Unexplained continued weight loss. Please help!!

[ken9876321]

Hello everyone, I live in Hong Kong. My Pig, Black Tea, is 3year and 8months baby. He has suffered the stone in the ureter rather than bladder now.
He was around 860 to 890gram in September. However His weight have been dropping from 15 October to 23 Novemeber (850grm to 792gram)

He had a CT scan in 5 Oct, and found some cysts in his liver and very small stone in his bladder(1.5mm). The exotic vet has a blood test recently shows that his liver and kidney still working fine.
17 October, The vet explained the ct report to us. The blood test shows his everything is fine.
31 October, We went to the vet for body check and the X-ray showing that he has the 6mm stone in the bladder. We changed the diet that day.
7 November, We went to the vet and do the X-ray showed the stone is 5.9mm. but Black Tea's weight is keeping loss. (820 to 838gram)
21 November, We went to the vet and do the Ultrasound and Blood test. The Blood test is fine but the vet thinks the 5.9mmstone is located in his ureter that is near the bladder rather than the bladder. The vet believes that the stone shown at the CT scan is gone and the 5.9mm ureter stone is new. Black Tea's lowerest weight was 796gram.

I am very worried and frustrated cus I cant make his weight besing stable and his illness cannot be cured by surgery. I dont know what can I do....

Diet:
Before the 2 October, His diet is at least 1 tbsp Oxbow adult guinea pig pellets, Boiling water(not filtered), 25mg vitamin C tablet, health supplment tablet(3-5mg vitamin C contained), Timothy 1st cut hay(small pet select).
After the 2 October, His diets changed to 2gram pellets per day(Sherwood grain & soy-free choice), Distilled water, 10mg vitamin C, Timothy 1st cut hay(small pet select). 8gram of oxbow critical care per day.

Medicine:
He is eating Potassium citrate, Prazosin, Silymarin now. The vet also changed the Meloxicam to Gabapentin on 21 Novemeber.

blood test report
x-ray ( 7Novemeber)
Ct report ofLiver (5 October)

 

[ken9876321]

Please Help Black Tea!

 

[ken9876321]

The Attachments is wrong photo. Please ignore it.
[HEADING=3][/HEADING]

 

[Siikibam]

Boars have an awkward nook in their urethra. Stones can become lodged there, causing multiple issues including being unable to pass urine. The chances of passing the stone are low and it’s usually recommended that the stone is surgically removed. Has the vet mentioned that option or are they going down the route of painkillers and getting him to pass the stone?

I’m also not sure about the chances of a stone being dissolved. The one they see is possibly the same one that’s been there all along.

As he is losing weight, it means he’s not eating enough hay. You have to step in and syringe feed him. 5-10ml every 2 hours during the daytime. You need to aim for 60ml in a 24 hour period. You should also weigh him once daily at the same time (morning might be best). If he’s still losing then you have to try and up the amount you’re syringe feeding him. I will link to some useful guides below.

I think you need to speak to the vet again and think about what to do next. All the best and I hope you can get your boy sorted.

I’ll also tag @Piggies&buns @VickiA @PigglePuggle

Not Eating, Weight Loss And The Importance Of Syringe Feeding Fibre
Complete Syringe Feeding Guide

 

[VickiA]

I’m really sorry, but I don’t think that a stone of that size can be dissolved. Nor can it be passed naturally. As far as ai know the only way to get it out is by surgery but I don’t know how successful boar stone surgery is.
Sadly, if your boar has developed a stone of that size in such a short space of time he clearly has some sort of problem with metabolism and absorption. This has happened to me in the past with one of my own beloved boars. He had an enlarged liver. His blood showed a lack of platelets and he then developed a very large inoperable stone within a matter of weeks despite being on a very low calcium diet.
Have you had a discussion with your vet about what the long term plan is?

 

[ken9876321]

Boars have an awkward nook in their urethra. Stones can become lodged there, causing multiple issues including being unable to pass urine. The chances of passing the stone are low and it’s usually recommended that the stone is surgically removed. Has the vet mentioned that option or are they going down the route of painkillers and getting him to pass the stone?

I’m also not sure about the chances of a stone being dissolved. The one they see is possibly the same one that’s been there all along.

As he is losing weight, it means he’s not eating enough hay. You have to step in and syringe feed him. 5-10ml every 2 hours during the daytime. You need to aim for 60ml in a 24 hour period. You should also weigh him once daily at the same time (morning might be best). If he’s still losing then you have to try and up the amount you’re syringe feeding him. I will link to some useful guides below.

