Two pigs: tooth abscess, enlarged heart & liver, fluid in lungs and separately, a URI

Clint The Cuy

Post   » Sat Dec 23, 2017 4:54 pm


The radiologist is Steve Pokorny with Northwest Veterinary Imaging. The vet that took the radiographs would need to forward them on to him for a report. They use a PAC system for DICOM images so I don’t know if they would accept a jpeg.

As for the diuretic and calcium. Loop diuretics such as furosemide (or Lasix) actually cause hypocalcemia where more calcium is excreted. Thiazide diuretics cause Hypercalcemia where calcium becomes elevated because it has a higher instance of reabsorption. Has to do with the chemical balance within the cells of the kidney tubules. It is more like potassium gets kicked out of the cell and the Ca takes up its void as a positive charge within the interstitial space of the cells. Loop diuretics have actually been used to treat Hypercalcemia in humans.

Pboots

Post   » Mon Dec 25, 2017 1:49 pm


Happy Holidays/Merry Christmas

I don't suppose there may be an image floating around here that provides a visual example of urine "crystals" on a bit of bedding/fleece? I've heard of people reporting calcium "crystals" in their pig's urine as opposed to powdery or grit deposits.

I would just love to know if it's something there's a difference between the two and whether the crystals are pretty visible.

I also hoped someone might know of a radiograph/example of a guinea pig with a kidney stone. I've searched around and have only found bladder stone radiographs.

Butter still has quite a bit of blood present in his urine on and off for 3 weeks now since we started all the different antibiotics for his now diagnosed strep/pasteurella. Have kept him on fluids constantly, 25mL per day. He can't take much more, but we do soaked wet veggies and a constant supply of fresh growing wheatgrass. He used to drink so much more water before all this. When he started the antibiotics 2 months ago, he became more dehydrated/blood showed up in his urine but urinalyses at the vets (almost one per week) never showed bacteria or even blood. But here we are today, with his urine spots still testing positive for full on blood. Middle of the urine spot fills out the square positive for blood. The "outer edges" of his puddle has pretty heavy traces. His urine sample right before hand tested negative.

I have a long list of questions for the vet. But am nervous they so quickly dismissed any kidney stone issues from the X-rays Lynx posted. I have tried to compare Butter's x-rays with those of ones with bladder sludge, and frustratingly still cannot make heads or tails of it.

I had been doing shi lin tong every so often (I think it may cause a bit of extra bloating. Goes away when off shi lin tong. Understandably there's the azithromycin throwing things off and making him uncomfortable. But he does alright with lots of probiotics.) He seems relatively comfortable. I'm concerned about using meloxicam for his pain management (pain from osteoarthritis and pain from wherever that irritation/blood is coming from?) since this may be a kidney thing? I continue to use the CBD.

Merry Holidays everyone!

Pboots

Post   » Mon Dec 25, 2017 1:57 pm


Ah, also--

We decided to stop the lasix with Peanut (heart pig with fluid in lungs). One of the emergency vets that I moderately trust (at a clinic we no longer go to) offered some insight that Peanut may be slowing down and his stools are smaller because he's become a bit dehydrated. It would be helpful to know exactly to what degree there was excess fluid in his body (I am not sure what severe excess fluid/moderately severe excess fluid is supposed to look like on an x-ray). They also chimed in that it doesn't make any sense that a supposed pocket abscess on/around his mandibular (lower jaw) tooth is placing pressure on his eye ball. But overgrown teeth pushing against his eye would. So maybe there is a partial misdiagnosis. I am hopeful for a certified radiologist to someday soon take a look at our x-rays. And put this all to rest.

I apologise for not including this in my previous post.

Pboots

Post   » Thu Dec 28, 2017 8:14 am


UPDATE

So we set out for a second opinion and there doesn't appear to be an abscess, according to Golan, in Peanut's mouth. We actually stopped the Baytril the day before after carefully rereading the notes from the previous veterinary clinic and saw they wrote "abscess on lower mandibular," for the cause of the weepy eye. Which, while we are not vets, did not seem to make sense to us at all. I was very hesitant to make that call on my own, but none of the vets were able to get back to me the week before or the week after (understandably the holidays). Thankfully it ended up being the right call to make.

As for the pulmonary edema and the fluid his liver and lungs were taking on, she seems positive those are correct diagnoses. He's back on Lasix until he can get in for a echocardiogram (without anesthesia). I pushed for an ACE inhibitor of some kind just for the meantime, but she was hesitant to assign him one until we could find out more. There are some side effects I was not aware of in many ACE inhibitors apparently (still unclear). Their clinic's choice inhibitor is Enalapril. I'm hoping it's a type that also acts as a mild diuretic as well.

Butter (Mr. Bloat) is still on the azithromycin and will have to stay on it for the full 20 day course. Thankfully he's showing some signs of improvement, like clear "discharge" coming from his singular nostril instead of opaque. But since his single nostril is still persistently wet and he sneezes a bit, we'll be staying on it for an additional 6 days. I hope month-long URI fighting is common in these cases.

As for his kidney stones, Dr. Golan strongly feels there aren't any. And that the object of interest that the previous clinic had pointed out was actually something circulating in his gut. That was her interpretation anyway. When we finally saw his most recent x-ray in better resolution at the office again yesterday, I did notice a small trail/swirl of mineral/stone looking things in the lower left quadrant of his gut-area when viewing the "from the top." Please excuse my lack of knowledge when it comes to guinea pig anatomy, terminology, and radiographs.

I only noticed the collection of minerals from being able to view examples on here, which I am very grateful for.

