Bladder infection - tips?

[Spring100]

Hi everyone,

A few weeks ago, I noticed my two-year-old boar's backside was a bit wet. I didn't think much of it at first, but at some point I suspected a bladder infection.

Today I went to the vet. There was blood in his urine (which was tested), but no bacteria. They took an X-ray, and thankfully, nothing showed up.

I've now been given painkillers and anti-inflammatories for two to three weeks. Do you have any tips on what else I can give him to calm his bladder? So it doesn't seem to be caused by bacteria or grit/stones.

Good to know he's eating well and maintaining a healthy weight.

Thanks!

 

[Piggies&buns]

I’m sorry to hear that.

I have added a guide below which will help, particularly the section on sterile cystitis.

Glucosamine can be given to help alongside the anti inflammatory. If he does have sterile cystitis, then the meds are usually given lifelong. Glucosamine is a food supplement which helps coat the bladder.

Wiebke's Guide to Pees and Stones

 

[Spring100]

Thank you for you're replay.

The vet also mentioned that the medication might be permanent.

Glucosamine...I can't quite figure out what I should give and how. Do you perhaps have a link?

On the vet's recommendation, I ordered some homeopathic bladder syrup. I don't know if it's translatable. This would also be helpful as support.

Blaassiroop

Is there anything else I should be aware of regarding vegetables? Or any other ideas?

 

[Wiebke]

Thank you for you're replay.

The vet also mentioned that the medication might be permanent.

Glucosamine...I can't quite figure out what I should give and how. Do you perhaps have a link?

On the vet's recommendation, I ordered some homeopathic bladder syrup. I don't know if it's translatable. This would also be helpful as support.

Blaassiroop

Is there anything else I should be aware of regarding vegetables? Or any other ideas?

We recommend a UK based cat bladder supplement called Feliway Cystease capsules for cats. I have copied the list of active ingredients. We have made good experiences with this product over the last 15 years or so. Sterile cystitis in cats and in guinea pigs seem to be very similar in symptoms and respond to the same treatment. They both have a stress-related component. Both species have an alkaline urine and are therefore more prone to problems with the urinary tract. However, guinea pigs don't respond to well to cat pheromone based products (calming scents).
The product is classed as a food supplement and not as a medication.
I know that the Netherlands and Germany are much more into herbal remedies.

• THE SCIENCE | Feliway Cystease has been specially formulated and works in 2 ways. It contains N-acetyl and glucosamine to support the bladder lining as well as L-tryptophan which research has determined has a calming effect. Always consult your vet for the best advice on which Feliway medicine will improve cat health.

 

[Spring100]

Thank you. I can only find these two:

1: AA Cystitab with 125 mg N-Acetyl-D-Glucosamine.
This one is only with glucosamine.

2:
I think i found the one you're referring to, but it is chicken-flavored (last dot means chicken flavored for beter taste and acception) -->
Protexin Cystophan Kat 30 capsules
- N-acetyl D-glucosamine: Draagt bij als bouwsteen voor GAG’s.
- Hyaluronzuur: Een belangrijk bestanddeel van de beschermende - GAG-laag in de blaas.
- L-tryptofaan: Wordt in het lichaam omgezet in serotonine, het gelukshormoon.
- Kunstmatige kipsmaakstof: Verbetert de smaak en bevordert de acceptatie.


How do I give these pills? I doubt a guinea pig would just eat them straight up. And how much and how many times a week?

 

[Wiebke]

Thank you. I can only find these two:

1: AA Cystitab with 125 mg N-Acetyl-D-Glucosamine.
This one is only with glucosamine.

2:
I think i found the one you're referring to, but it is chicken-flavored (last dot means chicken flavored for beter taste and acception) -->
Protexin Cystophan Kat 30 capsules
- N-acetyl D-glucosamine: Draagt bij als bouwsteen voor GAG’s.
- Hyaluronzuur: Een belangrijk bestanddeel van de beschermende - GAG-laag in de blaas.
- L-tryptofaan: Wordt in het lichaam omgezet in serotonine, het gelukshormoon.
- Kunstmatige kipsmaakstof: Verbetert de smaak en bevordert de acceptatie.


