Persistent cystitis/blood in urine?

[Liv]

Hi All,
My neutered boar Boh has been peeing bloody urine for over a month now. His urine sample tested positive for blood and he had an ultrasound of his bladder which didn't show anything unusual, except for a small amount of calcium deposits. He was put on a 10 day course of sulfatrim at 0.4 ml twice a day, cystease for 5 days, and metacam for 7 days, during which the blood seemed to clear up but when the course finished it came back. The vet then took another urine sample to test for bacteria but the results came back inconclusive - apparently there were a lot of bacteria but none of them could be identified...? They said the sample was possibly contaminated. So they put him back on sulfatrim for another 3 weeks. It's been 10 days now that he's been on this second course and I'm still seeing little red spots in his urine. Does this mean the antibiotic is not working or do I need to be more patient?
I've been reading on this forum about interstitial cystitis and wondering if that's what he might have? How is this diagnosed?
Also, he doesn't seem to be in any discomfort which seems odd. Appetite and activity levels are normal and he doesn't hunch or squeak when peeing...

 

[Swissgreys]

Bumping this for you so it doesn't get lost - I know someone on here will have some good advice.

The only thing I would suggest is possibly trying a different antibiotic?
When Ruby had a bladder infection it took 2 courses of different antibiotics to fully clear it up.

 

[Flutterby]

Sometimes infections need a longer course of antibiotics, it would be worth them trying to take another sample to see if they can test the bacteria again, it would help to make sure he is targeted with the correct antibiotic.

 

[Wiebke]

Hi All,
My neutered boar Boh has been peeing bloody urine for over a month now. His urine sample tested positive for blood and he had an ultrasound of his bladder which didn't show anything unusual, except for a small amount of calcium deposits. He was put on a 10 day course of sulfatrim at 0.4 ml twice a day, cystease for 5 days, and metacam for 7 days, during which the blood seemed to clear up but when the course finished it came back. The vet then took another urine sample to test for bacteria but the results came back inconclusive - apparently there were a lot of bacteria but none of them could be identified...? They said the sample was possibly contaminated. So they put him back on sulfatrim for another 3 weeks. It's been 10 days now that he's been on this second course and I'm still seeing little red spots in his urine. Does this mean the antibiotic is not working or do I need to be more patient?
I've been reading on this forum about interstitial cystitis and wondering if that's what he might have? How is this diagnosed?
Also, he doesn't seem to be in any discomfort which seems odd. Appetite and activity levels are normal and he doesn't hunch or squeak when peeing...

Please be aware that it can take 3-4 weeks on septrin/sulfatrim to get on top of UTI.
Perhaps a new urine sample can bring more clarity about bacteria to show that another antibiotic may be more effective.

IC can only ever diagnosed by default. It is basically what remains when your vets have excluded stones/sludge and antibiotics have not been able to get on top of the problem despite several rounds of them.
This has become a lot more common over the last decade. Since we don't know what is causing it, treatment can only be for managing the symptoms, mostly with metacam (which is an anti-inflammatory as well as a painkiller) and by giving a glucosamine-based cat food supplement like cystease which supports the natural glucosamine coat of the bladder wall as well as by cutting out root veg and grains (pellets!) from the diet.
Long Term Balanced General And Special Needs Guinea Pig Diets

The good news is that IC does NOT cause stones and does NOT impact on longevity. It goes eventually away on it own. The bad news is that this is a matter of a few years rather than months.
Just as an example: my Nerys has been through nearly 3 years of IC to have another 3 years free of it and die at the ripe old age of 8 years.

The red flecks you see in the urine are not blood; red coloured urine is not at all uncommon in urinary tract issues. There can however be a surprising amount of blood and protein in clear urine. You can find blood as red dots in the middle of a rusty/orange dried pee puddle on a light towel as blood doesn't mix with urine when it dries.

More information on IC
Links - Interstitial Cystitis - Guinea Lynx Records

 

[Liv]

Thanks all for your comments! I didn't realise UTIs can take that long to clear. I will keep giving Boh his sulfatrim and hope that it'll work. Will definitely take him back in for another urine sample too. I really hope he won't need long-term meds or a special restricted diet...

