I read one of your posts about the unreliability of at home human urine test strips, it was very reassuring. My only concern is that the center of his eliminations (from earlier today) dried to a dark brown with orange poryphyrin urine surrounding it. While the rest of his eliminations from late last night showed up as very small dark, dark brown dried spots--I've never seen his poryphyrin eliminations dry that dark brown before.
Does UTI blood spots dry up brown within within 24 hours? I have a feeling it's difficult to answer that question. And the only way to know is get a lab urinalysis.
Thank you for your insight.
We're still bleeding, now with a little more blood in the urine and a prominent red dot in the center. I am pretty confident I'm not dealing with blood clots here. The vet nuanced that if it were a UTI, the azithromycin is a "broad spectrum" drug---and thus should keep the possible UTI in check? Also we're due to end the azithromycin in 3 days (20 days total). So I'm not sure that's long enough for the azithromycin to keep the UTI at bay. He still has clear (no longer opaque) discharge in one nostril.
In the meantime I've been checking in on his penis every so often and it's super raw. Usually it's not so purple. I am sure it was the grit that was causing irritation inside and out (more inside the urethra). Once we started having this grit issue, I've been rinsing away the grit off his penis at least every week--then I began to check every few days after the blood started to show up.
I do the rinses with gloves on (so as not to introduce things, though gloves that come in boxes are never sterile) and some warm water with just a bit of witch hazel squirted in. Then I just point and gently shoot the syringe. While it appears to rid of the grit on the outside, we still have problems with the inside of the penis.
I requested some kind of ointment to hopefully help with the pain/inflammation, and the vet prescribed some gentamicin to apply to his penile tissue twice a day. It appears to be more of antibiotic more than anything. It also supposedly helps with UTIs but I'm not sure how topically applying it to his penis (or even at the entrance of his urethra) would keep any serious UTIs at bay.
Am tempted to take him in to emergency if his intense bloat and mini stools don't subside. We suspect the uptick in bloat is from the pain that's amplified from his raw penis. His bloat is usually from pain of some kind. We've been pushing the probiotics like crazy the last few days, twice as much as we usually do for the azithromycin. Before the blood spots in his urine became more prominent, we got in an "okay" groove with a high & frequent dosage of probiotics.
The vet recommended 0.9ml of meloxicam (1.5mg/ml) twice per day to manage his current pain. We've bumped up the dosage but it hasn't had much effect in relieving the pain. I'm also not so hot on that high dosage. He's also on CBD and I have him on the Assisi loop 4x's/ day. I stroke his spine, which seems to release a little bit of pain. But even after settling in on my lap, he remains poofed with a very prominent hollow sound coming from his distended gut.
Anyone have any suggestions when it comes to a pain/inflammation relieving topical ointment that won't cause even more of a bacterial mess "down yonder?"
I looked into lidocaine-based ones, but many (like orajel) have a mess of other ingredients I'm worried about applying to his penis.
- And got the T-shirt
The 0.9ml of the 1.5mg/ml metacam is extremely high, even for once daily, let alone twice.
As far as topicals for his irritated penis, I would stay away from the oragel as you had already anticipated. Oragel is actually pretty gritty and sticky so that it will stick to the mucous membranes in the mouth. If numbing is what you are after, topical lidocaine gel from your vet would be better. However, my suggestion is silver sulfadiazine cream which is also a Rx that is used frequently in burn patients. At the very least you could use some aloe Vera to help sooth the area. As bpatters has mentioned, I would try not to use any forceful pressurized lavaging on his sheath.
I wish it were his typical smegma, this was definitely sandy grit. It was also slightly discolored from what I understood to be his poryphyrin urine that began to show up this last March. Though I think we're dealing with a full blown UTI at this point.
Thank you for the ointment recommendation. I think we're going into emergency in a few.
Thank you for relaying that information again.
We are on our second day off the azithromycin for Butter's URI and are still having very small stools with some what appears to be constant pain--pain that started to get worse towards the last few days of the azithromycin. So we went out and got tramadol new years eve.
With it being -10 degrees the last few days, I was apprehensive about running him to the vet to get a urinalysis after hours. The vet said it would be extremely unlikely he has a UTI having been on azithromycin, but I have no reference for that. We're on a tramadol 6.5mg/dose twice a day and maxed out on meloxicam at 1.35mg/dose also twice a day. I was concerned his discomfort was being made worse from the pain relievers and the GI upset they can cause--but we always make sure he's got food in his stomach before administering. When he's not on pain medication or is nearing the end of a dose, he exhibits more intense signs of pain.
The smaller misshapen stools we are getting now are sticking around longer than when we were on azithromycin (while on the antibiotics, his stools would normalize a bit during the day between doses and when I was administering probiotics constantly).
