Bladderstones and Sludge

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pinta

Post   » Tue Jan 22, 2002 6:34 pm


This information on bladderstones is from Karen Easley, 8/14/99, (reprinted with her permission).
Karen Easley <keasley@hms.harvard.edu>


I have actually been
very interested in this subject for the last year, since my piggy, Butie,
had 2 stones last year. One was removed by surgery and the other was close
enough to the tip of his penis that the vet was able to flush it out. He
did very well this past year after we made some major dietary changes and
had him on a medication called Polycitra syrup, which is used for human
stone treatment. Unfortunately, our little Butie died on August 1st, but
from the preliminary autopsy results, it may have been an urethral plug and
not a stone that was the cause of his death. It came on very suddenly, so
it was quite a shock to us. He was 5 1/2 years old, so we&acute;re glad we were
able to share our lives with him for so long, but it&acute;s never easy losing one
of our little friends. We have many happy memories of him, which helps
console us during this sad time.

As far as the subject of bladderstones, let me tell you about my
experience. When I tried to find out how to stop the recurrence of these
stones, my vet told me that they really didn&acute;t know what causes them and
that lowering calcium in the diet was the recommended course of action.
She&acute;s an exotics specialist and is very knowledgeable about gps. I found it
frustrating that even people who are considered experts really don&acute;t know
how to prevent these animals from forming stones. I decided to see what I
could learn about the subject and with the help of a guinea pig knowledgable
friend of mine (Tex Green, tex@cavyinfo.com) and several other members of a
listserve I belong to called the GPDD, we started the Bladderstone
Project in the beginning of August 1998. We have also solicited the help of
several professionals to help us interpret the information we come across,
including several vets (mine included), an animal nutritionist, an
herbalist, and a rodentologist from the UK.

It seems that the more information we find, the more we learn that this
is a pretty complicated issue. Sometimes stones are found
along with bladder infections and sometimes they are not. It seems that the
composition of the stone is also important in deciding how
to proceed with treatments. Did you happen to have her piggy&acute;s stone
analyzed? Was she checked for a bladder infection? Butie&acute;s stone was
calcium carbonate and he did not have a bladder infection. The girl piggy
I&acute;m fostering also had a calcium carbonate stone.

In the process of our searching, we have found other groups of people
working on the problem of bladder stones in gps as well.
Some of the information we have collected suggests that there are most
probably several factors involved in the process of stone
formation, but at this point it seems that diet/nutrition and genetics are
the most commonly cited. Another problem, at least in
humans, is that different types of stones are caused by different factors.
>From the data I&acute;ve been able to collect so far, it seems
that the stones formed by gps are predominantly composed of calcium either
calcium carbonate or calcium oxalate. Oxalates are found
in many types of foods (spinach being one) and reducing them in the diet is
thought to help prevent the recurrence of this type of
stone. I&acute;ve also learned that it&acute;s not only the calcium concentration
that&acute;s important, but also the ratios between calcium,
phosphorus, and other minerals in the diet. It also appears that stones
associated with bladder infections are not usually calcium
based, so reducing calcium in the diet in this case may not have an effect
(although it wouldn&acute;t hurt). This is why I think having the
stone analyzed is so important in determining the next step in treatment and
prevention.

Here are a couple of the suggestions I&acute;ve gotten to help prevent the
recurrence of stones:

1) Try to increase the amount of water intake, which would dilute the
urine and thus help prevent stone formation. You could
add 1 oz. of fruit juice to 16 oz. of water to try to get a piggy to drink
more. Another suggestion for getting them to drink more water
is to reduce the amount of fresh vegetables given.

2) Reduce the amount of calcium in the diet. Try using timothy based
pellets rather than the alfalfa ones. (Oxbow Hay
company makes one called Cavy Cuisine) Also, feed timothy hay rather than
alfalfa hay. I&acute;ve also been told to cut back on the
fresh veggies, because some have pretty high calcium levels. (check out
Seagull&acute;s website, http://www.aracnet.com/~seagull/Guineas/ it has a list
of veggies with their vitamin C, calcium, and phosphorus contents) Some have
suggested that the main diet should consist of water, pellets, and unlimited
timothy hay, only giving fresh veggies on a limited basis. I know of some
people who have had success with this type of diet in preventing recurrence
of stones.

_________________________________________

reprinted with Kim&acute;s permission

2/01/00

There is a drug called actigall that is used to disolve gall bladder stones in
humans and it is given to cavies as well. Vedra at the CCT has given it and my
vet has one of my pigs on it since she has problems with bladder sludge. The
problem is that no one wants to study this drug any further, so there isn&acute;t any
real cavy data available, just a lot of individual case studies. Vicki at Jack
Pine Guinea Pig Rescue has used this drug as well, she actually had a cavy with
an x-ray verified stone on a Friday, she started giving actigall and then an
x-ray the following Monday showed a stone that was breaking down. I&acute;m not
saying that this is a stone treatment, but in that case the x-ray was very
interesting. My vet gives actigall as part of a preventative measure to prevent
sludge and stone pigs from reforming these conditions. This is done in
conjuction with a low-calcium diet and trying to encourage a pig to drink lots
of water. The problem with actigall is that it&acute;s about $3 a pill (one pill is
an eight day supply). Perhaps after surgery your vet would be interested in
checking into this for you. I&acute;d be happy to provide with the contact info for
my vet.