 

[Wiebke]

Thanks all for your comments! I didn't realise UTIs can take that long to clear. I will keep giving Boh his sulfatrim and hope that it'll work. Will definitely take him back in for another urine sample too. I really hope he won't need long-term meds or a special restricted diet...

The special restricted diet is pretty much what we recommend for as a long term veg mix anyway as it minimises the risk of bladder stones!

But if you do not end up with IC that is a lot less upset.

 

[Liv]

Thanks @Wiebke that's good to know. Is that example veg mix portion to be fed once or twice a day? It doesn't look like very much to me which makes me wonder whether I'm overfeeding veggies...

 

[Wiebke]

Thanks @Wiebke that's good to know. Is that example veg mix portion to be fed once or twice a day? It doesn't look like very much to me which makes me wonder whether I'm overfeeding veggies...

I would feed once a day (I split my single portion up in a morning and an evening meal but add one extra rotating veg in lieu of the lettuce - which I feed about twice weekly - to keep things interesting), but you are also still OK with twice a day. Many people overestimate how much veg should be fed. In fact, piggies are healthier and more long lived with less, so the trend in terms of veg and pellet amounts is going down.

I leave out the watery veg like cucumber and celery on spring lawn days when there is plenty of fresh, juicy grass.

 

[Liv]

Update: second urine sample showed no signs of bacteria so they didn't do a culture. Blood was still present. I then noticed a small swelling to the left of Boh's groin. A second ultrasound was booked to investigate. They took a needle biopsy during the ultrasound which revealed an abscess. The vet is switching him to Baytril today based on the bacteria present in the sample. Fingers crossed the Baytril will do the job!
The vet has no idea what might have caused an abscess in that area. His castration was last October which makes it very late for a post-neuter abscess...

P.s.: I've read on here that baytril is really hard on the gut - what is the best probiotic I could give him to lessen the damage?

 

[Wiebke]

Update: second urine sample showed no signs of bacteria so they didn't do a culture. Blood was still present. I then noticed a small swelling to the left of Boh's groin. A second ultrasound was booked to investigate. They took a needle biopsy during the ultrasound which revealed an abscess. The vet is switching him to Baytril today based on the bacteria present in the sample. Fingers crossed the Baytril will do the job!
The vet has no idea what might have caused an abscess in that area. His castration was last October which makes it very late for a post-neuter abscess...

P.s.: I've read on here that baytril is really hard on the gut - what is the best probiotic I could give him to lessen the damage?

Any probiotic will do. Most piggies thankfully only get slightly softer poos for a while. If he loses his appetite completely, I would recommend a course of probiotics.

Please be aware that baytril is often not strong enough to cut through a fully developed abscess; it may also need either draining and regular flushing when close to the surface or operating out as well as a much stronger antibiotic like zithromax or even a combination of zithromax and marbocyl.

Abscesses and hernias can appear more than half a year after a neutering operation. It is rare, but not completely unknown (the late hernia piggy is one of my already neutered adoptees, by the way). You have just been very unlucky!

 

[Liv]

Any probiotic will do. Most piggies thankfully only get slightly softer poos for a while. If he loses his appetite completely, I would recommend a course of probiotics.

Please be aware that baytril is often not strong enough to cut through a fully developed abscess; it may also need either draining and regular flushing when close to the surface or operating out as well as a much stronger antibiotic like zithromax or even a combination of zithromax and marbocyl.

Abscesses and hernias can appear more than half a year after a neutering operation. It is rare, but not completely unknown (the late hernia piggy is one of my already neutered adoptees, by the way). You have just been very unlucky!

OK thanks. Yeah I mentioned zithromax to my vet who said this could be considered if the baytril doesn't work, with surgery being the last resort. I really do hope it will go away with the antibiotics. He seems happy and healthy and the swelling actually feels a little smaller today compared to yesterday so fingers and toes crossed!

 

[Wiebke]

All the best!

Please be aware that even the tiniest bit of infection needs to be gone, or the abscess will come back worse than ever, even if that takes weeks or months!