How do I give these pills? I doubt a guinea pig would just eat them straight up. And how much and how many times a week?

Forget the ones with chicken flavour.

The best way with pills is to establish their their glucosamine content per pill. You are looking at giving around 120-150 mg per day, so in your case, each AA pill gives you a day's amount - no big maths needed!

Grind up the pill in a little kitchen mortar and mix with 1-2 ml of water until it is well dissolved. Give once every 24 hours or twice daily roughly every 12 hours.

You can get a small medicine bottle from your vet or a pharmacy to keep the mix. You may find it more convenient to make up the amount for 2 days in one go (i.e. 2 pills at once). In this case, keep the bottle between dosages in the fridge and shake well before any application. I would recommend to compute 1 ml of water for each application as the carrier powder can continue to absorb water and the solution can thicken.
If you prefer a freshly made up mix every 12 hours, you may also want to get a pill cutter from the pharmacy; again, mix each half pill with 1 ml of water.

You can double the dose for the first 3 days and also for another 2-3 days at the onset of a flare. I have found that upping the glucosamine shortly during a flare is more effective in bringing it back down than upping the metacam although upping both is generally best to get on top of acute symptoms in mild to medium cases.

I hope that this helps you?

 

[Spring100]

Thank you so much for this information. This is definitely very helpful.

He's now getting 0.45 ml Novacam twice a day. His backside hasn't been wet since he started taking it. This works really well! After a week, I need to reduce this to 0.27 ml twice a day. The vet said we can see if we can completely wean him off this over time, once his urine is free of blood. She advised me to buy test strips so I can test it myself every week.

This is the first time he's had bladder problems. Is it wise to start glucosamine now, or should I see if his bladder problem disappears after weaning him off the Novacam?

Suppose it returns, can he stay on Novacam for life? Are there any downsides? His appetite doesn't seem to be affected by it.

 

[Wiebke]

Thank you so much for this information. This is definitely very helpful.

He's now getting 0.45 ml Novacam twice a day. His backside hasn't been wet since he started taking it. This works really well! After a week, I need to reduce this to 0.27 ml twice a day. The vet said we can see if we can completely wean him off this over time, once his urine is free of blood. She advised me to buy test strips so I can test it myself every week.

This is the first time he's had bladder problems. Is it wise to start glucosamine now, or should I see if his bladder problem disappears after weaning him off the Novacam?

Suppose it returns, can he stay on Novacam for life? Are there any downsides? His appetite doesn't seem to be affected by it.

He can be on metacam (novacam) for life. What concentration is it - for cats or for dogs?
I would give him the glucosamine now.

Unfortunately, sterile cystitis has overtaken the bacterial urinary tract infection now, so don't be upset if symptoms return.

 

[Spring100]

It's for dogs (1.5mg/ml).

What is the recommended long-term dose of Novacam? The vet has now recommended 0.45ml twice a day for one week (equivalent to a 7kg dog) and then 0.27mg twice a day (equivalent to a 3kg dog) for as long as needed.

Is it wise to stop this at some point to see if the bladder problems disappear?

I ordered the glucosamine, so i will start with this as soon as the pills have arived.

 

[Wiebke]

It's for dogs (1.5mg/ml).

What is the recommended long-term dose of Novacam? The vet has now recommended 0.45ml twice a day for one week (equivalent to a 7kg dog) and then 0.27mg twice a day (equivalent to a 3kg dog) for as long as needed.

Is it wise to stop this at some point to see if the bladder problems disappear?

I ordered the glucosamine, so i will start with this as soon as the pills have arived.

Good. Your vet knows their stuff. That is the dosage I would like to see for one of my own piggies.