During my lunch at work today I'll try and post a link to an image hosting site (something I've picked up on as an alternative to bothering Lynx about posting photos for users on here--please correct me if I surmised incorrectly) to Butter's x-ray with the mineral cluster circled.

As for his blood spots showing up on his bedding, it continues to be on and off. I removed his pellets quite a few days ago (something I really should have done sooner) and the only time we got a bit of blood/calcium grit show up again is after I gave him half of a dang joint oxbow tablet the night before. So just hay, water, low calcium veggies for this pig. (Anyone in the Chicago area want a few pounds of probiotic feed? Haha)

Hopefully all of the above is being exacerbated by this bout of dehydration we're experiencing. Which the vet said is hopefully being brought on by the antibiotics. I certainly hope that's the case. Otherwise it's 25-30ml hand syringed water everyday for life.

I believe that's it for now. Both of their teeth looked good to her, no need for trimming in her opinion. Our vet will be gone for 3 months to have a baby, so I'm selfishly praying nothing major happens during those 3 months. And that her delivery goes smoothly, of course.

User avatar
Lynx
Celebrate!!!

Post   » Thu Dec 28, 2017 7:46 pm


It is actually helpful to have the pictures on your thread permanently for future readers. But you could certainly put them up using a different host more quickly. If you are okay with my continuing to add the most clear and useful ones to your thread permanently, that would be great.

Sounds like you got some good info (ruling out a couple issues).

Your vet can also show you how to administer subcutaneous fluids 2 or 3 times a week (vs. syringing fluids). This is most frequently done (if I remember right) with kidney and/or stone issues.
subcue.html

You wrote:
I did notice a small trail/swirl of mineral/stone looking things in the lower left quadrant of his gut-area when viewing the "from the top."
Do they look like the string of stones in the ureter shown on this page?
stones.html

Pboots

Post   » Thu Dec 28, 2017 9:15 pm


Lynx

Thank you I didn't get around to doodling in his x-ray this afternoon. But will mail the image to you to post instead.

I did ask about getting trained in Sub Q, they didn't want to train me to do it unless he had confirmed kidney failure.

Yes it looks almost exactly like that swirl of stones but it's farther above his left hip. Almost underneath his lowest left rib and closer to the vertebrae. I'll get on that doodle after this.

I had a more pressing question I hoped someone could address---i think with the stress yesterday coming and going, and being at the vet, and that dang oxbow treat creating a huge grit pile, we undid everything from before. He began showing signs of blood again. I set him aside in a "sterilized" (alcohol, wiped with clean paper towel, alcohol, then finally air dry) plastic bin and did a full dip. No blood or leukocytes showing up.

Pees on a clean towel or bedding, test on the towel (not the best way, I know) tests fully positive for blood in every part of the urine puddle. That was not the case this morning. Now we've done this before with the same towels and it has tested negative multiple times (while the gritty center tested positive). I considered it may have been the residual bleach in the towels (though we also do a double rinse) however, the clean fleece bedding he just urinated on (that doesn't get bleached) tested positive for blood, with a full square field totally blue.

So my question is, with UTI's, can you have intermittent results for blood? We'll keep testing as the night goes on. But I'm concerned his pre-urination in the sterile bin didn't have any blood trace in it due to it being not a complete elimination. He sat next to me in the chair while I sat there to test the urine for a good couple minutes and didn't urinate anymore. The second we placed him in his home, he urinated a bunch more (ugh) and that's when we tested the non-bleached bedding--which came up positive for blood. I would love to just drop by the ER clinic tonight that's 40 min away, but a few factors: it's -1F wind chill, we're just about out of resources, hitting past the $2k mark on these guys this season, and speaking of funds we would have to cab it. We were saving that money for the echocardiogram for Peanut but obviously we don't want to risk one pigs life over another's preventative care. I really hoped to get some experience input on at home urinalyses and testing.

Thank you

Pboots

Post   » Thu Dec 28, 2017 9:24 pm


Edit very sorry,

The vet mentioned that porphyrins in urine can also create a false positive for blood on urine test strips. She didn't explain how that could be... other than the urine is orange. Which I'm not sure if she understood that the field for blood on those strips already start out orange and turn blue with blood. Though we've tested Butter's porphyrin urine many times before and it's come up negative for blood.

Does anyone have any knowledge or experience with this? Can anyone help with this?

Sorry my heart is in my throat right now. I hope I'm making sense.

bpatters
And got the T-shirt

Post   » Thu Dec 28, 2017 10:00 pm


I'm not sure about all the possible reactions with the strips, but the general consensus is that they're not reliable for pig urine. Herbivore and carnivore urine have very different characteristics, and can react very differently with the strips.

Pboots

Post   » Thu Dec 28, 2017 10:14 pm


Bpatters-

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.

Pboots

Post   » Sun Dec 31, 2017 1:45 am


Bpatters-

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.

bpatters
And got the T-shirt

Post   » Sun Dec 31, 2017 11:31 am


The "grit" in his penis sheath sounds like smegma. It might work better to retract the sheath and wipe it off with q-tips dipped in cold pressed virgin coconut oil. That will make the penis easier to retract, and won't risk flushing any more of the stuff farther up into the sheath.

Clint The Cuy

Post   » Sun Dec 31, 2017 11:39 am


If his bloat is not resolving, it is definitely time to take him in. He sounds like a chronic bloater, but bloat can have a wide array of causes, some of which can not be resolved at home. Is he on any metaclopramide and Simethicone? People also massage their belly to help he gas along or use an electric tooth brush. I put mine on the massage chair and turn on a vibrate setting. Is he eating at this time?

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.

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