I think you need to speak to the vet again and think about what to do next. All the best and I hope you can get your boy sorted.

I’ll also tag @Piggies&buns @VickiA @PigglePuggle

Not Eating, Weight Loss And The Importance Of Syringe Feeding Fibre
Complete Syringe Feeding Guide

Hello！Thanks for you reply. The vet not recommend surgically removed the urethra stone unless there are complete blockages or infection of the urethra. He said the surgery is high risk and the ureteral wound closure may block the urethra too.

Now his plan The treatment plan is giving the metacam and Potassium citrate, Prazosin for keeping his life quality. Low calcium diet. Regular ultrasound and X-ray tracking the stone. I am so sad

 

[Siikibam]

Waiting till there is a blockage would be very risky as that would be an emergency situation.

It’s good you’ve lowered the calcium in his diet, but that is more of a long term thing rather than a quick fix. So sorry you’re in this situation.

Just one last question. Is he on any anti-inflammatory/pain meds?

 

[ken9876321]

Waiting till there is a blockage would be very risky as that would be an emergency situation.

It’s good you’ve lowered the calcium in his diet, but that is more of a long term thing rather than a quick fix. So sorry you’re in this situation.

Just one last question. Is he on any anti-inflammatory/pain meds?

The vet gave Black Tea Meloxicam before, then changed to Gabapentin last Sunday. I am so frustrated that he cant be quick-fixed. I am so upset because Black Tea has a similar situation with his friend -- Eral. He also had suffered from the stone.

My another pig, Earl, died on 2 October because of his kidney failure meanwhile he suffered from unexplained pneumonia that antibiotics cant help with. He got two stones. The x-ray shows what the stone looks like in the bladder. I don't know the actual reason for his death.

On his last day, the vet gave him an ultrasound and he could not find any stone in his bladder. He found there are some ascites and waters in the kidney, The vet thought the stone was properly in the urethra or ureter. He fainted the night before and his pee contained a small point of blood, and his hind legs were weak. I took him to the vet immediately in the morning. He could still urinate at that time, but he died softly soon after returning home.



The photos was the situation of Eral.

 

[ken9876321]

Hello！Thanks for you reply. The vet not recommend surgically removed the urethra stone unless there are complete blockages or infection of the urethra. He said the surgery is high risk and the ureteral wound closure may block the urethra too.

Now his plan The treatment plan is giving the metacam and Potassium citrate, Prazosin for keeping his life quality. Low calcium diet. Regular ultrasound and X-ray tracking the stone. I am so sad

Sorry, *It is ureter stone not urethra stone. The vet said ureter surgery is very high risk and the wound closure may block the ureter.

 

[ken9876321]

I will take Black Tea to another vet hospital this Sunday for x-ray.

 

[Free Ranger]

I am so sorry for your situation with Black Tea - he is lovely. I have also heard ureter stones (the tube between the kidney and the bladder) are very difficult.
@Wiebke is this what you know?

I have no magic answer - I had a boar called Panda who needed surgery to remove a bladder stone. He was between 3 and 4 years of age we think, and I was told 2 things: (1) the surgery is high risk, and (2) even if successful the chances of stones recurring are high. My vet had removed a stone before from a boar who had survived the surgery but on the post-op check 2 weeks later another stone had formed. This vet had an old boy with a stone herself and she did not rate his chances of survival so she just kept him on high doses of 1.5mg/ml meloxicam twice a day to manage his pain. If they are in pain they eat less - sometimes weight loss is that simple. I did not want to have my splendid big boy put to sleep but he was in pain and peeing blood, so we decided to risk the surgery. Sadly, he died on my lap at home a few hours afterwards. I think you are doing so well for Black Tea to investigate all possibilities but also think about making his life as happy and comfortable as possible just in case these are his last days. We will be thinking about you x

 

[ken9876321]

I am so sorry for your situation with Black Tea - he is lovely. I have also heard ureter stones (the tube between the kidney and the bladder) are very difficult.
@Wiebke is this what you know?

