Ginger's Medical Thread

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sosumi

Post   » Sat Jun 28, 2014 12:47 pm


Our Ginger has a stone in her bladder. We have a vet that is relatively ok, been going there for some time. We don’t know of any other vets with any guinea pig experience.

The vet's game plan was to see if he could manipulate the stone out through the urethra. If that didn't work, then surgery while she was still under anesthesia. My husband mentioned pushing it back into the bladder to buy some time and get her a little healthier since she had lost some weight and had some stasis issues because of the pain.

It sounded like the vet didn't even think of that option but agreed to it. I also asked him how many cystotomies he did and after trying to avoid the question, he replied "a fair amount!" He also put her survival at less than 50% if a cystotomy was done. Well, he couldn't get the stone out but did push it back into the bladder. She is three years old. That was on Thursday.

She is now on Meloxicam, Baytril, Reglan, and Cisipride. I have to force feed her critical care, as her weight is still dropping. She munches on hay, but not enough.

Overnight, she left a few pink spots on the bedding. She is urinating, but today there is still a pinkness where she goes.

We have been mixing oxbow and KMS pellets with bladder stones in mind.

I am hoping you can recommend someone near the Detroit area, I'm willing to travel, who has more experience with guinea pigs and who might have a better outcome with removal of the stone via the urethra (can the urethra be dilated?) or through cystotomy. Are there any alternatives? Any advice would be greatly appreciated!

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sosumi

Post   » Sat Jun 28, 2014 4:01 pm


I see there have been quite a few views of this thread but no replies.

She is leaving some blood when she pees, but not every time. We are making her drink extra fluids including diluted cranberry juice and shilingtong.

Does the blood mean the stone is on the way out?

We have been in contact with 2 other vets, one out of state (that used to be nearby) and one a couple hours away. They both mentioned there are ways to make the stone shrink.

Can anyone offer some suggestions of alternatives or how to shrink the stone?

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Lynx
RESIST

Post   » Sat Jun 28, 2014 9:47 pm


I agree with you that it is worthwhile looking for a vet with more experience and better outcomes. From what I have read here, most stone removals are relatively successful and people report good recovery with proper postop care.

I have not come across any reliable methods of making the stones shrink. Guess I would keep looking for a good vet.

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Delaine
Supporter in '14

Post   » Sun Jun 29, 2014 1:32 am


I am so sorry to hear Ginger has a stone. I know how stressful it is.

In September 2013 my sow Zoe was passing blood in her urine and losing weight. An X-ray showed two small stones. The vet said because they were small we would wait and see if she could pass them.

I changed from Oxbow pellets to KMS and limited the daily amount. I added two more water bottles to my two sows' cage and increased their exercise. I had already been eliminating high calcium greens.

In January I heard Zoe crying when urinating and saw she had passed some very gritty urine with two small stones. A couple of weeks later she passed some more urine with large gritty deposits. After that she started to gain weight and seemed so much better.

In April 2014 I had another X-ray done and the stones were gone. I had saved the stones to show the vet. We were very lucky the stones were passed and didn't grow in size.

Did you see how large the stone was? Is it small enough to pass or is surgery the only option?

I think eliminating Oxbow pellets, encouraging her to drink more water and move around more made a huge difference.

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Delaine
Supporter in '14

Post   » Sun Jun 29, 2014 1:38 am


I would be interested in what the vets said about shrinking the stones.

Talishan
You can quote me

Post   » Sun Jun 29, 2014 5:22 am


"It sounded like the vet didn't even think of that option but agreed to it."

Not a good vet. Backflushing is a common protocol to get the stone back in the bladder where it can be surgically removed more easily, and with less potential for damage to surrounding tissues. Your husband knows more than that particular vet does.

"He also put her survival at less than 50% if a cystotomy was done."

Bull@#$%.

"(can the urethra be dilated?)"

Sorta kinda per se. A veterinary teaching hospital, and some extremely well-equipped vets, can slip a tinytiny kitten catheter in there and attempt to flush it out. There's been a couple of cases on here where that has been successful. Much easier with females than with males.

The stone can be dug out of the urethra in a female, but it's got to be pretty darn close to the opening to do this nonsurgically.

"Does the blood mean the stone is on the way out?"

Possibly but not necessarily. It's more likely that the stone is irritating the bladder wall. Mammalian bladders for reasons unknown to me are extremely sensitive; lots of surface blood vessels and the tissues bleed easily.

"They both mentioned there are ways to make the stone shrink."

