Bladder stones and mass around kidney

Talishan · 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.

Sef · 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):

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.

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.

Sef · 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.

Sef · Post » Thu Mar 28, 2019 10:26 pm

If I go with a low end dosage of Tramadol at 5 mg/kg (range for rodents runs anywhere from 5-15 mg/kg), and assuming his weight is 1 kg, the calculation would be:

5 mg (recommended dose per kg) x 1 kg (his weight) divided by 100 (mg/ml suspension) = .05cc. That's a heck of a lot closer to the .06cc that your vet stated vs. 0.6 on the bottle. My references also vary on the frequency of dose, from once every 12 hours to once every 24 hours, but certainly not three times a day. Maybe somebody can double-check my info and calcs, but the pharmacy's label seems WAY off.

If it were me, I think I'd be inclined to ask for Metacam when you talk with her tomorrow about the supplement (maybe citing that his appetite and activity level have slowed down on the Tram) and see how he does on that for a few days. You haven't really indicated that he has shown signs of being in a lot of discomfort, and IMO Tramadol is taking pain management up a notch before it's needed.

Hang in there; you're doing a good job with him.

Talishan · Post » Thu Mar 28, 2019 11:28 pm

Ditto Sef. In my experience Tramadol can be dosed three times a day if needed, but I agree with Sef's dosage. It sounds like the pharmacy screwed up by a factor of 10.

Good on you for being alert and checking on it. You're doing a great job for him.

Go by how he feels and how he is acting. In my experience the narcotics, mild or strong, go on a straight sliding scale; the more you give, the greater the relief (and also the greater propensity for zonking). Tweak it to make him as comfortable as possible, while the least zoned.

RKelly · Post » Wed Apr 03, 2019 9:16 pm

He's doing so much better. Eating normal amounts/frequencies. Haven't noticed any more bathroom issues. He's back to running around and demanding whatever he wants. I'm one happy pig slave.

Sef · Post » Wed Apr 03, 2019 10:24 pm

That's encouraging! Thank you so much for the update. Is he on any meds, now?