SMOOTHIE AND THE BLADDER STONES

15 May

Hi, please use the information provided in this blog with cautions. Consult the vets as each case may be unique. What helps my piggy may be harmful to others.

Smoothie’s Vital Stats
Sex: Male
Age: Estimated 11 months old at the time of diasnosis with bladder stones
Normal Weight: 1035-1045g
Breed: Sheltie

He was diagnosed with the bladder stones but after the treatment with Potassium Citrate, Baytril, Shilintong, fluid therapy, TLC (tender, love & care), and prayers, he recovered without having to go for a surgery.

This is what happened and what we learnt.

23 Feb – Noticed the Symptom
He made noise when peeing. Unsure if he was just nagging (his normal self is very naggy.)

24 Feb – Continued to Observe
Throughout the day, he didn’t made noise when peeing.

25 Feb – The Symptom was Back
The noise was back when peeing. This was how it sounded like:

The night before bringing Smoothie to see the vet, we separated Smoothie from his friend, Nuggets and monitored the followings:
Appetite: His appetite was good. He ate and drank normally.
Poops: The size, the texture and the amount were normal.
Weight: His weight was stable, no sudden drop or surge.
Urine: The color was normal, some were orangy, some were white-yellowish. No blood presence (use white lining such as kitchen towels and pee pads for easy monitoring of the urine color.)
Activity level: His activity level was normal. He was active and playful as usual.

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Above: His overnight urine on a pee pad.

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Above: His overnight urine in the toilet lined with kitchen towels. The orangy stains was due to oxidization of the urine.

26 Feb – Brought him to visit our usual cavy savvy vet at The Animal Doctors.
The vet performed “2-view X-ray” and “LAB Urinalysis (Urine Stick)”.

Diasnosis:

  • The X-ray images discovered 2 small stones
  • Urinalysis shown a sign of infection

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  • Vet commented that both stones were small and there was a chance that they might move down and cause blockage. If that happened, Smoothie wouldn’t be able to pee and he would have to be admitted at the clinic immediately as an emergency case.

    Quoted from Guinea Lynx

    Stones can become lodged in the urethra slowing or completely blocking urination. This is especially dangerous for boars, as their urethra is narrower than that of a sow.

Treatment plan suggested by our vet:

  • Not to go for the surgery right away (the surgery maybe needed immediately in some case).
  • Potassium Citrate 1G/5ML (1ml twice a day) was given (to balance the urine PH level).
  • Feed lots of water  throughout the day – The stones may be dissolved and/or flushed out.
  • Take antibiotics to cope with the infection (Enrofloxacin 10% [Baytril] Solution – 0.1ml twice a day).
  • Monitor closely – if he can’t pass urine, he must be brought back to the vet immediately as an emergency case.
  • The next review was 10 days later (8th Mar) to do the X-ray again.
  • The tentative date for the surgery was set on 11th Mar (3 days after the second review, if the stones were present).

Notes: Please check the dosage of the medications with your vet. The concentration of the medicine, the piggy’s weight, age, health conditions may be different thus required different dosage.

27 Feb – Day 1 of the Treatment
We didn’t hear him make noise when peeing. The toilet lining (kitchen towels) was changed every hour. He was able to pass urine as normal. His appetite was good. We fed him medications (Baytril & Potassium Citrate) twice a day and fed him water almost every hour.
Note: We avoided feeding him lots of water right after the medications as it might reduce effectiveness of the medicine.

How did we monitor if Smoothie passed urine?

Choose a corner where he likes to pee -> his toilet.
toilet 3

Line the toilet with white kitchen towels or pee pads, so we’ll be able to monitor urine stains as well as urine colour in case there is blood.
toilet1

Check his toilet every hour, replace new kitchen towels/pee pads once they are stained.
toilet3

How much water did we feed Smoothie and how often?

We fed him water almost every hour, except when we just fed him medications as we didn’t want to dilute the medicine.

Because we didn’t want to overfill his stomach with water as the piggy will need some spare stomach space for pellets and hay. Feeding too much water might stop him from eating food normally (thus depriving him of other nutrients), it might do more harm to the digestive and teeth health than good.

We weighed Smoothie before and after feeding water and checked against his average weight and his maximum weight (the weight after eating a big veggie meal) to estimate how much more water he could take in. What we actually did was feeding him water until his weight reached above his average weight but 15g-20g below his maximum weight.

Example:

  • Smoothie’s average weight was around 1040g.
  • After a veggie meal, it could go up to 1070g (maximum weight).
  • We syringe-fed him water until his weight hit somewhere between 1050g-1055g and stopped. It should be a comfortable level for him and he still had some stomach space for hay and pellets.

We had a notebook to record his weight (as well as the activities during the day (eg., medication time, water feeding time) and also to record the symptoms we noticed).
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  • Before feeding water, recorded his weight.
  • After feeding water, recoded his weight.
  • Before we began the next water feeding session, we checked his weight again. His weight should come down as he passed urine and poops. If his weight didn’t come down, we would check the surrounding for urine (it’s important to change the toilet lining regularly). If there was no fresh urine, we would wait another 30-45 minutes and if he still didn’t pee, maybe it was time to pack and go to the vet as an emergency case. Please do not delay seeing your cavy savvy vet if your piggy doesn’t pee!
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  • Click here to view the water feeding session vedio.

