Clearing Bladder Sludge Effectively

[Parnassus]

Hi friends! I'm feeling heartsick tonight. My sweet Whistler has been diagnosed with bladder sludge. It's my first guinea pig with sludge! So, I'm convinced she's just more naturally gifted in developing it than others. ;D I could use some advice, even if it's just to keep doing what I'm doing/planning.

Whistler and me watching Gilmore Girls together.


Vet's Instructions (we follow to a T):

Baytril twice daily for two weeks

Probiotics twice daily for two weeks (in the States we're recommended to give probiotics 1 hour before antibiotics, so we're doing that -- I have seen suggestions on the site of giving probiotics 1 hour afterwards instead, so I thought I should clarify.)​

Metacam once daily for two weeks
Filtered water only (started yesterday), and plenty of it
Switching out Timothy hay 2nd cut for oat hay (currently now giving a mix of 3rd cut Timothy [0.44% calcium] and oat hay)

Whistler says hello! And please help me heal fast!


Additional Things I Want To Do:

Looking for a high quality local feed store to swap our 3rd cut Timothy with orchard grass
Wanting to syringe feed filtered water every day for the treatment period
Want to swap out Oxbow Vitamin C for a lower calcium content option (Oxbow's Vitamin C supplements have between 0.5% and 0.7% calcium content -- that seems pretty high for my bladder piggy!)
Mix in some cucumber with skin into their daily veggie intake

P.S. We already only give low calcium veggies (red leaf or green leaf as staples. Sometimes cilantro, parley, or cucumber to mix things up). We also switched to KMS pellets some time ago, because the max calcium is significantly lower [min/max = 0.41/0.54%] than Oxbow pellets [min/max = 0.35%/0.85%].


Questions:

How do I know for sure I've found a good feed store for guinea pigs? I've only ever ordered hay via Oxbow and KMS Hayloft.
How much is too much per water feeding attempt (per day, they should get 10-15mL, right?)
Oxbow Vitamin C has become sort of a staple in the guinea pig community over here. Does anyone know of or use something else for Vitamin C that's comparable in quality? I can't find any reliable sources on this one myself.
Is there anything else I can do to help my girl?
Has anyone successfully helped a pig get rid of bladder sludge? If so, what did you do to set your piggies up for success?

Whistler (left) and Blade (right), best friends forever! Having lap time and being too adorable! They've only found each other 1 year ago, I want to give them a long life together.

 

[Parnassus]

How much is too much per water feeding attempt (per day, they should get 10-15mL, right?)

Whoops! This should read *100-150mL (what a typo!).

 

[DM030819]

Wet the veg as well. My bladder sludge boy isn't a great drinker so i make sure his veg is wet when he gets it.

Also, lots of floor time. This will shake up his bladder and make sure the sludge doesn't settle and be more likely to form into a stone. It could be peed out quicker that way too.

 

[Parnassus]

Wet the veg as well. My bladder sludge boy isn't a great drinker so i make sure his veg is wet when he gets it.

Also, lots of floor time. This will shake up his bladder and make sure the sludge doesn't settle and be more likely to form into a stone. It could be peed out quicker that way too.

Excellent, thank you! Setting up floor time now.

 

[VickiA]

That's a very good point activity and about bladder sludge. One of my previous piggies (old Mrs Fudge) had to have a bladder flush for bladder sludge. But she was not keen on activity due to old age and arthritis (and generally being a couch potato pig by choice) The vet told us to keep her active afterwards, too.

 

[Wiebke]

Hi! I am very sorry - bladder stones and sludge are never cheerful news.

You can encourage your piggy to make a big pee and hopefully flush out some crystals by offering it water, ideally up to 10-15 ml, BUT please do NOT give them more water than they are willing to take! Never give them more water than they can swallow, i.e. about 0.3-0.5 ml (1/3 - 1/2 of a 1 ml syringe) in one go. That is about one mouthful. Wait until that has gone down before offering more.

To be honest, you can give probiotics anytime, both before and after if you wish to - it is either meant to bolster the guts for the arrival of the antibiotic or re-stock them in the wake of the antibiotic. How effective probiotics are is still a matter of debate amongst vets and has not been researched. You can also add them to the water you are syringing.
In order to re-stock the guts, you can also offer "poo soup", water in which you have soaked fresh poos from a healthy piggy. It is a bit gross, but this mimics natural behaviour. Ideally you get hold of a caecotroph or too (those are the ones that piggies eat for redigestion), but even a normal poo still contains plenty of the "right" stuff.
Most guinea pigs cope well with any brand of antibiotic, and in my own experience it doesn't make any difference whether you give probiotics or not, but some guinea pigs can have a bad reaction to them (which can happen with any brand), lose their appetite completely and require syringe feeding. Baytril is one of those where bad reactions are more common, but it is still the only officially licensed and therefore most prescribed brand, so that is a major factor in the number of reports and enquiries that we get on score, too.

