Bladder/bowel issues and calcium questions

[Pig & Pymble]

This is my first post and is quite long as everything has been a bit of a saga recently! Massively high levels of stress and upset at home, but I'm feeling optimistic about my boy's recovery. I thought it would be helpful to get some advice/guidance as this forum has been so helpful to me, but some more specific and personalised advice would be great.

Back in February, we had concerns about Pig's belly as it was making really loud gurgling sounds and we noticed lots of small poos in the cage - I was concerned about bloat. We saw a vet who prescribed him Emeprid, but they weren't sure if it was bladder/bowel issues and recommended we go to a different vet with more knowledge of small furries. When we went there, they didn't think it was bloat, and suggested leafy greens only for feeding and said if we were still concerned without improvement, they could run some imaging. Towards the end of May, he ended up having a CT scan due to him doing some small squeaks when weeing/pooing but it was hard to differentiate which it was. The CT showed some bladder sludge but no visible stones and no issues with the gut. They mentioned loxicom if he was in pain and the squeaking got worse, which it did.

On 15th June (Tuesday) we started him on co-trimoxazole (0.5ml twice a day) and loxicom (cat strength, 2ml across a day) considering it may be a UTI/cystitis. We'd tried to get a wee sample but he was only doing tiny bits of wee in different places around the cage. We'd also noticed some grittiness around his bottom area, and on some urine on his bedding. The urine sample we took showed some bacteria but it had been off the floor of the pen so wasn't entirely reliable. The squeaking got worse over the next two days (every time he did a wee every 5 mins or so, up to 60 seconds and at times really loudly) so we took him into the vet on the 17th (Thursday), where they were going to do some imaging again and see if they needed to take any further steps (would sedate and use a catheter to flush the bladder/operate for stones if they had to). I noticed on the way to the vet a bit of blood in the urine too. They did an ultrasound but his bladder was small so they couldn't see if there was anything in there of concern, so they suggested they keep him in overnight for monitoring and give pain relief and fluids. The next day (Friday) he had conscious X-rays, more ultrasound scans and they'd seen he'd passed some urine and poo. Still no sign of bladder stones anywhere which was good, so they sent him home with cerenia, loxicom, and co-trimoxazole.

He was like a completely different boy, with wee soaking his underside, shakey, weak, not eating, there was quite a lot of blood in his wee which also really smelled. It was heartbreaking. We were back in the vets the next day (Saturday), where they gave us some tramadol and ranitidine, but the tramadol totally knocked him and he couldn't eat vegetables and swallow properly over the weekend. We hadn't been given any critical care or anything for him so I sourced this on the Monday. It was really scary and we stopped the tramadol and he gradually improved his eating of veg but remained quite lethargic. We've had to keep taking him back and forth to the vets and he also went into gut stasis, though for a week or so his squeaking when weeing stopped. We got some Emeraid IC from the vets and were syringe feeding him every day around 20-30mls, but he has been happy to eat his veggies since coming off tramadol. His poops are still not quite there, and he's not eating enough hay still - only little bits here and there. He gets a really nice quality local timothy hay and we got some meadow hay to put in with it to tempt him.

He's had another CT scan that still showed no stones, just the sludge, and he's been on antibiotics (co-trimoxazole) and Loxicom (along with cerenia and ranitidine) for 2 weeks, but he's now still squeaking when weeing since Friday (25th) evening. He was quite lethargic and shakey on Monday so we took him in again, and there wasn't anything of concern but she could see the sludge had moved to the exit of the bladder. There has been a lot of chalky sludge in his wee but Emeraid IC is about 1% calcium, and the supreme recovery we got is also 0.6-1.2% calcium, so both seem like they could be impacting the sludge if we continue with those. We are giving filtered water, and have recently swapped nuggets to Oxbow essentials, but he doesn't like those so I've got some science selective grain-free in the post. We're also syringe feeding him water and some Emeraid still. I feel like we're back at square one, with him still squeaking when weeing, and chalky wee, except he's worse than when he went into the vet because he went into gut stasis after and has really been through the wars I don't know if the squeaks are just him passing sludge in his wee, as he is getting more himself the rest of the time, just isn't eating properly but I don't want to keep giving Emeraid/liquid feed if it's going to add to the sludge! We feel so stuck and like we've gone in a big (expensive) loop and any advice or tips would be much welcome.

