Sulfatrim dosage for cystitis

[Cazzledazzle]

Hello,

My poor piggy Star has been battling cystitis for some time. Each time the vet prescribes 0.17mls of Sulfatrim twice a day. Star weighs 978g. I’ve questioned my vet about the dose as it seems low to me and the cystitis keeps returning. Could someone shed some light on the dosage here: too low, too high, just right?

Thanks,
Catherine

 

[Wiebke]

Hello,

My poor piggy Star has been battling cystitis for some time. Each time the vet prescribes 0.17mls of Sulfatrim twice a day. Star weighs 978g. I’ve questioned my vet about the dose as it seems low to me and the cystitis keeps returning. Could someone shed some light on the dosage here: too low, too high, just right?

Thanks,
Catherine

Hi!
Please keep in mind that sulfatrim is same strength than adult septrin and double the strength that pediatric septrin. The standard dosage for a 1 kg piggy is about 0.25 ml.

However, if you are dealing with a persistently recurring cystitis that won't go away, you are more likely dealing with a sterile (i.e. non-bacterial) interstitial (recurring) cystitis rather than a bacterial cystitis. With a sterile cystitis, antibiotics can temporarily suppress the symptoms of a milder one but they cannot cure it. Sterile IC cannot be healed, only managed until it is going away on its own - which is usually more in the matter of years than months or even never.
Sterile cavy cystitis is not much known outside vet circles that see a lot of piggies but it has become increasingly common over the last decade; in fact, most cases of urinary tract infections we are contacted over turn out to be sterile IC, which seems to affect particularly the natural glucosamine lining of the urinary tract, which prevents the very corrosive urine from coming into contact with raw tissue. Since symptoms of all urinary tract issues are rather similar, most diagnoses of sterile IC happen by default after any other potential problem has been ruled out.

Treatment is with glucosamine (either oral in mild cases or via injection (cartrofen) in more severe cases); acute flares every few weeks/months are managed with upping the steady metacam maintenance dose. It will take a few weeks for the glucosamine to build up so it is not a quick fix. This approach follows the treatment of FSC (feline sterile cystitis), which is the other species that presents with a similar problem. Your vet may need to do some research digging on it if they have never come across it.
The good thing is that it is not a life-shortening illness (unless in the most severe cases, which you are not dealing with) and that it doesn't cause bladder stones.

Some more information:
Links - Interstitial Cystitis - Guinea Lynx Records
Long Term Balanced General And Special Needs Guinea Pig Diets (see chapter special diets)

I hope that this hels you?

 

[Cazzledazzle]

Hi!
Please keep in mind that sulfatrim is same strength than adult septrin and double the strength that pediatric septrin. The standard dosage for a 1 kg piggy is about 0.25 ml.

However, if you are dealing with a persistently recurring cystitis that won't go away, you are more likely dealing with a sterile (i.e. non-bacterial) interstitial (recurring) cystitis rather than a bacterial cystitis. With a sterile cystitis, antibiotics can temporarily suppress the symptoms of a milder one but they cannot cure it. Sterile IC cannot be healed, only managed until it is going away on its own - which is usually more in the matter of years than months or even never.
Sterile cavy cystitis is not much known outside vet circles that see a lot of piggies but it has become increasingly common over the last decade; in fact, most cases of urinary tract infections we are contacted over turn out to be sterile IC, which seems to affect particularly the natural glucosamine lining of the urinary tract, which prevents the very corrosive urine from coming into contact with raw tissue. Since symptoms of all urinary tract issues are rather similar, most diagnoses of sterile IC happen by default after any other potential problem has been ruled out.

Treatment is with glucosamine (either oral in mild cases or via injection (cartrofen) in more severe cases); acute flares every few weeks/months are managed with upping the steady metacam maintenance dose. It will take a few weeks for the glucosamine to build up so it is not a quick fix. This approach follows the treatment of FSC (feline sterile cystitis), which is the other species that presents with a similar problem. Your vet may need to do some research digging on it if they have never come across it.
The good thing is that it is not a life-shortening illness (unless in the most severe cases, which you are not dealing with) and that it doesn't cause bladder stones.

Some more information:
Links - Interstitial Cystitis - Guinea Lynx Records
Long Term Balanced General And Special Needs Guinea Pig Diets (see chapter special diets)

I hope that this hels you?

Thank you so much for this information. I’m going to speak to my vet about this tomorrow.

