Guinea Pigs - haematuria and dipsticks

RE: Guinea Pigs - haematuria and dipsticks

Mark Rowland — Tue, 17 Apr 2018 11:47:55 GMT

Potassium Citrate dose: 20mg/G pig PO SID

Goodluck

RE: Guinea Pigs - haematuria and dipsticks

Martin Atkinson — Tue, 17 Apr 2018 09:00:57 GMT

Erm...back to the OP.

Latest update, piggie was booked in for Wednesday for cystotomy but was presented as an emergency yesterday with profound haematuria. We would have had to cancel another urgent op if we'd performed surgery but I sedated and X-rayed him and low and behold, there are only 6 visible calculi in the bladder and none visible in the ureters or kidneys so he is obviously passing them. After a long discussion with the owner over relative risks we elected to keep him on antibiotic and meloxican, gave him some SC fluids and see if he'll pass the rest. This is a bit of a between a rock and hard place strategy.

The owner had done some research and looked at the relative calcium levels in foodstuffs and elected not to feed any more brassica and kale which she says are high calcium greens. Not sure how relevant this is but it can't do much harm.

RE: Guinea Pigs - haematuria and dipsticks

Arlo Guthrie — Tue, 17 Apr 2018 07:28:18 GMT

[quote user="David Mills"]Well abuse is a bit strong for someone throwing dicks about, and what was actually said, but hey ho, there we go, agreement on most other things. [/quote]

[quote user="Mark Rowland"]I hope we can do it better.

Cant be too hard [/quote]

An entente cordiale, I hope

RE: Guinea Pigs - haematuria and dipsticks

Mark Rowland — Tue, 17 Apr 2018 01:04:23 GMT

Dicks were only thrown in response as you totally know.

I hope we can do it better.

Cant be too hard

RE: Guinea Pigs - haematuria and dipsticks

David Mills — Tue, 17 Apr 2018 00:32:24 GMT

[quote user="Mark Rowland"]

Well David perhaps you should try to see things from the other side ( with respect).

What boils my piss are dissmisive comments sometimes interspersed with personal abuse based on no evidence or indeed fact whatsoever.

I am happy to give detailed answers and receive comments on any issue here as long as they don’t invoke the above. We all of us have skills, experience and post grad qualification in many disciplines on this forum. I’m not forcing or asking anyone to take my advice but it makes me reluctant to detail it if I’m going to be abused for giving it.

I think and hope that I’ve always tried to be more than the “well you need bloods ct mri ultrasound X-rays “ crowd simply because the discipline I choose has more of the low paid clientele as its source of questions. Its a dilemma I face daily many times. I hope I try to give practical solutions. Perhaps I don’T always. Thats for me to work on.

Taking a guinea pig really deep for anaesthesia still does not eliminate local reflexes. I think that the risks of complications in these cases outweigh the benefits of something like a cysto with its associated potential morbidity. So I choose not to do it. The VDS would defend you I’m sure. I choose not to go there. And yes the bladder in these guys is small and very painful. I’ve seen g pigs seizure with the irritation of skin parasites so I would have to really establish a need.

As for evidence I agree I wish there was more The simple fact is that studies fall short of those for dogs and cats thats why I pump mates for info at conferences. I choose to share this and it may seem as if I’m preaching with no studies to back me up. Trust me there is diligence though. If I had the cash to turn them into studies I would. But I don’t

But that’s just me :)

best Mark

[/quote]

Well abuse is a bit strong for someone throwing dicks about, and what was actually said, but hey ho, there we go, agreement on most other things.

C'est la vie.

RE: Guinea Pigs - haematuria and dipsticks

Mark Rowland — Mon, 16 Apr 2018 23:37:29 GMT

Well David perhaps you should try to see things from the other side ( with respect).

What boils my piss are dissmisive comments sometimes interspersed with personal abuse based on no evidence or indeed fact whatsoever.

But that’s just me :)

best Mark

RE: Guinea Pigs - haematuria and dipsticks

David Mills — Mon, 16 Apr 2018 21:30:45 GMT

[quote user="Mark Rowland"]Anaesthetised dog and cats will from time to time shake their heads or scratch their ears during Aural examination something I am sure we have all seen[/quote]

Yes and what's the answer? They are obviously not truly anaesthetised, not deep enough if you like.

[quote user="Mark Rowland"]Local skin reflexes are very present in Guinea pigs hence why I put local[/quote]

Not what you said originally. It was something dismissive like "not a good idea to put a needle into a small sore bladder". Completely different.

Problem is with all this is clarity and overly short posts. They appear dismissive and high handed, something, like bags on seats on trains, boils my piss when someone who knows more about a subject appears to expect people to just take them at their word. I may be a lot of things on here, but if people want an opinion clinically I don't rile if they then ask for evidence.

RE: Guinea Pigs - haematuria and dipsticks

Mark Rowland — Mon, 16 Apr 2018 11:45:35 GMT

Anaesthetised dog and cats will from time to time shake their heads or scratch their ears during Aural examination something I am sure we have all seen

Local skin reflexes are very present in Guinea pigs hence why I put local blocks in during routine flank ovariectomy.

From the X-ray, as I suspected the bladder is very small. With a perfect hit the yield would be less than 0.1mls and contaminated with blood from the needle entry so little is achieved and yes there is a risk of organ puncture which can be devastating in small hind gut fermenters

wrt the radiograph:

This is not the normal presentation for G pig urolithiasis where large solitary stones are more common. If there are multiple large stones, the ureters are usually involved. Here there is a sabulous nature to the condition with calcified deposits in the pelvis and proximal ureter of one (or both) of the kidneys.

A good DV is required here if for nothing else to ascertain renal size as I suspect there is an end stage kidney here.