I'm also conscious of the veg we're giving him, as vets continue to say mostly give leafy greens (but not too dark), but I am so muddled by calcium contents in those and if it's going to make things worse! Sorry for the huge post, we are in conversation with the vet, but I wanted some other opinions and help too.

Thanks so much xx

 

[Free Ranger]

Hi, and I'm so sorry for all your woes. It is difficult to hear them in pain. Is he young or an older boy?

I had a girl who had passed a surprise stone and also got a UTI (I've never had a stone without a UTI). She was x-rayed and they saw something which they reckoned could either be a small stone or an accumulation of grit in the bladder exit/urethra. They wanted her to try and pass this so they gave her a sub-cutaneous fluid injection and it was a LOT of fluid. Def more than 5ml - I think nearer 10ml! - and it made a huge humpy lump on her shoulder. She also had an injection of opioid painkiller in case the pain of peeing made her hold it in (classic UTI sign is wet bits as it hurts them to pee so they try to keep it in but leak in dribs and drabs). She was really zoned out, poor girl, but she peed like an absolute tap for the next few hours and blasted everything through without a squeak. Didn't eat till tea-time - in all honesty I didn't dare leave her alone for the first few hours as she was totally stoned and it was upsetting to see. Next x-ray saw nothing there. Have they suggested anything like this for your boy - especially if they can't see any solid stone blocking the route? It's easier for girls though, the males have narrower tubes and an awkward corner in the urethra that causes problems.

In terms of calcium the nuggets and hard water contribute most of it to the diet. We feed a lot of grass to our (mainly) indoor piggies and they are more excited about the grass arriving in the morning than anything else they get. Grass will also help to keep teeth down - if they are only eating soft foods for weeks you can face the problem of teeth overgrowing. Check his chewing (of anything, including the mush) is still smooth and rapid - also that his incisors are not so long they prevent his mouth from closing! your vet will be watching out for this though I am sure. We are in a hard water area and I actually buy the piggy water in bottles from the Waitrose - the 'Royal Deeside' Still water has 3 mg/L (1/100th of our tap water!) Most piggy wee is a little bit milky to see even in the healthy ones because unlike people they absorb all the calcium in their gut and so then have to get rid of the excess. If things can be kept flushing through it prevents a build-up or this, or it becoming concentrated and forming stones etc.

There is a food supplement called Cystease for cats which people whose piggies have something called 'Sterile Interstitial Cystitis' use to support the inflamed bladder but this is not an overnight 'cure' and apparently takes a few weeks to take effect. SIC is essentially cystitis where no bacteria can be spotted and it is characterised by 'flare-ups' and then periods when things are OK. Sometimes it can be triggered by certain foods (people can get it too). Your boy doesn't sound like SIC but I'm just wondering whether he's on anything from the vet to support his bladder in this way - sorry if he is but I am not familiar with all your meds. Also, if he's on antibiotics for a while I know people like to give a probiotic too, like Fibreplex or something similar, to help the gut keep going.

Good luck little Pig x

 

[Pig & Pymble]

Hi, and I'm so sorry for all your woes. It is difficult to hear them in pain. Is he young or an older boy?

I had a girl who had passed a surprise stone and also got a UTI (I've never had a stone without a UTI). She was x-rayed and they saw something which they reckoned could either be a small stone or an accumulation of grit in the bladder exit/urethra. They wanted her to try and pass this so they gave her a sub-cutaneous fluid injection and it was a LOT of fluid. Def more than 5ml - I think nearer 10ml! - and it made a huge humpy lump on her shoulder. She also had an injection of opioid painkiller in case the pain of peeing made her hold it in (classic UTI sign is wet bits as it hurts them to pee so they try to keep it in but leak in dribs and drabs). She was really zoned out, poor girl, but she peed like an absolute tap for the next few hours and blasted everything through without a squeak. Didn't eat till tea-time - in all honesty I didn't dare leave her alone for the first few hours as she was totally stoned and it was upsetting to see. Next x-ray saw nothing there. Have they suggested anything like this for your boy - especially if they can't see any solid stone blocking the route? It's easier for girls though, the males have narrower tubes and an awkward corner in the urethra that causes problems.