I have no magic answer - I had a boar called Panda who needed surgery to remove a bladder stone. He was between 3 and 4 years of age we think, and I was told 2 things: (1) the surgery is high risk, and (2) even if successful the chances of stones recurring are high. My vet had removed a stone before from a boar who had survived the surgery but on the post-op check 2 weeks later another stone had formed. This vet had an old boy with a stone herself and she did not rate his chances of survival so she just kept him on high doses of 1.5mg/ml meloxicam twice a day to manage his pain. If they are in pain they eat less - sometimes weight loss is that simple. I did not want to have my splendid big boy put to sleep but he was in pain and peeing blood, so we decided to risk the surgery. Sadly, he died on my lap at home a few hours afterwards. I think you are doing so well for Black Tea to investigate all possibilities but also think about making his life as happy and comfortable as possible just in case these are his last days. We will be thinking about you x

I am glad to hear your experience. I will do my best to keep his life as happy and comfortable. I hope I can stabilize his weight and minimize his pain. Just so upset that I cannot do more for him. I never face this situation when they were young. They are so adorable and I love them so much. I am so sorry for your lost.

 

[ken9876321]

The x-ray on 28 November shows that the stone didn't change. We would go to the vet for a follow-up this sunday 12 December.

 

[PiggyRupert]

Sorry to hear your beautiful piggy has a stone. My 7yo piggy also had a stone stuck in his ureter (not urethra). It was 5mm. He was on potassium citrate and moduretic. After 6 months we discontinued the moduretic because it was making him sick, so he stayed on potassium citrate and a low dose of tramadol in case he was in pain. Over several years, the stone never changed and piggy was happy & lively. Sometimes if my piggy jumped around too much there was a little bleeding but the stone caused no problems over the long term. I know that medications can affect appetite (moduretic made my piggy sick and off-colour, doxycycline in one of my other piggies made her eat & drink very little) so perhaps a vet medication review may help your piggy’s weight problem. I’m not sure of the mechanism but meloxicam made the ureter stone bleed after several days, so tramadol was the best pain med for my piggy.

 

[ken9876321]

Update：

Today we take black Tea to the specialist vet.
Based on the ultrasound, the stone in the right ureter has NOT gotten larger which is good news, but it is blocking the urine from the right kidney. The right kidney is damaged and not functioning.

-The left kidney is stable in size with NO signs of a stone. The left kidney will get larger with time because it needs to make more urine because the right kidney is non functional.

We can only use medications and herbs to try to prevent a stone from forming in the left ureter.

The vet said our goals are to do everything we can to protect his left kidney and prevent it from forming a stone. If he forms a stone in the left kidney or ureter this will kill. He needs to eat/drink 120 ml of water per day. If I cannot syringe feed this much water, he will need injections of fluids under his skin.

 

[Free Ranger]

Poor Black Tea. Is he able to maintain his weight on his own with pain management? Or is he still losing weight.

I can understand trying to protect the functioning left kidney and it seems that one is currently in good condition - not enlarged. 120 ml seems a very specific amount...? And that is ever such a lot per day. I think you will struggle to get that much water down him to be honest. Mine only really drink water when eating the dry pellets - they drink less when munching hay and they drink very little when they are eating 'wet' foods like fresh grass or vegetables so I think the intake of water is probably about the same either way. The problem with syringing liquid water is that they don't expect it and can inhale the fluid and either choke or cause lung infection. If you are still syringe-feeding him or at least giving some of the slurry in a bowl for him to eat that water will count. Doing things like soaking lettuce before you give it to crisp it up and make it more water-full can help. But I'm not sure how you can measure the amount of water he takes in.

One of my pigs was given a fluid injection under the skin and they do work at the time - she peed a LOT - but I wouldn't want to have done this on a regular basis as the needle hurts and there is a huge blister on the skin from just 10ml of the 120. My girl was given a strong opioid painkiller and then had the fluid bolus. She was left to see if she could pass a bladder stone. She managed it - the fluid is absorbed into the body over the next few hours and the blister goes down - but she looked very poorly on the opioid and I hated to do it to her even once. She did not eat anything until it had worn off. I personally have not heard of a guinea pig regularly receiving sub-cutaneous fluids to maintain health - only as a short-term emergency measure like for this bladder stone.

