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Specialist Recurrent Uti/ Bladder Sludge/ic In Male Neutered Guinea Pig

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Este22

Este22

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Hi I'm Este. I am new to this forum. I have read many threads in this forum throughout the years, but have now decided to join as I would like to participate in conversations, particularly surrounding the topic of the very difficult to treat bladder infections/ UTI/IC/bladder sludge! I don't really know why I haven't joined before!

I am currently 'Mummy' to five guinea pigs which have all come from a rescue near where I live - Sam, Angel, Alice, Sandy and Scruffy (one boy and four girls). I have been keeping guinea-pigs for many years (18 years to be precise!), have always had at least two, but often three piggies, and still continue to learn about how amazing they are!

The main reason why I am now posting is because Sam (my boar) is having another 'episode' and is currently on 0.5 - 0.8ml Bactrim (or Septrin as it says on the bottle) and ibuprofen for pain relief (10mg - specified dose on http://www.guinealynx.info/analgesics.html)
The reason for the ibuprofen instead of metacam is that he absolutely hates metacam and I don't feel it does anything for him, whereas 10mg of ibuprofen twice daily seems to work very well in his case during his episodes (he doesn't cry or squint his eyes and appears completely pain-free). I'd be interested to hear what you might have to say on my choice of pain relief. I also wonder whether I should keep him on a 'maintenance dose' of either or both(?)

I re-homed him from a rescue along with Angel; fell in love with him at first sight. I already had 3 piggies, so I don't know what I was thinking! Five is definitely my max! :) This was approximately just under 3 years ago. I don't know his age, but I think he is about 4 or 5 years old. He is such a little character and is absolutely gorgeous (as are all guineas :)) - see his photo), but he suffers from bladder problems. :( In all 18 years of keeping guineas, I have never had a piggie with this problem (maybe I have been particularly lucky!), and I have tried so many things to try to cure him/ prevent the reoccurence, but nothing completely works. The only thing that I rely on is Septrin for about 2 weeks and avoiding too many vegetables (although I do wonder whether the fewer veggies actually makes any difference).

I have been through some rough times with him. This was mainly during the first few weeks of knowing him. According to the rescue, he had just recently recovered from being neutered. I still wonder whether this was the start of his bladder/kidney problems... Getting up 2 hourly in the night and hand-syringing water and Critical Care for several nights, x-rays, scans, various antibiotics (some useless, some good, resistance to baytril came along sooner rather than later), changes in diet, avoiding pellets, avoiding long periods in the garden, cranberry juice, vitamin C and vitamin D crushed and put on dandelions and hand-fed, hydrangea root extract, shillintong,... etc. etc. to name a few! It suddenly occurred to me the other day that for the nearly 3 years I have known him, I have checked his urine about every 2 to 3 days for fear of missing an infection! It has been exhausting at times and I have nearly given up on him on multiple occasions. I expect he has tried to give up on me on multiple occasions too! When he is ill, my heart breaks for him every time, but then a couple of days of Septrin and he is back! He is one of those guineas who seems to be on deaths door on multiple occasions, but then perks up within hours of having medication and is back to his cheeky cheerful self running around in the garden with his four girls again! As a result, we have a very special and understanding relationship. I think he both loves and hates me at the same time! :)

So, to make sure I have given you all the details: a neutered male guinea-pig, who is approx 4 or 5 years old, and that has been suffering from acute frequent UTIs and bladder sludge for AT LEAST 3 years that I know of (roughly every 4-6 weeks, sometimes much longer. He is being treated for a UTI now. His last one was in April. I don't know whether he had the problem before as he was rescued). No stone has been observed via x-ray or scan. My very good guinea-pig loving vet (best I have found - and I have been to MANY!) reckons it is a chronic problem that can only be kept under control by minimising high calcium foods, avoiding prolonged time on clover/grass/dandelion, minimsiing pellets and feeding mainly hay and a few key vegetables - cucumber, peppers, with apple, carrot, and romaine lettuce occasionally (although I hasten to add that they do spend a good amount of time in the garden, particularly in good weather. I have considered putting down boards so there is less grass available.. What do you think?).

The only thing that I have read on this forum that I haven't yet tried out, but have now bought, is Cystease Advanced Urinary Tract Support for Cats. I've got my fingers-crossed that this will be the cure, but having tried so many things already, I am not feeling all that confident! I'll keep you posted.