In terms of calcium the nuggets and hard water contribute most of it to the diet. We feed a lot of grass to our (mainly) indoor piggies and they are more excited about the grass arriving in the morning than anything else they get. Grass will also help to keep teeth down - if they are only eating soft foods for weeks you can face the problem of teeth overgrowing. Check his chewing (of anything, including the mush) is still smooth and rapid - also that his incisors are not so long they prevent his mouth from closing! your vet will be watching out for this though I am sure. We are in a hard water area and I actually buy the piggy water in bottles from the Waitrose - the 'Royal Deeside' Still water has 3 mg/L (1/100th of our tap water!) Most piggy wee is a little bit milky to see even in the healthy ones because unlike people they absorb all the calcium in their gut and so then have to get rid of the excess. If things can be kept flushing through it prevents a build-up or this, or it becoming concentrated and forming stones etc.

There is a food supplement called Cystease for cats which people whose piggies have something called 'Sterile Interstitial Cystitis' use to support the inflamed bladder but this is not an overnight 'cure' and apparently takes a few weeks to take effect. SIC is essentially cystitis where no bacteria can be spotted and it is characterised by 'flare-ups' and then periods when things are OK. Sometimes it can be triggered by certain foods (people can get it too). Your boy doesn't sound like SIC but I'm just wondering whether he's on anything from the vet to support his bladder in this way - sorry if he is but I am not familiar with all your meds. Also, if he's on antibiotics for a while I know people like to give a probiotic too, like Fibreplex or something similar, to help the gut keep going.

Good luck little Pig x

Thank you so much for your reply! I know - it's absolutely heartbreaking hearing the squeaking in pain, it was so hard to know whether to ignore it or investigate more thoroughly. He's not even 2 yet, so I really want him to have a good chance at recovery. He actually went into the vets again last week on Thursday (and emergency vets the night before) as after his veg dinner which he was quite excited for, he suddenly took himself off to a cosy bed and didn't really move for hours. He's not strong enough for a general anaesthetic at the moment but they say next step if we don't see changes in a week is to get bloods. Risky though and I'm reluctant about it!

I am so pleased to hear your girl was a trooper and passed the stone! He's had a couple of overnight vets stays, where they've given him lots of fluid under the skin, so have been flushing stuff through, but no indication of stones from imaging luckily. I hope he's passed most of the sludge, but he's got pretty bad cystitis we think (probably the one you said) - so are now trying to help him with that along with the gut stasis from stress and he's also not eating his hay or biscuits, only veggies so we're syringe feeding! It's helpful to know about Cystease, we did get some actually and will be introducing it soon, just want his guts back to normal first. We're trying to keep up with the probiotic too to try and help.

Thanks so much for your advice about calcium. Ours are indoor piggies and we don't have a garden so can't get grass from there but I wonder about us trying to grow some indoors! That way he might go back onto hay too. Will definitely keep an eye on his teeth. The vets been trying but of course he's reluctant to let someone in there! Love that your piggies have Waitrose water - we've got a filter which I hope helps but will consider bottled too.

Thanks so much again for your message - I really appreciate it!

 

[Free Ranger]

@Wiebke any advice for a 2 year old boar with bladder/bowel problems? He's really going through the wars and has stopped eating now... could be SIC?

@Pig & Pymble there is something called Readigrass which is popular and apparently a good way to get them back towards eating hay. Also something called Hay Cookies which we have as a treat (or distractor... depending on what's going on) which is just dried grass pressed into a block as far as I can tell.

 

[Pig & Pymble]

Thank

@Wiebke any advice for a 2 year old boar with bladder/bowel problems? He's really going through the wars and has stopped eating now... could be SIC?

@Pig & Pymble there is something called Readigrass which is popular and apparently a good way to get them back towards eating hay. Also something called Hay Cookies which we have as a treat (or distractor... depending on what's going on) which is just dried grass pressed into a block as far as I can tell. View attachment 179858

Thanks so much! I’m wondering if the antibiotics are affecting his appetite for hay/biscuits (he still munches his veggies and gets excited for those), he’s been on them 3 weeks but the squeaking is still there and hasn’t stopped really in that time but it’s hard to know if they would take longer to work. Also the vet may be trying to prevent other infection. I’ve just never seen him so disinterested in hay! He is eating other things he shouldn’t - like his cardboard box and tube, and lots of a willow chews which I guess helps with his teeth growth so I’m tempted to let him do that. Just want his gut working and realise we probably need to up syringe feeding to more like 50ml a day rather than 25-30ml. I’ve read so many articles on this site which has been super helpful, it’s trying to balance not stressing and overwhelming him more with handling, but needing to get stuff into him!
I will look into getting some readigrass today though think I read somewhere it’s a bit higher in calcium? But I guess short term that’s okay. Thanks so much!

