Specialist Kidney stone in male guinea pig

[Piggymomma29]

Hi everyone, I'm new here and would really appreciate any help or advice that anyone can offer.

My male, unneutered guinea pig who is 4 years old was recently diagnosed with a kidney stone after a previous diagnosis of a unitary track infection.

The stone was successfully removed and his bladder flushed to remove sludge. He was then prescribed Buprenorhine, Loxicom, Co-trim and Potassium Citrate (the latter as a life-long treatment twice daily)

After the initial couple of days where he was a little under the weather, he seemed to recover well and was back to his usual self. However, the operation was 6 weeks ago and his vocalizing during urination has returned accompanied by straining and hunching. He is obviously in a great deal of discomfort and was off his food/drink for a few days. He also seemed to be suffering from diarrhea (which was most likely my fault as I was giving him water in a syringe to keep him hydrated)

After a further visit to the vets, a scan shows that another kidney stone has formed. He was weighed and had lost 30% of his body weight (he is a naturally slight pig to begin with) He has been prescribed Metacam daily which does not seem to be easing his discomfort at all.

I have asked the vet whether it would be possible to prescribe stronger pain relief for Mickey, together with an antibiotic and/or anti-inflammatory. I have also asked whether there is any medication that can dissolve the stone as the vet does not think he will survive another surgery, and even if he does, another stone is likely to form. The vet is awaiting a response from a specialist but in the meantime Mickey is suffering.

I am told that I need to consider euthanasia. This is a last resort for me and I would like to try any and every other option before this is decided. I am conscious however that in the meantime Mickey is extremely uncomfortable and in pain.

I must add however, that apart from when he is urinating he seems to be his usual perky self. His appetite and water intake have increased (I have also been supplementing this with syringe feeds) he will happily churp for his veggies in the morning and eat treats as usual and is more than happy to be petted and stroked. He is not docile or inactive in his cage. He seems alert and energetic the rest of the time.

I'm not ready to give up on my little guy, and I don't think that he is ready to give up either. Perhaps I'm fooling myself as I really don't want to make the difficult decision to have him put to sleep, but I'm prepared to do this if it really is the only option.

Please can I have your advice as to whether there is any treatment options that have not been mentioned and if it would in fact be the kindest option to have him euthanized.

I'm so heartbroken and upset that I need an outside perspective to provide some clarity.

Thank you in advance.

 

[Wiebke]

Hi everyone, I'm new here and would really appreciate any help or advice that anyone can offer.

My male, unneutered guinea pig who is 4 years old was recently diagnosed with a kidney stone after a previous diagnosis of a unitary track infection.

The stone was successfully removed and his bladder flushed to remove sludge. He was then prescribed Buprenorhine, Loxicom, Co-trim and Potassium Citrate (the latter as a life-long treatment twice daily)

After the initial couple of days where he was a little under the weather, he seemed to recover well and was back to his usual self. However, the operation was 6 weeks ago and his vocalizing during urination has returned accompanied by straining and hunching. He is obviously in a great deal of discomfort and was off his food/drink for a few days. He also seemed to be suffering from diarrhea (which was most likely my fault as I was giving him water in a syringe to keep him hydrated)

After a further visit to the vets, a scan shows that another kidney stone has formed. He was weighed and had lost 30% of his body weight (he is a naturally slight pig to begin with) He has been prescribed Metacam daily which does not seem to be easing his discomfort at all.

I have asked the vet whether it would be possible to prescribe stronger pain relief for Mickey, together with an antibiotic and/or anti-inflammatory. I have also asked whether there is any medication that can dissolve the stone as the vet does not think he will survive another surgery, and even if he does, another stone is likely to form. The vet is awaiting a response from a specialist but in the meantime Mickey is suffering.

I am told that I need to consider euthanasia. This is a last resort for me and I would like to try any and every other option before this is decided. I am conscious however that in the meantime Mickey is extremely uncomfortable and in pain.

I must add however, that apart from when he is urinating he seems to be his usual perky self. His appetite and water intake have increased (I have also been supplementing this with syringe feeds) he will happily churp for his veggies in the morning and eat treats as usual and is more than happy to be petted and stroked. He is not docile or inactive in his cage. He seems alert and energetic the rest of the time.

I'm not ready to give up on my little guy, and I don't think that he is ready to give up either. Perhaps I'm fooling myself as I really don't want to make the difficult decision to have him put to sleep, but I'm prepared to do this if it really is the only option.

