Pigjes: Kidney failure - bladder stone - crystal sludgy pee

Stones · UTI · Interstitial Cystitis
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Lynx

Post   » Mon Jun 11, 2012 8:58 pm


Contributed by Pigjes:

Kidney failure -- bladder stone -- crystal sludgy pee
Name:
Whoopy & Woozy, Rex sisters born on the same day
Sex: Sow
Age at onset: 6 months old
Signs: Whimpering when peeing

Summary:
A series of UTI’s in the Rex sisters lead to the unfortunate death of one of them before she was 2 years old, caused by kidney failure. Her death wasn't in vain, as a treatment for her sister was discovered.

History:
Around the age of 6 months, at the beginning of 2010, I noticed an increase of crystal deposits on the cage liners. I have had pigs for many, many years, so I was used to seeing them every now and then, but they increased. Setting apart the pigs one by one for a few hours each, I noticed that the Whoopy and Woozy were the ones causing it. As the pigs diet at the time was a careful mix of 0.6% calcium average, with high calcium vegs as a treat only, I decided to stop giving them high calcium vegs like parsley and spinach. The crystal formation reduced, yet didn't disappear.

A few months later, the first UTI set in for both sisters. They whimpered when they had to pee. There is a lack of decent vets in Belgium. It took years to find one that was so and so, but not great at all. I took one of my earlier pigs with a UTI and they prescribed the wrong meds and didn't even do any tests or ultrasounds, not even when I begged them to, so there was no need to go there with a UTI again.

Because of this, since I had pigs for many years, I knew how to handle a UTI. I also have the necessary urinary strips at home to determine a UTI. I would not advise to buy them, as reading them is hard, but due to my own medical condition, I am used to handling them. Always go to a qualified vet. Yet, I had none, so I had no choice.

I treated them with Bactrim (also known as Trimethoprim sulfa; Tribrissen; Sulfamethoxazole Trimethoprim, Septra, Septrim) at maximum dosage: oral Dosage: 30 mg/kg q12h (i.e. 30mg/kg is given every 12 hours, for a total of 60 mg/kg in 24 hours) . Both pigs healed within 2 weeks. Bactrim treatment was stopped a week after the last symptoms occurred.

A few months later, another UTI. Same treatment, same result. It repeated once more. The third time was the hardest to stop the UTI, it took several weeks. This lead to taking more action. I decided to give the pigs some extra remedies to try and prevent problems in future. I gave cranberry daily, to up the acidity in the bladder, so the bacteria can't grow well. I have to use Elusanes Urinasol myself, due to MS bladder issues. It contains the active ingredient for battling bladder infections, extracted from cranberries: 1 pill in 10 cc water, give 1cc daily. I decided to add a daily dosage of herbal tea, Chanca Piedra, to prevent bladder stone formation: make strong tea in 50 ml water, give 2 cc daily. I also decided to dose with Cystease daily: ½ pill in 10 cc water and dose 1 cc daily. This has a bladder repairing effect. Dissolving pills and making teas means they have to be stored cold and replaced every 7 days, to prevent it from going bad.

I already had done the necessary precautions in the past: I have extra absorbent fleece pads under their hideys, which get flipped after a day and washed the day after, on a hot cycle with a dollop of disinfectant added to the washing detergent. That’s how the cage liners are washed here too. I weigh the pigs weekly, so that the slightest indication of them feeling ill and causing weight loss would show up. I have a decalcifier on my water system and installed a carbon tap filter, so the remaining calcium gets extracted out of the tap water. I did however start using low calcium bottled water, as I wasn't too pleased with the smell and taste of the carbon filter tap water, although it got replaced on a regular basis.

October 2011. Whoopy got a UTI, Woozy not this time. Woozy seemed to manage with the herbal remedies and cranberry, it wasn’t sufficient for Whoopy. It took 3 weeks to get over the UTI. The Bactrim was given for 4 weeks, largest dosage, as usual.

November 15, 2011. We were woken up at night by Whoopy, who was obviously in serious pain, a few days after her Bactrim was stopped and everything seemed fine. I stopped giving Chanca Piedra at the same time, as it made the pigs gassy and had ordered Eurologist instead. Despite that Chanca Piedra also has a characteristic of removing intestinal gas, it can have the opposite effect too. I noticed Whoopy seemed to flush out a lot of crystals.