Please be aware that your measures may not be able to get rid of the sludge by natural means and that your piggy may require a bladder flush or an operation in the end. You need to have a very experienced vet for a bladder flush, though, as the unexperienced ones will flush too much too hard, meaning that the fluid backs up into the kidneys and the piggy dies within about 10 days of the procedure.
My Cariad required a number of flushes when her calcium absorption went suddenly out of kilter for some reason; so it can be done in the right hands - she was a tiny and seemingly fragile piggy, yet she made it through a number of problems, several operations and flushes, and survived seemingly stronger and fitter companions.
If necessary, ask Portland Guinea Pig Rescue whether they have a vet that is experienced with the procedure.

The rescue may also be able to help you with brand recommendations. There are now grain-free and calcium-free pellet brands available online, but most of the ones we can get hold of in this country are European, so I don't know whether there are US brands doing the same (Rosewood?). These pellet brands are not cheap, though. If you are not able to, cut down on the amount of pellets, or cut them out completely.

A number of members (including me) have found that filtering water has made a difference with bladder piggies. It is not just the calcium, but also the minerals in the water that can contribute to the formation of stones and crystals, so it is not just a matter of cutting out hard water.

Another area you can look at is at a long term balanced vegetable diet. I am tagging in @helen105281 for you on that score.
We have got a list of low calcium veg here, but there seem to be some veg that are more prone to trigger infections than others although that is still in the more experimental stage. The veg you are citing are all "good veg". You will need to feed a small amount of slightly higher content calcium veg (like a slice of spring greens), as magnesium seems to be tied to the calcium content, and it is not one of the minerals that is added to pellets. it is unfortunately not quite as easy as simply to cut it all out!
Low Calcium Diet For Bladder Piggies

Giving a glucosamine-based food supplement is usually recommended by piggy savvy vets in the UK. It helps to protect the natural glucosamine coat of the bladder walls from the constant irritation of the crystal shards. Most use a cat food supplement for cats, which are he other pet species prone to urinary tact problems. Can you get cystease online in the US? It is not a medication, but a food supplement and therefore prescription-free.

As long as you have got sludge in the bladder, you have to brace yourself that cystitis caused by the irritation of the walls can can come back. It is an inflammation of the bladder walls and not necessarily reaction all that much to

All the best!

 

[helen105281]

The veg I feed twice a day (one has bladder issues) is:

1 sprig of coriander (cilantro in the US)
1 piece of pepper
1 piece of celery
1 piece of cucumber
a slither of spring greens (collard greens in the US)
1 green bean

I do give the odd treat of a small piece of carrot or apple but not more than once a week.

 

[Parnassus]

Terrific advice, all around! Thanks for being so thorough!

Unfortunately, I haven't had very good experiences with the PGPR -- but that's a story for another day! I've called my cavy savvy vet this morning and asked if I could run some dietary tweaks by her (Dr. Surrency, one of the few experts in our area) via email this weekend, and she is totally on board for it, so I'll be collecting some of your feedback to pass along for our vet's input and approval.

On Pellets: I love the idea of a no-calcium pellet choice, I'll be interested in hearing of any local options, and cutting down on the amount of pellets as well.

On Water Intake: Whistler is loving the water syringe during pellet time, so she doesn't need to move to make any pellet slurry in her mouth. Blade also insists on getting the grade A treatment, so we share a bit of the water "treat" with her, too.

On veggies: Thank you @helen105281! This makes things much less complicated on the veggie front!

I've passed all recommendations along to my vet's office for her final approval on any/all of what we're not already doing. Thanks again! Will keep you updated.

 

[Parnassus]

Update:

Our vet has us giving a mix of celery, cucumber, red/green leaf lettuce, an occasional spring of cilantro and bit of non-sweet tomato.

Our vet ordered us a potassium citrate compound-- We just got our delivery today (0.28mL 2x a day)! Question: is it okay to start these doses tonight, along with metacam and baytril? Or do we need to wait until we're done with our baytril/metacam treatment course first?

Our vet has suggested we start giving monthly shots for a PSGAG called Adequan to help protect Whistler's bladder lining, as opposed to the suggested cat supplement. I am wondering if anyone gets their bladder pigs monthly shots? Is it worth it? Won't the shots hurt her -- are we just trading one kind of pain for another? It won't be cheap or easy. I want to be sure it'll be worth it -- pain, cost and all.

We have our re-check with the vet this Thursday, and Whistler is acting like her normal self, only had pain when urinating and significant chalky white stuff in her urine almost a week ago -- I hope that's a good sign!

 

[Poppy'sMum]

I have given Potassium Citrate to my bladder pig when she was alive, together with monthly Cartrophen injections. She also had a small dose of Metacam pain relief daily too. Both helped greatly & she was treated for 4 years successfully.

 

[Parnassus]

I have given Potassium Citrate to my bladder pig when she was alive, together with monthly Cartrophen injections. She also had a small dose of Metacam pain relief daily too. Both helped greatly & she was treated for 4 years successfully.

Oh good! So glad to hear that it really helps.

Do you know if giving potassium citrate and baytril the same night is safe?

 

[DM030819]

My Anselmo has had both on an evening and was okay. If you're not certain though then give your vet a quick ring to check.