Please can I have your advice as to whether there is any treatment options that have not been mentioned and if it would in fact be the kindest option to have him euthanized.

I'm so heartbroken and upset that I need an outside perspective to provide some clarity.

Thank you in advance.

Hi and welcome!

I am very sorry for the bad news!

Coming to terms with the the fact that there is nothing more that you can do is hard. Apart from death itself, it is the second most toughest moment because your grieving process starts right here. Your instinctive reaction is very normal in trying to block it out and stave it. However, when you do that you also deny yourself an important hidden gift that comes with living the end consciously and making every shared day special and make it count.

Mickey is not yet quite ready to die; he still has a zest for life. Please rather celebrate what you have while still have it. Unfortunately there is not much that can be done for guinea pigs with kidney failure. Since it is terminal you can go higher in painkillers and can use stuff that normally would not be recommended because of its long term side effects.
Concentrate on that and on enrichment instead. You will know when the time has come and Mickey has lost his zest for life; then is the time to let him go as the last and most loving gift you can ever make a beloved one.

Please take the time to read the information in the link below. You may find it very helpful as I addresses all the issues in a practical but sensitive way to help you through it time and make the best of it for the sake of both of you.
Death, Dying, Terminal Illness, Grieving and Bereaved Companions: Information and Support for Owners and Their Children

 

[DMS260820]

Am I reading this wrong? I didn't know kidney stones could be removed?

 

[Piggymomma29]

I'm so stupid, I think this should be bladder stone. Does this make a difference to the outcome at all?

 

[Piggymomma29]

Hi and welcome!

I am very sorry for the bad news!

Coming to terms with the the fact that there is nothing more that you can do is hard. Apart from death itself, it is the second most toughest moment because your grieving process starts right here. Your instinctive reaction is very normal in trying to block it out and stave it. However, when you do that you also deny yourself an important hidden gift that comes with living the end consciously and making every shared day special and make it count.

Mickey is not yet quite ready to die; he still has a zest for life. Please rather celebrate what you have while still have it. Unfortunately there is not much that can be done for guinea pigs with kidney failure. Since it is terminal you can go higher in painkillers and can use stuff that normally would not be recommended because of its long term side effects.
Concentrate on that and on enrichment instead. You will know when the time has come and Mickey has lost his zest for life; then is the time to let him go as the last and most loving gift you can ever make a beloved one.

Please take the time to read the information in the link below. You may find it very helpful as I addresses all the issues in a practical but sensitive way to help you through it time and make the best of it for the sake of both of you.
Death, Dying, Terminal Illness, Grieving and Bereaved Companions: Information and Support for Owners and Their Children

Thank you for your kind words. I appreciate it.

 

[DMS260820]

I'm so stupid, I think this should be bladder stone. Does this make a difference to the outcome at all?

Yea quite big. I don't know for sure, but once. A Guinea pig gets kidney stones, it's sort of a waiting game until they have to be put to sleep. Il tag @Wiebke because I'm not sure.

 

[Wiebke]

I'm so stupid, I think this should be bladder stone. Does this make a difference to the outcome at all?

Yes, it does. Bladder stone removal is a fairly straight forward procedure with a good recovery rate (provided the piggy is healthy and doesn't have any underlying problems) while kidney stones are inoperable. I had assumed that yours had been removed from the ureter (the pipe that leads from the kidney to the bladder) were removal is touch and go for the most experienced vets but occasionally comes off.
If a bladder stone fetches up in the urethra (the pipe between bladder and anus) then again, it can be a very tricky operation in boars as they have got an awkward inglenook were stones can fetch up and get stuck.

 

[DMS260820]

I'm taking it your vet either thinks it's a bad idea to do another operation because your boy has lost a fair bit of weight, and isn't all that young but isn't really that old either.

A diet changed to filtered water and only a very few amount of pellets a day with plenty of fresh grass fed, can help prevent bladder stone. Also a lower calcium diet on the veg side aswell

I don't know wether I would try another op and give him one last chance instead of being put to sleep would be the right thing to do? Obviously it's a lot of money involved aswell.

