibiotics this time? I don't know what the protein indicates... I've not had an SIC piggy before. I guess an SIC piggy can get a UTI just like anyone else.

When we've had bacterial cystitis and been prescribed antibiotics we have usually seen a marked improvement within a day or two (although we always complete the course). The AB starts to work straight away but needs time to knock down the numbers of bacterial so the body can start to recover. On one occasion there was no difference after 3 days and I reported back to the vet who changed the AB straight off to a second one - which behaved more as expected. Did you see any improvement between 1 and 3 days of starting your course?

The next step for my non-SIC pigs would be x-ray to check for the presence of stones/bladder sludge. When we've found stones we have usually been being treated for UTI anyway, it's not an either/or thing. Stones can make UTI more likely and can continue to prevent the bladder healing after. Sometimes they've been wedged in the urethra in the girls and have been able to be passed or extracted manually. It will be important to rule out a stone. Check that she is still able to pass urine - if you turn her over (which she won't like) and look at her tummy just 'above' her bits this is about where the bladder is. It should feel soft, not like a hard bulge of a blocked bladder. Be gentle as she's probably very tender. If she's not peeing and there's a swollen lump like a conker she may have a blockage and this would be urgent enough not to wait till Monday. Otherwise it's pain control.

How much metacam were you prescribed and what is the concentration? And how often do you give it?

Thank you so much for your detailed response.

Bramble was spayed due to increasingly "hormonal" behaviour with her friend Holly and the presence of ovarian cysts on both sides. This was about 12-13 months ago when she was quite young-the vet was surprised that she had developed the cysts at such a young age!

She's being treated for uti due to the swollen glands, pain whilst peeing which hadn't been an issue since beginning on cartrophen injections, and pain in her bladder area. She did improve rapidly the first 2-3 days on the medication and the pain stopped within this time. She's not appearing to be in any pain now either which I'm at least thankful for, despite being very worried abort the red urine.

Thanks for the tip-I am going to give her medication shortly so I'll check the bladder area too for anything that feels hard.

She's on both metacam 0.4ml 2x daily and cotrimox 0.4ml 2x daily, she weighs a little over a Kilo.

 

[Free Ranger]

It's great her pain is under control. Is the metacam the 0.5mg/ml cat variety or the stronger 1.5mg/ml dog? I ask because I'm thinking if it's the former she might not actually have much pain bothering her, the latter would be more the sort of thing that my vet would give us for peeing pain. But whichever as long as it's working for you that's great. Has she lost much weight or is her eating OK?

Have a look at this info thread by @Wiebke for another poster asking about UTI and SIC pigs. Cystitis and UTIs
It mentions that initially the 'blood' seen can be porphyrins. I think I've seen that the red is more of a pinkish red although it would take a much more experienced eye than mine to tell the difference! But that the pee will still test positive for blood because the test is so sensitive.

I'd ask about an x-ray though. But I'd be wary of general anaesthetic which is stressful for any pig. Some vets can swaddle piggy firmly in a towel to get the shot. Some have posted pics of their x-rays and it is obvious that piggy is just sitting in a little box! Perhaps "a whiff of gas" might be suggested... just have a think about what Bramble can cope with.

 

[Lazw]

It's great her pain is under control. Is the metacam the 0.5mg/ml cat variety or the stronger 1.5mg/ml dog? I ask because I'm thinking if it's the former she might not actually have much pain bothering her, the latter would be more the sort of thing that my vet would give us for peeing pain. But whichever as long as it's working for you that's great. Has she lost much weight or is her eating OK?

Have a look at this info thread by @Wiebke for another poster asking about UTI and SIC pigs. Cystitis and UTIs
It mentions that initially the 'blood' seen can be porphyrins. I think I've seen that the red is more of a pinkish red although it would take a much more experienced eye than mine to tell the difference! But that the pee will still test positive for blood because the test is so sensitive.