She refused to eat on her own, but was eager for some Critical Care. I also kept her hydrated meanwhile. I gave her a painkiller. An emergency visit to a local vet was set. Keep in mind that there are almost no knowledgeable vets around in Belgium, so I went to the best one I knew. I educated myself in bladder x-rays before I went, not trusting their judgment of those either.

The vet did an x-ray, after me begging for one, as they didn’t want to in the first place. According to the vet, it showed a bladder stone, but it looked too evenly shaped to me to be one. It didn't look like a bladder full of grit or sludge, like one of my earlier pigs had. It filled up the entire bladder, but there was a rim of pee surrounding it. The vet’s practice prescribed Baytril, which I refused, as Bactrim is a lot better suited for an UTI. They offered no help and said to wait till the stone popped out, as they didn't have too many pigs survive surgery, so they wouldn't even try. I told them so and they basically said that she either would pop out the stone or die. I knew a stone of that size can't come out on its own. They signed her death sentence and didn't even care.

One of my friends in The Netherlands takes her pigs to the University Clinic for Exotic Animals in Utrecht when there is a special health issue, as they are supposed to be the best. http://www.uu.nl/faculty/veterinarymedicine/nl/dierenklinieken/ukg/Pages/default.aspx

It’s 3 hours from home, but there was no option left for Whoopy. You can't get in except if you have a reference of your vet. As vets here won't do that, I was happy that my friend explained the situation to them and got me an appointment with the head vet of the department himself. So, the day after the local vet didn't even bother, hub took a day off and we were on route from early morning.

The head vet had an ultrasound done and as I suspected, the bladder stone wasn't a stone, but a giant blood clot. There was also a small stone, which was lodged at the top of the urethra, which wasn't visible the day before. There were calcifications on both ureters too. They have better ultrasound equipment than most vets have, with more details coming out of it.

She was very poorly by then. We left her there for emergency surgery, both of us heartbroken, as chances are big that we won't see her again. I told hub that she should not see us cry, so our last words were to cheer her up. She was shocked to see us cry, so we had to stop that, which put her at ease.

An emergency op was scheduled a few hours later, by a urinary specialist. They managed to push the stone back into the bladder, so the urethra was undamaged. Doing surgery on a urethra in a piggie is microsurgery, as it’s so small, so they try and avoid that at all costs, as it’s very hard to do. The leftover scar would also be a spot to accumulate grit and form stones, so that has to be avoided at all costs as well. Then they took the stone out and cleared the blood clot from the bladder as well.

They put her on an IV-drip, so her system was forced to rinse itself properly. She was doing great after surgery. Yet, her kidney tests weren't great, which is normal after bladder stone surgery, especially as a stone blocked the bladder, so the kidneys can't work properly. The rinsing makes this pick up soon.

36 hours after surgery: no poos came out of her yet. 48 hours is about the point of no return, so we were keeping our fingers crossed. Her kidney tests still didn't pick up either.

A few hours later. Her kidney tests got worse. This pointed to kidney failure, which had been the culprit to start with. This can't be seen at the moment that a piggie has a stone blocking the bladder, as those test values match the ones of a failing kidney. Only when test values got worse, it was clear that her kidneys failed and that was an ongoing process since birth. She was born with bad functioning kidneys to start with, so is her sister. It can be detected when the first problems occur, but as we have no access to a decent vet locally, that was not an option to start with.

The vet’s advice:
These are the university vet’s words of advice. He told us to change the pigs diet in future. He said that all piggies absorb 50% of the calcium in their body out of all the food they eat. That’s a lot more than humans do. Despite that piggies are genetically close to humans, that’s one of the differences.

He told us to keep strictly to this new diet, also for healthy pigs with no bladder issues. He says piggie owners feed all our pigs far too much calcium. The theoretical calcium level in all the food offered to pigs should be 0.3-0.4% max (not dry weight). Never, ever, feed anything above that level, not even as a treat, as it’s an attack to the kidneys each time the limit of 0.4% calcium is crossed.

