*URGENT* Passing blood...squeaking

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Becky

Post   » Sun Jan 22, 2006 10:54 pm


GracieLee hasn't been around lately, but maybe someone knows where she can be reached. She used to be from that area.

Also, where is Caroline these days? She lives in the vicinity, too. You can do a search on either name and email them.

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sef1268

Post   » Fri Feb 03, 2006 7:41 am


Update: the urine sample came back from the lab. No red or white blood cells and no bacteria, but crystals were found -- both struvite and calcium oxalate.

The vet left me a message last night saying she'll call me today to discuss treatment, but gave me the impression that the presence of both types of crystals will make it difficult to treat, since one type requires the urine to become more akaline in order to prevent stones, and the other type requires the urine to become more acidic in order to prevent stones. Is this true?

Initial x-rays showed no stones. I'm wondering if a second set might be wise?

Zachary is still eating and drinking normally, does squeak occasionally when defecating (usually when I'm holding him, as if there is some discomfort in the way he sits in my lap), feces are back to normal, and is maintaining his weight at 2 lbs. 10 oz. -- there had been some initial weight loss, but it seems to have leveled off.

Any recommendations here?

GP Lover
My home, ruled by pigs!

Post   » Fri Feb 03, 2006 8:32 am


"...one type requires the urine to become more akaline in order to prevent stones, and the other type requires the urine to become more acidic in order to prevent stones. Is this true? "

Yes, that is true so you need to be careful about the urine pH.

Is he crying when peeing? If so you may want to consider pain management. Not having a stone is good but I would imagine it's possible those crystals may contribute to forming one in the future.

Let's see how your vet plans to treat it. You don't know yet what the plan of action is.

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sef1268

Post   » Fri Feb 03, 2006 9:49 am


You're right -- I need to take a deep breath. I guess stress of work, husband's health problem, and now this have made me a little stressed.

I'll wait to see what the vet says when I call back at noon. I'm off to go try to test his urine for pH, since the lab forgot to...

User avatar
Becky

Post   » Fri Feb 03, 2006 10:14 pm


Since you really don't want to mess too much with the urine itself (no polycitra!), I'd strongly recommend doing subcues at least three times a week. That, more than anything else, might be the best treatment.

Other suggestions--if he isn't too active, the sludge tends to settle in the bladder and this irritates the bladder, leading to more inflammation, more sludge, etc. It's a cycle. My vet suggested using a small vibrator daily to keep the sludge moving.

Pain management, as GP said.

One more element I've been discussing with my vet is daily full spectrum lighting as a means of helping to process the calcium?

GP Lover
My home, ruled by pigs!

Post   » Fri Feb 03, 2006 10:18 pm


For pain management you may want to consider Shilintong, a chinese herb. I had very good results with it.

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sef1268

Post   » Sat Feb 04, 2006 8:16 am


I'm not seeing any sludge. I've been monitoring, but nothing so far. The whole thing started out on Christmas Eve as peeing blood and squeaking when defecating. He's still squeaking when he defecates, but only on occasion. No crying when he pees. I might try the herb...the Metacam seemed to help, but I certainly don't want to use long-term.

I'm confused by what the vet said, about there being both struvite and calcium oxalates in Zachary's urine. From what I've read, it's not uncommon to find struvites in low levels. When I asked how much we were talking on both types of crystals, she said +1.

pH of the urine is 8. Is that considered within normal range? I know it's usually closer to 9.

The vet's recommendation is to do nothing at this point...monitor, and return in a month for another set of xrays and urinalysis. I'd like for her to do via cystocentisis (sp?), since we seem to have trouble getting a decent-sized sample, but she didn't seem too comfortable with that.

I wish I had a little more confidence in this new vet. The episode with the Metacam dosing has made me a little concerned about her expertise...

Crap. I hate it when a good exotics vet retires.

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sef1268

Post   » Sun Feb 05, 2006 5:14 pm


I have been searching here and on the web this weekend, and can't really find any information about incidences of having both struvite and calcium oxalate crystals in the urine at the same time. Since one favors alkaline and the other acidic conditions, how in the heck can there be both? Does anyone here have any experience with this type of situation?

I was also reading that refrigeration and storage of urine samples *can* cause crystals to form. I'm wondering if that's the case here...that one type is present and causing the trouble, but the storage process involved in getting the sample sent out to the lab in Indianapolis might account for the other?

Zachary is squeaking again when defecating (but not when urinating), and it's getting more frequent so I put him back on the Metacam. Since the current vet is adopting a ho-hum "let's wait and see" approach, I'm opting for a second opinion from a vet down around Corydon who is supposedly good with rabbits.

User avatar
Lynx
RESIST

Post   » Sun Feb 05, 2006 6:20 pm


I forget, have you had an xray? Increasing fluids should help but if there are stones, you'll need to have them removed.

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sef1268

Post   » Sun Feb 05, 2006 6:34 pm


Yes, xrays (3 views) didn't reveal anything last month. Lynx, do you know under what circumstances both types of crystals might appear in the urine? Does that even sound plausible?

Juliemarie

Post   » Sun Feb 05, 2006 7:14 pm


Just read through this thread. You must be so frustrated.
You always thought it was poop rlated, right from the start. Yet no-one can offer a difinitive diagnosis.
I feel so sorry for yor piggie. it must be awful to feel pain each time he poops.
For what its worth, I would definitely be seeking another professional vetinary opinion.