Sorry this is a LONG conversation, but I just thought I would 'set the scene' and am hoping that some of you experienced piggie lovers will be able to suggest something for Sam and I. I would very much appreciate ANY advice you can give me (and I would even welcome constructive criticism!). I constantly worry about him, and wish I could find something that would help me, and him, relax a little!

Thank you,
Este

sam2.webp Sam.webp guineas3.webp
 
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Can I just add one more thing?!
Throughout the time I have had Sam, I have been endlessly encouraging him to drink water! This means having multiple drinking bottles around the pen and hutch, and multiple bowls of water. He LOVES drinking from a bowl and has his favourite bowl. So I always make sure these are changed daily (if not more, especially the bowls!). Any other method of encouraging to drink water would be greatly appreciated, as I know that this has definitely helped him. I have even tried squeezing either dandelions/cucumber/apple to extract the juice and putting that in the water for some 'flavour' to encourage, but I have found with experience that just plain water is the most effective. I worry that dandelions contain too much calcium(?). Thanks, Este
 
Hi and welcome!

I am very sorry for your problems. Bladder piggies can really give you headaches, can't they? I have been through it with my Cariad, whose calcium absorption suddenly went haywire. I could eventually get her issues mostly, but not completely under control after several bladder flushes by a very experienced vet (it needs to be done very carefully, or it backs up into kindeys and can be fatal). it very much depends on what is wrong in the complex business of the calcium absorption, and not all of it can be controlled medically or with a diet. Sadly, pretty much all of the alternative miracle medications that have made the rounds in the last years have not delivered.

Unless you syringe filtered water once daily as much as he can take to help flush the bladder out, there is not a lot you can do about the water intake; bladder issues happen more frequently with guinea pigs that are bad drinkers by nature, as the bladder is not flushed as much as with better drinkers and bacteria, minerals and calcium can build up as a consequence.
Filtered water is one of the things that can make a real difference in the frequency of the build-up. Additives to water are usually not welcome by guinea pigs.

There are also now a couple of low calcium pellet brands available in the UK. @helen105281

Dandelion is quite high in calcium, but it is also mildly diuretic and can help in certain circumstances (like the onset of a urine infection or an acute cystitis).
You may want to try the IS diet for a change and see whether that makes a difference - this diet tries to balance out the various nutrients needed while still maintaining a sustainable low calcium balance. It is the latest attempt to address the thorny business of addressing ongoing bladder issues with a healthy long term diet.
We have listed this diet under daily veg in our general diet thread, as you basically feed the same every day:
1 slice of bell or sweet pepper/capsicum of any colour; 1 slice of cucumber; 1-2 chunks of celery; 1 French bean; 1 sprig of coriander/cilantro; 1 one inch strip of spring greens (for magnesium)

Please be aware that cystease (or vegetarian glucosamine, which is its main ingredient) is a bladder coating food supplement. It cannot heal as such. What it does, is to help protect the inflamed bladder walls from the constant irritation of cystals and sludge. It has worked with some piggies of mine with a long term interstitial cystitis problem.
An alternative to cystease that is sworn by some people is to do the same by syringing barley water (as much as wanted). You make barley water by boiling pearl barley in some water for 20-40 minutes until the water becomes gloopy. Drain this fluid through a sieve and adjust the texture by adding a bit more filtered water if necessary. Piggies generally like it. It is said to have healing qualities, but this is not proven.

Unfortunately, you often look rather at managing an ongoing bladder issue in a guinea pig than heal it because there is often more than one factor involved. it is a matter of trial and error to work out what works best for your specific piggy and what doesn't. There is sadly not yet a lot of medical research into this area.
 
I feed the IC diet and it really helps my pig Amy who has Interstitial Cystitis. The pellets I recommend are either of these, though the Bunny is lower in calcium. In the Vitakraft it is higher but it is not from calcium carbonate like a lot of the UK pellets, and that does make a difference.

http://www.zooplus.co.uk/shop/small_pets/food/guinea_pig/bunny/195679

http://www.zooplus.co.uk/shop/small_pets/food/guinea_pig/vitakraft/262148

I also only feed 5 of these pellets a day to each pig which helps to control the calcium levels. The pellets are bigger than Burgess etc. They are also grainless which can help reduce any inflammation.
 
