I have a sow who has been under the vet over the past two/three years trying to figure out what’s going on with her bladder. She had a stone in her urethra in 2018 that the vet was able to manipulate out, which was good, but has intermittently had pink pee and squeaked whilst peeing over the last couple of years. She has been to the cat and rabbit clinic this week after being on cystophan, bendrofluazide and Loxicom for a month but still squeaking whilst peeing. X-rays showed no stones and the bladder inflammation that had been present earlier had subsided, so the meds had worked to an extent. She is now also on gabapentin as well to see if that can help with the obvious pain she is feeling, but she is squeaking again after being relatively quiet for two days after the vet (Friday). I have looked at the IC diet (they have all been on the low calcium diet for the past two years) and will start her on that stricter diet to see if that helps too. What I wanted to ask is can she have the cabbage (it says no lettuce) and someone mentioned something about glucosamine - could you tell me how that helps please? Many thanks in advance.
Hi!
Diet:
You still need to feed a modicum of calcium. Unless with a bladder or kidneystone/sludge, calcium is not the kind of issue with a sterile interstitial (i.e. flaring) bladder infection that doesn't respond to antibiotics because it doesn't cause stones directly or messes with the calcium absorption process itself.
What we have found in the intervening years is that it is not so much about which foods to feed and which not (apart from the fact that root veg and grains should be treats at the best in ANY diet) but whether they are a regular part of a diet or not. We have observed that the problem of sudden flares caused by foods seems to sit more with changes in the usual diet - like putting piggies out on the lawn when grass has not been gradually introduced and is a already a very regular part of the diet.
I haven't found that it has made any difference to my own current IC piggy Breila whether she was on lettuce or not and she had no issues on the lawn as long as I did re-introduce fresh grass gradually in spring, starting with just a little and then slowly upping the quantity with every passing day. If your diet is fine, then just continue with it and only be careful if you have to make changes. My own experience echoes that of other owners of IC piggies on here. We always try to test any advice that is making the rounds ourselves if possible and see whether it really stands the test of time. But that means that we need to be faced with a particular problem in our own piggies first.
Why is glucosamine key in treating sterile IC?
The walls of the urinary tract are coated with a layer of glucosamine that prevents the corrosive urine from coming into direct, very painful contact with raw tissue (hence the squeaking when peeing). While a bacterial cystitis is generally result from mechanical abrasion of this glucosamine layer by a stone or sludge banging into the walls and scratching them badly, in IC it seems to be this glucosamine layer that is most affected.
It takes several weeks of building up the glucosamine and it can take some months to bring the symptoms outside the flares that happen every few weeks under control but depending on the severity, a regular oral dose of glucosamine (capsules are easiest do give and dose but ground up mixed in water tablets do work, too) for mild to medium cases is perfectly adequate while recent research in Europe has shown that high glucosamine injections with cartrofen (an arthritis drug) do not just help cats as the other species with sterile cystitis but also guinea pigs in cases of severe cystitis where daily oral treatment is not enough. Since glucosamine is not a medication, vets will not necessarily prescribe it.
Personally I have found that doubling the amount of glucosamine during flare ups is more effective than only upping the metacam.
Metacam is both an inflammatory and a painkiller, and it is used in both capacities, especially during flares.
Sterile interstitial cystitis is a problem that has become a lot more common over the last decade but is not well known outside vet circles that see lots of piggies on a regular basis. Like FSC (feline sterile cystitis), it seems to be an issue that particularly affects the more skittish ones that have experienced high stress levels from their mother in the womb and have taken those as their default level. Companions can catch it but their immune system is strong enough to deal with it without ever showing much in the way of acute symptoms or only having the odd flare when very upset in the borderline cases.
With pets mass produced like never before to satisfy the increasing demand, it is perhaps not surprising that we find that this industrial approach to churning out pets for sale comes with its own consequences...
However, it is always important that you exclude the potential of a stone or sludge as symptoms can be very similar; including phases of squeaking, depening on where the stone is located at that time.
I hope that this answers your questions? I am working on an information guide for guinea pigs with urinary tract issues but finding the time to work on it has been somewhat elusive to put it mildly...