 

[Piggymomma29]

Yes, it does. Bladder stone removal is a fairly straight forward procedure with a good recovery rate (provided the piggy is healthy and doesn't have any underlying problems) while kidney stones are inoperable. I had assumed that yours had been removed from the ureter (the pipe that leads from the kidney to the bladder) were removal is touch and go for the most experienced vets but occasionally comes off.
If a bladder stone fetches up in the urethra (the pipe between bladder and anus) then again, it can be a very tricky operation in boars as they have got an awkward inglenook were stones can fetch up and get stuck.

Thank you for your prompt response. I have just read his discharge note which reads 'Mickey underwent a general anesthesia, cystotomy, urolith (stone) removal and bladder flush'

Does this clarify the matter at all?

 

[DMS260820]

Cystotomy is a surgical incision into the bladder

 

[Piggymomma29]

I'm taking it your vet either thinks it's a bad idea to do another operation because your boy has lost a fair bit of weight, and isn't all that young but isn't really that old either.

A diet changed to filtered water and only a very few amount of pellets a day with plenty of fresh grass fed, can help prevent bladder stone. Also a lower calcium diet on the veg side aswell

I don't know wether I would try another op and give him one last chance instead of being put to sleep would be the right thing to do? Obviously it's a lot of money involved aswell.

Thank you for your reply.

The vet is unwilling to perform a further stone removal surgery as she feels that he most likely will not survive it, and even if he does, due to the speed at which the stone has returned it is most likely to return for a third time and the process would start again. She is of the option that the kindest thing to do is not put him through another operation.

I just want to make him as comfortable as possible at this point.

 

[DMS260820]

Thank you for your reply.

The vet is unwilling to perform a further stone removal surgery as she feels that he most likely will not survive it, and even if he does, due to the speed at which the stone has returned it is most likely to return for a third time and the process would start again. She is of the option that the kindest thing to do is not put him through another operation.

I just want to make him as comfortable as possible at this point.

Ok I understand I didn't realise it was the 3rd time I thought it was 2nd

 

[Wiebke]

Thank you for your prompt response. I have just read his discharge note which reads 'Mickey underwent a general anesthesia, cystotomy, urolith (stone) removal and bladder flush'

Does this clarify the matter at all?

Yes, this is a bladder stone removal. Cystotomy is the cutting open of the bladder.

 

[DMS260820]

Sorry that you and your boar are in this position x

 

[Piggymomma29]

Yes, this is a bladder stone removal. Cystotomy is the cutting open of the bladder.

Thank you, I apologise for the confusion.

Do you know of any pain relief which is stronger than the Metacam which I can request from the vet please? I was only given a few days supply in any case. Or any other medication which would help Mickey feel more comfortable?

 

[Piggymomma29]

Sorry that you and your boar are in this position x

Thank you, I appreciate that. The vet has put it down to unfortunate genetics (I have another boar who is fed the same diet who does not suffer with bladder stones)

I just can't make such a final decision until I'm sure I've exhausted all other options.

 

[DMS260820]

Thank you, I appreciate that. The vet has put it down to unfortunate genetics (I have another boar who is fed the same diet who does not suffer with bladder stones)

I just can't make such a final decision until I'm sure I've exhausted all other options.

I've had 2 same family boars before on the same diet, one boar got 3 bladder stones and his bro had no bladder issues at all

 

[Piggymomma29]

I've had 2 same family boars before on the same diet, one boar got 3 bladder stones and his bro had no bladder issues at all

I guess some pigs are just the unlucky ones. It's heartbreaking and feels so unfair when you've done 'everything right' as my vet assures me.

 

[Wiebke]

Yes, this is a bladder stone removal. Cystotomy is the cutting open of the bladder.

Have you looked at diet? Most calcium comes from water and pellets and not so much from veg, so filtering the water and reducing the pellets to max. 1 tablespoon a day does make a huge difference in combination with a diet that should have a fair amount of fresh grass (if available and dog pee free) and high water veg in the veg allotment to encourage urination (but please don't overdo it either - too much veg can make a piggy more prone to bloating). Again, it is not a quick fix; it will take a few weeks of working its way through the body.

Calcium absorption is a complex process and it depends on what has gone wrong. There is a certain genetic disposition or it can just flip, as my Cariad (Ceri's relative did). she produced a large bladder stone within weeks and then for a while required regular bladder flushed to wash out the sludge that kept building up (which thankfully didn't take a full GA and could be done during a consultation). I did eventually manage to prolong the intervals between flushes to about half a year until she became too frail for them. But she did have another 2 years of life and made it through a full emergency spaying op when her womb went wrong with flying colours.

