Reoccurring bladder infections

[pinta]

He has had a recent xray, right? stones can form very quickly.

I think the clue is with the metacam. It's an NSAID. Nonsteroidal anti-inflammatory. It sounds like the metacam is keeping down inflammation and as the drug wears off something is getting inflamed and bleeding.

Could he have a sensitivity to something that's causing swelling somewhere? Bladder lining? Hmmmmmm - what kind of sutures were used for his first surgery? Could he be intolerant to the suture material? Seems to be a common problem with a lot of pigs.

[Kallie]

Chestnut had an x-ray done tonight – 3rd in about as many weeks. All came clear from signs of any stones and swelling. I’m not sure what type of sutures were used inside, I never thought to ask after his surgery and his next appointment isn’t until Jan. 13th so I will ask then. On the outside, she used some type of glue to close him up. After 2 months, would his bladder be healed enough for the stitches to either dissolve or fall off depending what type the Vet used? I’ve never been through this before with any of my piggies or with any of my other animals, so I’m not sure what to expect.

[pinta]

Don't wait til Jan 13th. Find out now what kind of sutures were used. I've had sutures erupt out of totally healed pigs weeks after surgery. Their bodied rejected them and instead of the sutures benignly dissolving, they were gradually cast out of the body thru healed skin by what I assume was the immune system response.

Josephine knows more about particular sutures than me(I know piss all about the details of the materials) - I just know many pigs are rejecting sutures that are supposed to be perfectly safe. From what you are describing, it really is pointing toward suture rejection.

-Trouble since surgery, never fully recovered.
-no stones on xray
-ABs aren't helping
-anti-infammatory seems to be the only thing really helping which indicates something is inflamed which indicates something is reacting to something else.

[Kallie]

Your suggestion sounds exactly how Chestnut is reacting since his surgery. I will phone them first thing in the morning and ask and will post it here for you. If this is the case, how can we find out if this is what's happening and how do we solve the problem?

I really appreciate your help with this. I've gained many gray hairs these last 2 months between Chestnut and Stevie. I just don't know where else to turn with him. I hate seeing him go through all of this.

[Lynx]

Maybe an ultrasound would help. Or perhaps bloodwork would show up an infection? If the sutures are being rejected, I would imagine there would be one?

I'd continue with the Metacam for the pain. I'm assuming it gave him some relief before.

I'm sorry you aren't finding the cause.

[Kallie]

Thanks Lynx, when I call about the suture type tomorrow morning I will also book an appointment for Friday morning before the office closes and get the ultrasound and blood work done if possible. Dr Munn is very good at fitting us in on short notice. I just worry because her office is closing very early morning for a week. I don't have another Vet that I would trust enough to take care of him properly.

[pinta]

Ooh, time for Josephine to hop in since she actually knows what the heck the sutures do once they're in there. Possibly over time they would gradually dissolve and be expelled from the body but I don't know if any fragments would be left and if there is a reaction if that reaction will subside in time.

One of my pigs(amputation) just thrust all the sutures up on her own(think Alien) but another one(spay) required emergency surgery through a healed incision site to get all the sutures removed. The rejection had caused a massive infection requiring 2 ABs concurrently and a huge clean up. She made it but it was very touch and go.

[Josephine]

It sounds as if the initial infection from October never cleared up? That is difficult. Perhaps ask if your DVM can post on VIN re: antibiotic choices. Do you know the actual microbes that have been cultured? It sounds as if you're saying he's never had a clear culture. That's not great. The method of collection (free catch vs. cystocentesis) can have a lot to do with what is cultured, but since the signs are there--he's definitely got something.

I would ask about abdominal ultrasound. The ultrasonographer/radiologist can get a cysto that way and see how reactive the bladder is. Potentially, biopsy could be another diagnostic. I'm not sure if they can get a good sample via ultrasound, but it would be worth asking. If there was any suture reaction (not too common, but possible), you should be able to see something on ultrasound. It really depends on the suture material used (too many to comment), but most absorbables they'd use on such a surgery take a couple of months to completely dissolve. Stainless steel is the least reactive suture, but never dissolves and can be less comfortable in the long-run. Usually, it's a non-issue.

If you don't have a very experienced radiologist nearby, you can also ask if one would be willing to do your pig (and a healthy, comparison pig's bladder) as a professional interest case for a reduced fee (or no-charge). It just depends on who's available and if you're willing to accomodate their schedule.

Long-term, if this is simply chronic UTIs, I would definitely make it mandatory to dose the pig with daily cranberry/blueberry extract (the apple doesn't help with the bacteria) and consider giving NSAIDS +/- Shi Lin Tong (and you may want to consult with someone who does TCM before dosing). If there is a decent antibiotic that he doesn't react to and the bacteria seem sensitive to, then you can also consider long-term pulse therapy (off/on dosing indefinitely).

[Kallie]

Thanks for all the info and suggestions. I have printed off and faxed it to Chestnut's Vet. I will phone her once I get into work to see what she says. I'll let you know.

[Kallie]

Just wanted to give an update on Chestnut. This is his 12th straight day of Nitrofurantoin and Metacam and everything seems to be going well. There’s been no blood at all for the last 4 days. He has at least 1 more week to go before we can think of stopping the medications. He goes in to the Vets for another urine test next week to make sure the infection is gone first. It will depend on those results if the medication can be stopped yet or not. The ultra sound showed nothing out of the ordinary.

I finally got him to eat fresh blueberries and now he gets 5-6 per meal, twice daily. So now onto trying to convince him about the cranberry juice. We still have him on towels that are changed twice daily, still eating a lot of veggies, hay and some fruit and drinking lots of water and diluted apple juice. Activity levels, peeing and pooping are all still normal. We just might beat this yet!

If I can figure out how to post photos, I would love to introduce Chestnut and Stinker to you all.

[Lynx]

There's a sticky in the Feedback forum with tips (also in the FAQ linked to at the top of each page).

Thanks for the update.

[Kallie]

Here are some photos of our babies:

Chestnut, the king of the house



Stinker, our newest addition and soon to be Queen of the house



And Stevie, whose sadly died on Dec 29th, 05 and is greatly missed