Bladder stones and mass around kidney

RKelly

Post   » Thu Mar 21, 2019 10:26 pm


Took RKelly to the vet this morning because his urine was dark and he squeeked once while going. He has stones and a mass surrounding one kidney. Vet ordered a medication that may help dissolve stones. Is this even possible? The local gp rescue uses her so I assume she knows what she's doing but I don't want to get my hopes up. Not that they can get too high with mass. She also ordered pain meds that need to be compounded. Any idea what it might be? He's not a good candidate for surgery due to age. Is there anything I can do to make him comfortable until meds get here? He's only squeeked once since we got home but it's killing me not being able to do anything.

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Sef
Supporter in 2019

Post   » Thu Mar 21, 2019 11:03 pm


How old is he? Unfortunately, if he has calcium carbonate stones, there is nothing known to dissolve them. I'll be very interested to know what this vet has ordered.

Also not sure what pain med she is prescribing. Metacam is the safest and generally most effective analgesic, but there are other NSAIDs in the same class that could also be used--none of which need to be compounded as far as I know. There are heavier duty pain meds in the opioid class, though. Maybe she is thinking along those lines.

Can you post a follow up when you find out what these medications are?

Talishan
You can quote me

Post   » Thu Mar 21, 2019 11:16 pm


The compounded med is likely a mild narcotic like Tramadol. This is stronger than an NSAID, but will not hammer them as hard as the stronger opioids.

An NSAID like Metacam might give some relief until the compounded med arrives.

How large are the stones?

Since he is male, the biggest danger is that one of the stones travels into the urethra and blocks his urine flow. (This can happen to females, too, but since the tubing is larger, the danger is a little less.) Keep an eye out for this. If it happens you'll know. He will be in agony and he will let you know.

All that said, if the stones are tiny he may pass them; if they're too large to get into the urethra, they may make him vaguely uncomfortable from time to time but not unmanageable. We had one who lived for nearly two years with a very large but slow-growing stone (also not a good surgical candidate).

Ask the vet if you can get some Metacam until the compound shows up. Also consider making him some barley water. I'll see if I can find the thread on it.

Talishan
You can quote me

Post   » Thu Mar 21, 2019 11:21 pm


This is a long read but worth the time:

viewtopic.php?f=2&t=62698

Good luck and blessings to him and to you.

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Sef
Supporter in 2019

Post   » Fri Mar 22, 2019 5:50 am


Thanks for posting that link, Talishan.

RKelly, is there any chance you could get a copy of the xrays and post them here? I am also wondering if the vet was able to get a urine sample. You mentioned the dark urine (is it bloody?). Urinary tract infection is often a secondary issue with a stone; the antibiotic Bactrim would be a good choice to help deal with that and hopefully make him a little more comfortable, along with Metacam.

Also see:
http://www.guinealynx.info/stones.html
http://www.guinealynx.info/uti.html

Bookfan
For the Love of Pigs

Post   » Fri Mar 22, 2019 12:01 pm


We had a pig who had a mass on her kidney (along with a bunch of other problems) and she lived to be 8. Her death had nothing to do with the kidney.

RKelly

Post   » Fri Mar 22, 2019 9:43 pm


Thanks so much guys. You've given me some realistic hope. I'll see about getting x rays and more info from vet asap. His urine did have blood in it according to test. Believe vet said they were small. I did not handle the news well. Pretty much lost it when I talked to her on the phone. A friend had to pick him up since I had a doctor appointment I couldn't miss. My head is back on so I hope she's ready for a lot of questions.He doesn't seem to be in much discomfort. Still being his normal demanding self. Still popcorning at 5.5y. My main goal right now is to deal with the stones and keep him comfortable. He's the only gp I've had so I have no idea what I'm doing. I will definitely ask about metacam while we wait. As to antibiotics should I ask about getting a culture done to make sure it's needed or just try to get them? I'm willing to try anything including voodoo if anyone knows someone.

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Sef
Supporter in 2019

Post   » Fri Mar 22, 2019 11:44 pm


You can ask the vet if urinalysis could be done to check for signs of infection/secondary UTI, but she may say to go ahead and put him on Bactrim for 10-14 days just to be on the safe side.

What is his diet?

Bookfan
For the Love of Pigs

Post   » Sat Mar 23, 2019 1:07 pm


This post is from 2006 so I don't know if these people are still practicing. These recommendations are from Guinea Lynx members. A second opinion might be helpful. Sorry if I missed this - do you know of any exotics vets near you who treat gp's besides the current vet?

http://www.guinealynx.info/records/viewtopic.php?f=76&t=276

RKelly

Post   » Sun Mar 24, 2019 8:56 am


Right now he's eating small pet select third cut timothy, oxbow adult, green leaf lettuce, cucumber, one small baby carrot per day. Those are the main veg. I rotate others like green pepper (he'll eat those for a couple days then won't for a week), endive, red leaf lettuce, raddiocchio, parsley, cilantro, weird lettuce like oak leaf, blueberry, strawberry, bite of banana. I try to give him variety while feeding high calcium stuff as more of a treat situation. He was on kms hay and pellets but I got nervous about the issues some people were having after they changed hands. He seems to be feeling okay. He's running around the house making his bubble noise. Played a long game of hide and seek Fri night, if he can't see me I can't see him. He's back to telling me when he feels it's my bedtime. As to a second opinion there's two other exotics vets around. I went with this one because she's who the gp rescue uses and they've had some really touch and go surrenders who made it under her care. Unfortunately people around here buy pet store pigs for the kids and when they get sick don't get care. Why spend $300 on some x rays and office visit when you only paid $40 for the gp. Cheaper to buy another. One more reason why I dislike people. Other than googling reviews of other vets I don't know how to find out if others are even worth trying. Hopefully I can get x rays, etc tomorrow or Tues at the latest. I have to have a procedure tomorrow morning so I'm not sure if I'll be able to get them tomorrow. How do I go about posting them on here? Even though I've never met any of you I trust your experience. It's scary when you don't know what you're doing and a tiny critter depends on you to make the best decisions.