Please take the time to read our diet advice for guinea pigs with urinary tract problems in the special diets chapter: Long Term Balanced General And Special Needs Guinea Pig Diets

Another area where you can support the healing process of the beleaguered bladder is glucosamine to help repair the scratched natural glucosamine coating in the bladder and urinary tract and contribute to the overall comfort; this in turn helps also with the weight gain.

My Ceri weighed a borderline 520g when she underwent an emergency bladder stone operation; she'd gone down from 700g over the weekend despite syringe feeding support. But she was back to 700g again within 2 weeks after the op. Once the stone is remove the source of the worst discomfort is removed so piggy often bounces back rather quickly. She was my last bladder stone piggy and a hangover from the time I experimented with the diet and for a while got it exactly wrong with a stone that had built up very slowly but had never caused any symptoms. That was 7 years and about 50 piggies ago... so our diet recommendations do work. We have seen a lot less bladder stones in regular longer term members in the intevening years.

Your boy is by no means at death's door yet and has a good chance of making it with your help, which would not have been the case with a kidney stone.

 

[Piggymomma29]

Have you looked at diet? Most calcium comes from water and pellets and not so much from veg, so filtering the water and reducing the pellets to max. 1 tablespoon a day does make a huge difference in combination with a diet that should have a fair amount of fresh grass (if available and dog pee free) and high water veg in the veg allotment to encourage urination (but please don't overdo it either - too much veg can make a piggy more prone to bloating). Again, it is not a quick fix; it will take a few weeks of working its way through the body.

Calcium absorption is a complex process and it depends on what has gone wrong. There is a certain genetic disposition or it can just flip, as my Cariad (Ceri's relative did). she produced a large bladder stone within weeks and then for a while required regular bladder flushed to wash out the sludge that kept building up (which thankfully didn't take a full GA and could be done during a consultation). I did eventually manage to prolong the intervals between flushes to about half a year until she became too frail for them. But she did have another 2 years of life and made it through a full emergency spaying op when her womb went wrong with flying colours.

Please take the time to read our diet advice for guinea pigs with urinary tract problems in the special diets chapter: Long Term Balanced General And Special Needs Guinea Pig Diets

Another area where you can support the healing process of the beleaguered bladder is glucosamine to help repair the scratched natural glucosamine coating in the bladder and urinary tract and contribute to the overall comfort; this in turn helps also with the weight gain.

My Ceri weighed a borderline 520g when she underwent an emergency bladder stone operation; she'd gone down from 700g over the weekend despite syringe feeding support. But she was back to 700g again within 2 weeks after the op. Once the stone is remove the source of the worst discomfort is removed so piggy often bounces back rather quickly. She was my last bladder stone piggy and a hangover from the time I experimented with the diet and for a while got it exactly wrong with a stone that had built up very slowly but had never caused any symptoms. That was 7 years and about 50 piggies ago... so our diet recommendations do work. We have seen a lot less bladder stones in regular longer term members in the intevening years.

Your boy is by no means at death's door yet and has a good chance of making it with your help, which would not have been the case with a kidney stone.

Thank you so much for your post which has been very informative and I'm now feeling much more optimistic. I will mention glucosamine to my vet and bladder flushing to see whether these are possible options. I will also read the suggested article and examine pigs diet.

Thanks again

 

[eileen]

tramadol is a stronger analgesic that can be given,it is stronger than metacam.i agree with the above posters,a change in diet may help.i hope all comes good.

 

[DMS260820]

What diet have you been feeding, I might be able to pick put some culprits for bladder stones

 

[Piggymomma29]

What diet have you been feeding, I might be able to pick put some culprits for bladder stones

Both my pigs are fed Burgess Excel nuggets, a combination of Burgess Excel feeding hay and either Oxbox Orchard grass or Timothy hay. I also provide hay cookies on occasion which they love. I provide fresh fruit & veggies daily, favourites are carrots, celery, fennel, peppers, apples, coriander, parsley, cucumber, pak choi, broccoli & cauliflower. Occasional treats are a small piece of banana or a segment of satsuma, tomatoes or grapes. They both enjoy a daily treat of a either a single VetIQ Nibblot or one of the pets at home range guinea pig treats. They also have the occasional Vitakraft treat sticks. I obviously provide fresh water and a salt lick at all times.