But what would be the alternative? I suppose his medications and his pain management to see if he can keep his weight up on his own (maybe with a daily portion of slurry) and a very 'wet' diet if you can source fresh grass (too much general veg can upset the tummy) and just regular monitoring of his health and his kidney to let you know how he is doing. It might be that he only has another 3 to 6 months before the remaining kidney starts to have problems... maybe it will be shorter or longer (I have no experience here). I will start a thread asking if anyone has experience of a piggy with only one functioning kidney to see if they have any advice for you that can be directed back to this thread. But I can imagine that Black Tea would start to get very depressed if he had to have a daily fluid injection... my old George has to be un-plugged at the back end every night and he doesn't even like that - he gets worried and hides when he sees me approach at tea-time although he doesn't bother if I am around earlier in the day. You have a tough decision x

 

[Bill & Ted]

I can only suggest wetting all veggies before serving otherwise I have no medical experience but wanted to wish the little piggie the very best of luck x

 

[Merab]

I can’t add advice, but assure you of my support

 

[Wiebke]

Hi!

Unfortunately, I have no personal experience with this scenario. Ureter stones that are stuck are unfortunately not good news. Nobody can make any predictions; kidneys in guinea pigs are more difficult to manage compared to other species and are still rather at the limit of veterinary possibilities.

All you can do is to cherish every day as a special gift and take it as it comes.

Wishing you as many days together as you can get.

 

[Free Ranger]

Hi again @ken9876321 there is now another thread you might like to check occasionally to see if anyone has posted experience. It is Any experience of piggies with one functioning kidney? so I hope this can help give you more of a clue about what the future could hold and help you with your decisions for Black Tea x

 

[ken9876321]

Poor Black Tea. Is he able to maintain his weight on his own with pain management? Or is he still losing weight.

I can understand trying to protect the functioning left kidney and it seems that one is currently in good condition - not enlarged. 120 ml seems a very specific amount...? And that is ever such a lot per day. I think you will struggle to get that much water down him to be honest. Mine only really drink water when eating the dry pellets - they drink less when munching hay and they drink very little when they are eating 'wet' foods like fresh grass or vegetables so I think the intake of water is probably about the same either way. The problem with syringing liquid water is that they don't expect it and can inhale the fluid and either choke or cause lung infection. If you are still syringe-feeding him or at least giving some of the slurry in a bowl for him to eat that water will count. Doing things like soaking lettuce before you give it to crisp it up and make it more water-full can help. But I'm not sure how you can measure the amount of water he takes in.

One of my pigs was given a fluid injection under the skin and they do work at the time - she peed a LOT - but I wouldn't want to have done this on a regular basis as the needle hurts and there is a huge blister on the skin from just 10ml of the 120. My girl was given a strong opioid painkiller and then had the fluid bolus. She was left to see if she could pass a bladder stone. She managed it - the fluid is absorbed into the body over the next few hours and the blister goes down - but she looked very poorly on the opioid and I hated to do it to her even once. She did not eat anything until it had worn off. I personally have not heard of a guinea pig regularly receiving sub-cutaneous fluids to maintain health - only as a short-term emergency measure like for this bladder stone.

But what would be the alternative? I suppose his medications and his pain management to see if he can keep his weight up on his own (maybe with a daily portion of slurry) and a very 'wet' diet if you can source fresh grass (too much general veg can upset the tummy) and just regular monitoring of his health and his kidney to let you know how he is doing. It might be that he only has another 3 to 6 months before the remaining kidney starts to have problems... maybe it will be shorter or longer (I have no experience here). I will start a thread asking if anyone has experience of a piggy with only one functioning kidney to see if they have any advice for you that can be directed back to this thread. But I can imagine that Black Tea would start to get very depressed if he had to have a daily fluid injection... my old George has to be un-plugged at the back end every night and he doesn't even like that - he gets worried and hides when he sees me approach at tea-time although he doesn't bother if I am around earlier in the day. You have a tough decision x

Thank you for your advice. We will not do the fluid injection every day. Maybe once a week. Black Tea is maintaining his weigh between 790 to 810 now. We will take the plan of pain managrment and medicine. We are feed him 15g critical care mixed wilth 60ml water perday divided by 3 times. We marked the scale on the water bottle for monitoring his water drinking. We hope he can live longer.

I am so sad for hearing his right kidney is in bad situation

 

[ken9876321]

Hi again @ken9876321 there is now another thread you might like to check occasionally to see if anyone has posted experience. It is Any experience of piggies with one functioning kidney? so I hope this can help give you more of a clue about what the future could hold and help you with your decisions for Black Tea x

Thank you! I will follow it.

