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Recovery After Bladder Flush?

Swissgreys

Swissgreys

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Ruby is quite unwell right now.
On Wednesday morning she was eating as normal.
By Wednesday lunchtime she seemed a bit 'off'. Nothing major, just quieter than usual.
By Wednesday evening she was hardly moving, so we took her to the emergency vet.
We are SO lucky that the on call vet that night just happened the be the guinea pig specialist!

She immediately felt that Ruby's bladder wasn't right, and there was a lot of blood in her urine.
A quick conscious x-ray showed a large 'stone' at the bottom of her badder blocking the urethra.
The x-ray also showed a lot of sludge in the bladder itself.
We opted for surgery straight away to removed the stone and flush the bladder.

Once Ruby was asleep the vet decided to try and gently manipulate the stone down before opening Ruby up, and she managed to get a huge amount of sludge out.
She then took another x-ray to check the position of the stone, and it was gone, as was most of the sludge in the bladder.
She had collected all of the fluid and filtered it to check she hadn't missed the stone, but it wasn't there.
She thinks this means it wasn't actually a solid stone, but a concentrated build up of sludge, and the manipulation was enough to break it up and allow it to be flushed out.

This all happened on Wednesday night.
Ruby is home and on Metacam (0.3ml twice daily), probiotics, Baytril (0.15ml once day), and critical care (our goal is 40ml a day spread over 5 feeds).
She is ok, but just so listless.
She has only lost 40 grams since the operation, and I hope tomorrow will be the first day she has stopped loosing.
She hates syringe feeding, Baytril, being handled, and the world in general right now.
I feel so bad for her, but appreciate it is early days.
She is in our hospital cage on her own as she was having big problems with Lucy after the operation, and we didn't want to add to her stress levels.

I spoke with the vet again today and have a follow up appointment next week.
The vet feels this is the best we can hope for, and the fact that Ruby started pooing again today is a good sign that we are doing everything right.

But I would love to know when I can expect her to start eating for herself again and start moving around and feeling brighter in general.
For anyone whose pig has been through a similar procedure, how long did it take your piggy to return to normal afterwards?
 
Please keep syringe feeding for as long as necessary and make sure to offer her as much water as she will willingly take.

I am lucky that I have never had problems after a bladder flush (Cariad needed a number of them because she kept developing sludge), but I have dealt with bladder trauma twice in the wake of the removal of a bladder stone.

Loss of appetite can be a reaction to either bladder trauma or a flush that has been done too forcefully so the fluid in the bladder has backed up into the kidneys.

Bladder trauma can take some time to heal; it can be a reaction to the relief from a major irritation/damage from a bladder stone or rough sludge. It is more likely when the stone is rough or, like in your case, uneven sludge is tightly packed and has really badly scratched the bladder walls.
I would recommend to look into cystease or a comparable glucosamine cat food supplement brand that is available in Switzerland. It will help to rebuild the natural glucosamine coating of the very irritated bladder walls.
Have you been given a strong painkiller/anti-inflammatory?
 
Wiebke said:
Please keep syringe feeding for as long as necessary.

I am lucky that I have never had problems after a bladder flush (Cariad needed a number of them because she kept developing sludge), but I have dealt with bladder trauma twice in the removal of a bladder stone.

Loss of appetite can be a reaction to either bladder trauma or a flush that has been done too forcefully so the fluid in the bladder has backed up into the kidneys.

Bladder trauma can take some time to heal; it can be a reaction to the relief from a major irritation/damage from a bladder stone or rough sludge. It is more likely when the stone is rough or, like in your case, uneven sludge is tightly packed and has really badly scratched the bladder walls.
I would recommend to look into cystease or a suitable glucosamine cat food supplement that is available in Switzerland. It will help to rebuild the natural glucosamine coating of the very irritated bladder walls.
Have you been given a strong painkiller/anti-inflammatory?
Click to expand...

Thanks @Wiebke
Ruby was given both Metacam and a local painkiller during the surgery.
The vet ( a specialist who works at 4 different clinics because her services are in high demand) kept saying how painful these things can be, and how we should be generous with pain meds.
Currently Ruby is on Metacam (0.3mls twice a day).
She is showing a vague interest in food, and will have the odd nibble, but basically right now I am syringe feeding as much as possible to keep her going.
I don't think her own food intake counts, as it is so little.
The vet was concerned at the amount of bladder sludge in a 2 year old piggy who has a knowledgeable owner and a good diet.
Apparently most of her clients don't arrive with a fresh urine sample, and expressing a preference for Emeraid over Critical care. :whistle:

I will look into the supplements you suggested to try and prevent further problems.
 
Swissgreys said:
Thanks @Wiebke
Ruby was given both Metacam and a local painkiller during the surgery.
The vet ( a specialist who works at 4 different clinics because her services are in high demand) kept saying how painful these things can be, and how we should be generous with pain meds.
Currently Ruby is on Metacam (0.3mls twice a day).
She is showing a vague interest in food, and will have the odd nibble, but basically right now I am syringe feeding as much as possible to keep her going.
I don't think her own food intake counts, as it is so little.
The vet was concerned at the amount of bladder sludge in a 2 year old piggy who has a knowledgeable owner and a good diet.
Apparently most of her clients don't arrive with a fresh urine sample, and expressing a preference for Emeraid over Critical care. :whistle:

I will look into the supplements you suggested to try and prevent further problems.
Click to expand...