Guinea pigs metabolise metacam differently to other species and don't suffer from the same kidney damage, not even after years. Just as an illustration, none of my several piggies who had to be euthanised because of kidney issues over the years was on long term metacam and none of my longer term sterile cystitis and arthritis piggies died because of kidney failure.

Please don't be tempted to leave the metacam off or play around with the minimal dosage (maintenance dosage just once a day or not?) until you are sure that you actually have sterile cystitis with regular flares every few weeks and until you are sure where on the spectrum of running from the very mild to the very severe your piggy is situated.
After about three flares you can try out just how low on the maintenance metacam dose you can go in between flares without triggering a new one and how high you need go very shortly during a flare to help capping it as soon as possible. The metacam is important for helping to relax the walls of the bladder plus the pain and the urinary tract because sterile cystitis seems to attack the natural insulating glucosamine layer of the walls. Fresh urine coming into contact with raw tissue stings mightily - hence the squeaking when peeing.

Right now, please concentrate on getting the symptoms under control in the first place. You then need to wait whether you have bacterial UTI or sterile cystitis (i.e. is there going to be a return or not) and how severe it is going to be - thankfully you seem to range more on the mild to medium spectrum.
Symptoms for all urinary tract problems are very similar and so is the medication - metacam for pain and swelling relief and glucosamine for protecting the lining of the urinary tract is recommended for all of them.

Unfortunately, you have take these things step by step and cannot skip ahead of yourself. They have to play out in real time and there are no shortcuts. The good news is that milder sterile cystitis can go away on its own but we are not talking weeks or even months, we are talking years.

 

[Spring100]

Thank you for your detailed answer. I really appreciate it.

I'm glad to hear my vet gave good advice. I've switched to a vet with a "rodent expert." This vet also has guinea pigs, so I definitely think she knows a lot about them.

Do I understand correctly that you recommend continuing with 0.27ml twice a day after a week until a new flare-up has occurred?

The vet also said it could take years for it to resolve, perhaps never. So I was prepared. But I don't quite understand how I can know whether I can reduce/stop the Novacam or whether I need to continue with a maintenance dose for life. I also don't want to continue with Novacam for nothing. And it turns out it wasn't necessary.

How can I tell if it's a bacterial infection or sterile cystitis? The test strips didn't detect any bacteria, which is why my vet thought it was sterile cystitis.

Sorry for all the questions. My English isn't perfect, so I sometimes struggle to interpret all the information correctly. Thank you so much for your efforts.

 

[Wiebke]

Thank you for your detailed answer. I really appreciate it.

I'm glad to hear my vet gave good advice. I've switched to a vet with a "rodent expert." This vet also has guinea pigs, so I definitely think she knows a lot about them.

Do I understand correctly that you recommend continuing with 0.27ml twice a day after a week until a new flare-up has occurred?

The vet also said it could take years for it to resolve, perhaps never. So I was prepared. But I don't quite understand how I can know whether I can reduce/stop the Novacam or whether I need to continue with a maintenance dose for life. I also don't want to continue with Novacam for nothing. And it turns out it wasn't necessary.

How can I tell if it's a bacterial infection or sterile cystitis? The test strips didn't detect any bacteria, which is why my vet thought it was sterile cystitis.

Sorry for all the questions. My English isn't perfect, so I sometimes struggle to interpret all the information correctly. Thank you so much for your efforts.

Hi

Your vet really knows their stuff if they have already tested for a no or very low count of bacteria, which means that there is no bacterial infection (UTI or urinary tract infection).
Additionally, your vet has most likely also been able to exclude bladder stones etc. either by feel (palpation) or by scan. This means that you are for sure dealing with sterile cystitis.

You can stop your novacam after a week if you wish but brace yourself for a return of symptoms.
Once symptoms return you will have to stay on the novacam for as long as it takes.