    28 Feb – Day 2 of the Treatment

    The additional things we did today was feeding a chinese herb called Shilintong (Shi = stone, Lin = forest, Tong = pass).

    Many people recommended this herb to us.  There are many discussions about this herb in various guinea pig forums including Guinealynx. We decided to give it a try.

    We bought it from a neighborhood Chinese Medical Hall in Singapore. It costs SGD 6.50 per bottle for 60 tablets.

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    We learnt that different brands may have different combinations and proportion of the herb mix maybe different, see this discussion for more info. (So there is no specific dosage, but to be safe, start small first and observe.)

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    Quoted from the discussion

    Due to the manufacturing issues in China, it is not recommended for people in other countries to utilize Chinese-manufactured remedies due to various impurities.

    Our vet told us the same thing – to avoid China made herbs.
    What we bought was product of Singapore. It should be fairly safe.IMG_2707

    This is how the pills look like. The pills have pink powder coating which has to be washed off before feeding.

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    Dosage

    The recommended dosage for guinea pigs has not been established due to lack of studies of this herb in guinea pigs, but according to the discussion in Guinealynx, it says:

    “… dissolved 1 pill in about 2.0 cc water and syringed 1.0 cc to her guinea pig Angel twice/day. Since the pills are coated and very hard, soak first for several minutes in water and then crush.”

    To play safe, we start with small amount, 1/4 tablet twice a day, 6 hours after the medications prescribed by vet (in case they react to each other) and observed if the piggy is doing fine.  

    1-2 days later, Smoothie seemed to get worse (made noise and urinated in small amount every 5-15 mins. First we thought we would want to stop feeding him Shilintong but we took a step of faith to increase the dosage to 1/2 tablet twice a day (= 1 pill per day). We did that on 5th Mar (3 days after first feeding with Shilintong) and the condition improved since.

    Shilintong Preparation

    • Use a pill cutter to cut the pill. It’s dark brown inside.
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    • Wash off the pink powder coating in running water.
    • Soak the pill in water (we used distilled water as tap water contains trace of calcium).
      IMG_2736
    • It takes several minutes to dissolve.
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    • Feed using 1ml syringe.
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    • Without crushing the pill first, it will take forever to dissolve. The left over can be fed directly into piggy’s mouth if it’s small and soft enough for the piggy to chew.
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    Other things we did

    • Kept the floor/bedding dry and clean. We did a major wipe twice a day and a minor wipe many times throughout the day. (We’re using Joint Drain Board flooring.)
    • Disinfected the floor once a day using disinfect wipes, followed by wiping the floor with wet cloth to remove the trace of chemicals, and wiped dry with kitchen towels.
    • Kept piggy’s butt fur short. Cleaned perineal sac and xx using soft cotton and Q-tip soaked in baby oil, removed the baby oil by wiping with cotton pads soaked in warm water. Check Guinealynx for how-to.

    1 Mar – Day 3 of the Treatment

    As mentioned above, Smoothie got worse even after feeding Shilintong (dosage: 1/4 tab, twice a day)

    Symptoms:

    • Cried/made noise more often (when peeing and resting).
    • Small and frequent urinating (every 5-15 minutes).

    Possible cause – Shilintong has diuretic property so it may cause him to urine more often.

    We continued to monitor his urine, his weight, food intakes, and activity level.

    2 Mar – Day 4 of the Treatment
    We continued Potassium Citrate and Baytil twice a day as usual, followed by Shilintong (1/4 tab twice a day, 6 hours apart from Potassium Citrate and Baytril). He didn’t get better, still made noise when urinating.

    3 Mar – Day 5 of the Treatment
    Everything remained the same.

    4 Mar – Day 6 of the Treatment
    Everything remained the same.

    5 Mar – Day 7 of the Treatment
    Increased Shilintong dosage from 1/4 tablet twice a day to 1/2 tablet twice a day.

    6 Mar – Day 8 of the Treatment
    No more making noise! That was a good sign!
    Stones1

    7 Mar – Day 9 of the Treatment
    Continued meds and Shilintong as usual. No more noise or cry when urinating.

    8 Mar – Day 10 of the Treatment and the 2nd Vet Visit

    Side track – While waiting for the vet, we spotted Smoothie’s friends on the clinic’s board. 😀

    It wasn’t long before Dr Wendy came out to bring Smoothie in for the X-ray.

    Good news!!! The stones disappeared!!! Praise The Lord!!!

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    Dr Wendy advised us to stop Potassium Citrate but continue Baytil until day 20.

    Yay! We can’t believe Smoothie doesn’t have to go for the surgery to remove stones. God has answered our prayers. 😃

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    Lessons we learnt

    • Be observant, detect the symptoms early.
    • Do not delay the vet visit.
    • Always go to cavy savvy vet.
    • Be diligent in the care.
    • Pray. Nothing is more powerful that that.

    We hope the information we posted here may be beneficial to those who’re facing the bladder stones issue in piggies. We don’t claim to be an expert, we just shared what we did to help our piggy. Please bring your piggy to the cavy savvy vet to get the correct diagnosis and treatment. In some cases, the surgery maybe needed immediately.

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