Bladder Stone Surgery Delay

[Katie A]

Hello,

My 2 year old boar was diagnosed with a bladder stone on Tuesday. He is currently on antibiotics and a pain med. He's only been on the meds for 2 days but he's crying loudly when he pees or poos and it's pretty constsnt. Every 5 minutes or so. His surgery is scheduled for Wednesday and I've called probably 10 other vets and no one can do it sooner. He's currently eating fine and he's no longer losing weight. Energy level is also fine. What signs do I need to watch for to go to emergency vet? Should he still be in so much pain?

 

[Claire W]

I am very sorry The danger you face is the stone getting stuck in the urethra which I’m sorry to say is more difficult in boars stopping urine flow and causing urine to flow back to the kidneys. A stuck bladder stone is a life or death emergency. I appreciate that you’re in the states where vet care is more difficult to access than it is here in the U.K. but please do keep trying. Wednesday is 5 days away which is a long time, I'm surprised your vet was happy to leave him that long to be honest

 

[Katie A]

Yeah the vet was saying that because of the size and location he didn't think it was as urgent to remove immediately as he didn't see it moving in the next few days and wanted to do a week of antibiotics first.

I'm so lost on what to do. Most of the vets I've tried aren't comfortable with this level of surgery and the ones that can do it can't until next week. The last option is an emergency vet 3 hours away but I don't know if he'd qualify since he's eating and no more weight loss. And even they said it would be an exam but probably not immediate/same day surgery.

 

[Katie A]

I am very sorry The danger you face is the stone getting stuck in the urethra which I’m sorry to say is more difficult in boars stopping urine flow and causing urine to flow back to the kidneys. A stuck bladder stone is a life or death emergency. I appreciate that you’re in the states where vet care is more difficult to access than it is here in the U.K. but please do keep trying. Wednesday is 5 days away which is a long time, I'm surprised your vet was happy to leave him that long to be honest

Sorry meant to reply to you directly but it posted on the main reply thread

 

[Claire W]

I guess if the stone is in the bladder, it has less chance of getting stuck but I would perhaps keep trying and see if one of the vets who are comfortable with doing the surgery have a cancellation

 

[Katie A]

I guess if the stone is in the bladder, it has less chance of getting stuck but I would perhaps keep trying and see if one of the vets who are comfortable with doing the surgery have a cancellation

Okay I will definitely keep trying them but I'm not too hopeful.

Will the pain persist even while on pain med? He's on 0.4 ml metcam once daily.

 

[Piggies&buns]

I’m sorry to hear this.
Is that cat or dog metacam? That makes a difference as dog is three times stronger so would be the preferred option for something as painful as a bladder stone.
If it is cat metacam then it is likely not enough and certainly not at once a day.
Piggies need their pain meds twice a day as they metabolise in around 12 hours.

If he is still in pain, then contact your vet and ask them to review dosages

 

[Katie A]

I’m sorry to hear this.
Is that cat or dog metacam? That makes a difference as dog is three times stronger so would be the preferred option for something as painful as a bladder stone.
If it is cat metacam then it is likely not enough and certainly not at once a day.
Piggies need their pain meds twice a day as they metabolise in around 12 hours.

If he is still in pain, then contact your vet and ask them to review dosages

Hmm I'm not sure if it is dog or cat. Will it say on the bottle? I'll look when I get home. Yeah I called the vet this morning and they left a message to his vet. Just called again and they said vet has been in surgeries all day and hasn't looked at his messages yet. 3 hours till they close so hoping they call back soon.

 

[Piggies&buns]

Hmm I'm not sure if it is dog or cat. Will it say on the bottle? I'll look when I get home. Yeah I called the vet this morning and they left a message to his vet. Just called again and they said vet has been in surgeries all day and hasn't looked at his messages yet. 3 hours till they close so hoping they call back soon.

Yes it will either say cat or dog or it will give the concentration -

0.5mg/ml is cat
1.5mg/ml is dog

 

[Katie A]

The vet just called and is upping the metacam to twice a day and adding a second pain med gabapentin.

 

[Katie A]

Okay, The bottle says meloxicam 1.5mg.

