plasticsushi
Junior Guinea Pig
(apologies in advance for the length)
Nori is a 4yr 4mo old female pig, unspayed. Since mid-December, she has been experiencing UTI-like symptoms- painful urination, blood in the urine. There was little to no bacteria found when my vet collected a sample of urine (examined in the office, not cultured). In December she was given pain medication (meloxicam/Metacam) and antibiotics (SMZ-TMP/Sultafrim), and the symptoms seemed to resolve quickly, within about 3 days. Unfortunately, about a month later, the symptoms returned.
Since mid-January, Nori has had multiple x-rays, an ultrasound, and bloodwork done, as well as a second urinalysis. X-rays were negative for stones or other obvious issues, ultrasound found Nori's bladder lining to be thickened and revealed some small ovarian cysts, bloodwork all came back ok (kidney function was good), and still there was no bacteria in her urine. We also did a second round of antibiotics at that time, for 10 days.
My vet currently has her on .45ml of Metacam 1.5mg/ml per day. She is also on a .07ml of Gabapentin (50mg/ml) twice daily and, as of a few days ago, .08ml of Tramadol (25mg/ml compounded from a tablet at home) once daily. She also advised a dose of 50mg of glucosamine per day. My vet seems hesitant to give a diagnosis here for some reason, but it seems like we've essentially found sterile cystitis for all intents and purposes.
Some backstory that may or may not be relevant here: I've had guinea pigs as pets for more than 30 years now. This being a UK based forum, I would guess that many members here are aware of the disparity in guinea pig health care available in the UK vs the US. I've done my best over the last couple decades to find competent vets that don't make me do all the research and treatment recommendations for conditions that seem to have wide awareness elsewhere, and the practice I currently visit is probably the 2nd best I've ever been able to find in the states (the best is a 5hr drive away and did a high risk spay on another pig some years ago, she's still with my herd and soon to turn the ripe old age of 8). They are already in a different state from where I live, and it is about an hour's drive away.
That all being said, my vet is doing her best, and she is experienced with exotics, but I get the sense that she's never encountered a case of sterile cystitis before. She has consulted with other vets, but so far the additional recommendations I've received have just been to put Nori on more painkillers (the Gabapentin a couple weeks ago and now the Tramadol this week). As of this past Wednesday, my vet has told me that the only other things she can think to do are:
I have been doing a lot of reading on IC, mostly from this forum, and started Nori on Cystease in place of the generic glucosamine eight days ago. One tablet mixed with 2ml of water, given twice daily. I don't know that I have seen any improvement since starting the Cystease. My vet also did not feel switching to Cystease had any advantages over the regular glucosamine, or that increasing the glucosamine would have any effect. I made that decision myself based on the overwhelming anecdotal evidence I've found to the contrary.
Nori is already on a low calcium diet along with all my other pigs, water is filtered. I put about 3 tablespoons of pellets (Oxbow) in a bowl in the cage daily, for 4 pigs. They don't always finish them all, and I wouldn't say Nori is much of a pellet hog. I saw references to an IC food list, but haven't been able to find that. If someone could link it in a reply, I would appreciate it.
In addition to all the medications that have been prescribed by my vet, I have been giving her additional Metacam the last couple of days (instead of 0.45ml total, 0.4ml in the morning and 0.4ml at night) because of how much pain she seems to be in. My vet does not feel it is safe to go over 0.45ml daily and is concerned about Nori's kidney function. I acknowledge that I am going against her recommendation.
Other things not previously mentioned:
Nori is a 4yr 4mo old female pig, unspayed. Since mid-December, she has been experiencing UTI-like symptoms- painful urination, blood in the urine. There was little to no bacteria found when my vet collected a sample of urine (examined in the office, not cultured). In December she was given pain medication (meloxicam/Metacam) and antibiotics (SMZ-TMP/Sultafrim), and the symptoms seemed to resolve quickly, within about 3 days. Unfortunately, about a month later, the symptoms returned.
Since mid-January, Nori has had multiple x-rays, an ultrasound, and bloodwork done, as well as a second urinalysis. X-rays were negative for stones or other obvious issues, ultrasound found Nori's bladder lining to be thickened and revealed some small ovarian cysts, bloodwork all came back ok (kidney function was good), and still there was no bacteria in her urine. We also did a second round of antibiotics at that time, for 10 days.
My vet currently has her on .45ml of Metacam 1.5mg/ml per day. She is also on a .07ml of Gabapentin (50mg/ml) twice daily and, as of a few days ago, .08ml of Tramadol (25mg/ml compounded from a tablet at home) once daily. She also advised a dose of 50mg of glucosamine per day. My vet seems hesitant to give a diagnosis here for some reason, but it seems like we've essentially found sterile cystitis for all intents and purposes.