@helen105281 and @Wiebke Thank you soooo much for your reply . It really makes me feel so much better to know that you understand what Sam and I are struggling with and gives me so much more motivation to try something different which might ultimately help him.

Having four others does make changing/restricting diet harder, but they have been very good at adapting to Sams needs! Obviously they miss out on veggies like spinach and broccoli -too scared to give him these because of the calcium!

I am definitely going to try all of your suggestions. For a long time I have stuck with Burgess, but I will definitely try the bunny one and start the IC diet. Sorry to ask so many questions, but I have suspected Sam has IC for a while now because of lack of stones and reoccurrence of infection, but how is it actually diagnosed and how is it different from bladder sludge?

Thank you so much for your advice, I will keep you posted on how he is doing. He has responded well to Septrin even though he has only had two doses + 3 doses ibuprofen. Going to keep AB going for at least 5days. X
 
@Wiebke Never has any of the vets i have seen with Sam suggested flushing of the bladder. Perhaps they were not experienced enough or that it is more diffiult in boars? Is this something I should consider investigating?

The filtered water idea is something I will try. Please could you recommend a method? It it one of those Brita filter jugs or similar? I do not own one but would like to find out which one that is good to get.

It is interesting what you say about dandelions, because I have always tried to avoid them since i have had Sam knowing the calcium content. I pick them out of the lawn before grazing time! The only time he has them is with the dose of ibuprofen powder which sticks to a watered leaf! Works very well. He is none the wiser.

The cystease is going to arrive on Monday so I am looking forward to that hopefully making some difference. I will also try barley water. I wonder whether Sam will avoid if I put in a bowl and I'll need to syringe it instead?

Many thanks again, Este
 
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Este22 said:
@Wiebke Never has any of the vets i have seen with Sam suggested flushing of the bladder. Perhaps they were not experienced enough or that it is more diffiult in boars? Is this something I should consider investigating?

The filtered water idea is something I will try. Please could you recommend a method? It it one of those Brita filter jugs or similar? I do not own one but would like to find out which one that is good to get.

The cystease is going to arrive on Monday so I am looking forward to that hopefully making some difference. I will also try barley water. I wonder whether Sam will avoid if I put in a bowl and I'll need to syringe it instead?

Many thanks again, Este
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I would not suggest bladder flushing to a vet who is not experienced with it. We have seen a number of member's piggies die in the wake of it not being done gently enough when it was somewhat fashionable. :(

Definitely recommend a Brita filter, especially if you are in a hard water area.

You will likely need to syringe both the water and the cystease, but many piggies actially like it. My Nerys would make a beeline of a syrine filled with cystease/water solution, so I didn't even have to pick her up for it... I would however only try either cystease or barley water at any time, as they are basically doing the same job.
 
Hi, welcome to the forum. Can I ask what part of Devon you are in, I live in Plymouth and down here good vets are few and far between. I though have a good one who is open to ideas but it is always nice to hear of other local piggy owners and their experiences. I too have 2 'bladder' piggies. Maggie had sludge which was cleared through long-term antibiotics, pain relief and a daily capsule of nutracys +. Touch wood she has not suffered in 12 months. Rosie on the other paw has recently has a bladder stone removed and has/ just recovering from a very nasty bladder infection. A long term course of septrin, metacam, critical care mixed with cranberry juice. Also pro-c probiotic to encourage her to drink more. As well as a very limited diet of low calcium veg mainly romaine lettuce and cucumber seems to have done the trick We also cut grass and dandelions completely out of her diet. She is also having an additional 50-100mg vit c daily.
 
Thank you @Wiebke I have soft water, but I will try brita filter and just one thing at a time; that is good to know. My Sam is so used to the syringe now, he will probably be the same! He loves the septrin as it is banana flavoured!
 
@Midge&Panda Thank you for your reply and advice - it is so good to (virtually) meet people with piggies in the same situation, although sad to know that it is common in piggies but that there is not an easy cure! I am from Plymouth too! I see a very nice lady vet at Lipson. She has guinea pigs herself, so she knows them well.
I have never heard of nutracys... where can I find this? Which probiotic do you use out of interest? Anything that encourages drinking I am keen on!
For a long time, I fed mainly cucumber - I find it the 'safest' calcium wise, and they all love it! That is disheartening about the grass - they love being out in the garden! They are house piggies in winter, gradually moving into the shed for summer nightime and garden daytime...Is grass a big no?!
 
