Co Trimoxazole, what dosage is safe?

[Lel]

Hi all, my boy had a second bladder stone op two weeks ago after passing one stone himself (tough cookie). 15 days after the op, all was going well until I noticed red urine.
The vet has advised that she does not believe he has an infection but possibly inflamed bladder lining.
He is on 0.5ml metacam daily and 0.85ml Co Trimoxazole.
My question is, 0.85ml seems a lot, almost a full syringe, is this correct?
Thanks in advance x

 

[Piggies&buns]

You need to go by what your vet has told you. If you aren’t sure, then double check with them.
We can’t comment on what dosage is safe as we aren’t vets nor do we know the history or weight of your piggy.

 

[Wiebke]

Hi!

If you have any concerns, you are always within your rights to ring the clinic and ask.

What you can do is to split the dosage in half and give both metacam and the antibiotic (which is another brand name for bactrim/septrin) every 12 hours instead of every 24 hours as guinea pigs have a faster metabolism if your vet is OK with that.

We cannot comment on dosages without knowing your boy's weight and without knowing which considerations have gone into your vet's prescription. However the antibiotic dosage looks to me like it is within the parameters of a reasonable prescription (not knowing the weight of your piggy), if at the upper end. But that is also something that I would not think unreasonable under the circumstances. UK vets can look up guide lines for dosages in guinea pigs if they are not sure about maximum possible dosages and most will do if they have any doubts.
PS: Have you been given cat or dog metacam? Dog metacam is three times stronger than cat metacam; both are being prescribed for guinea pigs.

Here is our diet advice for guinea pigs with bladder stones in the chapter for guinea pigs with special needs. Please be aware that most calcium is usually coming with the water and the pellets, and not with veg, so filtering the water and reducing the amount of pellets to max 1 tablespoon (15 ml) per piggy per day is vital. Even pellets with no added calcium contain more weight per weight than the highest calcium veg. Long Term Balanced General And Special Needs Guinea Pig Diets

I would also recommend to discuss with your vet the use of a glucosamine based cat food supplement like cystease capsules. Experience has shown that while it takes a little to build up, it is very effective in helping to heal and repair the damage to the natural glucosamine coat that prevents the very corrosive urine coming in touch with the raw tissue of the bladder walls and tubes of the urinary tract. Since it is classed as a food supplement and not as a medication, it is generally not prescribed by vets. As the stone is banging into the bladder walls and scratching against the exit hole with every pee your piggy makes, bladder trauma and bacterial or sterile cystitis are not uncommon secondary complications that become noticeable only after the big immediate discomfort of the stone has been removed since symptoms are very similar.

 

[Lel]

Ohh hi Wiebke, hope you and the piggies are all well xx
Thank you so much for your advice. I did double check the dosage with the vet but I'm just an overly anxious owner and the amount seemed a LOT. Yes the vet agreed that it is fine to split the dosage.
He has been given dog metacam and he weighs 1333 at present which is small for him but he has been poorly for a while bless him.
Thank you so much for the diet link, that is what I have been following since his first op, plus the filtered water and very few nuggets (grain free science selective).
Ahhhh, the vet actually mentioned cystease and said that she wanted to use that first, she then decided on the Co Trimoxazole after I showed her pics of the blood on his fleece. I will 100% discuss cystease with her when I update her on Friday, thank you so much!
I did have a discussion with the vet regarding interstitial cystitis thanks to the knowledge you gave me about it last time you helped me. She doesn't seem to think that is what his issue is so he has 15 daily doses of Co Trimoxazole and ofc metacam and then we take it from there.