 

[Free Ranger]

Aah yes, it is awful to hear news like this
You will be doing a great job just by keeping him fed and comfortable. He is such a fluffy little fellow and he must know how much he is loved
The hope is that the other kidney will be able to keep going normally and he will have plenty more life to live. We will keep everything crossed for you!

 

[ken9876321]

I am afraid whether 20g critical care per day is too much calcium for black Tea? I want him to have low calcium diet.

 

[Free Ranger]

I am linking in this guide which talks about the 'standard' piggy diet and then some tweaks for different situations. You may have already seen it? Long Term Balanced General And Special Needs Guinea Pig Diets Most of us follow this to a greater or lesser extent - at least until a piggy starts to show problems. Then we might tweak something.

There is also a different method of feeding which is used at TEAS (The excellent animal sanctuary) which is basically a much wetter diet Feeding the guinea pigs at TEAS This sanctuary is for piggies with special medical needs and so I think considerations and priorities might be different sometimes to the average piggy. There is an opinion that bladder flare-ups (some pigs seem to get cystitis for no reason) and maybe stones can be triggered by stress. There is also a genetic element - some piggies do seem to be more prone to them than others. However I don't know if ureter stones come under the 'stress' group.

I can understand your concerns about Critical Care but he does also need to (1) get a full balanced diet, (2) keep up his fibre intake and (3) ideally gain some weight back - although I don't know whether weight gain should actually be a 'target' or just seen as a reflection of his general health and happiness. If you cut down the CC you will be compromising 1, 2 and 3 together. I suppose it's a matter of immediate priorities. Also if he likes the CC and enjoys eating it he will feel better afterwards. There are other things you can offer to increase weight, at least in the short-term: have a look at this thread about a calcium sludge piggie Help my guinea pig put on weight where people are discussing oats (by this they mean dry porridge oats and not actual porridge). It is very important though that Black Tea continues to eat hay as this will keep his teeth in check... if his molars start to overgrow you will have a whole new issue! Grass can also keep molars down. You will see cystease mentioned at the end. This product is actually made for cats who can also get bladder flare-ups of cystitis from stress. It is a food supplement rather than a medication and people will give it to their bladder problem piggies to help keep the bladder wall healthy. It doesn't work immediately - it takes a couple of weeks to ease things. If you do a site search you will see this mentioned a lot in relation to something called Interstitial Cystitis (IC) which is pain when peeing but no bladder infection.

By far the greatest source of calcium in the diet is dried pellet food and hard water. In my area of the UK (as in most of the UK actually) there is high calcium in the tap water. Here it can be 300 mg/L and even with a filter you will still get 30 mg/L as about 90% calcium is removed. That is much better but we actually use bottled soft water for our piggies which has only about 3mg/L. I monitor the pee patches to make sure that the occasional bit of white powder does not build up into thick white grit. I also give a lot of grass to my indoor pigs. Water companies often advertise their calcium content online so you can see what is in the water. Bottled water should list it on the label - some bottled water is actually very high in minerals as people want higher calcium for themselves!

I would be tempted to keep giving the CC - at least in the short term. Longer term if he cannot maintain his weight by himself he is showing you that he is not feeling happy and maybe his pain meds need tweaking. If he is feeling good he should be able to maintain his weight by himself... even if you are putting the CC in a bowl he should be eating it by himself. Mine don't like the aniseed one - but we have used the papaya flavoured 'fine grind' cc in a brown packet and any pig that gets to the bowl will lick it clean!

Good luck with your lovely boy. It will be a balancing act now but Black Tea will not be thinking about the future - he only measures his life in Happy Todays so if he has a full tummy today and is happy he will count that as a win x

 

[ken9876321]

New updates：
Today we take him to vet for checking.
Based on today's examination, we noticed:
Clinically stable.
- Weight stable (@ 805g)
-Bit gaseous intestines.
-Normal range of blood test
-- Dense material/calcification/stone @ right kidney and right ureter. The stone in right ureter got a bit smaller. It seems like the stone is slowly disolving.

The vet prescribed these drugs him chinese medicine Concentrated Crystal Stone granules. since 27 Nov. This is a Chinese herbal medication to clear Heat and Damp, resolve crystals and stop hemorrhage. I think it might help me.

 

[VickiA]

Thinking of you and hoping that the treatment continues to work.

 

[Wiebke]

All the best!

 

[Idris]

Wishing Black Tea well in 2022. We use a water filter here in London to keep the calcium to a tolerable level.