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Welcome to the forum . I can see you've had lots of advice above. It would be such a shame to cut out grass time completely for your guinea pigs. Cuould you reduce grass time to a few hours a day and see how your boar responds?

PS I have read somewhere that the calcium content of grass depends on what your soil type is. Perhaps other forum members could advise more.
 
Hi, I know the surgery it's part of the animal hospital if I remember rightly. I've been there once or twice met a very nice vet called Sue. The probiotic is called Pro-c from a company called vetark. You should be able to pick it up at pets at home. Just don't give it at the same time as the antibiotics it can interfere with their absorption. The nutracys is from the vets it contains an ingredient which coats/protects the lining of the bladder. I don't know how much of a no grass is but the vet mentioned it and because I was very worried that there was a risk of a new stone forming (she already had grit in her urine) I wanted to give everything a chance.
 
Fantastic amount of very useful info already provided by other members on this thread - thank you all.

Only thing I would add to all the above info is that, a bladder infection is a much more likely scenario in a sow than a boar because their urethra is a lot shorter. In boars what is often diagnosed as an infection is actually a crystal-induced inflammatory cystitis.So in the case of recurrent bladder issues where infection is suspected, my vets would at some point perform a cystocentesis (extract a sterile sample of urine directly from the bladder using a needle) and send it away for culture/drug sensitivity testing before diagnosing an infection and prescribing abx.

Whilst septrin is the favoured abx for urine infections in piggies....some vets think that prolonged use can actually contribute to crystal/sludge formation as the active drugs themselves can form crystals in the bladder. Also with repeated on/off use, there is a risk of building up a septrin-resistant bacterial population (hence why my vets culture first). Another point to consider is that maybe the septrin is merely reducing the bacterial load back to sub-clinical (symptomless) levels and not completely eliminating the bug, therefore leaving a residual population to grow up again to the point where new symptoms occur. Additionally, if the piggie is unable to thoroughly expel/empty the bladder, (can be a post-op result from neutering) this leaves a residual amount of urine continuously in the bladder which helps support bacterial growth and can be the cause of recurring infections.
Of course this is all assuming that there actually IS an infection present and that the symptoms are not just caused by a non-specific inflammatory cystitis (with no bugs present at all) resulting from irritation of the bladder by crystals/sludge. The latter is a condition that can;t be cured (although a bladder flush can help)....merely managed as per all the above suggestions.

HTH
x
 
Thank you all very much for all of your replies @Wiebke @Midge&Panda @PiggyOwner @Kerrie74 @Pebble ! :D

Sam has been in extremely good health since his episode last week, his usual cheeky self, bright round eyes, running after the girls and chewing at my shoelaces in a loving way. It's great when he's like this. I know he is feeling well. :) The septrin and neurofen is working well.

@PiggyOwner I know, it's so hard reducing time on the grass! I know that the reason why he has been particularly well this time is because he has had just a short amount of time on the grass and clover the last three days, only a few pellets - just plenty of hay and cucumber. I've noticed the trend, it's so obvious. They are out on the lawn today, but I cut it quite short last week so it's not too long. My piggies have always spent long summer days in the garden (shed for night-time. In the house all Winter and cold nights), but I have started to realise that I have to compromise between Sams health and grass time, so that is why I now cut it short and they only go out during the day. I've started to keep it short by mowing (they have a large indoor space with lots of hidey places, tubes, cardboard boxes, and hay bags... never EVER cramped up in a hutch. I will post a photo soon). I will research my soil type :)

@Midge&Panda Yes Sue was my vet - she was absolutely brilliant! Although I heard recently that she has gone travelling, so not sure who I am going to go for in case of next time. Thank you for the extra info - I shall look into those. I have used a probiotic (which was meant for rabbits, but was good to use on guineas before and that worked well).

@Pebble Thank you for your advice. I think you are SPOT-ON! I am going to call it crystal-induced inflammatory cystitis from now onwards (unless I discover another symptom) - I have done so much research over the last 3 years, and that is the best way to describe it! I dread the day Sam gets a septrin-resistant bacterial infection, because he is already become resistant to Baytrl (although he hasn't had that for over a year now, so maybe it might be worth trying again if he does become resistant to Septrin?). I would definitely say that his infrequent illnesses are a result of infection because the Septrin works like a miracle every time (and has done for over a year now), although I could be wrong...