I've learned more from your reply than I would after hours of searching online, thank you again so so much, loads of love to you and your furbabies

 

[Wiebke]

Ohh hi Wiebke, hope you and the piggies are all well xx
Thank you so much for your advice. I did double check the dosage with the vet but I'm just an overly anxious owner and the amount seemed a LOT. Yes the vet agreed that it is fine to split the dosage.
He has been given dog metacam and he weighs 1333 at present which is small for him but he has been poorly for a while bless him.
Thank you so much for the diet link, that is what I have been following since his first op, plus the filtered water and very few nuggets (grain free science selective).
Ahhhh, the vet actually mentioned cystease and said that she wanted to use that first, she then decided on the Co Trimoxazole after I showed her pics of the blood on his fleece. I will 100% discuss cystease with her when I update her on Friday, thank you so much!
I did have a discussion with the vet regarding interstitial cystitis thanks to the knowledge you gave me about it last time you helped me. She doesn't seem to think that is what his issue is so he has 15 daily doses of Co Trimoxazole and ofc metacam and then we take it from there.

I've learned more from your reply than I would after hours of searching online, thank you again so so much, loads of love to you and your furbabies

Hi!

If I were you, I would recommend to start with the cystease asap as it can be used alongside any prescription medication; it really helps with the healing process!

I thought that your boy would be rather likely on the large side and that your vet was maxing out on the possible dosage - BUT we really cannot comment on any medication without having an idea whether we are dealing with 700g or a 1500g piggy, just give you a faint idea. You can generally trust a UK vet's dosage when it comes to antibiotics etc. as they do have guidelines that include the safe maximum per weight for every safe medication for that species.

A bacterial cystitis is not uncommon after a bladder stone due to bacteria (and there are always some in the bladder) getting into the scratches in the surface of the bladder wall. Bleeding can also be caused by bladder trauma.

I just wanted to mention sterile IC in case the symptoms would not react to antibiotics. It is to my knowledge not connected to bladder stones because the irritation is not caused by mechanical damage to the glucosamine lining of the walls of the urinary tract. Unfortunately the symptoms for all urinary tract problems are very similar.

 

[Lel]

Hi!

If I were you, I would recommend to start with the cystease asap as it can be used alongside any prescription medication; it really helps with the healing process!

I thought that your boy would be rather likely on the large side and that your vet was maxing out on the possible dosage.

A bacterial cystitis is not uncommon after a bladder stone due to bacteria (and there are always some in the bladder) getting into the scratches in the surface of the bladder wall. Bleeding can also be caused by bladder trauma.

I just wanted to mention sterile IC in case the symptoms would not react to antibiotics. It is to my knowledge not connected to bladder stones because the irritation is not caused by mechanical damage to the glucosamine lining of the walls of the urinary tract. Unfortunately the symptoms for all urinary tract problems are very similar.

 

[Lel]

Ahh okay I will thank you, I will look to purchase some online tonight and I will email my vet to ask about dosage etc.
May I be cheeky and ask you another question..... I use Oxbow natural science urinary tablets mulched up in water every day and have done for ages, in my mind the extra filtered water is helping, is this something you would personally say is a good idea? I'm just trying to rejig everything to be extra cautious x

 

[Wiebke]

Ahh okay I will thank you, I will look to purchase some online tonight and I will email my vet to ask about dosage etc.
May I be cheeky and ask you another question..... I use Oxbow natural science urinary tablets mulched up in water every day and have done for ages, in my mind the extra filtered water is helping, is this something you would personally say is a good idea? I'm just trying to rejig everything to be extra cautious x

If you opt for Feliway cat cystease capsules, then you mix the powdery contents of one capsule with 2 ml of water shake well and wait until the powder is fully absorbed. Shake well before any use. You can give either 1 ml of the mix twice daily or give 2 ml every 24 hours. I find a little medication bottle most useful, like an old metacam bottle, or one of these brown bottles the vets use for dispensing small amounts.
The capsules are easiest to deal with re. computing the amount of glucosamine. You do not have to grind down any human tablets and then adding so and so many 1 ml syringefuls of water to get to the correct strength...

 

[Lel]

Fantastic, thank you thank you thank you! I have a lot of old bottles that I have sterilised lying about so that's great

 

[Lel]

The cystease capsules arrived this morning so he had his first one as per your very kind advice.
Unfortunately for the last 3 hours he has been crying when urinating so I'm trying to contact the vet to see if I can up his metacam dosage but the phone lines are down
He has only had 2 full doses of septrin thus far so I'm praying both that and the cystease start to help soon as his crys are heartbreaking xx