 

[Free Ranger]

@VickiA @PigglePuggle any clues for this piggy? Do we know whether the Cystease will affect a delicate gut adversely?

I have a cardboard eating pig and it actually does help his gut (he gets impaction). One of my sows used to shred newspaper when she got a UTI - it was the first sign anything was wrong... she chewed when she felt discomfort. Mind you, I now have a big fat girl that just does it out of boredom - she needs to stop chewing and get moving!

Have a look to make sure his incisors are not too long. I lost a girl last year to a mystery illness and she was syringe fed for a long time but ate nothing herself. Her back teeth were ground because of a spur at the beginning but I don't think the front teeth were touched. After 3 weeks of not feeding herself after this I noticed her trying to bite at a piece of wood in the garden - an unusual thing for her. On her next vet check a new vet picked up that her incisors had overgrown and she couldn't even close her mouth properly! It was a quick job to cut them down (apparently they use something like a tiny circular saw!) and the speed and smoothness of her chewing improved immediately - she was also on painkillers for that. But we think her issue was swallowing... anyway, she was still chewing her mush with the long incisors but she was chewing a lot better when they were trimmed. Did your chap chew those willow things before or is it a recent behaviour?

I've heard that there can be a 'confidence' issue with eating after some illnesses. Piggies who have had dentals and not been eating were encouraged with one blade of grass at a time until they realised they were able to do it themselves again. You will be in the best position to judge if this is the case... but it sounds like the cystitis issue is dominating at the minute x

 

[Piggies&buns]

Antibiotics can affect their appetite as they also kill off the good gut bacteria. This is when you need to step in and give plenty of syringe feed to replace the hay they aren’t eating for themselves.
If he isn’t eating any hay for himself, then he needs a lot more than 25-30ml of critical care - more like in excess of 60ml in a 24 hour period. Your daily weight checks are your guide though as to how much syringe feed to give him. Eating veg isn’t enough as it only makes 15% of daily food intake. Veg on an unbalanced gut can make things worse.
A piggy who is eating cardboard is likely feeling unwell. Give a probiotic while he is on antibiotics as it can help replace the gut bacteria. Give it 1-2 hours after an antibiotic dose.

 

[VickiA]

I am really not sure what to suggest. Do the vets think the bladder sludge is causing him pain on peeing? Has a sample of urine been tested for crystals? Some crystalline deposits can really irritate the bladder and the urethra on passing (I am currently dealing with this issue with one of my own pigs). If they think the issue is bladder sludge/crystals have you tried potassium citrate to help break up the crystals? My Holly has been passing blood caused by sludge. She’s currently on ABs (to prevent secondary infection), Metacam for pain relief and anti inflammatory properties, potsssium citrate and I am also syringing cranberry juice and filtered water to help encourage the bladder to flush out the crystals. If unsuccessful she will be having a bladder flush operation. Not ideal as she’s almost 5, but if it doesn’t pass then that will be the next step for her.
If your boy isn’t eating, please with daily to help monitor his weight. As @Piggies&buns has said, if he isn’t eating, then stepping in with syringe feeding is extremely important. I am going to link the syringe feeding guide for you Complete Syringe Feeding Guide

 

[Pig & Pymble]

I am really not sure what to suggest. Do the vets think the bladder sludge is causing him pain on peeing? Has a sample of urine been tested for crystals? Some crystalline deposits can really irritate the bladder and the urethra on passing (I am currently dealing with this issue with one of my own pigs). If they think the issue is bladder sludge/crystals have you tried potassium citrate to help break up the crystals? My Holly has been passing blood caused by sludge. She’s currently on ABs (to prevent secondary infection), Metacam for pain relief and anti inflammatory properties, potsssium citrate and I am also syringing cranberry juice and filtered water to help encourage the bladder to flush out the crystals. If unsuccessful she will be having a bladder flush operation. Not ideal as she’s almost 5, but if it doesn’t pass then that will be the next step for her.
If your boy isn’t eating, please with daily to help monitor his weight. As @Piggies&buns has said, if he isn’t eating, then stepping in with syringe feeding is extremely important. I am going to link the syringe feeding guide for you Complete Syringe Feeding Guide