Now with just the probiotics routine, he doesn't seem to be improving in his stools or un-puffing. He IS, however, taking water for the first time in a month. But we had also discovered they weren't drinking the distilled water/filtered water combo on purpose--we can only assume it didn't appeal to them. They did drink it earlier on in the beginning when we made the switch to 50/50, but it didn't occur to us that they stopped drinking because they became tired of it. We felt stupid for not doing something to troubleshoot the water bottles sooner.
Vet doesn't believe UTI is likely. Admittedly I would really rather know than not know. But I also do not want to be impatient and rush him off to the vet unnecessarily--especially if some of the symptoms he's exhibiting are to be expected coming off azithromycin. I'm just surprised because I thought he'd be rather better by now, not worse. Especially with the same amount of probiotics being continually administered (will continue for a week and perhaps longer following the azithromycin). Still giving extra fluids.
I understand that the urine test strips are sort of "out the window" and unreliable at this point, but he was clear of blood for a day, then it showed up again. More trace than before.
Any chance I'm missing something else here?
Thank you, I read mixed reviews of doing that. Some said it helped, others not. I wasn't excited about it not having all the essential minerals. Chicago has particularly hard water--and it wasn't much of a concern for us as long as he drank enough, as we assumed flushing with fluids was more important than whether the fluids were high in calcium. I also read somewhere here someone very adamantly stating calcium in water could have no effect on calcium in the bladder/kidney etc. However, there are some posted protocols for people with kidney and bladder stone issues in some of the hospitals here for residents drinking the tap water. I figured lake Michigan couldn't have water that was too hard, but what comes out of our tap, comes out of our tap (and into a Brita pitcher).
Thank you for your input about the strips. I think we're out of the woods with blood in the urine finally.
Now Butter just has odd shaped stools and what appears to be large soft balls of stools. His willingness to help himself to vegetables and water more often (for the first time in 2 months) may be the cause of his very moist stools. I will be pulling back on the vegetables now that he finds them appealing again.
As for Peanut and his heart/fluid issues, the side effect we have been instructed to treat until his echocardiogram later this month is the fluid that was in one of his lungs (and likely also his liver) with lasix. I figured I could ask my questions then provide a bit of context afterward.
Is there a minimum dosage of lasix that a heart pig typically receives while waiting to receive a heart drug assignment--if he'll receive one at all?
Is it normal for pigs on lasix to struggle with dehydration when they never had issues with it before? Is this just part of the territory and do I need to be supplementing him with fluids constantly while on lasix?
Does a pig still need to have the fluid so aggressively removed to the point that it's dehydrating the rest of his body?
At this point, it's sadly my call since the vet office does not seem to grasp the situation.
According to his x-ray he had an enlarged liver and they believe just one of his lungs was taking on fluid. Upon a second assessment, his heart did not appear enlarged.
At first, he was put on lasix twice per day at 0.07ml for life and within 1 week he began to slow down and exhibit dry stools (we had stopped the mis-prescribed Baytril by this time). This is when I consulted another vet at a different clinic about the situation, since we couldn't get through to our own vet and the front desk wouldn't allow us to leave a message/question. The vet from the other clinic suggested that he may be becoming dehydrated and some damage could be done to his kidneys if he's on too much lasix.
We had been pushing probiotics daily to try and rule out whether or not it was his GI tract that was having issues from being on Baytril (previously, he had the best, most beautiful dark, moist but firm stools and was overall an extremely sturdy-seeming pig that was inquisitive and did zoomies) but nothing seemed to have changed for the better.
Back in December we finally made it in to an appointment after not being able to leave a question for our vet at the front desk. I brought up the concern that lasix at his current dosage of 0.07ml twice per day was really slowing him down and his stools had become very small and dry. So the vet recommended doing the total daily amount (0.14ml) only every other day. We tried that and he still seemed slow (understandably it may be the heart issues) and his stools did not improve too much. We were still giving him probiotics at the time and I was trying to supplement him with fluids+electrolytes.
3 days ago I nervously made the decision to stop the lasix until we could get his dosage re-assessed. Following this change, for the first time in a few weeks his stools appeared to be slowly returning to "normal."
I am not comfortable making these sorts of calls on my own but the vet office (sadly it seems that when our vet is not there, everyone else's advice is uninformed/uninterested. Then our questions never reach our vet. Their answer is always that we need to bring in our pigs right away, without considering our questions) wasn't much help in assessing our situation. They said to give him the lasix 0.07ml twice a day, everyday (the original dosage that was really draining him) and when I reminded them that was the original dosage that seemed to be too intense, they just repeated the instructions.
