The stone is in the ureter. I don't know if a suregery would be successful but I'm not up on the latest advances.
I would assume if the stone could be removed he would recover but I have no idea what the risk level is of the surgery and whether the kidney has already been compromised and if the surgery is possible.
If someone didn't know him as well as we do, you'd never know he was so sick, he plays, runs, purrs and seems to be himself now that we managed to put his weight back on.
We are obviously hoping for the best, but it's breaking our hearts to know that there is a good chance we may not be able to help him any more then we have, other then to keep him as comfortable as possible. At what stage do we say enough is enough?
Our vet seems to think the kidney is blocked (by the colouring on the xrays) and where the stone is lodged, and it being such a large stone. She wants to wait until the lab results come in tomorrow afternoon. She's never done a surgery like this before so she is putting a post on her vet board in hopes of getting some advice. If she can somehow safely release or remove the stone, then it will be done right away. I highly dought he can pass the stone into his bladder.
The ureter is very, very tiny. If it's lodged there and large, I'm afraid that's not good news.
Cookie was her same happy self all the way to the end. I continued to handfeed her and gave her hydration subcues. She certainly didn't appear to be in any pain, just very tired. Almost like she wound down.
This was several years ago, so maybe something new has been developed, so hopefully, Jo will get back with more info.
- Little Jo Wheek
There is not any surgery I know short of removing the entire kidney and associated ureter to solve this problem. Usually the recommendation is aggressive nursing care and pain meds. I did have one boar diagnosed with a uretral stone on ultrasound that turned out to be incorrect on necropsy. It is sometimes hard to tell on these guys. If the stone is large enough, it is probably a good assumption that there is a problem there. I don't think it is likely to pass into the bladder if it is very large.
Just a bit of an update. All Chestnut's blood work came back normal, much to Dr Munn's surprise. She will be putting him on another pain killer along with the Metacam starting Friday once it has been compounded. She says we have a couple options:
1) We can remove his left kidney and ureter, but this is very risky since he seems prone to stones and if this happens again he is doomed. He can live on one kidney easily enough, but the risk of getting stones a third time is quite high.
2) We keep him very comfortable on the 2 pain killers and hope he can pass the stone into the bladder or the stone shifts down closer to the bladder opening where she can do surgery to remove it from the ureter. Where it is right now, it is too high to grab, and she can’t cut into the ureter itself. Like you said Josephine, it’s very hard to tell on the x-rays just how big the stone is, and if it can shift enough.
For now, we continue hand feeding 5+ times a day in hopes of keeping his weight and strength up, and the double pain killers will hopefully make him comfortable enough to want to eat on his own again. He hasn't eaten any hay since Sunday night and I managed to get him to eat a couple pieces of lettuce and cucumber the last 2 days on his own, which is good. Thankfully he doesn't fight the hand feeding at all.
We just have to take things day by day and hope for the best.
- Little Jo Wheek
It sounds as if you are doing the best given the circumstances. Unfortunately, this is one of those things that you have to give some time and see how it goes.
Chestnut seems to be keeping his weight steady around the 950 gram mark the last couple of days. Hand feeding is going well, although I don’t like it on days I am working because he doesn’t eat during the day. My youngest son comes home at lunch and makes sure he gets a lot of water. It really does take 2 people to hand feed him, if not he runs off and wants nothing to do with eating. Thankfully I’m only working 3 days a week for a month.
He starts his 2nd pain killer tomorrow. We changed his Metacam slightly, he’s still getting the 0.2ml a day, but we are now dividing it into 2 doses in hopes it helps him more. He’s getting 15 cc’s of Critical Care a feeding, 5 times daily, lots of extra water and we’ve discovered he will eat cucumber on his own. We’ve been slicing it up in bite size pieces and mixing it into his salad that we leave out during the day. He’ll at least eat that and a couple pieces of lettuce.
Is having too much cucumber bad for him, and how much is too much?
Cucumber is a fruit and so, yes, I think you probably should limit it, particularly since he's not eating enough other greens to balance it.
What about hydration injections? Are you doing them? If not, you might want to look into getting the equipment and doing them every day or every other day.
I’ll double up his Metacam again tonight, funny you mention that because he started peeing blood again yesterday, so it doesn’t seem to be working as well as we had hoped. So far, he seems to only like crunchy food. We’ve got him to eat yam, cucumber, a few bites of his carrot and green beans now. But he refuses to eat anything leafy or soft.