In the lower to medium ranges, sterile cystitis is more of a nuisance with daily medication once you have worked out the maintenance level; outside of a few days of discomfort every weeks your piggy will be eable to enjoy a normal life. In the milder to medium forms (which you seem to be dealing with), the time between flare-ups will eventually lengthen and they will eventually stop. The life span won't be affected.
My Nerys (the large guinea pig in my avatar picture on the left) had 3 years of sterile cystitis (after half a year of being treated for 'recurring UTI'at a time when SC only just started to be recognised but then she had another 3 years free of any bladder problems until her death aged 8 years. I hope that this gives you a bit of a perspective.
In the milder forms you are looking at about one and half to two years durination.

Please trust your rodent vet but also trust that they have to go through all the steps in making sure.

 

[Spring100]

Thank you!

The vet tested for bacteria with a test strip and microscopic examination (which was very low), and an x-ray. The x-ray only showed a tiny bit of grit, but she said this was a normal level. No stones or a lot of grit.

After a week, I'll switch to 2 x 0.27 ml and then call the vet to find out how long I should continue. I'm also going to buy the test strips. I thought I understood I could test myself every week. If there's no blood, I could reduce the Novacam and see what happens. I believe that's what she said.

Do you have any tips for collecting urine for the test strip? The vet expressed it by pressing on his bladder, but I don't do this myself because of the risk of doing something wrong.

 

[Wiebke]

Thank you!

The vet tested for bacteria with a test strip and microscopic examination (which was very low), and an x-ray. The x-ray only showed a tiny bit of grit, but she said this was a normal level. No stones or a lot of grit.

After a week, I'll switch to 2 x 0.27 ml and then call the vet to find out how long I should continue. I'm also going to buy the test strips. I thought I understood I could test myself every week. If there's no blood, I could reduce the Novacam and see what happens. I believe that's what she said.

Do you have any tips for collecting urine for the test strip? The vet expressed it by pressing on his bladder, but I don't do this myself because of the risk of doing something wrong.

Expressing can cause a tiny bit of blood being mixed in the urine. Put your piggy on a plastic surface about 30 minutes to an hour after you have fed her fresh veg and wait and wait and wait... Piggies can hold their bladder for a surprisingly long time on surfaces they don't like but there is no other way.
Then just dip the test strip into the puddle or ideally several puddles. Please be aware that dark, slightly dull red porphyine pees are normal for the onset of a urinary tract infection of any sort or a cystitis flare. They may or may not contain blood. Seemingly clear pees can test high for blood. I've played that particular game with Nerys...

 

[dongzheng]

It's heartening to see your discussions—my guinea pig has faced the same issue. After adopting your approach, the little one is now much more comfortable. I've noticed that feeding more vegetables causes extreme acidification of its urine, making it whimper when urinating. The urine often appears dark in colour, and I suspect it may contain traces of blood. Could this be pyelonephritis? Have you encountered similar symptoms? Additionally, I've observed that whenever it feels unwell, its legs and hindquarters become involuntarily soaked. For some reason, local vets have limited knowledge of guinea pigs, and the prescribed meloxicam dosage was clearly insufficient, rendering the treatment entirely ineffective. The vet detected a significant number of cocci in the urine sample, diagnosing it as a bacterial infection based on the data. However, given the recurring symptoms, I've always suspected it might be non-bacterial cystitis. The exact cause remains unclear.

Additionally, which test strips did you purchase? Might you share a photograph? I wish to buy test strips for my guinea pig but am unsure how to select them. Translation software often contains inaccuracies; an actual photograph would be more helpful. Regarding glucosamine, there are currently no high-quality products available domestically. I found a British formula containing artificial feed and chicken flavouring, but I hesitate to use it—currently, only glucosamine hydrochloride capsules or glucosamine sulphate capsules are available. Both lack N-acetyl (N-acetylglucosamine): I understand this component protects the mucosal layer, so I wish to confirm whether the current options lacking N-acetyl can still repair the bladder mucosa and exert a protective effect?

