Uroliths in guinea pig

RE: Uroliths in guinea pig

Gillian Mostyn — Sat, 25 Feb 2017 12:57:17 GMT

[quote user="alibali"]But actually can only advise owner of my opinion.[/quote]

No, you can do more than that if the welfare of the GP is at risk.

[quote user="alibali"]It is her decision.[/quote]

Yes, but you can make it very clear that you feel she is being cruel and selfish. I have used those terms with clients on rare occasions, when 'normal' discussion fails.

[quote user="alibali"]I don't think it was unreasonable to medicate and syringe feed him in attempt to improve his chances of surviving surgery.[/quote]

For a few hours or a day maybe. Any longer than that is, IMHO, wrong.

I doubt anyone would leave a dog or cat in such pain! Exotics owners can be the worst for allowing little critters to suffer, with the excuses ranging from poor anaesthesia risk and costs to 'he doesn't seem to be suffering' because they don't howl and scream in pain.

I know you're doing your best for this little GP, and that is great, but allowing the owner to dictate the timescale for a decision is not reasonable in this patient.

RE: Uroliths in guinea pig

alison silvester — Sat, 25 Feb 2017 12:40:33 GMT

Totally agree. But actually can only advise owner of my opinion. It is her decision. Has been poorly compliant in returning for checks and administering the medication when dispensed and has realised now far too late how sick he is. He is on melox and bid and vetergesic bid so is at least better pain releived while she considers the options(now after these replies euth or ex lap with grave prognosis). I don't think it was unreasonable to medicate and syringe feed him in attempt to improve his chances of surviving surgery.

RE: Uroliths in guinea pig

Gillian Mostyn — Sat, 25 Feb 2017 12:16:32 GMT

[quote user="alibali"]9 months later has these so IF he survives surgery and IF we succeed in removing these will they recur?! [/quote]

Probably.

Whether they will or they won't, this poor animal is suffering terribly with every day that goes past, and has probably been suffering pain for most of the last 9 months. It is now fairly emaciated and, in my honest opinion, needs surgery with significant analgesia and post op support, or euthanasing, ASAP. I wouldn't be leaving it another 12 hours, let alone another few days, while a decision is made.

RE: Uroliths in guinea pig

alison silvester — Sat, 25 Feb 2017 11:44:44 GMT

I have had this conversation with the owner. When he was xrayed last year he had tiny stones some of which were passing or passed. And nothing present at the pelvis. She then made all the advised changes to his diet to reduce calcium intake and 9 months later has these so IF he survives surgery and IF we succeed in removing these will they recur?!

RE: Uroliths in guinea pig

Sarah Keir — Sat, 25 Feb 2017 10:45:36 GMT

Any thoughts on how to prevent these in future as I've had piggies that I've removed stones only for them to reform within a short period of time. If we can't prevent the same situation occurring again perhaps these should be straight to euthanasia?

RE: Uroliths in guinea pig

alison silvester — Fri, 24 Feb 2017 21:53:54 GMT

Thanks everyone. Thats kind of what I thought. I do have a DV view which I cant seem to upload but just confirms those opacities are within the pelvis.

I kind of feel as frail as he is surgery is just going to be a long winded euthanasia! Had hoped his appetite and weight might improve with pain releif and supportive feeding and make him a bit stronger for surgery.

As a total side issue I am pregnant and usually would use domitor/ketamine/vetergesic with mask isoflurane. To avoid gas is there more reliable injectable GA combinations or should I nominate a colleague!

Thanks again,

Alison

RE: Uroliths in guinea pig

Marie Kubiak — Fri, 24 Feb 2017 19:57:19 GMT

This doesn't look good.

The bladder stones are straightforward to deal with but, as Glenn says, the urethral ones are a bigger problem as they are difficult to access and stick fast. You can try and retropulse them, try and grasp them through a cystotomy incision with some long, fine forceps but many are impossible to retrieve this way. I have contemplated a pelvic split in a couple of similar cases where a more conventional approach failed but couldn't convince myself that it was in the animal's interests to do something so major that would have long-term consequences and pain. Both were euthanased instead.

Incidentally you probably also have a distal urethral stone- might be worth palpating/repeating rads with legs draw back if you opt to treat and can't find it, just in case it is an osteophyte in the stifle instead.

Marie

RE: Uroliths in guinea pig

CatherineThomas — Fri, 24 Feb 2017 19:51:15 GMT

I agree that this is likely to be a poor prognosis and i'd doubt medical treatment will do much more than keep it going very short term until you can operate or pts.

I've always found catheterising male guinea pigs to be really fiddly so give yourself plenty of time and catheters. Maybe one of the others will have some tips. Otherwise a normal cystotomy is quite straight forward. I think I would ga, place catheter and radiograph with contrast to see if you can get a better idea of where those pelvic densities are and if they are causing a blockage. Then go straight in for cystotomy with retropulsion unless it looks horrible. But i'm not sure of your chances of it being successful so would make sure the owner is aware of very poor prognosis.

RE: Uroliths in guinea pig

Glenn Hodgson — Fri, 24 Feb 2017 19:22:48 GMT

Evening.

That looks like bad news..

I'd take a dv radiograph too if I were you as might get a bit more info for little risk.

I've had one that looked like this on radiography and the surgery was extremely challenging. I think you have bladder lumen stones and 2 others which are very likely to be adhesed (like araldite, not Wilco copydex) within the proximal urethra /trigone. I do not think this is calcification of soft tissue.

Options: Give owner very poor prognosis and inform the options are euth or surgery. IMO medical management would be for the owners benefit not the guinrapigs. If operating I'd do it very soon and have plenty of catheters ready to attempt retropulsion.

Good luck!