And update. I got home and gave him all the meds. Weight is still stable. The vet said to make sure he can still pee and Odi gave me a large pee puddle on the bathroom floor.

I have a question about next week's surgery. I have a bonded boy pair. I'm dropping Odi off at 7am and picking him up around 4pm. Can I put him and his cage mate back together immediately? Will being apart for the day break the bond? They have a 2x6 with a 1x1 loft.

 

[Piggies&buns]

Okay, The bottle says meloxicam 1.5mg.

And update. I got home and gave him all the meds. Weight is still stable. The vet said to make sure he can still pee and Odi gave me a large pee puddle on the bathroom floor.

I have a question about next week's surgery. I have a bonded boy pair. I'm dropping Odi off at 7am and picking him up around 4pm. Can I put him and his cage mate back together immediately? Will being apart for the day break the bond? They have a 2x6 with a 1x1 loft.

That’s dog metacam. it’s good you’ve been able to increase it to twice a day and he’s got another pain killer too

I would ask the vet if you can take both piggies. My vets always allow companions to be there. They are kept in the same cage right up until surgery. Surgery will happen and then the piggy will be put back into a different cage to recover but they try to put them in cages next to each other. Once the piggy is awake from anaesthetic and doing well then they are put back together for comfort and companionship for them both.
If they will not allow you to take both piggies in, then you want to get them back together as soon as you can once Odi is home.

This guide explains more - Tips For Post-operative Care

Make sure you switch to weighing him daily so you can step in and syringe feed if he needs that support

 

[weepweeps]

I’m so sorry your piggy has a stone. My advice would be to make sure you take him to the vet that has the most experience with this operation. Good luck

 

[Katie A]

Thank you so much! Just talked to the vet and they said I can bring his cage mate along for company.

He's so much better now with the extra pain medicine. Didn't cry at all last night!

That’s dog metacam. it’s good you’ve been able to increase it to twice a day and he’s got another pain killer too

I would ask the vet if you can take both piggies. My vets always allow companions to be there. They are kept in the same cage right up until surgery. Surgery will happen and then the piggy will be put back into a different cage to recover but they try to put them in cages next to each other. Once the piggy is awake from anaesthetic and doing well then they are put back together for comfort and companionship for them both.
If they will not allow you to take both piggies in, then you want to get them back together as soon as you can once Odi is home.

This guide explains more - Tips For Post-operative Care

Make sure you switch to weighing him daily so you can step in and syringe feed if he needs that support

That’s dog metacam. it’s good you’ve been able to increase it to twice a day and he’s got another pain killer too

I would ask the vet if you can take both piggies. My vets always allow companions to be there. They are kept in the same cage right up until surgery. Surgery will happen and then the piggy will be put back into a different cage to recover but they try to put them in cages next to each other. Once the piggy is awake from anaesthetic and doing well then they are put back together for comfort and companionship for them both.
If they will not allow you to take both piggies in, then you want to get them back together as soon as you can once Odi is home.

This guide explains more - Tips For Post-operative Care

Make sure you switch to weighing him daily so you can step in and syringe feed if he needs that support

 

[Free Ranger]

These are George's current stones...
which reformed shortly after this one was removed in Jan

Now these are massive so you'd have thought George would be in agony but actually he's not. He's 6, he has arthritis and impaction, and he squeaks when he pees and sometimes when pooping but it's hard to know what's happening there because of his impaction. He doesn't pee much more often than the other pigs here. I'm sure he could be more comfortable (future surgery hasn't been ruled out). But even the pee-squeaks aren't loud. These stones are rounded and the vets think they are likely calcium carbonate. There are different types of stone - some are a bit more pointy.

However, George is being treated for a UTI on top of having stones and he's had UTI before with his other one. The infections caused inflammation and it's the inflammation that makes them cry like that. In December when George had beaten his infection he was trundling round like a normal boy unless he was peeing. There was no visible blood in his pee even, despite carrying a stone like a marble. Hopefully your antibiotics will get on top of his infection and your painkillers will see him through. Personally, if I were in your shoes, I actually wouldn't want surgery sooner because it must be more difficult stitching a swollen and inflamed bladder. These few days give the antibiotic time to take effect. George is on a similar twice daily dose of the same metacam and he has 0.1ml of Gabapentin now and again if he is a bit inflamed for some reason. But it was only his infections which made him cry loudly and regularly throughout the day.