I'd ask about an x-ray though. But I'd be wary of general anaesthetic which is stressful for any pig. Some vets can swaddle piggy firmly in a towel to get the shot. Some have posted pics of their x-rays and it is obvious that piggy is just sitting in a little box! Perhaps "a whiff of gas" might be suggested... just have a think about what Bramble can cope with.

I really appreciate your input on this-I worry about them so much when they're not OK!

It's the dog strength metacam she has, which she loves the taste of so it's made medicine time a lot easier thankfully!

I've just given her evening dose of both and had a good feel where you said-it's all lovely and soft and she didn't flinch once- in fact she started licking my hand at one point so she's definitely not in any pain. She's just done a big wee when I out her back which was bright red, however I've mopped it up with white tissue to have a good look and it is very pink under bright light..... I've never had this happen before so perhaps it could be poryphin as you suggested? What wouod cause this? I've attached a photo

 

[Free Ranger]

She's peed and she's currently not in pain - that's great. And your vet sounds very knowledgeable.

It does look a bit pinky-red but here we have reached the limits of my experience. Other than porphyrins being involved in SIC I know little else about them. But if it is porphyrin and not blood that might explain why she has no pain peeing despite the alarming colour. If they are a sign that an IC flare-up is coming just keep an eye on her for usual symptoms is all I can suggest. I have tagged in Wiebke above who knows a good deal about SIC but nobody really knows what causes it other than stress being a trigger. And apparently cats get it too - and some people - though possibly for different reasons. Some foods can be a trigger but I think this can be different for different piggies.

But I have seen many posters on here talk about supplementing their pigs with glucosamine to protect the battered bladders (Feliway cystease or 4joints are common types). I don't know what cartrophen is but it might be a similar sort of thing seeing as it helps both bladders and arthritis! All I can suggest is keeping an eye on her weight and on her eating/pooping. If she's behaving normally and doesn't seem to be struggling you'd be as well completing your treatment course, maintaining her pain relief, and waiting for your own vet (although it might be Tues if Mon is a bank holiday?) If there is a stone in there somewhere but it's not causing her any trouble I would think she's better seeing her own vet who knows her history. And if it turns out there isn't then so much the better! Keep on getting better little Bramble x
Have a good evening

 

[Lazw]

She's peed and she's currently not in pain - that's great. And your vet sounds very knowledgeable.

It does look a bit pinky-red but here we have reached the limits of my experience. Other than porphyrins being involved in SIC I know little else about them. But if it is porphyrin and not blood that might explain why she has no pain peeing despite the alarming colour. If they are a sign that an IC flare-up is coming just keep an eye on her for usual symptoms is all I can suggest. I have tagged in Wiebke above who knows a good deal about SIC but nobody really knows what causes it other than stress being a trigger. And apparently cats get it too - and some people - though possibly for different reasons. Some foods can be a trigger but I think this can be different for different piggies.

But I have seen many posters on here talk about supplementing their pigs with glucosamine to protect the battered bladders (Feliway cystease or 4joints are common types). I don't know what cartrophen is but it might be a similar sort of thing seeing as it helps both bladders and arthritis! All I can suggest is keeping an eye on her weight and on her eating/pooping. If she's behaving normally and doesn't seem to be struggling you'd be as well completing your treatment course, maintaining her pain relief, and waiting for your own vet (although it might be Tues if Mon is a bank holiday?) If there is a stone in there somewhere but it's not causing her any trouble I would think she's better seeing her own vet who knows her history. And if it turns out there isn't then so much the better! Keep on getting better little Bramble x
Have a good evening

Thanks so much for your help this evening I appreciate having someone to talk to about this! Yes you're right, it's good she doesn't appear to be in pain. I'll wait to see if anyone has any further info regarding poryphins and hope that this passes. The cartrophen as far as I'm aware, helps to rebuild the lining of the bladder which is why vet recommended it and it has made a difference. I'll defintiely keep an eye out for signs of a flare up of cystitis, and whilst she's not in pain and passing urine I think I'll hold on so we can see our normal vet next week

Once again thanks and have a lovely evening x