Thanks again everyone. I will keep you updated.

Ooh by the way, does anyone know anything about clover and bladder sludge? I have quite a bit of it in the lawn and naturally Sam (and the girls) love it of course!
 
@Wiebke @Pebble @Midge&Panda @Kerrie74 @PiggyOwner Just an update - Sam is doing so well and has beem since 1st July when he started on Cystease. I am so happy for him I know it has only been a week but he seems so well, back to his lively cheerful self AND drinking water which is great! I give half a tablet of cystease morning and evening. It is based on weight, and seems to be the right amount for him. Keen to hear what others think.
Thank you everyone.
 
I'm delighted to hear you've seen an improvement.

I'm not an expert on cystease . I will tag @helen105281 as she is more familiar with cystease than me.
 
Este22 said:
@Wiebke @Pebble @Midge&Panda @Kerrie74 @PiggyOwner Just an update - Sam is doing so well and has beem since 1st July when he started on Cystease. I am so happy for him I know it has only been a week but he seems so well, back to his lively cheerful self AND drinking water which is great! I give half a tablet of cystease morning and evening. It is based on weight, and seems to be the right amount for him. Keen to hear what others think.
Thank you everyone.
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That is wonderful news! You must be so delighted! The dosage can vary individually; you sometimes have to up or lower it until you find the ideal one. I could lower it eventually with my Nerys, who was symptom-free on cystease for nearly three years before I could take her off for good. But right now, you are looking for comfort and long term quality of life.
 
Couldn't agree more @Wiebke - comfort and long term quality of life. For a long time now I have been feeling guilty that he was not getting a quality of life, but now I really think we are getting somewhere now. I'm going to keep him on Cystease for as long as it takes. Out of interest, how did you administer it? I am using a 1ml syringe - the powder mixed with a little water x
 
helen105281 said:
That's wonderful news and the dose seems to be right for him. Do you know what it is in mg?
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@helen105281 the one I bought online is Feliway Cystease Advanced 30 x 125mg Capsules. So half a capsule morning and evening approx 60g each dose - total 125mg a day. Please let me know if you think it's too much. X
 
So pleased you are managing his condition :) I also have a bladder piggy who we have been treating for 3 years now. At the moment she is on a low dose of Metacam 0.1 ml once or twice a day if required, monthly Cartrophen injections instead of Cystease & a daily dose of Potassium Citrate, which binds the calcium together to enable her to pass more. We also give her plenty of extra water by syringe, I add Avipro probiotic to some filtered tap water & she will happily drink a few syringes at a time without me even having to pick her up :)
 
Este22 said:
@helen105281 the one I bought online is Feliway Cystease Advanced 30 x 125mg Capsules. So half a capsule morning and evening approx 60g each dose - total 125mg a day. Please let me know if you think it's too much. X
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That's the standard dose for Cystease so is fine.
 
@Poppy'sMum it is working so well, I am so pleased with his progress. He is off the septrin antibiotic now and is still doing so well. Since 1st July, he has not cried at all when he wees and has normal looking and normal amount of wees. I'm over the moon. Sticking with Cystease twice daily and neurofen once daily for now as this seems to be perfect. Keen on how i could possibly hide the Cystease in something he will eat as right now can only mix with water and syringe. He takes neurofen fine on a wet piece of lettuce or dandelion as it's tasteless :-) he does not like metacam at all so I don't use that.
 
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@Poppy'sMum interesting you say about the Potassium citrate binding the calcium... I did not know this... Any brand in particular you would recommend? Thank you so much :-)
 
Hi, Rosie has nutracys capsules for her bladder problems. I open the capsule pour the powder onto a dessert spoon add a small amount of fruit (usually banana) baby food onto it and mix it together. Next comes the fiddly part. It then gets scraped into a 2ml dosing syringe then transferred to a 1ml dosing syringe. There you go Fruit flavoured medicine which piggy should love.
 
@Midge&Panda thank you very much for your tip. I am keen to stick with Cystease for now as it is working (this is a miracle in my opinion as have tried soooo many things in the last couple of years) but will try hiding it the way you do :-) I will also buy some nutracys (or is it prescription?) to have on hand in case Cystease starts to fail. X
 
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