When he had his stone removed I split him from the girls like this so they could see and interact with each other but there was a grid in between. This helped him take it easy for a while until his stitches had healed. And he didn't have any challengers for the snuggle tunnel! And I could monitor his eating and pooping.


Sometimes stones do reform - George has been unlucky. He is old now and has other issues which make things complicated. If I thought another surgery could work right now we'd go for it but the chances are that unless something changes for him he'll just form another stone. So I'm hoping for the right time. He maintains weight between 900 and 950 usually - currently he has dropped below 900 because if the new UTI (which makes his back end smell like fish - most unpleasant!) but at least his antibiotics (Baytril morning and evening) aren't putting him off his dinner too much.

Good luck with your surgery little man x

 

[Katie A]

Thank you for sharing George's story. Such a handsome little guy! Wow! I can't get over the size of his stone. That is massive! That is a good point about waiting on surgery until some of the infection goes down. I do remember the vet mentioning wanting to give the antibiotics a few days to work before surgery....that is scary though how fast George got another stone! Awww I hope he gets feeling better as well with his painful UTI. Poor little guy. Feel better George!

These are George's current stones...
View attachment 221989 which reformed shortly after this one was removed in Jan View attachment 221990

Now these are massive so you'd have thought George would be in agony but actually he's not. He's 6, he has arthritis and impaction, and he squeaks when he pees and sometimes when pooping but it's hard to know what's happening there because of his impaction. He doesn't pee much more often than the other pigs here. I'm sure he could be more comfortable (future surgery hasn't been ruled out). But even the pee-squeaks aren't loud. These stones are rounded and the vets think they are likely calcium carbonate. There are different types of stone - some are a bit more pointy.

However, George is being treated for a UTI on top of having stones and he's had UTI before with his other one. The infections caused inflammation and it's the inflammation that makes them cry like that. In December when George had beaten his infection he was trundling round like a normal boy unless he was peeing. There was no visible blood in his pee even, despite carrying a stone like a marble. Hopefully your antibiotics will get on top of his infection and your painkillers will see him through. Personally, if I were in your shoes, I actually wouldn't want surgery sooner because it must be more difficult stitching a swollen and inflamed bladder. These few days give the antibiotic time to take effect. George is on a similar twice daily dose of the same metacam and he has 0.1ml of Gabapentin now and again if he is a bit inflamed for some reason. But it was only his infections which made him cry loudly and regularly throughout the day.

When he had his stone removed I split him from the girls like this so they could see and interact with each other but there was a grid in between. This helped him take it easy for a while until his stitches had healed. And he didn't have any challengers for the snuggle tunnel! And I could monitor his eating and pooping.
View attachment 221991 View attachment 221993

Sometimes stones do reform - George has been unlucky. He is old now and has other issues which make things complicated. If I thought another surgery could work right now we'd go for it but the chances are that unless something changes for him he'll just form another stone. So I'm hoping for the right time. He maintains weight between 900 and 950 usually - currently he has dropped below 900 because if the new UTI (which makes his back end smell like fish - most unpleasant!) but at least his antibiotics (Baytril morning and evening) aren't putting him off his dinner too much.

Good luck with your surgery little man x

 

[Katie A]

Odi (fluffy one) and Flynn.

 

[Katie A]

Sorry, one more question! I'm trying to make some diet changes and have read the care guide for the long-term special diet. I'm confused about what Interstitial cystitis is and I don't remember my vet mentioning this during his exam. If he has bladder sludge, a UTI and a bladder stone does that mean he has IC too? I know the diet guide says to avoid lettuce if a pig has IC, but I'm just confused on what that is compared to sludge/UTI/stone diagnosis.... Thanks!

