Stones Bladder stone post-op worries

[PigPal123]

Sparky (2.5 year old boar) was diagnosed last week with bladder stones and they were removed on Friday. He came home on Saturday with Metacam and orders for a reduced Calcium diet (I feed KM timothy pellets and KM orchard hay). He has been eating and drinking well and his poops and urine look normal (i.e. no blood in the urine, no diarrhea). However, he's still making noises to indicate that something is painful. For those who have had the surgery, is this normal 5 days post-op? There's no white in his urine to indicate sludge or excess calcium and no blood whatsoever. The Metacam ran out on Monday, but we have more refills and I'm tempted to ask for more.
Any thoughts or suggestions? Thank you.

 

[pinky]

I would call your vet and ask if this warrants a follow up visit. Considering it's post op, I would hope that they would see him free of charge. My vet doesn't charge for visits related to anything post op; only meds.

 

[Paula]

Were you prescribed antibiotics for his after-care? Usually a bladder stone causes a bladder infection which is going to make urination painful. My guess is that although the stone's removed, the infection probably isn't and that's what's causing the discomfort and/or pain.

If you weren't given antibiotics, you need to have some. Bladder surgery is very invasive and the cut needed is quite deep - even if there's no suspicion of infection (which would honestly shock me) ABs are needed to ward of any infection while he heals from surgery.

 

[PigPal123]

The stone was cultured for bacteria and came back negative and there were no other signs of infections (e.g. thickening of the bladder wall, inflammation, etc.) - hence no antibiotics. My vet is very conservative with AB's and pigs due to the fragile nature of their intestinal flora, but perhaps we have a secondary infection here. I'll wait for another day to see if the pain subsides and then we'll give a call for some Bactrim perhaps. Thanks for the reply.

 

[Paula]

Was there a urinalysis done either before or after the surgery?

My vet is very conservatives with antibiotics, also, and seldom gives them after "routine" surgeries like spaying or neutering - but the bladder surgery is more intense and more invasive and for that reason he absolutely always gives antibiotics after stone removal surgery.

Your pig should not be having pain during urination after the surgery is completed - did your vet do a follow up x-ray after surgery to ensure that all stones were removed?

 

[PigPal123]

Hi Paula. There was a post-op xray done to insure the stones had been removed and they did a UA before surgery on Friday, which came back negative. I've got a call into the vet and am expecting a call back soon. I figured there would be initial pain associated with urination, but I agree that this seems a little concerning 5 days post-op with no other signs of bladder trouble (e.g. normal urine output and no blood in urine - he's been on white towels and has been watched like a hawk). I'll post again when I hear from the vet.

 

[PigPal123]

Took Sparky in and they did a UA and found white blood cells in his urine. He's at home now with a 10-day course of Baytril and directions to bring him back in if he doesn't start feeling better in 5 days and sooner if he gets worse. Thanks for all the good advice and I'll keep you posted.

 

[Paula]

I'm glad to hear you have an answer and I hope Sparky is on the mend in no time!

 

[PigPal123]

Sparky did very well post op for a month and then developed stones again. In cases like this, I feel like more and more surgeries are inevitable and I a) don't want to put Sparky through more pain and b) don't have the funds to do more surgeries. I spoke with my vet and she supports this stance. However, we've started him on a dose of metacam and tricitrates to try and leach the calcium from the urinary tract.
Has anyone had any experience or luck with this treatment?

 

[Paula]

It's not thought to be terribly effective against stones in guinea pigs, particularly with aggressive cases like yours is.

With one of my pigs, my vet's long-term plan was Reglan twice a day, rather than any kind of Polycitra or anything like that. The thought behind it was that perhaps it would cause him to empty his bladder more often and effectively eliminate all the calcium from the bladder.

Metacam is a good idea. Has your vet talked with you about altering the diet? I would switch to KMs pellets if you haven't already, and give no more than a teaspoon per day of her timothy formula. Beyond that, I'd consider switching to oat hay (it's lower in calcium) and feed only very low calcium veggies like zucchini, tomato, and cucumber.

Are you going to remove this stone?

I agree with the notion of not putting him through more surgeries. I had one pig I put through three surgeries and he died from complications soon after the third. I decided then, that I'd never go that far again. You get to a point where their quality of life drops to a level that is nearly intolerable and I can't recommend putting such a fragile animal through so many surgeries.

My recommendation would be to perhaps remove this most recent stone, severely limit his calcium intake, and keep him comfortable and happy for as long as you are able to.

Good luck.

 

[pinky]

I don't think there is any effective treatment for bladder stones. The vet I use said a lot of major universities have tried to find a cure or solution for guinea pig stones because, sadly, they are often used in experiments and they want to keep them alive as long as possible. When they develop stones, they often lose them before the testing is done. I had one of my guinea pig euthanized when he developed stones because the stones were inoperable and I didn't want him to suffer. Later, I found out they can survive for quite a while, pain free, if you give them pain meds so that might be an answer to keep him comfortable so he can enjoy the remainder of his life. My vet had contacted one of the universities in IL to see if there were any promising new treatments out there. They recommended adding a drop of vinegar to their drinking water to make it slightly acidic to avoid the formation of new stones but not necessarily eliminate the ones they had. i hope someone out there might have some answers for you.

 

[Paula]

Later, I found out they can survive for quite a while, pain free...

They can, and this is something I wish I had known years back before several stone surgeries. I think it's a unfair and a little selfish to put these guys through surgery after surgery. Like I said, it becomes a quality of life issue, and if pain meds without surgery can buy him a few more months, I would go for that route, now, knowing what I know about stones and their long-term prognosis.

 

[PigPal123]

That's where I'm at as well. We're on a low Ca diet (2 tbsp of KM timothy formula for two pigs), KM's blue grass hay, and romaine and green bell peppers with occasional low Ca treats. I'll continue with the metacam and tricitrates, although I'm not convinced the tricitrates are doing anything besides making him pee frequently. He's still eating and drinking and generally doing ok, but there's blood in the urine and it's evident that it hurts him to go. Thanks for your advice though.

 

[PigPal123]

I should also add, all of his care has been at the veterinary research hospital here at WSU. They did the surgery and all post-op care.

 

[Nicolene]

I have a piggie of unknown origin (found him in a park). He's had 2 UTI's. Our vet said that he doesn't offer up surgery as a first option for stones because he said that 2 out of 3 of the stone surgeries he does on pig results with new stones after a month or 2. So he said if we ever find stones in Snickerdoodle (so far he's clear) he would suggest longer term AB's first. He's had some success with treating with AB's only (if there is an infection) and he's even seen stones get passed after a few months.

It would be a hard decision for me to make if we are ever forced to deal with stones. My pigs are on a low calcium diet (baby gets calcium rich veggies on the side) and I STILL find calcium deposits from Snickerdoodle from time to time.

When my piggies are sick I am a mess, so I can only imagine how you feel. I wish you the best of luck and I hope you find some great advice and resources to help you figure it all out.