I figured that I'd just end up hitting a wall by trying to call and ask them, and that's exactly what happened. If we had the means to drop by every moment, we may consider doing so. Perhaps I am wrong and making a bad decision not going in at the drop of a hat. I agree that it's best to be able to assess the patient in person as opposed to over the phone. But does anyone else feel some vet offices abuse this? Causing a bit more undue stress to pigs than necessary? Also it always seems they "forget" to do a thorough vetting while we are there. (We we're just there a couple weeks back and they decided against doing a chem panel while he was on lasix. Now they decided it was necessary) I am always strung out when we go, trying to think of everything, despite the fact that I thoroughly lack the skills or knowledge of a veterinarian. I want to be grateful for what they do, but often I feel like they're not assessing the situation/patient fully while they have opportunity after opportunity to do so.
After we get home something will have been apparently "missed" or forgotten to be looked at while we were there. I hate to think I am jeopardizing their health, but I am also not sure I want them to live out the rest of their lives at the mercy and forgetfulness (and sometimes negligence) of their vets. We will hopefully get a full chem panel (while on lasix) when we go in for his echocardiogram.
Sorry to bring up this unrelated topic/venting to this thread. I would be grateful for any experience or insight on lasix.
Also, I hesitate to ask, but would anyone be willing to direct to me to a thread where others may have vented about having to navigate the "gate keepers" and unnecessarily bureaucratic processes that come with trying to get their pigs the help they need?
Any stories are welcome! It would certainly help. There are a number of other things they've missed the mark on, and it's just been a bit discouraging for us. We feel we may not be adopting/fostering any pigs in the future due to feeling like we won't be able to get their needs met. I am reluctant to "start over" at another vet clinic. I believe this is the best place we can be. I know I really need to work past the hurtles to advocate for my pigs--but I've felt rather browbeaten lately. I am often angry at myself for not having "thicker skin" in these situations, but I know the harder I push, the more dismissive they become at the vet clinic. I already have trouble advocating for myself dealing with similar blockades from managing my own chronic disease with doctors, pharmacies, and unhelpful personnel. No matter how politely, patiently, and calmly I try to be it will just be wall after wall after wall.
Thank you for allowing me a moment to decompress.
--Also, I apologise that I haven't gotten his "mineral swirl" as the vet called it, highlighted in a posted image yet. I need to put my nose to the grindstone to figure how to do that on my phone or the desktop at work so that the edited image remains in full resolution.
In the meantime, we are removing vegetables from Butter's diet, to his great disappointment, to try and address these massive--random sized moist clumps of stool he has been producing. He's an avid hay eater, and I realize the introduction of wheatgrass full time (he was always offered it while on azithromycin, as he had little appetite for anything else) may not help to mitigate the soft stool issue. However, when he was on the wheat grass before, he had plenty of firm stools. I will adjust accordingly if we cannot yield better results.
We are grateful that the "dehydrated" phase during Butter's antibiotics course has passed. He is more able (perhaps comfortable) to help himself to water. There is still some minute amounts of visual grit being passed in his urine, but much less than before. He's back to being an avid hydrater to our great relief. He remains on a twice a day dose of meloxicam at .45ml (1.5mg/ml). I hope with his added supplements, we may be able to decrease that dosage. But for the time he has left, (we believe with his very prominent spine/hips and sagging belly he may actually be more like 4-5 years old) maybe it's best to give him what will just keep him comfortable. I won't push him. Now if only we could get the other one to take an interest in water...
I am hoping that in following a course of antibiotics--taking weeks to normalize their guts and stool is a "normal" and expected thing. They are both still on a substantial dose of probiotics everyday, with extra hydration for Peanut--the one with the heart issues, was incorrectly prescribed Baytril, and who once had the most beautiful firm, dark, shiny, consistently kidney shaped stool specimens I had ever seen. Recently his dry, mishapen stool showed to be totally porous (many tiny bubbles) when I broke them open after they had dried a bit more. Before when I would break them open they were compact, bubble-less little beans. He's also had the occasional mucous attached to his stool now so I put a little bio-sponge in his probiotic syringe last night. He does not exhibit any of the signs of bloating that I am aware of (Butter having offered me an example on many occasions). He is also rather pert and perky following a hydration session. I placed him back on lasix, out of paranoia about fluids filling up his lung and liver. This time .07ml twice a day, every third day. I wish they had provided the concentration of the lasix somewhere in his discharge papers or the bottle.
I hope it is just patience that I need and all of this will pass. I'm also hoping their stools will normalize if I adjust their diets & supplements accordingly. I could also be over my head in issues and just kidding myself.
