Sow red blood bleeding

[ceciliaxdee]

Hi there
Unfortunately my nearly 3 year old piggie who has chronic cystitis (been lab tested and pee is sterile) has had an episode of bleeding an amount of bright red (frank) blood in the last two weeks. It was a one of episode and hasn’t happened again after that day however she has had smaller spots of bleeding on and off for a year (which we put down to the cystitis).
I took her into emergency but they could not figure out what was wrong. However this type of bleeding isn’t usual for cystitis. They said they believe this type of blood could either be 1) she passed a bladder stone 2) there’s something going on with her uterus.

My piggie was spayed by having her ovaries removed in March this year and she has had chronic interstitial cystitis for a year. One of her cage mates also passed in July, and since then her gut has been upset (I’ve tried everything poo test, poo soup, probiotics, antibiotics, gut protectant, gut stimulant). It has gotten a bit better eg solid seperate poos but not 100% and can turn mushy if she has a bad day. Along with the funky gassy gut, she’s also lost a bit of weight (~50g).

We have done numerous ultrasounds over the past year without anything strange being picked up. The last ultrasound was last month. About 2-3 weeks before the bleed. She also had a blood test then and it came back normal.

The vet is suggesting removal of her uterus. I am a bit worried about having a surgery if unnecessary because she’s had a bad gut and also the chronic cystitis issues. Has anyone else had similar intermittent red blood in their Guinea pigs and what was it? Or any experiences on removal of uterus?

Thanks

 

[VickiA]

If your vet is confident that the bleeding is coming from the uterus and not the bladder/urinary tract then removal of the uterus may be the way to go. I’ve had 2 sows spayed with full uterus removal - one for pyometra and one for persistent bleeding. Both did well, but it’s a much more invasive procedure than the oophorectomy and they need TLC and support feeding for longer. She’s still a good age (in the prime of her life) so you’d expect her to make a full recovery.

If your vet is not confident that the bleeding is from the uterus and that she may have passed a bladder stone, have they re- checked their scans from before the bleed to see if there was any evidence of sludge or a stone at that time?

If in doubt you could ask for a second opinion and adopt a wait and see approach while you’re waiting.

 

[ceciliaxdee]

If your vet is confident that the bleeding is coming from the uterus and not the bladder/urinary tract then removal of the uterus may be the way to go. I’ve had 2 sows spayed with full uterus removal - one for pyometra and one for persistent bleeding. Both did well, but it’s a much more invasive procedure than the oophorectomy and they need TLC and support feeding for longer. She’s still a good age (in the prime of her life) so you’d expect her to make a full recovery.

If your vet is not confident that the bleeding is from the uterus and that she may have passed a bladder stone, have they re- checked their scans from before the bleed to see if there was any evidence of sludge or a stone at that time?

If in doubt you could ask for a second opinion and adopt a wait and see approach while you’re waiting.

Thanks so much for your response. She’s seen three vets since the recent bleed episode, the emergency exotic vet, her long term exotic vet, a new exotic vet.
Unfortunately none of them are 100% confident. They all think either bladder or uterus however her long term exotic vet suggested a CT scan under anaesthesia first while the new exotic vet said she doesn’t believe a CT scan will provide anymore answers as if it was a bladder stone it’s already passed or will show that they need to go into uterus (she also flagged that here in Australia, CT scans are very expensive - actually more than the surgery and it may be a waste of money).
As either way she will need to go under anaesthesia she believes surgery will be the best option as when she goes in she can also see the bladder while removing uterus and look around. Her gut feeling is uterus with the intermittent bleeding pattern. They’ve checked the scan but all said that Guinea pigs have a lot of gas which can hide many things on scans. She also gave me the wait and see option but said if it is in the uterus it may be riskier to wait than remove the uterus. I also have a picture of a blood clot looking thing she passed 1-2 months ago (again once off then nothing). I’m just so worried about my lil potato as this is the largest amount of red blood passed I’ve seen from any of the issues my pigs have had (I have another sow with intermittent bleeding also which resolved but nowhere near this much blood).
Would sterile cystitis and sludge cause bleeding this bad?

 

[VickiA]

It’s a tough call, but your vet does sound to have considered everything first. Only you can make the decision whether or not to proceed. When I had bleeding issues like this with one of my sows we did proceed to full spay and the vet did (as yours is suggesting) have a good look at all the structures and was satisfied that the bladder looked ok. Sometimes it’s only with performing the surgery that the vet can be sure. You sound like a very caring owner and any decision you make will be made with her best interests in mind.

 

[ceciliaxdee]

It’s a tough call, but your vet does sound to have considered everything first. Only you can make the decision whether or not to proceed. When I had bleeding issues like this with one of my sows we did proceed to full spay and the vet did (as yours is suggesting) have a good look at all the structures and was satisfied that the bladder looked ok. Sometimes it’s only with performing the surgery that the vet can be sure. You sound like a very caring owner and any decision you make will be made with her best interests in mind.

Thanks - she’s booked in for surgery on Tuesday. That’s my vet is planning to do also. She said since she’s already had the ovaries removed, it’ll just be the uterus this time and she can also take a good look. Did you do any scans before you did the full spay and did anything show up?