Pigs need a lot of calcium when they are under 6 months old. Once at that age, any excess is too much. They need calcium to function properly, but any excess is bound to cause problems. It will build stones in pigs who are prone to getting them, according to him.

I also had to limit the daylight bulb use above the pigs cage to 20 minutes a day. My pigs have no direct sunlight, so they need the bulb in order to make vitamin D in their skin, just as humans do. Despite that sunlight helps with vitamin D production, to help the calcium / phosphorus ratio, the vitamin D helps to absorb more calcium, which is even worse. So, instead of leaving it on for a long time, the daylight bulb is now switched on for 20 minutes only.

He also told us to cancel the cranberry and other herbal remedies, like Chanca Piedra, Eurologist, Chillington, Cystease (Glucosamine). Those address the problem, but don't address the cause of the problem. When the diet is correct, there is no need for them.

He told us to offer low calcium water in their bottles, but that was already solved upfront.

Hub and I were shocked at first. We already had a careful 0.6% average calcium diet and it was completely wrong. It should be 0.3-0.4% maximum. That’s quite a difference.

So, I had to change the meadow hay to Timothy hay, as that’s 0.3% calcium or less. Not so easy to find in Europe, apparently. Most brands sell horrible hard stalks of Timothy, which can poke an eye out easily. It took months to find reasonably Timothy hay and meanwhile the awful Timothy hay I had available had to be hand sorted daily to remove hard poky bits.

The vet asked to try a pellet-less diet. That caused a severe case of bloat in one of my piggies. So, I was informed by friends of a 0.4% calcium pellet. I ordered dried veggies of 0.3% calcium or less (not dry weight) to mix with that, so the average of the pellet mixture I offer is 0.3% calcium now. That works well.

I had to compose a grocery list of veggies which contain less than 0.4% calcium. We felt sorry that we had to cancel treats like parsley, but the pigs didn't mind.

So far that’s what the university vet’s words of advice were.

Result:
I have kept the pigs on a strict low calcium diet and it works. I haven't found any crystal sludge in the cage since I started the low calcium diet, not even once.

I have seen a drastic change in Woozy. She was sweet, but she was my grumpy pig. She also was rather calm. She loved her sister to bits and her loss didn't cause any dominance issues, as she was boss over Whoopy. The cage we have is humongous, it’s not that she was relieved to gain extra space anyway. After grieving for her sisters loss, she became a changed pig. She is happy, cheerful, popcorns at least daily, does zoomies, all things I never saw before, so I can only blame the new diet. She obviously feels better because of it.

She can do perfectly without cranberry and any other herbal remedy since I started the low calcium diet. Her change is so dramatic, I will always stick to this diet, so future pigs will benefit from it as well.

As the change is so dramatic, I am now advocating for a low calcium diet for all pigs. I also hope more manufacturers will reduce calcium levels in the pellets they sell.

Note: Always seek qualified veterinary care. If you feel your guinea pig has issues due to calcium intake, please consult your veterinarian before changing their diet.

Addition:
Woozy was doing great on her low calcium diet. She did develop an unrelated bladder cancer, which was undetectable and therefore noticed too late. Read about that here.
http://www.guinealynx.info/records/viewtopic.php?p=355#355

Her pee was examined the day of her bladder surgery and it showed that her kidney function had deteriorated. The local vet had been very skeptic about the entire low calcium diet thing, but he admitted he saw it worked, when he looked at her remaining kidney function. He said it was a miracle that she was doing so well 22 months after the start of the diet, so that was obviously working. Not only had the diet prevented stone formation, it also had kept her kidney function up to an acceptable level. But, if she had not died from bladder cancer, she still was on borrowed time and her kidneys would have eventually failed. If she had been on a low calcium diet from the age of 6 months old, when pigs don't need extra calcium to grow anymore, she would have been able to extend her life to the max with her kidney dysfunction and most likely lead a full life prognosis, not much shorter than a healthy pig. Still, even when the diet only started at the age of 27 months, it still did the trick well.

I will now keep every pig over 6 months old on this low calcium diet and will never change it again. Not once, not even as a treat, will anything be fed over 0.4% calcium, to prevent bladder stones and early kidney failure as much as possible.

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