There is a genetic component that you can do nothing about.

Are you filtering the water or using low calcium water? Water and pellets are generally contributing more to the formation of bladder stones/sludge than veg. The harder the water, the more you need to make allowance for it in the veg diet.
Contains tips for guinea pigs with urinary tract issues: Long Term Balanced General And Special Needs Guinea Pig Diet
 
Poor Ruby, get well soon sweetie (I don't believe the rumors your slave spreads about you, you are sweet). Sending you loads of healing vibes. X
 
Oh poor Ruby. Mabel had something similar earlier this year. The manipulation, flush and removal were definitely very painful for her, and we had very large amounts of metacam twice daily plus vetergesic twice daily. It really knocked the stuffing out of her, and I was having to give her Emeraid until she perked up. Perhaps you could ask the vet for increased pain relief? Once we got her pain relief right the desire to eat started again. But I’ll be honest she needed pain relief for much longer than I’d anticipated. I think it must really hurt.
Our vet recommends Vetpro or Cystease to help with long term bladder care after something like this.

Come on Ruby, you can do this.
 
I'm sorry Ruby is unwell.I have used cystease with good effect with a piggy with bladder stones.i use a very small amount of grainless pellets with bladder piggies.i use the strict diet used for longterm bladder piggies to all my piggies.luckily ive not had any problems since with any of my piggies.there is an element of genetic disposition.i hope Ruby makes quick progress and recovery.:hug:
 
Just a quick update.
Ruby seems a little brighter today.
She is still fully syringe fed for now, but is slowly starting to show an interest in eating on her own again.
Plus today for the first time since she became ill she has gained weight :yahoo:

And thanks to those who asked about DD1.
She does indeed have a very special bond with Ruby, and she has taken this very hard. :(
She is actually away on an overnight trip with her orchestra right now, and although she wanted to stay home to be with Ruby I made her go anyway, as I think a change of scenery will do her good for 2 days.
She did text earlier to check on Ruby, and admitted she was having fun (but not much - just a little :))).
So it has been tough on her, but also an extremely valuable life lesson.
We have had a lot of long chats about mortality, and love and loss.
She also told me she is going to work extra hard in school so she gets a good job when she is older - so far the vets bills are eye watering! :yikes:
So we are all slightly older, more exhausted and a lot wiser, but we are all here and have much to be thankful for.
I am convinced that the knowledge this Forum has offered has played a huge part in Ruby's recovery.
 
So just another update on poor Ruby.
We are now 6 days post op, and to be honest I had expected a bigger improvement by now.

Ruby is ok, but still fairly quite and quite listless.
What worries me most is that she is still almost fully syringe fed, and is showing little to no interest in food.
She will nibble at things, but after a few bites just goes and lays down again.
She is drinking on her own, but if I drop below 30ml critical care a day she starts loosing weight.
Could it be the Baytril making her feel rubbish?

She is still on her own in the hospital cage because I am constantly taking her out to feed and give meds, and this was placing a huge strain on her already fragile relationship with Lucy.
I am really hoping I can re-bond the two of them once Ruby feels better. They can all still see and hear each other.

We have another follow up with the vet tomorrow, but I am after ideas as to what more we could be doing for her.
 
I'm sorry to hear that Ruby still isn't feeling well. Are you giving her a probiotic? It sounds as though the baytril might be affecting her. I think it would be a good idea to see if you can change the antibiotic to Septrin, as that is very well tolerated and is good for bladder problems.
 
Sending you and Ruby hugs. I am so sorry she is still poorly. I hope you can get some answers from the vet, as @Lily & Rose said it could be the Baytril affecting her. Come on Ruby, get better soon.
 
Lily & Rose said:
I'm sorry to hear that Ruby still isn't feeling well. Are you giving her a probiotic? It sounds as though the baytril might be affecting her. I think it would be a good idea to see if you can change the antibiotic to Septrin, as that is very well tolerated and is good for bladder problems.
Click to expand...
Thanks so much for your suggestions. They are really helpful.
She is taking a probiotic and pooing/weeing ok (not at a normal level, but clearly things are moving through her system ok).
But she is so listless and disinterested.
She is still on a good dose of Metacam too, so I don't think she is in pain.
I will suggest changing antibiotics when we see the vet tomorrow.
And of course I might just be expecting too much to soon?
 
Oh dear. Sorry to read this x
Will be interested to hear what the vet says. If the pain relief is sufficient I’d expect her to be making some effort to feed herself by now if there is nothing underlying wrong (eg infection or pain).
I have had this once before with a piggy who became a “patient” and felt v sorry for herself. She just became totally passive and expected to be fed like a baby bird. After the vet assured me there was nothing wrong other than her mental state (she was clearly a bit depressed), I delayed one of her syringe feeds so I knew she was hungry and then offered her favourite herbs as a starter. I reduced the amount of syringe feed and offered herbs, grass and carrot part way through to help stimulate her appetite for feeding herself. It prompted her back into doing it for herself again. It took a while, though. I’m not saying that this will work for your Lucy but it may be worth a try.
@Wiebke what do you think?
 