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Sef
Supporter in 2019

Post   » Sun Mar 24, 2019 9:26 am


I'd stick with this vet for now and see what she comes up with as far as meds. If she'll email you the x-rays, you can either send them to me (shoot me a note through the mailer here, and I'll send you my email address) and I'll post them for you, or you can open a photo hosting account somewhere like Imgur. You'll just copy the image URLs and post here between opening and closing "img" tags. Lynx may also allow you to send her the images and she can host them here, since they are relevant to what's going on with your little guy.

With bladder stones, I'd cut out the parsley entirely. Everything else sounds good, and I'm glad to hear he is still active and eating. I'd be curious to know if he does have a secondary UTI and, if so, if the blood in his urine and the crying stops or at least improves once that gets cleared up. Is he still vocalizing quite a bit? Any straining when he eliminates?

ETA: As others mentioned, do be vigilant for any signs at all that he's in distress. If one or more of the small stones get stuck in his urethra, it can quickly become an emergency situation. Not to scare you, but it can and does happen. Does this vet have an after-hours number where she could be reached if necessary?

RKelly

Post   » Sun Mar 24, 2019 7:27 pm


In emergency he has to go to the vet school clinic. Definitely no more parsley. That was a few sprigs a month treat anyway so he won't miss it. He's pretty perky. Had to be away from home overnight and he woke up the sitter in the middle of the night for veggies. He isn't making noise now or straining to go.

Talishan
You can quote me

Post   » Sun Mar 24, 2019 10:40 pm


I've had only one experience with UT's teaching hospital, and it was a long time ago, but they were FREAKING. AWESOME. Hopefully you will not need to see them, but go with complete confidence if you do.

RKelly

Post   » Tue Mar 26, 2019 11:17 am


Vet is going to email x rays. She prescribed potassium citrate and tramadol. Some of the stones are the right size to block his urethra. No bacteria suggesting uti so that's one good thing. Sef1268 I'll send one the x rays when I get them. And thanks so much for posting them.

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Sef
Supporter in 2019

Post   » Wed Mar 27, 2019 11:36 pm


Here you go (apologies to Lynx: the images are fairly small but have an enormous border around them and my photo editor isn't working at the moment...you are welcome to crop these down if you prefer):

Image

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RKelly

Post   » Thu Mar 28, 2019 8:34 am


He had a rough day and night. Wasn't eating his normal amount of anything and didn't want to be bothered. Don't have any critical care right now that's next purchase. I made a pellet mash flavored with strawberries to get through the night. He actually ate it off a spoon. I fed him all he would eat. At least a tablespoon every hour and he was drinking more water than usual. He seems quite a bit better this morning. I am not lol. I'm too old to pull all nighters. If he doesn't demand his vegs in a few I'll be bothering him again.

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Lynx
RESIST

Post   » Thu Mar 28, 2019 5:08 pm


Yes, feeding during the night is very tough! Hoping he improves. The mash with strawberries sounds delicious :-)

RKelly

Post   » Thu Mar 28, 2019 6:17 pm


I'm used to cooking for picky old people so I'm pretty good at coming up with ideas lol . Trying the barley water as well. Finally got vet to send scrip to pharmacy and he just had his first dose. Hoping for a pain free pig not a stoned one but I'll take what I can get.

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Sef
Supporter in 2019

Post   » Thu Mar 28, 2019 8:26 pm


I have to go back and read my notes on potassium citrate from years ago, but I recall that it acts by making the urine less acidic. Guinea pig urine is naturally alkaline and not acidic (has his urine pH been tested?), so I'm not really sure how this will help dissolve his stones. From what I recall, it can help prevent certain types of stones that thrive in an acidic environment (oxalate), but again, not likely to have any effect calcium carbonate stones -- which tends to be the composition of most guinea pig and rabbit uroliths.

Unless his urine is unusually acidic, my concern would be that it might have the opposite effect of making the urine too alkaline and create an environment even more favorable for calcium carbonate stones to form. Again, I'd just be curious to know if the vet determined the pH of his urine before prescribing it.

Hopefully the Tram will help and not totally zonk him out. How often and at what dose does she suggest using it? I'm wondering why she went for a heavier gun (narcotic) vs. trying Metacam first. The advantage to Metacam is that, as an NSAID, it can also help with any bladder inflammation.

If the reduced appetite continues, I'd consider asking to change pain meds and possibly talk to this vet about the potassium citrate.

RKelly

Post   » Thu Mar 28, 2019 9:55 pm


The dose vet told me was .06ml twice a day. She sent script to local pharmacy so I could get it quicker but the bottle says .6ml tid. It's 100mg/ml. Meds weren't ready til after office had closed. I'm calling about that in the morning. I went with caution and did .06. I will ask about urine pH also. I'm not taking the chance of it making stones worse. He is moving around more. Went from living room to bedroom then came out later to go in kitchen to pick at veg. Didn't eat much but has been eating hay, a few pellets,barley water, and a little pellet mash. Unfortunately he did a squeak some while going to bathroom but he was wanting pets and purring immediately after. He's still drinking more water than usual but I'm hoping it's because he's not been eating as many vegs.

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