So sorry for not replying sooner - it all became a bit much! Thank you so much for your help. We did think the bladder sludge was a factor in the pain, and he did have some crystals we could feel (a grittiness occasionally in his urine), but we've ruled now it's likely to be a case of interstitial cystitis which is still going unfortunately. I hope Holly is okay, that sounds so sore for her! We did do a lot of syringe feeding, and are still doing so. He's eating for himself now as normal but unfortunately not gaining/maintaining weight when we reduce the syringe feed so about to start a new thread for help on that eek!

 

[Pig & Pymble]

Antibiotics can affect their appetite as they also kill off the good gut bacteria. This is when you need to step in and give plenty of syringe feed to replace the hay they aren’t eating for themselves.
If he isn’t eating any hay for himself, then he needs a lot more than 25-30ml of critical care - more like in excess of 60ml in a 24 hour period. Your daily weight checks are your guide though as to how much syringe feed to give him. Eating veg isn’t enough as it only makes 15% of daily food intake. Veg on an unbalanced gut can make things worse.
A piggy who is eating cardboard is likely feeling unwell. Give a probiotic while he is on antibiotics as it can help replace the gut bacteria. Give it 1-2 hours after an antibiotic dose.

@VickiA @PigglePuggle any clues for this piggy? Do we know whether the Cystease will affect a delicate gut adversely?

I have a cardboard eating pig and it actually does help his gut (he gets impaction). One of my sows used to shred newspaper when she got a UTI - it was the first sign anything was wrong... she chewed when she felt discomfort. Mind you, I now have a big fat girl that just does it out of boredom - she needs to stop chewing and get moving!

Have a look to make sure his incisors are not too long. I lost a girl last year to a mystery illness and she was syringe fed for a long time but ate nothing herself. Her back teeth were ground because of a spur at the beginning but I don't think the front teeth were touched. After 3 weeks of not feeding herself after this I noticed her trying to bite at a piece of wood in the garden - an unusual thing for her. On her next vet check a new vet picked up that her incisors had overgrown and she couldn't even close her mouth properly! It was a quick job to cut them down (apparently they use something like a tiny circular saw!) and the speed and smoothness of her chewing improved immediately - she was also on painkillers for that. But we think her issue was swallowing... anyway, she was still chewing her mush with the long incisors but she was chewing a lot better when they were trimmed. Did your chap chew those willow things before or is it a recent behaviour?

I've heard that there can be a 'confidence' issue with eating after some illnesses. Piggies who have had dentals and not been eating were encouraged with one blade of grass at a time until they realised they were able to do it themselves again. You will be in the best position to judge if this is the case... but it sounds like the cystitis issue is dominating at the minute x

Thank you both so much - sorry I got caught up with him and life generally! We upped the syringe feed massively, up to around 80ml, and this did help. We're still giving him about 60ml as he's eating normally for himself but with no weight gain or maintenance, so that's another worry to add to the pile. It's been such a saga already!

He's stopped the cardboard eating luckily, and his teeth are looking good at the moment. He's eating so much more hay too. And he has always loved munching on willow hehe.

I appreciate all the advice and help you've both given so far I'm posting a new thread soon regarding his weight issues!

 

[Free Ranger]

Oats will come up as a high calorie food - and there are a range of the supplement foods (Emeraid, Crit Care in 2 flavours, Recovery) which he might enjoy enough to eat himself out of a bowl. There's a piggy called Snowflake on the forum at the minute with what's looking like IC and they're having similar challenges. Check it out and see if it helps Crying when peeing and pooing.
The folks that have been able to give advice are the ones with experience of IC... it turns out there can sometimes be trigger foods which don't help but these are not necessarily the same for every piggy!

 

[Pig & Pymble]

He lives up to his name (Pig) with veggies, but when it comes to oats/supplement foods, he is such a fuss pot and not interested! We've tried most supplements and his favourite so far is Critical Care fine grind but he still only accepts it when it's forced via syringe, I wish he'd eat it himself. Thank you so much! Very helpful! I have vaguely identified some trigger foods, but it might just be me imagining it to try and find a solution haha!