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View Full Version : Stones Possible painful stone...a ActigallŽ (Ursodiol) to help?



snickers33
01-13-16, 04:19 pm
Our beloved pig, Snickers, seems to be battling a bladder stone. He will be five years next month and throughout his young life, he has overcome many URI's and mites as a young pup.

Currently, he is on Bactrim and Metacam for a possible UTI.

About a month ago, I noticed his eyes were more wide and he did not look as relaxed. He was frequently urinating, the urine smelled very strongly and he had pinkish urine.

I took him to the vet in another state, (visiting family for Christmas) and they wanted to do an x-ray, which was $90 and we did not want to spend that much (spent a total of $111)

Instead, she gave us pain meds for him until we could visit a vet in Maryland.

The second vet visit (spent $95) wanted to do urine analysis and an x ray but my husband and I just wanted to try anti biotics to rule out a UTI.

Well, a week later the blood in the urine has been on and off. Recently, there hasn't been blood.

Yet, we think its a bladder stone. He squeaks in pain, curling his bottom slightly under as in doing a crunch exercise, and within a second he stops. He is still on the generic metacam but the squeaking has not stopped.

He is eating and drinking fine.
He is playful and affectionate.

We don't want to put him down when most of the time he is acting so normally.

can ActigallŽ (Ursodiol) be used in this situation?

What would you do in my place? (Given that he is an older pig but he is so healthy without this stone!)


The vet is not in until Monday so we are waiting to hear if she will call us on her off time.

bpatters
01-13-16, 05:07 pm
I would take him to a good exotic vet before that stone blocks his urethra and he dies of a very painful blockage.

None of the things you mention will help, and may actually hurt. He needs surgery to remove the stone, and if he's in otherwise good health, there's no reason not to do it. It's not a terribly difficult surgery, and most pigs do very well afterward.

You need to put back some money for vet care for your pig. You've had two vets give you very good recommendations on diagnosing whether it's a stone, but you haven't taken either one of them. I don't know how much money you've saved, but your pig has been in pain the whole time. Responsible pet care means providing for medical care as well as food and bedding, and he depends on you for everything.

There are plenty of exotic vets around you. Please find one and get him in for treatment.

CavyMama
01-13-16, 06:23 pm
$90 is not a lot to spend when it comes to medical treatment for your guinea pig. I once gladly paid $500 to have a tumor removed on one of my boars. Then paid $800 to have it removed when it grew back and turned out to be cancer. You know why I GLADLY paid it? Because it meant that my pig would live. A stone is serious and very painful for your pig. Doing nothing is not an option.

ThePigAlchemist
01-13-16, 09:08 pm
My four year old pig recently developed a bladder stone and I opted for surgery. He did very well and is now happy and healthy again. Five years old isn't too old as long as your pig is otherwise healthy.

Rywen
01-13-16, 09:28 pm
snickers33 I live in Montgomery County, not sure where you are in MD but I can recommend 2 vets here if you're interested. Probably the best gp vet in MD is Dr. Keith Gold at Chadwell Animal Hospital just north of Baltimore, he's the vet for the Metropolitan Guinea Pig Rescue. I also had to take Penny to Pender Exotics in Fairfax one weekend (open 24hrs), surprisingly their fees were less than their regular exotics vet.

snickers33
01-13-16, 09:29 pm
Thank you for your non condescending post. Glad to hear your piggy did well and is still with you!

Because of the price and risks of the stones reappearing, we may choose to euthanize him. We love him very much and we will prayerfully consider what to do.

snickers33
01-13-16, 09:31 pm
We are down near Annapolis. Thank you for your kind, gracious response. I will discuss this with my husband.

Rywen
01-13-16, 09:47 pm
Oh, just a thought, an exotics vet on the Eastern shore may be less expensive, if you're willing to drive to Easton, etc.

snickers33
01-14-16, 05:09 pm
Oh, just a thought, an exotics vet on the Eastern shore may be less expensive, if you're willing to drive to Easton, etc.

Snickers does have a bladder stone...another vet visit was $224.

($180 for x ray!? Why is that even charged?)