 

[VickiA]

Thanks - she’s booked in for surgery on Tuesday. That’s my vet is planning to do also. She said since she’s already had the ovaries removed, it’ll just be the uterus this time and she can also take a good look. Did you do any scans before you did the full spay and did anything show up?

The sow in question had episodic bleeding. X-ray and an ultrasound scan showed nothing and she didn’t respond to antibiotics (in case of infection) As the bleeding continued she had a full spay. And afterwards no further bleeding, so it was the right choice. But it’s always a bit difficult making that decision when you aren’t 100% sure. I was fearful that some hidden mass or problem may materialise during the surgery but that fear was unfounded in this case. I hope that all goes well on Tuesday with the surgery. It’s always a very anxious time.

 

[ceciliaxdee]

The sow in question had episodic bleeding. X-ray and an ultrasound scan showed nothing and she didn’t respond to antibiotics (in case of infection) As the bleeding continued she had a full spay. And afterwards no further bleeding, so it was the right choice. But it’s always a bit difficult making that decision when you aren’t 100% sure. I was fearful that some hidden mass or problem may materialise during the surgery but that fear was unfounded in this case. I hope that all goes well on Tuesday with the surgery. It’s always a very anxious time.

Thank you, my sow’s case is similar with the episodic bleeding. Nothing has shown up in scans or blood tests and she’s also very bloated and has had the sterile cystitis so I wonder if it is all connected to the uterus. Did you seperate your sow from cage mates and how did you find the healing from the wound where they removed the uterus?

 

[VickiA]

Thank you, my sow’s case is similar with the episodic bleeding. Nothing has shown up in scans or blood tests and she’s also very bloated and has had the sterile cystitis so I wonder if it is all connected to the uterus. Did you seperate your sow from cage mates and how did you find the healing from the wound where they removed the uterus?

No - I didn’t separate her. I think they do better with the support of their friends. A friend went with her for the day of surgery to keep her company and when they came home they went back in with their friends (my herd live indoors). I just made sure she had a nice comfy bed to rest in and took her out for meds and syringe top up feeding and then put her back in again. She recovered very well. I was expecting to need to syringe feed her for several days but from memory she refused the syringe after about 24 hours. One of my other sows who was spayed for pyometra did need longer support feeding, though.

 

[ceciliaxdee]

No - I didn’t separate her. I think they do better with the support of their friends. A friend went with her for the day of surgery to keep her company and when they came home they went back in with their friends (my herd live indoors). I just made sure she had a nice comfy bed to rest in and took her out for meds and syringe top up feeding and then put her back in again. She recovered very well. I was expecting to need to syringe feed her for several days but from memory she refused the syringe after about 24 hours. One of my other sows who was spayed for pyometra did need longer support feeding, though.

She made it through the surgery today and the vet did not find anything strange with her uterus that she could see with her eyes however the bladder is thickened (not massively but it is) so confirmation of her chronic cystitis, they couldn’t feel any stones either. Hopefully that will be the last of the bleeding.
She’s eating so far by herself but not moving much. She went in with a friend too and currently I’ve made a smaller section of the cage for the two of them while she heals. Wondering if I should just open it up to the whole herd though (I have 6 including her) and an L shape 2x11 c&c cage.

 

[VickiA]

So pleased to hear that she is back home again. I would probably give her a syringe feed to make sure she is getting enough nutrition. As for whether to keep her and her cage mate separate for a little longer - that really depends on your herd. You know them best. If she's likely to be picked on or bossed around by a rather dominant sow, then that is one consideration. Another is that the longer they are separated, then you may have to consider an introduction on neutral territory again. Personally I don't tend to separate mine any longer than overnight of the day of surgery so that this doesn't become a reintroduction issue. Just make sure she has a comfy bed, food, hay and water all close by and keep an eye on the dynamics.

 

[ceciliaxdee]

So pleased to hear that she is back home again. I would probably give her a syringe feed to make sure she is getting enough nutrition. As for whether to keep her and her cage mate separate for a little longer - that really depends on your herd. You know them best. If she's likely to be picked on or bossed around by a rather dominant sow, then that is one consideration. Another is that the longer they are separated, then you may have to consider an introduction on neutral territory again. Personally I don't tend to separate mine any longer than overnight of the day of surgery so that this doesn't become a reintroduction issue. Just make sure she has a comfy bed, food, hay and water all close by and keep an eye on the dynamics.

Thanks so much! I’m actually friends with the vet nurse at the clinic she went to and they gave lots of critical care post surgery. I went to feed her last night but she was already up and eating herself. I gave heaps of veggies as soon as she got home and she also gobbled that all up. I’ll do a critical care feed tonight though just to top up.
Do I need to worry about wound infection and keeping cage super clean as it’s on the abdomen close to floor? I am cleaning her section very often but just thinking with the larger cage it gets dirty quicker with another 4 piggies poops.
I am worried about the reintroduction issues if separated for too long as they have been living in harmony for a while! But one of my other sows is super dominant so don’t want the whole bullying thing again when introducing back if their bond is broken.
Here is a picture of my piggie this morning eating her veggies (the grey one is the one who had the surgery).