Thank you for that information, I'm afraid that even with all my searching on wheatgrass on these boards, I never came across anything bringing up that wheatgrass is fairly sugary. I daresay that helped stopped Butter's loose stool pretty quickly so thank you. It took us a little while to get him back to firmer stools (had to stop vegetables for a good 2 days, as a full 24 hours wasn't working out either). Today will actually be the 48th hour that we will try slowly reintroducing them.
So to our great frustration, one day we stupidly mistook the loose stools for him over-doing it on the water and veggies. We thought it was safe to give him a portion of a Vita C Oxbow treat--it was not. After a nice 7 days of no pain/bleeding in his urine, that dang treat ripped whatever was healing right back open. How could I have been so stupid.
So we've returned to intense blood spots in the center of his urine. Back to full time flushing with fluids, barley goop, and most importantly managing pain the best we can. I'm feeling pretty awful about having a very stupid lapse in judgement and am so sorry to him. The last thing I would ever want to do is inflict more pain on his aging body.
On top of all this, I'm disappointed to report that his URI appears to have relapsed. About 4 days following his final azithromycin dose (20 days total), he started to have a bit of a runny nose. I prayed it was just some dust, I moved the hepa air filter right against the cage next to the haybins. As we went into day 10, there was a little milky discharge, but mostly clear. Then it would be dry for a day or two.
Here we are 14 days after his last azithromycin dose and this morning we had yellow/green discharge. I wish it were a considerably acceptable color of discharge, but I'm not betting that it is. Will have to go in for another culture, I'm sure.
The second antibiotic that both bacterial infections from the nasal culture showed a sensitivity to (other than azithromycin) was chloramphenicol. The culture of strep and pasteurella also showed sensitivity to doxycycline and a separate antibiotic that could have been nebulized--the name escapes me. They didn't clarify which bacterial infection was sensitive to which antibiotic, but they did say one culture was sensitive to one antibiotic while the other culture was sensitive to another separate antibiotic. They also didn't offer the option to treat the two bacterial infections with those two drugs, respectively, at the same time. Butter did alright on doxycycline, actually. Better than he has on any other antibiotic.
I am very desperate to learn whether chloramphenicol is available in nebulized form. I couldn't find any information about whether nebulizing it was an effective option. Reason being is I really don't think he has it in him for another month of this. He has an extremely sensitive GI tract and it was near impossible to get him "stable" for even a couple hours between azithromycin doses last month. He rarely had a fighting spirit, I'm confident he's much older than everyone suspected he was, and as much as it kills me to say this--I would rather he no longer be in pain than to force him to do a gut-throttling antibiotic orally only for it to maybe work and done repetitively if it's a stubborn URI?
It's not fair to him if nebulizing is an option and the vet won't authorize it. I am very determined to try and bring some materials in to the next vet visit (or email them), with some evidence showing the effectiveness of nebulizing the more powerful drugs for URIs (should they exist) but am having trouble finding resources. For instance other vet offices that have nebulized azithromycin for guinea pigs. I am sensing a pattern, that they seem to refuse to budge or learn anything beyond their own knowledge when it comes to treating guinea pigs. Especially when they refused to look into azithromycin in the nebulized form, simply because they've never heard of it.
Any help on this topic would be greatly, greatly appreciated.
Alright, well back to being busy with trying to keep a UTI at bay. I also hope 48 hours was sufficient to have taken him off veggies. Thank you again Lynx for that information about wheatgrass--it lead us to reread what I believe was a sticky on stools that was very helpful. Full access to fresh grasses + older guinea pig (after you've figured out that you in fact, have an older pig) may not always yield good results.
Bpatters- Sorry for being unspecific, what I mean to say is they did not prescribe a form of azithromycin powder that could have been nebulized---or so they told me. It was a bottle of (cherry flavored, sticky once wet) powder that required 9ml of distilled water to activate it. I asked if I could add a saline solution to nebulize it and they said it was the incorrect form and they did not know of any form of azithromycin that could be nebulized.
Our vet, whom I fully trust to "work" with (she listens and responds even when she hits the limits of her knowledge), happens to be sick this week and will be out on maternity leave starting February--given the baby doesn't come earlier.
I fear not being able to get Butter's needs met should this be a relapse after all. But will try to keep positive thoughts. But... Will also not get my hopes up. I was let go from my job from all the time I was taking off. I was expecting it. Admittedly it makes me a bit discouraged and at times resentful that the vet didn't give two figs about trying to work with me to get azithromycin in a form where we could administer it so it would bypass his gut--but that time has passed and nothing can be done now.
I'll still see if I can get some documented evidence of antibiotics that have been nebulized for guinea pigs for the specific purpose of bypassing their gut and directly treating the URI in his one lung. I suspect that there is no documentation of chloramphenicol being nebulized to treat URI's.