We are calling around to check prices on surgery.

bpatters
01-14-16, 05:18 pm
That does sound outrageous for an x-ray. They're about $40-$60 at my vet.

But I have recently discovered that some vets submit x-rays to a radiologist for reading, and that really inflates the charges. I can see the need for that if the vet isn't sure what the problem is when s/he looks at the x-ray, but there's not much room for doubt when dealing with a stone. I've started asking my vet not to send x-rays out before talking with me first, and us deciding together whether it's really necessary.

ThePigAlchemist
01-14-16, 05:27 pm
I agree, that does seem high for an x-ray. I am in Maryland as well, pretty close to you. I go to a vet in Laurel who charges just over 100 dollars for an x-ray.

Best of luck in finding a vet to do the surgery. I hope everything goes well.

snickers33
01-14-16, 05:30 pm
77992 his stone

snickers33
01-14-16, 05:34 pm
I agree, that does seem high for an x-ray. I am in Maryland as well, pretty close to you. I go to a vet in Laurel who charges just over 100 dollars for an x-ray.

Best of luck in finding a vet to do the surgery. I hope everything goes well.

how much was the stone surgery and who did the surgery?

ThePigAlchemist
01-14-16, 05:39 pm
Dr. Rhody at Lakeside Veterinary Center did mine. Everything for the surgery, including the follow up xray and all of the meds, was 800 dollars. It is on the high side of what I have seen people say they paid on here, but I was very happy with everything that was done.

snickers33
01-14-16, 05:40 pm
That's a reasonable number. The vet today said well over $1000. how soon can it be done?

ThePigAlchemist
01-14-16, 05:41 pm
I saw him on a Monday night and had the surgery done the next morning, so there can be a pretty quick turnaround. I think Tuesdays and Thursdays are the surgery days, but I might be mistaken.

snickers33
01-14-16, 05:42 pm
I am calling them now to get an estimate. It would be less since I already have an x ray?

ThePigAlchemist
01-14-16, 05:43 pm
You'd have to check with them. I imagine having an x-ray already would mean that you wouldn't need one for the consult before the surgery.

snickers33
01-14-16, 05:46 pm
Yes, just called and they are busy so he will give me a call with the estimate asap. Is there anything that was overpriced that I don't have to get? any advice you would give me?

bpatters
01-14-16, 05:48 pm
It depends on the size of the stone as to whether they'll do another x-ray. Also on the sex of the guinea pig. A sow can often pass small stones, so they'll do an x-ray just before they put her to sleep to make sure they're not operating for nothing. With larger stones, and with males, who usually can't pass a stone, they don't always do that.

But do get it done as soon as you can schedule it with a good vet. Stones can fall into the urethra and block the passage of urine. That's a very painful medical emergency that you want to avoid if at all possible.

ThePigAlchemist
01-14-16, 05:50 pm
I don't think there's anything you'd really be able to cut out. Everything in the bill was pretty necessary, like anesthetic and pain meds for afterward. I didn't contest anything that I was told.

The only advice I can think of is when he's post-op, just make sure you follow all of the directions you're given. I had to hand-feed my pig every hour until I went to bed the night that I got him back from surgery, and he had pain meds every day a week after the surgery. I kept him in a small cage that I kept super clean for a little over a week until I could re-introduce him to his buddy.

snickers33
01-14-16, 05:50 pm
So, have you checked if the stones came back? How long ago did you get the surgery?

ThePigAlchemist
01-14-16, 05:52 pm
The surgery was done about 2 months ago I believe. I haven't gone in for a recheck, although I will be pretty soon. I've seen no evidence of the stones coming back, though. When my pig had his stone, he cried every time he peed and I found blood in his urine, and I haven't seen anything like that since.

snickers33
01-14-16, 05:53 pm
It depends on the size of the stone as to whether they'll do another x-ray. Also on the sex of the guinea pig. A sow can often pass small stones, so they'll do an x-ray just before they put her to sleep to make sure they're not operating for nothing. With larger stones, and with males, who usually can't pass a stone, they don't always do that.