If the piggie is well and bloods are ok I would consider a nephrectomy based on further radiographic evidence of an end stage or calcified kidney. Otherwise an option would be too hospitalise this pig for fluid therapy to get a flush going over a cystotomy. Lots of pain relief (including opioids) and covering antibiotics could be administered at the same time.

Do this for 4-5 days then rexray and that will establish a need for further intervention or not.

If you have a good ultrasound probe then that would help too to gather more information.

If you manage to clear the deposits, longer term potassium citrate therapy will help to reduce urinary calcium. Plus encouragement of fluid intake and reduction of calcium in diet

If you rexray, can you include a good lateral head so we can get a look at the frontal bone?

Thats just what I would do anyway.

Goodluck

RE: Guinea Pigs - haematuria and dipsticks

Alistair Graham-Evans — Mon, 16 Apr 2018 07:42:47 GMT

I'd be interested to learn from the issues and outcome in this case.

RE: Guinea Pigs - haematuria and dipsticks

Mark Rowland — Mon, 16 Apr 2018 00:09:36 GMT

Sorry Martin

i Will pm my interpretation. There are some issues here

Best

Mark

RE: Guinea Pigs - haematuria and dipsticks

Mark Rowland — Sun, 15 Apr 2018 22:14:53 GMT

Based on evidence?

Trust me its good advice :-)

RE: Guinea Pigs - haematuria and dipsticks

David Mills — Wed, 11 Apr 2018 02:30:36 GMT

[quote user="Mark Rowland"]

They often react even when anaesthetised

[/quote]

Anaesthesia is defined as insensitivity to pain.

So by your definition the reaction is because they're...small...or inadequately anaesthetised (i.e. sedated). Or is it neuo? v odd if so.

Bladder on x-ray looks quite easily accessible by needle to me, no different to dog or cat, no overlying structures.

So. Is your advice based on any evidence, because this seems pretty black and white...

RE: Guinea Pigs - haematuria and dipsticks

Martin Atkinson — Tue, 10 Apr 2018 13:12:48 GMT

This is for Marie or Mark: Update on this piggy. I sedated him today but a) couldn't catheterise him despite Marie's instructional article and didn't want to force it and b) bladder was empty anyway. However we did see a dozen of or so small urinary calculi with a couple in a ureter on a plain radiograph. I will now see if the owner wants a cystotomy.

However there was a plug of creamy caseous material that I milked out of his penis. Questions: is this normal in Gn Pigs or likely part of the problem? - on a microscope slide there were no crystalline structures like you'd get in a cat urethral plug just amorphous material. At the moment he his asymptomatic - is it wise to just get on and remove the stones or leave them and see if they cause ongoing issues - there is still a persistent haematuria. There appear to be calculi in at last one ureter as well (they don't show on the DV view so can't tell which one). Owner is now concerned that that will be more of a limiting factor and wondering if its worth removing the bladder stones.

RE: Guinea Pigs - haematuria and dipsticks

Emily Rainbow — Thu, 05 Apr 2018 22:58:19 GMT

Put them on an inco-pad that’s upside down so it’s waterproof if you want a urine sample for cytology.

RE: Guinea Pigs - haematuria and dipsticks

Mark Rowland — Thu, 05 Apr 2018 19:32:50 GMT

Not sure I would cysto, the risks of morbidity are quite significant. Most pigs urinate when you gas them anyway so sampling is fairly easy. I would attach more significance as Marie has said to Ultrasonography and radiography and not stick needles into hind gut fermenters with a small sore bladder. They often react even when anaesthetised

Goodluck

RE: Guinea Pigs - haematuria and dipsticks

Martin Atkinson — Thu, 05 Apr 2018 16:09:59 GMT

Thanks Marie as ever.

RE: Guinea Pigs - haematuria and dipsticks

Marie Kubiak — Thu, 05 Apr 2018 15:19:14 GMT

Urine dipsticks pick up haemoglobin oxidation activity so porphyrins will not cause false positives and plant oxidative enzymes don't cross into urine (though apparently E.coli infections can result in oxidative compounds in urine and false positives). I would cysto, repeat rads if not done recently as stones can form secondarily and scan bladder if you have a decent probe looking for irregularities in the wall and crystalline debris. if truly cystitis they can have horrible necrotic bladder lining and often require flushing and long-term analgesia, diuresis and management to clear. Paper attached on catheterising if you need to go down this route, it isn't too bad, other than working out which of the holes you catheterise if you haven't done one before!

Marie

www.vetsurgeon.org/.../2007_5F00_LabAnimal_5F00_gpig_5F00_catheter-_2800_1_2900_.pdf

RE: Guinea Pigs - haematuria and dipsticks

Clive Ansell — Thu, 05 Apr 2018 11:35:36 GMT

maybe ga or sedation to get a cysto sample, and radiograph to exclude uroliths at the same time

RE: Guinea Pigs - haematuria and dipsticks

Martin Atkinson — Thu, 05 Apr 2018 10:49:08 GMT

Both good replies but can only get odd drops of urine at the moment - of course the pig peed in its basket immediately after it was put back and soaked into the newspaper. How do you get a sterile sample from a Gn Pig? I presume its possible to catheterise or cystocentese but not sure how much risk and if it can be justified.

RE: Guinea Pigs - haematuria and dipsticks

Michael Woodhouse — Thu, 05 Apr 2018 10:39:54 GMT

Cytology for red cells?

RE: Guinea Pigs - haematuria and dipsticks

Clive Ansell — Thu, 05 Apr 2018 10:39:39 GMT

Maybe microscopy of a spun sample to look for erythrocytes in addition to C&S?

I'm sure Marie or Rodney will be along soon with there usual good advice.