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Lynx
RESIST

Post   » Sun Feb 05, 2006 9:13 pm


So you've had the same squeeking since before the xrays and after? I would not focus too much on crystals in the urine. I would think this would be a common finding.

I think your plan to continue with the metacalm is a good idea. I would treat it like stones/ interstitial cystitis and focus closely on diet, more fluids, perhaps the herbs you were talking about. I understand why the vet is kind of at a loss if he can't find any stones and would suggest monitoring.

Becky has had good luck giving subcues to increase fluids. Sounds like there's no infection present so you're not giving antibiotics.

I don't feel like I'm being very helpful. I understand how hard it is to have your boar be in pain.

User avatar
Becky

Post   » Sun Feb 05, 2006 9:29 pm


I'm certainly no chemist or expert, but I really did wonder about having both oxalate and struvite crystals in the urine. I have no idea if it's possible, but as you said earlier, they form in different environments--struvite in alkaline, oxalate/carbonate in acid. I don't see the urine being both, so I'm at a loss as to how both could show up.

If there were crystals present, it's probably sludge. Again, increase the fluids. Balanace the diet if you haven't done so yet.

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sef1268

Post   » Sun Feb 05, 2006 10:50 pm


Correct, Lynx -- squeaking before and after the xrays. The squeaking is what first alerted me to a problem on Christmas Eve...I then found blood on the towels underneath his fleece. Started him on Bactrim that day, and by the time I was able to get him to the vet (the following Tuesday), the blood was only showing up as trace.

He was on Bactrim for a total of 3 weeks.

At this point, I think I'm inclined to discount the crystal findings for now. I asked the vet if it was possible that struvites in low levels would be common in alkaline urine, and she finally said, "Well, it's possible." Then after reading that crystals are not uncommon in urine samples that have been refrigerated/stored for more than 60 minutes prior to testing (source: http://www.antechdiagnostics.com/clients/antechNews/2006/jan06_01.htm ), and knowing that the sample was refrigerated by the vet prior to transport to the lab, it seems to me that the results are questionable at best. Particularly when it shows the unlikely presence of both types of crystal.

Agree with suggestions here to increase fluids, manage pain and adjust diet while monitoring.

Thanks again; I greatly appreciate the feedback.

User avatar
sef1268

Post   » Mon Feb 06, 2006 6:54 am


Something I meant to ask last night: as an alternative to SQs, can I syringe either unsweetened cranberry juice or Pedialyte? I have a bag of Ringers here, but I'd rather go with syringe-feeding for now.

Does, say, 20-30cc's of fluids daily sound reasonable?

User avatar
Lynx
RESIST

Post   » Mon Feb 06, 2006 12:40 pm


Ideally you want more fluids into your pig. People seem to find pedialyte a good idea. Try that and/or water.

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sef1268

Post   » Mon Feb 20, 2006 9:34 am


Update: I sent another urine sample over to our local vet this morning to test again for crystals. No crystals present, no white or red blood cells, but the vet said there was quite a bit of bacteria present. He wasn't sure how much of this to discount as contamination, but said it was "all the same type" and in amounts significant enough to make him think it's not contamination. Vets here don't seem to know how to do a cystocentisis...I'm thinking a free-flow sample would have been better than syringing it up from a clean surface, if we're looking at bacteria, but at the time I was more concerned with the "crystal" issue.

Vet thinks maybe we should do a round of Baytril, since we already tried a round of Bactrim and are still seeing issues with crying while defecating. He said this could be a kidney problem rather than just bladder infection, and pressure on the abdominal walls when having a bowel movement would cause discomfort.

Urine was diluted; 10-15?

At any rate, the vet made a comment that I'd like some input on. He said that there were some tubular casts -- Hyaline? I'm not sure I understand what this is or what it means. Can anyone here comment on this?

Thanks.

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Lynx
RESIST

Post   » Mon Feb 20, 2006 10:01 am


Josephine will have to comment on the tubular casts.

The bladder is small but fairly easy to find. If you have any xrays available, it would position it well for him to know where to do a cystocentisis.

User avatar
Becky

Post   » Mon Feb 20, 2006 12:08 pm


pressure on the abdominal walls when having a bowel movement would cause discomfort.

This is what my vet said, as well, except he said bladder instead of abdomen. Since the bladder is chronically inflammed, she tends to have pain when eliminating either urine or poos.

I had to Google tubular casts. This is what the article said about why the test is performed:

Why the test is performed:
The test is performed to see whether the kidneys are functioning properly and to check for certain conditions, such as kidney infections, glomerular diseases, and interstitial kidney diseases.


I also keep wondering whether or not they can get polyps or the human equivalance of hemorrhoids. That certainly would explain the pain and occassional passing of small bits of blood in my pig. I asked my vet and he said he didn't know.

User avatar
Becky

Post   » Mon Feb 20, 2006 12:31 pm


OK, this site talks about the various types of casts. It looks like Hyaline casts are protein. I believe they look for protein in the urine to test for kidney function? It also says some casts in the urine is normal, so clarification would set your mind at ease, I'd imagine.

http://www.drkoop.com/ency/93/003586res.html

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