Urinalysis increased bilirubin / protein

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daveandtiff

Post   » Mon Jul 24, 2017 9:10 am


We had a weight drop to 960g yesterday, at 970g this morning. Realizing increased syringe feeding needed, though do not want to interrupt his interest in eating on own. Have been placing new items in front of him regularly through day and he continues to go for them with interest, only interrupted when he's having pain pooping/peeing. Alternate hidey spot and remove often to encourage him to explore, which he does. Alot of the time he's just acting like himself and seems bright, though I know the underlying pain probably lingers if he is losing weight. Yesterday seemed to show darker blood in urine, and the blood has not stopped in varying degrees. I just don't know how long we could see this, doesn't seem to be settling, and worry about too much blood loss. Am waiting to learn measurement of stone to try to think on if there is any chance it could pass on its own or not. Have been getting him to play area several times a day to have him run around more and change position off from feet (one back foot a bit red so have had him extend it and have massaged around the area during feedings and have been putting cream on it. Last thing he needs is bumblefoot, too).

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daveandtiff

Post   » Mon Jul 24, 2017 10:28 pm


Am worried about his blood in urine. It's visibly red or diluted red multiple times while I'm holding him during feeding, and while in cage it absorbs into blankets more so apparent, but not as bright. Had left another message with doctor's office today about this and to ask for stone and urethra on xray to be measured (to try to decide if we should consider shilintong). Received a call back an hour and a half after they had closed, but was in the middle of feeding, didn't hear phone and they didn't leave message.

A week and a half is quite awhile with blood. I don't know if he could become anemic and not able to have surgery if needed. Hoping he isn't already. A couple of times he seemed wobbly. Breathing more noticeably may be discomfort or possibly not enough oxygen getting to all his parts causing him to need to breathe harder to transport enough nutrients? I just checked on him and he had emerged from his hay pile and was standing at his food pile nibbling, so he's not totally lethargic, but did skip over some of his favourite things during the afternoon which he usually would not do.

Doctor said a week ago that sometimes these things settle and that usually blood lost in urine doesn't lead to anemia, but am not sure if she was qualifying longterm blood loss in that statement. At what point does this become dire?

Talishan
You can quote me

Post   » Tue Jul 25, 2017 3:00 am


In my experience (only) -- mild blood loss over a long period of time is (by itself, anyway) no big deal. They make more, same as we do; the loss is not cumulative.

A large amount of blood lost in a short period of time IS dangerous. If you start seeing large areas of bright-red blood on bedding, even things that look like clots -- think like an assault crime scene or a really bad period -- give orange juice and get him to a vet as SOON as possible.

Vets can do a blood test called PCV (I think it means packed cell volume) that essentially gives a RBC count. They'll do this preop to make sure the pig is able to recover from any necessary surgery.

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daveandtiff

Post   » Tue Jul 25, 2017 6:46 am


Okay, thank you, Talishan. Had just put him down a couple of hours ago from feeding and this last time he did not pee/poop as much, so not as much blood seen this time, but hasn't otherwise let up. Not dark red most of the time once it hits blanket, usually pink or brown, but when I watch it stream out of him or when it collects into a puddle it looks pretty red. Maybe it's along the line of the drop of food colouring in water.

We've had some pretty long sessions through the day and he's had some blood during these times and in his cage. He was more tired and less interested this last time so didn't spend as much time working on it, he needs rest. Had eaten fresh things in his cage while waiting for me to prepare new juice. He was 982g an hour and a half ago so we're getting back on track. One thing I'd forgotten to write was his temp taken yesterday at 100.7 and urine test didn't show WBC's, but am regularly checking. His ears have been off/on warm or cool, red or pale. Not sure if a hydration thing or something other.

Can the PCV test be run with smaller amount of blood (could they get enough from a foot pad prick vs a draw?)? Am wondering if we start to worry more about him if this would be a good precautionary test to give us a status on him.

With your thoughts on rapid blood loss, this is the thing I've been considering when wanting to keep blood volume up and with hydrating him. To find some way to control bleeding (right now hoping Lysimachia he's taking is reducing inflammation and the tannin is helping somewhat to constrict vessels that are bleeding, but am wondering if we should try Vit K again, if no contraindications for an elder stone pig?). What I worry about is hypovolemic shock, related heart attack, etc. May try a bit of cooked cream of wheat to increase iron, too.

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daveandtiff

Post   » Tue Jul 25, 2017 8:47 am


A few edits/updates. His weight was taken before feeding (around 3a). Was editing times as had fallen asleep before finishing post and was trying be accurate, but realized later that I had missed editing his weigh-in time in the note, so at this time it looks as though it was taken after feeding, but was not. I looked at cream of wheat a bit more and appears it may also be higher in calcium, so think this is out. And wrapped his foot in a flex bandage to see it would help protect from bumblefoot by changing pace (was nervous that he would try to eat it, but so far so good).