But do get it done as soon as you can schedule it with a good vet. Stones can fall into the urethra and block the passage of urine. That's a very painful medical emergency that you want to avoid if at all possible.

Yes, this is why I would like to get it done tomorrow or Saturday.

bpatters
01-14-16, 05:56 pm
Make sure they send him home with pain medication -- and he really needs two. One for immediate pain in the 24 hours after the surgery, and then something milder for a couple of days after that.

Read http://www.guinealynx.info/postop.html for more on how to care for him afterwards.

snickers33
01-14-16, 06:11 pm
Make sure they send him home with pain medication -- and he really needs two. One for immediate pain in the 24 hours after the surgery, and then something milder for a couple of days after that.

Read http://www.guinealynx.info/postop.html for more on how to care for him afterwards.

hes on Meloxicam now....is there something they will give him that is more powerful?

bpatters
01-14-16, 06:15 pm
They'll probably give him buprenorphine right after the surgery. It controls pain very well, but really zonks a pig out, and you don't want to give it any longer than it's needed. Meloxicam is fine for the couple of days after surgery.

Most vets will prescribe one dose every 24 hours, but most people I know get better pain control by giving slightly more than half the dose every 12 hours. It just won't control the pain for a full 24 hours, and a pig in pain usually won't eat. That can set the pig up for GI stasis and bloat, and you certainly don't want that.

You can talk to your vet about it when they send him home, but my vet prefers the smaller dose every 12 hours rather than the larger 24 hour dose.

CaseyB
01-14-16, 09:34 pm
Meloxicam is not a medication that I would change the dose on or give every 12 hours. It is extremely hard on the GI tract. It also has to have time to cycle through the hepatic and renal systems. Giving doses every 12 hours doesn't allow this to happen. I would caution against meloxicam twice daily. Buprenorphine is a great drug for break through pain and given a lower doses will cut back on the sedative effects. I'm not wanting to start a debate about Meloxicam, but it's a drug with potentially severe side effects. And I don't think it's worth the risk. Don't get me wrong it's great for its anti-inflammatory and pain properties.

bpatters
01-14-16, 09:46 pm
Regardless, many people have given it that way. And to me, it's a risk I'm willing to take to avoid the zonking effects of buprenorphine, or allowing the pig to be in pain for 6-8 hours before it can be given the next dose.

CaseyB
01-14-16, 09:51 pm
To each there own. I have seen the devastating effects of over dosing with Meloxicam. But if it's a risk you want to take that is your prerogative. I just think that people should be aware of the side effects before they are told to go off label by a random person on a forum.

bpatters
01-14-16, 09:56 pm
I believe I suggested that he talk to his vet about it. That's hardly telling someone "to go off label by a random person on a forum."

And no one has suggested overdosing with it. The way it gets commonly used when the dosage is split is to give half the recommended dosage, plus 10% of the half. That's a total of 10% more than the total daily dose, which hardly qualifies as an overdose.

CaseyB
01-14-16, 10:03 pm
Like I said that your prerogative to give 10% more daily. But it is still an off the label recommendation and one that should only be recommended by a veterinarian. Sorry that I have offended you, it wasn't my intention. I just wanted followers to make educated and veterinary recommended decisions.

snickers33
01-16-16, 01:07 am
Sadly, snickers had to be put down tonight. We were trying to get him to a vet and get an estimate tomorrow morning but he was in so much suffering and pain and could barely urinate.

We miss him so much already. Thanks for all your replies and trying to help!

CaseyB
01-16-16, 08:26 am
I'm so sorry for your loss

spy9doc
01-16-16, 09:00 am
I just think that people should be aware of the side effects before they are told to go off label by a random person on a forum.

@CaseyB.........well, you certainly know how to endear yourself to the veterans on this Forum! I don't know what your credentials are to back your opinion, but I DO know that @bpatters is one of the most knowledgeable and respected people on this forum insofar as cavy care is concerned and rarely gives questionable advice.....certainly not a "random person". I happen to be a physician and I agree with her advice.

You are welcome to your own opinion, but you might soften your tone when disagreeing with someone else. I don't always agree with bpatters, but we politely each present our own opinion and perhaps "agree to disagree." Same with other respected members of the Forum.