Mumble. Not reliably. We've had a couple of cases here, Delaine's being the most recent as far as I recall, where this has worked. The stones most frequently don't actually shrink so much as break apart and then the grit is passed.

I know we've got some folks in your area. Hopefully one will see your thread before too long with a good veterinary recommendation.

Any surgery is risky in a small animal that is very sensitive to sedation. That said, a cystotomy is (very relatively speaking) not very invasive (that is, the body cavity itself isn't disturbed). With a good surgeon and good aftercare, the prognosis is usually excellent with a pig in otherwise good health and thrift.

http://www.guinealynx.info/cabinet/index.php/Veterinarians_Michigan

Talishan
You can quote me

Post   » Sun Jun 29, 2014 5:27 am


ETA: a pain medication like buprenorphine (Buprenex) can help alleviate pain and also act as a mild muscle relaxant, helping the animal to pass small stones and heavy grit that they might otherwise not be able to.

It is a narcotic and can zonk them out. If you find a vet willing to use it (it's a prescription med), use the very smallest effective dose. But it can have a helpful muscle relaxant (in addition to pain relieving) effect.

User avatar
sosumi

Post   » Sun Jun 29, 2014 1:32 pm


Thank you everyone for your thoughtful and detailed responses.

Last night she stopped passing urine, so we took her to the emergency vet and she had surgery. It was frightening, but this hospital (24/7) has experience with guinea pigs. We've taken other pigs there previously. And I like that they have 1 vet and 2 techs on staff throughout the night. (Our regular vet does not have overnight care.) They also have an exotics ward with incubators, etc.

They called us when she was in recovery and she was doing well. Two hours later she was still doing well and had eaten a bit on her own. We left some greens with the staff to offer to her.

She is still at the hospital. I will be calling shortly for an update and to find out when we can pick her up.

We are busy getting her recovery cage ready and reading all of the post-op care info from here. Lots of great information and tips. I like the idea of having a 3 sided box to pick her up. My husband is working on that now.

We don't have any questions at the moment, but I am guessing something will come up during her recovery. I will post updates.

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Delaine
Supporter in '14

Post   » Sun Jun 29, 2014 8:27 pm


Thank you for the update. I am sorry she had to have surgery but it sounds like she is doing well. It is a comfort to know a vet is on staff throughout the night.

My other sow Abbey had surgery for a very large sebaceous cyst just over 2 weeks ago so I can relate to the post-op care. I hope everything goes well and she will be up and about very soon. Looking forward to the next update.

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Lynx
RESIST

Post   » Sun Jun 29, 2014 10:20 pm


I hope she recovers well.

gl/postop.html

Talishan
You can quote me

Post   » Mon Jun 30, 2014 6:20 am


It's wonderful that you have a decent ER vet near you. So many places do not have the experience with, or equipment for, exotics, much less someone knowledgeable on staff 24 hours.

Be prepared to see blood in her urine, sometimes bright and clumpy, for a day or two. It may also smell horrible. That's to be expected.

Make sure they send you home with pain medication.

Please keep us posted as to how she's doing.

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sosumi

Post   » Tue Jul 01, 2014 5:59 pm


Thanks everyone!

This post was really helpful to us, too, Lynx and I would recommend it be read by anyone going through a surgery.

http://www.guinealynx.info/forums/viewtopic.php?t=69865&highlight=stones

Ginger stayed an extra night, which was fine with us! We picked her up yesterday afternoon. There was still blood in here urine and some clots yesterday but today if there is any blood it is not very noticeable... so far. She is walking around but is still not eating on her own. We suspect it's the abx. Ginger has always become anorectic when on abx. So we are hand feeding CC.

Her stools are also very dry and she is straining to defecate. At first we thought it was a problem urinating. So we really have to push the water. Our vet wants to try a little torb, but I am Leary that it may slow her GI tract down. Then again, it would make her more comfortable.

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sosumi

Post   » Tue Jul 01, 2014 6:49 pm


I'm thinking of giving her pedialyte. Should I give it full strength or diluted. If diluted, what is the ratio? Thanks!

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Lynx
RESIST

Post   » Tue Jul 01, 2014 9:35 pm


sosumi, that is indeed a wonderful thread. So many pet owners are worried and afraid - and so love their guinea pigs. I'm glad Barnaby recovered well.

Sorry I don't remember if most people dilute pedialyte or use it plain.