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daveandtiff

Post   » Tue Jul 25, 2017 3:20 pm


Doctor called and said his stone is 6mm. Not sure dimension of his urethra. She said it would most likely sit there, but always a possibility of blockage. Dimensions of his own urethra not known. What are the general dimensions (at smallest/largest points) of male urethra?

bpatters
And got the T-shirt

Post   » Tue Jul 25, 2017 3:52 pm


Six millimeters is very nearly a quarter of an inch. Not likely to pass in a male.

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daveandtiff

Post   » Tue Jul 25, 2017 4:12 pm


Thanks, bpatters. That's what I was figuring, cannot imagine anything in a boy stretching that much. So we will forego shilintong at this point if it might create a greater chance of blockage.

Am thinking of trying to make corn silk juice. It would take alot of it through the juicer, but heard that this can help to "lubricate" sludge/smaller stones to help them to pass through better. At this point, I would like to do whatever possible to make this larger stone less abrasive, not sure if this would work. He eats the silk, but is off/on with it.

bpatters
And got the T-shirt

Post   » Tue Jul 25, 2017 5:03 pm


Without reading back, is there any reason you're not having it surgically removed?

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daveandtiff

Post   » Tue Jul 25, 2017 5:17 pm


Well, just finished with our feeding. He was much better with it this afternoon than this morning (he's come to enjoy banana in small portion so needed to mash a bit into the juice where no time to clean juicer parts without a delay and him going to nap. juice was an epic fail, even though the ingredients were the same :}). He was (phew) eating and eating from his produce pile, but had to be encouraged to it. Waited awhile until he was finished.

Poop Soup Talk (Talishan, and fellow pooper scoopers) ~ I think today I've pulled out more poops for him to eat than a pig pulls out of his/her own butt. He approves, and is looking for my hand before I'm even halfway there :)

bpatters, yes, we are considering this, and am nervous with his age and lack of interest in the syringe (he's been practicing, but not taking to it still, all is my effort right about now unless he is really liking a juice. Am thinking his mouth is smaller possibly and he just is having a hard time accepting, of all of them, would not have thought it would be him, he who has loved critical care on spoon all his life). I know this surgery, for younger girls. Their Mom was up with me on facebook asking (because I had one girl post-op earlier that day to help them), "Do you think she is going to make it?" Really, I could not answer that. It was really that worrisome. I think alot of it was the buprenorphine at first, but this carried on for days even after bup was d/c'd. I know Nutter has will with certain things, but is very passive with other things (almost like a sandbag when you move him). I don't know what this says about his ability to fight after surgery and accept feedings enough to actually swallow vs spit out. So am nervous about the concept. Will have to have a cardiac eval as well. And am not sure who we would use for a surgeon, who would have the best success. I would prefer gas anesthesia for him if we have to go this route. Right now, though, am trying to give him as much comfort as possible. I wonder if metacam is enough? If his organs are okay to continue with it (we haven't had a chem panel or any bloodwork on him through his life). Does this act as a thinner and allow more bleed (I think it does)? Alot of thoughts going through my head right now, trying to do what is in his best interest that will be his least amount of suffering. Have read different thoughts from people going through it with their pigs, very mixed. I think it's hard enough when they're younger with this surgery, though age is not always as much a factor if they are overall healthy enough for a surgery. Will plays a role. We may have ultrasound to check heart first. Trying to keep his immune system up, good rest, peaceful and happy moments with the others, enjoyment with his foods/grass, exercise, stable weight, so if we get to a point we need to do this he will be as prepared as possible.

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daveandtiff

Post   » Tue Jul 25, 2017 5:33 pm


At his last exam, doctor did listen to his heart and did not hear arrhythmia so hopefully this is pointing to a healthy heart still. His Brother (we were told they were brothers) did have a heart attack last November unexpectedly shortly after he was going to town emphatically on his food pile. So this is one reason, besides his age, that I would really want the cardiac eval beforehand.

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daveandtiff

Post   » Fri Aug 04, 2017 2:10 am


We ended up in ER for most of night and was not a good experience. Nearly nothing was done or able to be done (ie diagnostic tools). Nutter hasn't been going for food (yesterday) other than a couple of blades of grass and a couple pieces of a leaf of chard. Shows some interest in a treat, but then doesn't eat it, or complete disinterest at all often, too. When I syringe feed he chews a few times then dribbles it out or lets it sit, isn't swallowing. Have maybe seen him swallow a few times in the past 12hrs. Doctor was inexperienced with pigs it seemed, would not give reglan and would only offer buprenex injection or possibly subligual, which was afraid would knock him out where he would not eat at all and that would put us into a worse situation (one that I am worried about already), stasis.

I gave him his metacam early at 11:30p, previously given 1p, but don't know what else we can do right now if he's not swallowing or going for things on his own. Am going to try to pick him up again to feed. He's been grunting and pushing alot more today, the same way he was when trying to push out poops. The stone may be causing him discomfort, though am not seeing obvious blood, just a couple of tiny dots of blood seen early. He is also slightly wobbly and protesting more when his legs are moved on feeding pillow.

What else can be done if he's not taking in food and actually swallowing? He looks exhausted, but not sure that he's preparing to leave us. But am worried this could happy. His incisors are even. I believe his molars were checked 3wks ago and he was eating well enough yesterday.

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