I also discovered the Chinese-market drug "Guangjinqiancao Total Flavonoids", used to treat human fallopian tube stones, possessing both lithotripsy and diuretic effects. This triterpenoid extract outperforms the plant itself, demonstrating favourable efficacy in rodent studies. However, guinea pig data is absent, and it remains unclear whether guinea pigs require equivalent dosing to rodents. Furthermore, this medication requires prescription in China and is restricted to human use. Nevertheless, I have administered this drug to my guinea pig with what I perceive as excellent results. I wonder if this information might be of assistance to you!

 

[Piggies&buns]

It's heartening to see your discussions—my guinea pig has faced the same issue. After adopting your approach, the little one is now much more comfortable. I've noticed that feeding more vegetables causes extreme acidification of its urine, making it whimper when urinating. The urine often appears dark in colour, and I suspect it may contain traces of blood. Could this be pyelonephritis? Have you encountered similar symptoms? Additionally, I've observed that whenever it feels unwell, its legs and hindquarters become involuntarily soaked. For some reason, local vets have limited knowledge of guinea pigs, and the prescribed meloxicam dosage was clearly insufficient, rendering the treatment entirely ineffective. The vet detected a significant number of cocci in the urine sample, diagnosing it as a bacterial infection based on the data. However, given the recurring symptoms, I've always suspected it might be non-bacterial cystitis. The exact cause remains unclear.

Feeding vegetables doesn’t acidify piggy urine. Their urine is naturally very alkaline and it is very hard acidify it. The alkalinity is why piggies can have bladder issues.
Dark urine is usually caused by dehydration, bladder stones/sludge/crystals/infections - all of which we know your piggy has.
If bacteria had been found, then your piggy does not have non-bacterial (sterile) cystitis. There is no (or a very low count) bacteria with sterile cystitis. If a bacterial infection is not being cured by antibiotics then you need different antibiotics.

 

[dongzheng]

Feeding vegetables doesn’t acidify piggy urine. Their urine is naturally very alkaline and it is very hard acidify it. The alkalinity is why piggies can have bladder issues.
Dark urine is usually caused by dehydration, bladder stones/sludge/crystals/infections - all of which we know your piggy has.
If bacteria had been found, then your piggy does not have non-bacterial (sterile) cystitis. There is no (or a very low count) bacteria with sterile cystitis. If a bacterial infection is not being cured by antibiotics then you need different antibiotics.

Thank you for replying to me, I don't know why my little pig has been given 7 days of antibiotics and meloxicam, but he still pees on his butt, the doctor prescribed me an upgraded version of enoxacin, this is the picture I sent,Because the artificial powder I bought to repair the bladder mucosa has a chicken flavor, I haven’t given it to him for the past two days, but I don’t know what went wrong. Normally, it shouldn’t be the butt anymore. I’m very worried.In addition, I took glucosamine and hyaluronic acid for 30 days to repair my bladder. At that time, I didn't see his butt so wet, so I still suspected that he might have a bacterial infection of the bladder, I don't know why, maybe it's because I didn't use the sulfa antibiotics this time, or maybe it's because the bladder protection I bought is not right.

 

[dongzheng]

Thank you for replying to me, I don't know why my little pig has been given 7 days of antibiotics and meloxicam, but he still pees on his butt, the doctor prescribed me an upgraded version of enoxacin, this is the picture I sent,Because the artificial powder I bought to repair the bladder mucosa has a chicken flavor, I haven’t given it to him for the past two days, but I don’t know what went wrong. Normally, it shouldn’t be the butt anymore. I’m very worried.In addition, I took glucosamine and hyaluronic acid for 30 days to repair my bladder. At that time, I didn't see his butt so wet, so I still suspected that he might have a bacterial infection of the bladder, I don't know why, maybe it's because I didn't use the sulfa antibiotics this time, or maybe it's because the bladder protection I bought is not right.

Maybe I shouldn’t appear in this clue, I’ll go back to my clue, otherwise, it will affect others!