Some backstory that may or may not be relevant here: I've had guinea pigs as pets for more than 30 years now. This being a UK based forum, I would guess that many members here are aware of the disparity in guinea pig health care available in the UK vs the US. I've done my best over the last couple decades to find competent vets that don't make me do all the research and treatment recommendations for conditions that seem to have wide awareness elsewhere, and the practice I currently visit is probably the 2nd best I've ever been able to find in the states (the best is a 5hr drive away and did a high risk spay on another pig some years ago, she's still with my herd and soon to turn the ripe old age of 8). They are already in a different state from where I live, and it is about an hour's drive away.
That all being said, my vet is doing her best, and she is experienced with exotics, but I get the sense that she's never encountered a case of sterile cystitis before. She has consulted with other vets, but so far the additional recommendations I've received have just been to put Nori on more painkillers (the Gabapentin a couple weeks ago and now the Tramadol this week). As of this past Wednesday, my vet has told me that the only other things she can think to do are:
- Urine culture: Nori would have to stay at the vet's office for an extended period of time so that they could ensure her bladder was full before they removed urine via a needle going through her abdomen and through the bladder wall, a procedure my vet feels is risky. And since the previous two urinalysis done with urine collected that Nori expelled herself while in the office and neither of those contained bacteria, this might be a lot of risk just to get the exact same result. I don't want to do this.
- CT scan: This would rule out anything else that could be causing these issues that the previous tests didn't show. My vet would have to refer me somewhere (not sure where, probably many hours away) and Nori would have to be put under general anesthesia. This would also be very expensive, likely $1200-1500+. I could probably pull this out of an emergency fund but that is a lot of money and probably a stressful experience for Nori that again might not actually tell us anything. I don't really want to do this either!
I have been doing a lot of reading on IC, mostly from this forum, and started Nori on Cystease in place of the generic glucosamine eight days ago. One tablet mixed with 2ml of water, given twice daily. I don't know that I have seen any improvement since starting the Cystease. My vet also did not feel switching to Cystease had any advantages over the regular glucosamine, or that increasing the glucosamine would have any effect. I made that decision myself based on the overwhelming anecdotal evidence I've found to the contrary.
Nori is already on a low calcium diet along with all my other pigs, water is filtered. I put about 3 tablespoons of pellets (Oxbow) in a bowl in the cage daily, for 4 pigs. They don't always finish them all, and I wouldn't say Nori is much of a pellet hog. I saw references to an IC food list, but haven't been able to find that. If someone could link it in a reply, I would appreciate it.
In addition to all the medications that have been prescribed by my vet, I have been giving her additional Metacam the last couple of days (instead of 0.45ml total, 0.4ml in the morning and 0.4ml at night) because of how much pain she seems to be in. My vet does not feel it is safe to go over 0.45ml daily and is concerned about Nori's kidney function. I acknowledge that I am going against her recommendation.
Other things not previously mentioned:
- Nori was given an injection of depo lupron at the last time I was in-person at my vet's office, February 26, on the chance that the ovarian cysts found on ultrasound were contributing to this issue. I don't know that it had any effect.
- Since December, I have seen a behavior change in Nori and with two of my other pigs, Miso and Ebi. Miso and Ebi are sisters, about 2.5yrs old. Miso and Nori were never BFFs before this, occasionally getting into little altercations. Never to the point of drawing blood, but otherwise they were also to coexist ok. But starting in December, Miso and Ebi have just sorta turned into, well, little jerks! Ebi never had a problem with Nori, and now she's bullying Nori right along with Miso! Nori has gone from being #2 in the pig pecking order, to being a very submissive pig. I had to take out two beloved twigloos from the pig cage because they only have one entrance/exit, and Miso and Ebi had taken to cornering Nori in them, and then chasing her out while nipping at her. Nori will just stand there and cry at the top of her lungs now if Miso or Ebi corner her or otherwise are in her space, and then will be chased off. I honestly don't know what to make of this, and whether this started because of Nori's health issues, or if this behavior is causing the health issues. Nori has always been a nervous girl, very sensitive and scared of certain sounds. Outside of the cage she is like a statue, "if I don't move they can't see me" is what I assume is going on in her brain, but inside the cage she was always a confident and outgoing girl. Now she is hiding a lot, cowering, scared to interact with Miso and Ebi. I'm sure this is causing her stress, and I am worried that this stress is contributing to the IC. I have been considering separating Nori with my oldest pig Salmon, and then Miso and Ebi would stay together. The reasons I have not yet done this is that Miso has also been a little jerk to Salmon in the past, and I am concerned that I might never be able to reintroduce these pigs in the future without permanent conflict. If splitting them up doesn't result in any kind of improvement in Nori's symptoms then I have caused major disruption for nothing. That and splitting the herd into two groups will mean major cage reconstruction, but even with expanding the cage a bit, both pairs will now end up in a slightly smaller enclosure
- Change Cystease dose, increase to 1.5 or 2 total capsules a day
- Decrease Metacam dose back to vet recommended maximum, to be safe
- Split the herd into two groups for at least a week, to see if Nori's time apart from the bullies improves her physical symptoms
- Removing a daily veg one at a time to see if one might be a trigger
- ?