You are right to be worried; that should not be the case!
Please contact your vets!

HUGS
 
We saw the vet again yesterday and she took my concerns very seriously.
She gave Ruby a full check up and was pleased to see she was looking well, her urine was clear, she isn't showing any signs of pain, and hasn't lost any weight.

I explained that I was worried that Ruby was so listless and not eating for herself yet, and the vet asked a lot of questions.
It was quite interesting actually - she asked all of the 'right' questions.
She wanted to know if Ruby's living area had changed since the illness (it has - she is on her own in the hospital cage after falling out with Lucy while ill), and how Ruby felt abut being handled before she became ill (she has always hated anyone but DD1 touching her).

After lots of questions the vet diagnosed 'depression with a touch of drama queen'!
She feels that clinically Ruby is fine, but she is depressed because she is sensitive to being handled firmly (necessary, but not nice for Ruby), she is on her own, and her cage is 'tiny (it's a 1 meter Ferplast, so not 'tiny' but smaller than her usual 5 x 2 C&C).
The vet also thinks Ruby might be allowing herself to 'wallow' a bit and all the time she is syringe fed, she doesn't feel the need to do much about eating on her own.
So basically what you went though with one of your piggies @VickiA

It was suggested that we stop syringe feeding, and just offer regular amounts of irresistible food (lots of hay piles, fresh grass, fresh veg, etc).
In addition we should re-bond Ruby with Lucy, and get her into a larger and more open cage asap.
I should add that the vet was open to switching antibiotics from Baytril to Septrin, but felt we should try the other things first, as Ruby only has 4 more days of Baytril to go.

The food part has gone quite well - Ruby is definitely eating and drinking more than she was, and has even started wheeking again at veg time.
This morning she hadn't lost any weight, but we will continue with daily weighing for the time being.

The bad news is that the re-bonding was a disaster :no:
We took it right back to basics (totally neutral area, no hideys, etc) and she and Lucy flew at each other within minutes.
We gave them a couple of chances, but it ended with continual teeth chattering, puffed up piggies and a couple of direct attacks, so we separated them with a grid to let them calm down.
But even with a grid between them they didn't settle and were flying at the bars every time they caught sight of each other.
So Lucy is back in the C&C alone for now, and Ruby is in an extended hospital cage and does seem much happier.
I may try the girls together again this weekend, but if that fails (and I think it will t be honest), I will try and bond Lucy with Eddi and Oreo, and put Ruby in an adjoining C&C for a while and see what happens.

So some good news and some less good news, but it is all moving in the right direction (apart from the bonding bit).
 
I am pleased to hear Ruby is getting better and is eating again. I do hope they bond again successfully though
it will be very sad if they won't but there's only so much you can do.
 
Glad that Ruby is better. Make sure that you monitor the weight daily and step in with top ups as and whenever needed. Depression can only ever be a diagnosis after everything has been excluded.

Maybe she is one of those piggies that are happier with their own territory, but with interaction through the bars. There are those; I've got quite a few of them!
 
Oh life with piggies like Ruby is never dull. I’ve had my share of them.
I’m glad there’s nothing medically wrong and she’s eating again. If she’s fit enough to fight Lucy she’s actually in good shape and no longer a “patient”.
Lucy may be better off with Eddi & Oreo. And Ruby may just be happier in her own space but with other piggies around her. She’s much like my Mollie was.
 
Thanks again everyone - I feel far less alone with this when i read all your comments.

And a big thank you especially to those who are making me feel better about the possibility that Ruby might end up in her own space.
I am actually devastated about it, and the vet made me feel even worse by reminding me it is illegal to keep a guinea pig alone, and Ruby is only 2 years old.
I do know all of this and will of course do everything possible to re-bond her with someone, but she has now had major falling outs with all three of the other piggies.

It is at times like this that I wish there were rescue piggies here so ! could take her somewhere and let her choose a new companion (but not really - of course it is wonderful that rescues don't really exist).
And I already have plans to maximize the number of shared grids she has between the cages.
I am still hopeful that in time she may also go back with Lucy.
 
Swissgreys said:
Thanks again everyone - I feel far less alone with this when i read all your comments.

And a big thank you especially to those who are making me feel better about the possibility that Ruby might end up in her own space.
I am actually devastated about it, and the vet made me feel even worse by reminding me it is illegal to keep a guinea pig alone, and Ruby is only 2 years old.
I do know all of this and will of course do everything possible to re-bond her with someone, but she has now had major falling outs with all three of the other piggies.

It is at times like this that I wish there were rescue piggies here so ! could take her somewhere and let her choose a new companion (but not really - of course it is wonderful that rescues don't really exist).
And I already have plans to maximize the number of shared grids she has between the cages.
I am still hopeful that in time she may also go back with Lucy.
Click to expand...


HUGS. You’re not alone xx. And Ruby is not alone other than by her own choice. She has company through the grids. Xx
 
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