Can I just ask is that 0.25ml a day or 0.25ml twice a day?
Thanks again,
Catherine

 

[Wiebke]

Thank you so much for this information. I’m going to speak to my vet about this tomorrow.

Can I just ask is that 0.25ml a day or 0.25ml twice a day?
Thanks again,
Catherine

0.25 m twice a day but if you are dealing with sterile IC, the dosage will really not make any difference.

Here is the link to our recommended vets list if you are not happy with your vet: Rescue Locator

 

[Guinea Slave]

I have a little girl who suffers from this problem. After lots of investigation and help from my vet we decided it was due to stress (she has a hormonal friend who has just been spayed so was being constantly humped!). With her, she doesnt get it badly so when she gets a flare up I give her cystease every morning and evening. 5ml each time and then a small dose of metacam. It calms things down within a few days and then I keep this regime for a few weeks. It works well for us, She is very easy to do and take the syringe without me even picking her up, so she does make my life easy!

I have had others also susceptible over the years and just ensured they were given lots of fluids. One had 10ml water every day twice a day all her life after recurring bladderstones and it also sorted her out and she never got bladderstones or cystitis again.

On Cartrofen, I had another who again had bladder issues which even with the above regime didnt help much, Cartrofen literally sorted her out very quickly and was very successful.

I guess they all different but anti inflammatories (metacam) and cystease and then Cartrofen if its not working, really helps.

 

[Pig & Pymble]

I have a little girl who suffers from this problem. After lots of investigation and help from my vet we decided it was due to stress (she has a hormonal friend who has just been spayed so was being constantly humped!). With her, she doesnt get it badly so when she gets a flare up I give her cystease every morning and evening. 5ml each time and then a small dose of metacam. It calms things down within a few days and then I keep this regime for a few weeks. It works well for us, She is very easy to do and take the syringe without me even picking her up, so she does make my life easy!

I have had others also susceptible over the years and just ensured they were given lots of fluids. One had 10ml water every day twice a day all her life after recurring bladderstones and it also sorted her out and she never got bladderstones or cystitis again.

On Cartrofen, I had another who again had bladder issues which even with the above regime didnt help much, Cartrofen literally sorted her out very quickly and was very successful.

I guess they all different but anti inflammatories (metacam) and cystease and then Cartrofen if its not working, really helps.

Hello, just came across this as have a very squeaky pig when he wees/poos, and we've done a load of imaging to rule out stones, have treated with antibiotics but more as a preventative for other infection rather than to treat cystitis, as we do think it's sterile IC. Totally breaks my heart how frequently he squeaks and he's clearly in pain. We're starting with Cystease which I am hoping starts to work in a few weeks - we've got the capsules though which we're mixing with water. Did you find a different product, as you mention giving 5ml? He's currently on Loxicom too, 0.4ml twice a day of the dog one.

 

[Guinea Slave]

Oh poor boy! Yes I should have been clearer. when she has a bad episode I give half a tablet mixed with water twice day for a day or two (one capsule a day) and then quarter a day twice a day for about two weeks after. Each time in about 5ml. She is very easy about It. It’s a bit trial and error but works for me. she is on a maintenance dose of metacam 0.3ml twice a day and so far so good.! Good luck with your boy x

 

[annachristina_piggies]

Just reading your comments and all very similar to what I am experiencing. Piglet was diagnosed with interstitial cystitis last summer, since then he has been on loxicom 0.4 once a day, and cystease 1ml twice a day. I've noticed in the past few weeks that the pain killer does not seem to be helping much, he squeaks a lot during the day when he is peeing. He even had had the injection at the vet for a month (basically a super dose of glucosamine). I'm at a loss now at what else i can do to help him and ensure he's not in pain. Any advice is very much appreciated.

 

[Free Ranger]

You can speak to your vet about upping the loxicom dose and/or giving twice a day instead of once. You do not say whether you are on the 'cat' version (0.5mg/ml and licensed for piggies) or the dog version (1.5mg/ml and given less frequently now the cat one has been licensed but prescribed regularly in the past). If you are on dog already it could still be upped/given more frequently if your vet is happy to do so - there are considerations of piggie weight, other medical conditions etc that mean we can't say here do this or do that. But I would be pushing for dog (volume is lower to get into piggie for same active ingredient) and for twice a day and yes I've given higher - especially for bladder issues. When you say 0.4 do you mean 0.4 ml or have they given you a syringe marked in 'units' because they are not quite the same... the units are less than the mls.