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sosumi

Post   » Wed Jul 02, 2014 3:29 am


Well, just as the post op page said she quit eating! Quit eating EVERYTHING!!! I had to force food yesterday and she ate unwillingly but now she is totally uncooperative! Fighting all the way. I try to be gentle but she needs to eat. She really struggles.

Also, she is now having more red in her urine again. I hope I didn't screw her surgery up with the way she fights the food so much. Surgery was 36 hours ago. Should I still be seeing blood in her urine?

I ended up giving her a dose of torb but it didn't make any difference as far eating is concerned. She is struggling less when defecating and stools are softer. I have been pushing more liquids and making her CC more watery.

Does anyone have any ideas on how I can tell if it's the pain or the abx that is making her fight the food so much? She's been on abx before which caused anorexia but has never put up such a fight when hand feeding, so probably the sum of both.

Talishan
You can quote me

Post   » Wed Jul 02, 2014 5:38 am


1. Pedialyte: full strength. Some like it cold, others like it room temperature. As much as she will take.

2. "Should I still be seeing blood in her urine?" Entirely possible. You can see blood in the urine nearly a week later. That isn't always the case, but a few days is to be expected.

3. What AB is she on, and was there any infection prior to the surgery?

If there was no known infection prior to the surgery, and the AB is only pre-emptive postop, don't use anything stronger than Bactrim. She does not need Baytril if it's "only" a preventative. She may not need it at all, although I always like to use something postop.

4. Buprenorphine (Buprenex) is in my experience only a better choice. Torb can be zonking and/or not work at all. Buprenorphine stays in the system longer and can be effective at smaller doses. Tramadol may also be a good choice. It's less zonking and may help her recover better than either torb or Buprenex.

Metacam can be given for its anti-inflammatory (as well as pain management) effect along with any of the narcotics. Don't skimp on the Metacam. Her bladder area is thoroughly swollen and inflamed right now.

In our experience 36 hours is right about when they bottom out. Lots of times they seem fine coming home from the vet, then go downhill, *then* turn the corner. Hang in and keep pushing the watery CC.

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sosumi

Post   » Wed Jul 02, 2014 12:33 pm


Well, now she seems to be giving up.

When I fed her at 8:00 am, she was fighting me, mostly running away, and moving her head, but not as hard as she fought last night. I made the CC very watery this am. Also gave her the pedialyte full strength. Last night I was diluting it a bit.

At 11:30 when I got her out of the cage for another feeding, she seemed very weak. Sorta limp, but not fully. When I tried to feed her, I could get it in her mouth, but she only chewed when I first put the syringe in, not when I squeezed some CC in her mouth. Even with me wiggling the syringe around, she didn't chew. She did not spit it out, but it seemed like she was giving up. She would just put her head down and look at me. She did try to run out of my arms but not much.

She is on Baytril. I am calling the vet and taking her in. I will ask for Bactrim and a sub-Q. Oh, and the pain med they Rxed last night is Tramadol. I gave her a dose last night, but not this am.

Are we at the bottom now? If we forge ahead, will she turn around? What else can we do? How long does the turn around take?

I am exhausted and frustrated, especially with her weakness and the not swallowing. But if she is not swallowing, where is the food? It does disappear. She is not spitting or dribbling it out. Her chin is sloppy, but not the whole 4 ml I squeezed in over the 20 min or so. So, maybe I made it that wet that it goes down real easy?

She is not eating anything on her own, not even lettuce, which I could convince her to eat one or two bits yesterday.

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sosumi

Post   » Wed Jul 02, 2014 2:08 pm


Also, is it best to lever her by herself in a "foreign" cage or should I split her and her friend's cage in half (2x4 C&C)? I don't know if she might feel abandoned not being in her own cage? Would seeing her cage mate right next door be good or bad for her?

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sosumi

Post   » Wed Jul 02, 2014 4:47 pm


She got a sub q and a shot of reglan. We are stopping the baytril. I think she is shutting down. She hasn't pooped since early this morning. X-rays showed gas. She is urinating.

Crazy4me

Post   » Wed Jul 02, 2014 5:04 pm


Infant anti-gas drops can help a little with the gas. If you have a battery powered toothbrush around or you can buy a cheap one, you can use that to vibrate her tummy to help her expel some of that gas.

Bloat is sometimes hard to get rid of, and requires frequent interventions with something that vibrates and anti-gas drops.

The reglan may help move things along too. BTW anesthetic slows everything down, including the digestive system. Hopefully the combination of the reglan, vibrating the tummy and antigas, things will start to improve.

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