Their current diet includes filtered water, 1 tablespoon of Oxbow pellets a day, fresh veggies and plenty of Timothy hay. Veggies were about 1.5 cups a day each. I admit to going a bit heavy on lettuce (red leaf, green leaf and romaine) but I thought it was safer than other veggies calcium wise. They get a variety of other veggies too (cilantro, parsley, green beans, cucumber, kale, spring mix, bell peppers, broccoli, carrot, fennel, celery, etc) that I would rotate each week. But lettuce was daily. Very confused now and a 2 year old piggie just seems young to have stone issues already. Thanks!

 

[Claire W]

You should really cut out the parsley, kale and broccoli if he has a stone and bladder sludge as these are all very high calcium veg. Lettuce and cilantro can be fed daily and everything else no more than once or twice a week.

IC is a sterile cystitis and presents with similar symptoms as a UTI but there’s no bacteria present so can’t be cured by antibiotics. It doesn’t cause bladder stones to form but some guinea pigs with IC do present with a thickened bladder wall x

 

[Katie A]

You should really cut out the parsley, kale and broccoli if he has a stone and bladder sludge as these are all very high calcium veg. Lettuce and cilantro can be fed daily and everything else no more than once or twice a week.

IC is a sterile cystitis and presents with similar symptoms as a UTI but there’s no bacteria present so can’t be cured by antibiotics. It doesn’t cause bladder stones to form but some guinea pigs with IC do present with a thickened bladder wall x

Is Romaine lettuce still okay? I know there is some debate on romaine and sludge issues. Romaine is their favorite. They will eat green leaf and only tolerate red leaf.

 

[Claire W]

Is Romaine lettuce still okay? I know there is some debate on romaine and sludge issues. Romaine is their favorite. They will eat green leaf and only tolerate red leaf.

I think so. Romaine is just a bigger version of little gem which can be fed daily but see what other members think first

 

[Piggies&buns]

Sorry, one more question! I'm trying to make some diet changes and have read the care guide for the long-term special diet. I'm confused about what Interstitial cystitis is and I don't remember my vet mentioning this during his exam. If he has bladder sludge, a UTI and a bladder stone does that mean he has IC too? I know the diet guide says to avoid lettuce if a pig has IC, but I'm just confused on what that is compared to sludge/UTI/stone diagnosis.... Thanks!

Their current diet includes filtered water, 1 tablespoon of Oxbow pellets a day, fresh veggies and plenty of Timothy hay. Veggies were about 1.5 cups a day each. I admit to going a bit heavy on lettuce (red leaf, green leaf and romaine) but I thought it was safer than other veggies calcium wise. They get a variety of other veggies too (cilantro, parsley, green beans, cucumber, kale, spring mix, bell peppers, broccoli, carrot, fennel, celery, etc) that I would rotate each week. But lettuce was daily. Very confused now and a 2 year old piggie just seems young to have stone issues already. Thanks!

Sterile Interstitial Cystitis (IC) presents with UTI symptoms but it is recurrent (interstitial) and without bacteria being present (sterile). It affects the glucosamine layer in the bladder which causes pain when urine comes into contact with the bladder tissue.
A bacterial UTI will be cured by a course of antibiotics because it is bacterial (faecal bacteria getting into the urinary tract). IC may be suppressed by antibiotics but cannot be cured because it is a non bacterial issue. It can only be managed by pain meds, glucosamine supplements and keeping the diet stable.
It can only be diagnosed when all other bladder issues (such as bacterial infection and stones) have been ruled out.
It is similar to a condition seen in cats, and is thought to be caused by stress.
The guide is a bit out of date. Piggies with IC can indeed be fed lettuce. IC flares tend to be exacerbated by changes to the diet, not the diet itself.

Just because your piggy has a stone, it does not mean he has IC.
A 2 year old piggy is not too young to have issues with stones.