Some people with this condition can have 'trigger foods' but I don't know if that's the same for piggies. Good luck piglet x

 

[Pig & Pymble]

That's really helpful to know about the dosages! Pig is still squeaky but it does come and go in terms of severity. Pig and Piglet sound like they need to chat about how to start getting better for their owners!

 

[Hogmex]

My piggie has a bladder issue, I have been given Sulfatrim 0.5ml to be given once a day and cat metacam (0.5/ml) at 0.2ml once a day. Don't piggies need this every 12 hours instead of one dose? Is the metacam high enough? (I've had the dog strength before 1.5/ml at .4ml twice a day. )
Also I see Cystease is mentioned in a liquid form, I can't find that anywhere, I'd prefer that to breaking up the capsules. Where do you get it from?

 

[Wiebke]

My piggie has a bladder issue, I have been given Sulfatrim 0.5ml to be given once a day and cat metacam (0.5/ml) at 0.2ml once a day. Don't piggies need this every 12 hours instead of one dose? Is the metacam high enough? (I've had the dog strength before 1.5/ml at .4ml twice a day. )
Also I see Cystease is mentioned in a liquid form, I can't find that anywhere, I'd prefer that to breaking up the capsules. Where do you get it from?

It is importanty to be aware that sulfatrim is double the strength of the old pediatric septrin, so 0.25 ml sulfatrim is the same as 0.5 ml old pediatric septrim. that is where the confusion comes from. Sulfatrim is the same concentration as adult septrin, just unflavoured.

 

[Hogmex]

It is importanty to be aware that sulfatrim is double the strength of the old pediatric septrin, so 0.25 ml sulfatrim is the same as 0.5 ml old pediatric septrim. that is where the confusion comes from. Sulfatrim is the same concentration as adult septrin, just unflavoured.

Oh dear, so 0.5ml Sulfatrim might be quite high once a day.

 

[Free Ranger]

We've had real variation with antibiotics - higher doses for 5 days, lower for longer - as long as piggy is eating and managing OK I'd trust the vet. You can always add in some probiotic like fibreplex to the diet (but leave a gap after the AB dose - I think I saw someone say about an hour later?)

Yes I had the same issue with the metacam... because the cat strength is now licensed for guinea pigs there is a real battle to get the dog strength and some vets simply won't do it. George in the pic has managed to persuade one vet to give him the 1.5 mg/ml because he's on it long term for arthritis so I don't have to renew his prescription so much. Contact your vet about upping your cat-strength dose or doing twice a day - perhaps your piggy has other considerations the vet is taking into account but it's likely that it is the licensing issue that has made the difference. It did with us - half the vets at my practice now won't budge from cat.

Can't help with the cystease, sorry, I have no experience of this. Hopefully your sulfatrim will solve the problem. I'm assuming it's pain when peeing and they're trying to rule out infection before thinking about stones etc? Good luck @Hogmex

 

[Wiebke]

Oh dear, so 0.5ml Sulfatrim might be quite high once a day.

No; it is the appropriate dose; you can give it all once a day or split into to doses of 0.25 ml every 12 hours. Your choice.

 

[Hogmex]

We've had real variation with antibiotics - higher doses for 5 days, lower for longer - as long as piggy is eating and managing OK I'd trust the vet. You can always add in some probiotic like fibreplex to the diet (but leave a gap after the AB dose - I think I saw someone say about an hour later?)

Yes I had the same issue with the metacam... because the cat strength is now licensed for guinea pigs there is a real battle to get the dog strength and some vets simply won't do it. George in the pic has managed to persuade one vet to give him the 1.5 mg/ml because he's on it long term for arthritis so I don't have to renew his prescription so much. Contact your vet about upping your cat-strength dose or doing twice a day - perhaps your piggy has other considerations the vet is taking into account but it's likely that it is the licensing issue that has made the difference. It did with us - half the vets at my practice now won't budge from cat.

Can't help with the cystease, sorry, I have no experience of this. Hopefully your sulfatrim will solve the problem. I'm assuming it's pain when peeing and they're trying to rule out infection before thinking about stones etc? Good luck @Hogmex

Thank you, I will have to ask, its quite a difference in mg per dose, I'm surprised.
She had a ultrasound scan done and she has a lot of sludge in her bladder and coating her urethra too the vet said. My piggie is having a hard time peeing, mostly pushing quite hard. I wondered if "Bladder flushing" could help? I read a few people here have some experience with that.

 

[Claire W]

My late Ellen was always prescribed 0.5ml of sulfatrim when she was having a particularly bad time