Specialist Sow with bladder stone in urethra - any experience

[Tangle]

So Jemima hasn't been a happy pig for a while and we've had various trips to the vets and explored various avenues. She had some dental work done in January and that seemed to help on one front, but she's been passing blood in her urine for a few weeks which we've been treating as cystitis. She's had some ups and downs but been fairly stable - until yesterday when she was clearly in quite some discomfort while trying to urinate so I rang the vets and took her in yesterday afternoon.

They've X-Rayed her this am and found she has a stone that has entered her urethra and apparently she hasn't managed to pass any urine at all yet today. They'll carry on observing, but clearly if she can't pass anything then its a critical situation.

While she was anaesthetised they took bloods, as they wanted to have some insight into her kidney function. If the results of that suggest kidney problems then there's really only one possibility, I think

Has anyone had a pig with a stone in the urethra and have them come through it? From what the vet said she hasn't given up hope, but she was also (understandably) extremely cautious in her prognosis. I'm catastrophising while I wait - any shared experience, or suggestions re. questions I should ask later gratefully received!

 

[Eriathwen]

My experience with a stone in the urethra isn't usual, in that it was lodged quite near the exit. The vet I took her to told me it wasn't a stone, but a cyst or scar tissue, I had to go to a vet I don't usually use as everywhere was closing for Christmas. So off I went with some painkillers and antibiotics 'just in case'
Next day she was in agony, I had to help her manouver the stone out myself and yeah.. it wasn't an experience I ever want to repeat, it was incredibly painful for her, but I was concerned she wouldn't have made it to our out of hours vet which is quite a distance away, we got the stone out and she did wonderfully after, she was almost back to normal immediately.

Usually they can try to move or flush them out the exit under aneasthetic, or break them up a little to help them pass, if they're near the exit. Another option if the piggy is a good candidate for surgery is to flush the stone back up into the bladder to remove via a normal cystotomy, as the stone has become adhered to the lining of the urethra.

 

[furryfriends (TEAS)]

If the stone is near the exit, then it should be able to be manoeuvred out and if closer to the bladder, it is possible to flush it back into the bladder and then remove from there.

 

[Wiebke]

So Jemima hasn't been a happy pig for a while and we've had various trips to the vets and explored various avenues. She had some dental work done in January and that seemed to help on one front, but she's been passing blood in her urine for a few weeks which we've been treating as cystitis. She's had some ups and downs but been fairly stable - until yesterday when she was clearly in quite some discomfort while trying to urinate so I rang the vets and took her in yesterday afternoon.

They've X-Rayed her this am and found she has a stone that has entered her urethra and apparently she hasn't managed to pass any urine at all yet today. They'll carry on observing, but clearly if she can't pass anything then its a critical situation.

While she was anaesthetised they took bloods, as they wanted to have some insight into her kidney function. If the results of that suggest kidney problems then there's really only one possibility, I think

Has anyone had a pig with a stone in the urethra and have them come through it? From what the vet said she hasn't given up hope, but she was also (understandably) extremely cautious in her prognosis. I'm catastrophising while I wait - any shared experience, or suggestions re. questions I should ask later gratefully received!

Hi!

BIG HUGS

I am every sorry that this has happened to Jemima!

If your piggy of any gender has got a stone blocking the urine flow, then the only option is a make-or-break emergency operation, unfortunately. If done promptly before the urine can back up into the kidneys, it can be life-saving. Once the kidneys are impacted then there is sadly only one outcome. It is one of those between a rock and a hard place scenarios that we all dread.

In sows the stone mostly fetches up just before the opening and can usually be removed quite easily just by manipulating out or with a small incision. Because of the relative short and straight urethra many stones are simple passed naturally. I have had about three urethral sow stones removed like that without a full operation but none of them was blocking the urine flow.
Jemima's stone must be sitting further back or be too large if your vets haven't considered this. If it is sitting just outside the bladder, your vets could try to flush it gently back in for a much easier operation.

Boars have a longer, narrower urethra with an akward inglenook where passing stones usually fetch up and can block the urethra. A urethral blockage is therefore a much more common problem in boars than in sows; we see several cases of it every year. It is always a race against time when a blockage happens.

I am keeping my fingers VERY firmly crossed for Jemima!

 

[Tangle]

OK - so they've emptied her bladder for her and she's much happier about life, at least for the moment! We're going to go over later and talk through options. I'm not clear at the moment exactly where the stone is or why it can't be moved either one way or the other, but hopefully we'll get some clarity later . They seem quite reluctant to do surgery, even if they can get it back into her bladder, and I'd like to understand why.

Initial blood results suggest her kidneys are absolutely fine, so that's some good news

Thank you for all your feedback and good wishes

 

[piggieminder]

Pleased to hear she is more comfortable.

 

[Wiebke]

OK - so they've emptied her bladder for her and she's much happier about life, at least for the moment! We're going to go over later and talk through options. I'm not clear at the moment exactly where the stone is or why it can't be moved either one way or the other, but hopefully we'll get some clarity later . They seem quite reluctant to do surgery, even if they can get it back into her bladder, and I'd like to understand why.

Initial blood results suggest her kidneys are absolutely fine, so that's some good news

Thank you for all your feedback and good wishes

Good that she is MUCH more comfortable and out of immediate danger, and that the kindeys have not been damaged!
You will know more once you know what is exactly going on and what your options are.

But it sounds so much more positive for Jemima now!

 

[Tangle]

Hmm. So she’s still not urinating by herself, and she’s a very sad piggy

Apparently their current view, and they say there’s research to support it, is that if they invite the bladder there’sa very high chance that the stitches will nuclear more stones - hence the reluctance to operate.