 

[DMS260820]

Parsley and carrot can be culprits. And too many pellets, how many pellets do you feed?

 

[Piggymomma29]

tramadol is a stronger analgesic that can be given,it is stronger than metacam.i agree with the above posters,a change in diet may help.i hope all comes good.

Thank you, I will mention this to my vet.

 

[Piggymomma29]

Parsley and carrot can be culprits. And too many pellets, how many pellets do you feed?

I basically just re-fill the bowl whenever it becomes empty. I'd say that generally Mickey doesn't have a big appetite for the nuggets, and a full bowl can last him a week (as apposed to my other boar who can eat a bowl full in two days)

 

[Piggies&buns]

I basically just re-fill the bowl whenever it becomes empty. I'd say that generally Mickey doesn't have a big appetite for the nuggets, and a full bowl can last him a week (as apposed to my other boar who can eat a bowl full in two days)

They should not have access to pellets in those quantities, it’s too much. They are the least healthy part of their diet and contribute a large amount of calcium. They should be strictly limited to just one tablespoon of pellets per day (is literally just 6 grams of pellets), and then when that tablespoon is gone, remove the bowl and they shouldn’t have any more pellets until the next day. The only food they should have Unlimited is hay.
Parsley is also high in calcium (but not as high as pellets) and should only be fed, along with any other high calcium veg, no more than once per week. Apples and carrots should also only be fed once per week.

I see wiebke has linked in the long term diet guide in an earlier post, so do give it a read as it contains a lot of useful information concerning pellets and filtering their drinking water to reduce calcium intake

 

[DMS260820]

I basically just re-fill the bowl whenever it becomes empty. I'd say that generally Mickey doesn't have a big appetite for the nuggets, and a full bowl can last him a week (as apposed to my other boar who can eat a bowl full in two days)

Yea you got some adjustments to make. Should be quite easy

 

[Piggymomma29]

I just wanted to thank you all for your responses and give you an update.

I have taken Mickey to another vet this morning for a second opinion. He was of the opinion that euthanasia is not necessary at this point. He believes that the previous stone was not removed correctly as it would take longer than 6 weeks to reform.

He gave Mickey a shot of antibiotics, has prescribed stronger pain relief of Baytril (explaining that the Metacam is basically the equivalent of ibuprofen and not nearly enough) and has said to start giving the potassium citrate again to neutralize his urine. He has asked to see him again on Monday when he will x-ray him and has asked to see the x-ray taken by the previous vet.

He also said that he would be happy to perform another stone removal on Mickey dependant on the results of the x-ray, and for a fraction of a price compared to the previous vet.

He said to stop feeding him nuggets altogether and that as long as he is eating hay and veggies, and drinking plenty (he told me to continue giving extra water in a syringe) that he will be fine.

Mickey already appears to be more comfortable! I am so relieved and so thankful that I listened to my instincts and got a second opinion. It's scary how close it came to putting him to sleep.

I really hope that Mickey has years left of life in him yet.

 

[Piggies&buns]

I just wanted to thank you all for your responses and give you an update.

I have taken Mickey to another vet this morning for a second opinion. He was of the opinion that euthanasia is not necessary at this point. He believes that the previous stone was not removed correctly as it would take longer than 6 weeks to reform.

He gave Mickey a shot of antibiotics, has prescribed stronger pain relief of Baytril (explaining that the Metacam is basically the equivalent of ibuprofen and not nearly enough) and has said to start giving the potassium citrate again to neutralize his urine. He has asked to see him again on Monday when he will x-ray him and has asked to see the x-ray taken by the previous vet.

He also said that he would be happy to perform another stone removal on Mickey dependant on the results of the x-ray, and for a fraction of a price compared to the previous vet.

He said to stop feeding him nuggets altogether and that as long as he is eating hay and veggies, and drinking plenty (he told me to continue giving extra water in a syringe) that he will be fine.

Mickey already appears to be more comfortable! I am so relieved and so thankful that I listened to my instincts and got a second opinion. It's scary how close it came to putting him to sleep.

I really hope that Mickey has years left of life in him yet.

I’m glad you’ve seen another vet

Baytril is an antibiotic not pain relief and will only help an infection, wont do anything for a stone itself. Metacam is the standard pain relief for guinea pigs and if given twice a day in good sized doses, then it is good to control pain but there are stronger pain killers available. What pain killers is he being given now?