In your case, you should review the diet. Although any changes in the diet will take several weeks to have an effect on the calcium levels in the body. Also note that taking calcium intake too low can cause as many problems as calcium intake being too high.
Most calcium comes into the diet via pellets and drinking water, not through veg.
Pellets contain more calcium than the highest calcium veg (kale), so ensure you feed only one tablespoon of pellets per day and ideally ensure they are grain free pellets. Also filter drinking water.
In terms of veg, don’t feel kale, parsley or spinach more than a tiny bit once a week. Grains and root veg should be avoided, so cut the carrot right down (it’s too high in sugar also to feature more than as a very occasional treat).
What is important is keeping the bladder flushing though - feeding a wet diet can help if piggy isn’t a bit drinker. A good amount of veg and you can also wet the veg and feed it dripping with filtered water to help increase water intake.
Safe daily veggies are lettuce, bell pepper, cilantro and cucumber.
However, there is also a genetic element to a piggy’s stone likelihood, but there is obviously nothing you can do about that, you can only manage the diet.

 

[Katie A]

Sterile Interstitial Cystitis (IC) presents with UTI symptoms but it is recurrent (interstitial) and without bacteria being present (sterile). It affects the glucosamine layer in the bladder which causes pain when urine comes into contact with the bladder tissue.
A bacterial UTI will be cured by a course of antibiotics because it is bacterial (faecal bacteria getting into the urinary tract). IC may be suppressed by antibiotics but cannot be cured because it is a non bacterial issue. It can only be managed by pain meds, glucosamine supplements and keeping the diet stable.
It can only be diagnosed when all other bladder issues (such as bacterial infection and stones) have been ruled out.
It is similar to a condition seen in cats, and is thought to be caused by stress.
The guide is a bit out of date. Piggies with IC can indeed be fed lettuce. IC flares tend to be exacerbated by a change to the diet, not the diet itself.

Just because your piggy has a stone, it does not mean he has IC.
A 2 year old piggy is not too young to have issues with stones.

In your case, you should review the diet. Although any changes in the diet will take several weeks to have an effect on the calcium levels in the body. Also note that taking calcium intake too low can cause as many problems as calcium intake being too high.
Most calcium comes into the diet via pellets and drinking water, not through veg.
Pellets contain more calcium than the highest calcium veg (kale), so ensure you feed only one tablespoon of pellets per day and ideally ensure they are grain free pellets. Also filter drinking water.
In terms of veg, don’t feel kale, parsley or spinach more than a tiny bit once a week. Grains and root veg should be avoided, so cut the carrot right down (it’s too high in sugar also to feature more than as a very occasional treat).
What is important is keeping the bladder flushing though - feeding a wet diet can help if piggy isn’t a bit drinker. A good amount of veg and you can also wet the veg and feed it dripping with filtered water to help increase water intake.
Safe daily veggies are lettuce, bell pepper, cilantro and cucumber.
However, there is also a genetic element to a piggy’s stone likelihood, but there is obviously nothing you can do about that, you can only manage the diet.

Thank you so much for all of this information! I'm going to start researching some different pellets but they are really picky with pellets. I had tried maybe 4 other brands before Oxbow and Oxbow is the only ones they will eat. But even then they aren't huge on them. I give a measured tablespoon a day and they only eat about half of it.

I need to keep reading but I keep seeing glucosamine and cystease pop up on other threads. Should I start him on that?

And should I start growing some fresh grass? They have loved it in the past, but it wasn't something that I do regularly.

Thank you!

 

[Piggies&buns]

Thank you so much for all of this information! I'm going to start researching some different pellets but they are really picky with pellets. I had tried maybe 4 other brands before Oxbow and Oxbow is the only ones they will eat. But even then they aren't huge on them. I give a measured tablespoon a day and they only eat about half of it.

I need to keep reading but I keep seeing glucosamine and cystease pop up on other threads. Should I start him on that?

And should I start growing some fresh grass? They have loved it in the past, but it wasn't something that I do regularly.

Thank you!

Glucosamine is what the bladder is lined with. Giving cytease can help replenish that layer and help repair a damaged bladder. It won’t stop stones being formed.
The only thing you can do to reduce sludge and stone formation is keep the bladder flushing through by ensuring piggy is taking on enough water and urinating frequently; and ensuring you find the healthy balance for your piggy in calcium and oxalate intake.
Pellets are such a tiny part of ghe diet and are actually the expendable part. If you can provide the nutrients in other ways, then don’t worry about them not eating many pellets. My four piggies only get about half a tablespoon or so (it’s not usually as much as one tablespoon) and I only give them about three times a week (my piggies think I’m mean!)