@Snickers33.......I'm so sorry for your loss. It's heart-wrenching when we lose our cavies. I know my beloved Chester & Maya were there to greet your baby just over the Rainbow Bridge and to show him where to find the most delicious dandelion greens.

CaseyB
01-16-16, 09:35 am
spy9doc....You are right I shouldn't have called bpatters a "random person". I have found this forum to be very helpful. But it has been stated in many many threads that the "veterans" are very rude and judgemental. I apologize if I am someone that is comfortable to speak my mind. Don't get me wrong I respect and have actually changed many of the ways I look after my pigs based on what bpatters has suggested. Yes I have worked in the veterinary industry for 17 years, and a part of our job is spent re-educating clients after the wrong information has been delivered to them. I have personably watch many animals suffer from the long term side effects of Meloxicam use as well as the short term side effects of over dosing. Meloxicam is a very useful drug when used properly, but very dangerous if not. Once again it was not my intent to offend anyone. I just felt if we are going to educate, the whole story should be told, so they can make an educated decision.

bpatters
01-16-16, 10:23 am
I'm so sorry you lost Snickers.

spy9doc
01-16-16, 10:47 am
I just felt if we are going to educate, the whole story should be told, so they can make an educated decision.

Thank you for that mature response. Apology accepted. It wasn't what you said so much as how you said it.

It is important to keep in mind that the goal of this forum is to educate, inform.........and to share. We all love these little creature passionately or we wouldn't be here. As both a healthcare professional AND a college professor, no one understands the need to educate and to teach critical thinking skills more than I.

With regard to the OP's situation, we weren't talking about long term usage or any over-dosing with the Meloxicam. I will freely admit that I sometimes don't follow the recommended standard dosing schedule for medications.......primarily those for pain. A six or twelve hour interval between doses is just not workable for many humans or animals. There is that initial bolus of medication that will just about knock out the individual, and then they are in too much pain before it's time for the next dose. A more reasonable approach is to take half the dose twice as often.

No, I don't recommend that most people tamper with medication dosing and schedules, but in this case, I absolutely agree with bpatters recommendation.

Rywen
01-16-16, 10:50 am
I'm so very sorry you lost Snickers, RIP little one.

bpatters
01-16-16, 11:01 am
CaseyB, I totally agree that long-term meloxicam can be very harmful, as can overdosing. And meloxicam was much more thoroughly tested on dogs than on guinea pigs, if it was even tested on them at all.

But they have to have something to control pain, and meloxicam is very widely prescribed for that purpose. It just doesn't keep them free of pain for 24 hours. And given all the problems that can happen when pigs stop eating, which they do when they're in pain, I'd far rather risk a slightly increased dose twice a day rather than a once a day dose that doesn't work. Besides, there's a range in the dosing recommendations, so if the vet has prescribed the minimum (which seems to be the usual practice), a 10% increase doesn't take it beyond the recommended maximum dose.

There's an interesting thread on it at GL, here: http://www.guinealynx.info/forums/viewtopic.php?t=35093

CaseyB
01-16-16, 11:13 am
Thanks for sharing bpatters. It was an interesting slightly frightening thread. I honestly do trust your opinion and experience and that may work for controlling pain.

My biggest concern was outlined in that thread. There are followers on that thread that are stating outrageous doses, they may not be recommending it but some followers take it as a recommendation. That's why I said (and so did you) about getting an experienced veterinarians recommendation.

I have seen too many clients come into the clinic that say they got the dose or recommendation off the Internet and it cost them either a lot in veterinary bills or a deceased pet.

snickers33
01-16-16, 01:16 pm
Thank you for your consolations and sympathies! My husband and I just loved him and it was so hard to lay him to rest but he is not in any more pain and we have so many wonderful memories!

We will definitely be getting another pig and sticking with a lower calcium diet and finding a good vet that has reasonable prices. It is important to be kind, gracious to posters and not to be judgmental or mean in responses...that is the last thing
posters need when posting about a sick animal.

God bless!