I tried to out-smart him the other night by grinding up some cucumber and mixing it well into his salad, all he did was get mad and start licking the cucumber off. He will just pick out the really hard and crunchy stuff and leave the rest. He is finally starting to pick at his hay a little bit too. He still gets his 15 cc’s of Critical Care 5 times daily since he isn’t eating properly. His weight is holding sort of steady between 925 and 935 grams… far below his 1075 grams.
His normal salad is: endive, red leaf lettuce, cilantro, dandelion, blueberries, 1 small baby carrot, cherry tomato, slice of red pepper. None of which he will eat, where before he would gobble up everything.
Is there anything good for him that I can buy to try and get him eating on his own again? Could it be he is getting too used to the Critical Care and only wanting that now, and will eat the really crunchy veggies (cucumber, yam and green beans) because he normally doesn’t get them other then for a treat? I don’t want to risk stopping the Critical Care completely because he can’t afford to lose any more weight.
- Little Jo Wheek
Oh, and yes on the wheat grass. They love it.
- I GAVE, dammit!
I would think with a stone that the point of increasing water consumption is to make him pee like crazy and give him a better thance of passing the stone or at least moving it?Becky, Chestnut has been drinking a lot of water. On a normal day, he’ll drink approx 3-4 ounces in his cage, plus the approx 4 ounces we feed him. He so far isn’t dehydrated, if his water consumption decreases, then that will be an option for him.
I may be wrong, but it seems to me that it might make sense to give hydration subcues to help this.
For example, when we started Elvis on metacam, he got 0.15cc twice a day for the first week, then once a day since then. And the only time I've given 0.2cc was post surgically.
And, yes, the idea of subcues with stones is first, to try to flush it out and second, to keep it from getting bigger or more stones forming. It has less to do with the pig being dehydrated.
Josephine, I’m a bit confused now. From October to last week he was on 0.1cc’s of Metacam, then Dr Munn changed it to 0.2cc. We tried him on the full dose once a day, but he didn’t seem too comfortable so we divided it in half for him (0.1cc in the AM and PM). When he started peeing blood again on Friday night, I put him back on the 0.2cc once daily and now the bleeding has stopped. I would prefer to keep him on the 0.2cc daily since he is doing better with it, but you say that is too high for him? At 940 grams, what’s the correct dose for him?
Mum, he pees non stop now (every 3-5 minutes) with all the water he is drinking (from his water bottles and what we give him), his cage has to be completely changed daily because it is soaked by the time I get home from work. He drinks a minimum of 8 ounces of water daily, but some days it gets up to 10-12 ounces. Dr Munn doesn’t want to add sub-q’s to this because we also need to save some room for his food that he also needs. There has to be a balance between food and water. He’s not going to be keen on eating if he is so full or bloated with water.
He did a bit better during the day on Wednesday, his energy and independent eating improved. By evening he seemed to start having troubles getting the Critical Care down or keeping it in his mouth and seemed to be hopping more then walking and would grunt when ever I touched his lower back or legs.
We brought him into Dr. Munn’s first thing Thursday morning and unfortunately there was nothing else we could do for him, his body was in the process of shutting down. She checked him for everything incase we were missing something like teeth problems etc. Once we ruled everything else out, we decided to have him put to sleep to end his suffering. He was in his favourite cuddle pocket – it has 2 teddy bears that wrap around him – when Dr. Munn put the mask on him, so I know he was very comfortable for his last moments.
He fought hard from October 2005 to July 06 2006 when this stone problem first started. We did everything humanly possible for him, which I hope and believe was his reason for him fighting so hard and long. I also know that he had a very happy and spoiled life with us for 3 ½ years. It breaks our hearts not having him with us anymore, but it helps knowing he is pain free now.
I would have done anything possible to help him and I’m sure he knew that. We’ll miss him, but others will benefit from what we learned through him. Dinnertime was rough because he normally had his dinner with us, so there was no wheeking when the salad was brought out. It sure won’t be the same around here without him.
Attached are a couple of photos my daughter took of him before we left for the Vet’s yesterday morning. The pillow he is sitting on is one my youngest son made at school for him.
I just want to thank everyone for all their help and concern with Chestnut over the last 9 months, we really appreciate it.
Rest in peace little buddy, we’ll all miss you.