Grass is their natural diet, so if you can provide it then definitely do so. Make sure to introduce it slowly though so as to not cause any digestive upset.

 

[Katie A]

Glucosamine is what the bladder is lined with. Giving cytease can help replenish that layer and help repair a damaged bladder. It won’t stop stones being formed.
The only thing you can do to reduce sludge and stone formation is keep the bladder flushing through by ensuring piggy is taking on enough water and urinating frequently; and ensuring you find the healthy balance for your piggy in calcium and oxalate intake.
Pellets are such a tiny part of ghe diet and are actually the expandable part. If you can provide the nutrients in other ways, then don’t worry about them not eating many pellets. My four piggies only get about half a tablespoon or so (it’s not usually as much as one tablespoon) and I only give them about three times a week (my piggies think I’m mean!)

Grass is their natural diet, so if you can provide it then definitely do so. Make sure to introduce it slowly though so as to not cause any digestive upset.

Thank you so much! I will get some wheat grass planted today!

 

[Katie A]

Update... I just got Odi home from surgery and it went well. He's still completely out of it from the drugs (won't move at all). But it's still been just a few hours since surgery. How soon do I need to syringe feed if necessary? Not sure how safe it is to force food into him when he's not even awake? I don't want any going into his lungs. Thanks!

 

[Free Ranger]

George wasn't quite right for 24 hours after his anaesthetic. He was checked post-op at 2 pm and they gave him 10ml syringe food which I was a bit surprised about. I thought by 6-8 pm back at home he was supposed to be ok, then I thought maybe I'd heard wrong and it was 8 hours not 8pm so at 10pm I ended up phoning the vet for advice. They said that it was because he was an old boy and also he'd had a double-dose of the opioid painkiller buprenorphine after it that it would drag on He didn't eat any hay at this point. But I did very small amounts of syringe food (not too thick) here and there. It was just to keep the guts moving. I had more success with veggies: he was hiding in a bag completely out of it and I touched a bit of cucumber or lettuce to his lips - he'd suddenly come to and eat about half then zone out again. I was worried about food being left in his mouth. I just had to monitor him closely all day and get up in the night to check too - little and often with food an drink. When he came out of it the next day he started eating by himself and made up for lost time. I hope Odi feels better soon x

 

[Katie A]

George wasn't quite right for 24 hours after his anaesthetic. He was checked post-op at 2 pm and they gave him 10ml syringe food which I was a bit surprised about. I thought by 6-8 pm back at home he was supposed to be ok, then I thought maybe I'd heard wrong and it was 8 hours not 8pm so at 10pm I ended up phoning the vet for advice. They said that it was because he was an old boy and also he'd had a double-dose of the opioid painkiller buprenorphine after it that it would drag on He didn't eat any hay at this point. But I did very small amounts of syringe food (not too thick) here and there. It was just to keep the guts moving. I had more success with veggies: he was hiding in a bag completely out of it and I touched a bit of cucumber or lettuce to his lips - he'd suddenly come to and eat about half then zone out again. I was worried about food being left in his mouth. I just had to monitor him closely all day and get up in the night to check too - little and often with food an drink. When he came out of it the next day he started eating by himself and made up for lost time. I hope Odi feels better soon x

Thanks for the reply! I'm still pretty worried but it really hasn't been that long yet. He's just laying there and hasn't budged but I feel like he's still probably out of it from the surgery drugs. I did bring him a cucumber and he wanted it enough to pretty strongly grab it out of my hand. But then he only took a few nibbles before going back to sleep. I'll give him about an hour then I'll try a little water and syringe food. I'm hoping he'll be more energetic in the morning like your George was!

 

[Wheekallweek]

I hope Odi is feeling better in the morning. He must be very tired after his big day

 

[Katie A]

He did at least move off the bed he was on. Not far, but did move. He also ate about half a slice of pepper. Gave him his own private hay pile which he smelled then fell asleep with his face in it. :/ But at least there is interest in food.