Assuming she doesn’t deteriorate in the night, the plan is to see if the stone has moved in the morning, and then decide what to do. Options include medication to dissolve the stone (if it can be got back into her bladder), surgery or euthanasia. It’s going to be a tough day.

 

[Tangle]

Having cuddles

 

[Wiebke]

HUGS

I am so sorry that things are so difficult for your poorly girl and you!

A medical approach to dissolve the stone is not possible unfortunately. I am keeping my fingers crossed for tomorrow!

@Abi_nurse @furryfriends (TEAS)

 

[furryfriends (TEAS)]

I’m no expert, but none of this is sounding right to me. I can't see why they can't try to flush the stone back into the bladder, so it can be removed. I'm pretty sure there is no medication to dissolve the stone and surgical removal would be the only way to get it out. My worry is, your girl will be deteriorating all the time and unless something is done soon, she will be too poorly for surgery.

I am so sorry you are in this position. I really hope that something can be done for your girl xx

 

[Tangle]

I’m no expert, but none of this is sounding right to me. I can't see why they can't try to flush the stone back into the bladder, so it can be removed. I'm pretty sure there is no medication to dissolve the stone and surgical removal would be the only way to get it out. My worry is, your girl will be deteriorating all the time and unless something is done soon, she will be too poorly for surgery.

I am so sorry you are in this position. I really hope that something can be done for your girl xx

Thanks for this .

The good news is that the stone seems to have relocated itself back into her bladder and she passed lots of urine all by her own self last night .

We share your concerns, though, and have a long list of questions to ask. We use vets who do have a specialist exotics team and a lot of experience with guinea pigs. They've been consistent in saying they are now reluctant to remove stones surgically as they find they come back so quickly (more quickly than they originally formed), but we don't feel like we fully understand what they're suggesting instead - so we've asked them to call us back and have a list of questions to run through with them.

Fingers still firmly crossed...

 

[furryfriends (TEAS)]

Thanks for this .

The good news is that the stone seems to have relocated itself back into her bladder and she passed lots of urine all by her own self last night .

We share your concerns, though, and have a long list of questions to ask. We use vets who do have a specialist exotics team and a lot of experience with guinea pigs. They've been consistent in saying they are now reluctant to remove stones surgically as they find they come back so quickly (more quickly than they originally formed), but we don't feel like we fully understand what they're suggesting instead - so we've asked them to call us back and have a list of questions to run through with them.

Fingers still firmly crossed...

Is this where John Chitty works? I know he's got very strong views about why bladder issues occur and about the treatment of!

 

[furryfriends (TEAS)]

Is this where John Chitty works? I know he's got very strong views about why bladder issues occur and about the treatment of!

I've just googled and yes it is. I know he's done webinars about guinea pigs and bladder issues, resulting in stones. I haven't seen any of these webinars but I've heard that he thinks that they are often caused by stress and that he rarely prescribes antibiotics now for bladder issues. He seems to think that a lot of the problems are to do with the way we keep guinea pigs nowadays.

 

[KathT]

I was lucky with my sow when she had a stone stuck in her urethra. I took her to Ellie Whitehead who x-rayed to diagnose the stone but luckily it was close to coming out, so once Mya was under she just had to manipulate it out. A few days of pain meds and she was back to normal. I hope your piggie gets sorted soon.

 

[Tangle]

I've just googled and yes it is. I know he's done webinars about guinea pigs and bladder issues, resulting in stones. I haven't seen any of these webinars but I've heard that he thinks that they are often caused by stress and that he rarely prescribes antibiotics now for bladder issues. He seems to think that a lot of the problems are to do with the way we keep guinea pigs nowadays.

Yes, it is. I guess the crux of our conflict is that whilst we can see the logic that surgery can cause issues and more sympathetic living conditions can help manage a chronic condition, we don't entirely understand how that deals with the acute situation we're in right now! Hoping we can get hold of him and get some answers.

Ach! Why do we have to stumble into a contentious area of veterinary medicine? Things were complicated enough already...

 

[furryfriends (TEAS)]

Yes, it is. I guess the crux of our conflict is that whilst we can see the logic that surgery can cause issues and more sympathetic living conditions can help manage a chronic condition, we don't entirely understand how that deals with the acute situation we're in right now! Hoping we can get hold of him and get some answers.

Ach! Why do we have to stumble into a contentious area of veterinary medicine? Things were complicated enough already...

I would sit down and have a conversation with him. As an owner you have the right to access the treatment your pet needs. I wish you were closer as Simon carries out this type of surgery frequently, with very good results.

 

[furryfriends (TEAS)]

How are things?

I had a chat with Simon yesterday about bladder stone removal and the chances of recurrence and he said that some do recur, but many don't. He said that since he's been advising to feed a wetter diet, less handling of the piggies, encouraging them to move around more and also prescribing a diuretic, the recurrence has reduced even more.

 

[Tangle]

Thanks for asking . We had a morning running around trying to make sure we had everything we need for the weekend so we (hopefully) don't have to run out in the storm.

She's doing OK. She's back home with an assortment of drugs , seems to be able to relax and is passing urine and is taking an interest in her surroundings (although she's not got much of an appetite right now so we're giving her critical care as well). They believe that with patience, support and a bit of time she will be able to pass the stone and be back to normal.

It turns out we'd misunderstood and whilst the stone had moved, it had carried on down rather than back up. If they'd offered surgery when we first went in we'd probably have gone down that road, but they didn't and we're now in a different place. We all know that surgery is never a risk free option, and I do think that to try it now would be higher risk - and we can't turn back the clock. We went to an approved vet, have taken their advice and are now doing the best we can to support Jemima on that basis. As it would have been with any choice, we're just crossing all available digits that it works out the way we hope.