Kim

_________________________________________

2/18/00

We had a pig who could not metabolise calcium AT ALL.

We knew there was a problem when she started to squeak when she peed.
The vet took an xray and saw that her bladder was filled with something
and assumed she had a massive stone. She went under the knife and
the vet found her bladder was completely full of calcium sludge. This was
not normal. The vet contacted the University of Saskatchewan Exotic
Department(Canada&acute;s school of veterinary medicine) and got the
diagnosis of an inability to metabolise calcium..

When the vet finally figured out the problem, she suggested
euthanising Delilah who was hunched and squeaking in pain. Then when the vet
touched her back, Delilah, thru all her misery, purred. The vet felt she was
showing enough determination to try to find a way to manage her problem.

She was put on a low/no calcium diet with the Potassium Citrate added
to help break up the calcium that made it into her system. We gave her a
pinch (amount that you can hold between your index finger and thumb)
once a day dissolved in 1 cc of organic cranberry juice. She was on this
dose permanently. She also was on baytril permanently because the
calcium that got into her system continually scraped her urinary tract
leaving her open to infection. We maintained her for 6 months before
her metabolism problems did her in at 4 1/2 years old.

Within a week of special diet et al, Delilah was back to a life of
quality, punctuated with visits to the vet to flush recalcitrant stones
out of her urinary tract. She still cried when she peed (which was
always bloody and sludgelike) but when not peeing was happy and active

The Potassium Citrate is commonly used with cats and dogs. We took a
wild guess on the dosage. The vet thinks it is a fairly benign substance
and unlikely to be dangerous in uncertain doses.

Before using it, discuss it with your vet to see if it is an appropriate
course of treatment and if you do use it, make sure that you order it
thru a vet as there are noningestable versions out there that are dangerous.

Had we known about the Actigall back then, we definitely would have tried it.

pinta

_________________________________________

Reprinted with permission from Lilly whose Sam(who suffered from bladderstones) did very well on Polycitra:

10/11/01

Sam took Polycitra Syrup, which comes in a standardized dosage. My vet spoke with another vet (from a fellow GPDD person) who explained her dosing on another guinea pig. We settled on 0.13 cc once per day, which I mixed with water to fill the 1 cc syringe. I do not know if it was helpful for Sam, but I always fed him a little starchy veggie before medicine, in case it was irritating to his stomach.

Polycitra Syrup, as I understand it, has 2 functions:
1. to alter urine to become alkaline (which in humans is a shift from acidic, but in guinea pigs has no effect)
2. to bind with excess calcium. This prevents it from binding with other excess calcium crystals that form the core of new stones. It may also help a guinea pig excrete calcium crystal &quot;bladder sludge.&quot;

Potassium citrate is the same component as #2, so I can see how that might have helped a lot.

With Sam, the vet & I compared urine samples before taking Polycitra & after being on it for two weeks. The difference was impressive. Before it, the urine sample settled into layers and the crystalline content was visible as a significant layer. After the polycitra was in effect, the crystalline content was almost entirely gone. Just before his surgery to remove existing stones, the vet took an x-ray to confirm the number and location of stones. Sam had formed a new stone in 2 days. In my vet&acute;s experience, that indicated he would likely continue to form new ones. Whether it is genetics, bladder qualities, or who knows what, some guinea pigs seem more prone to develop stones, and the ones who form new ones even while they have older ones are likely to be prone to forming stones all their lives. After the polycitra. Sam never formed a new stone (calcium carbonate).

For general reference, polycitra syrup is made by Alza corp. You can get patient info leaflets and etc. from them at: (800) 634-8977
Last edited by pinta on Tue Jan 22, 2002 6:35 pm, edited 1 time in total.

User avatar
Truffles

Post   » Mon Jan 06, 2003 2:01 pm


Polycitra sounds promising. Unfortunately my vet did not prescribe it. He prescribes Cosequin instead. It is for aching joints. He is hoping that this will coat the bladder. I left a message on his VM regarding Polycitra. Can vets prescribe this? Unfortunately it is not over the counter.

I would like to try it. I live in the Bay Area. Anybody knows a good vet that has treated sludge and stones with Polycitra?

Evangeline

Post   » Wed Jan 08, 2003 10:06 pm


I think you have it the other way around. Polycitra has been used for a while and it,s not for all kinds of stones. Sometimes it works, sometimes it doesn't. From what I understand, Cosequin is much more promissing. I would really stick to that vet and try this med instead of wasting time with something that has been proven ineffective in many cases.

User avatar
Becky

Post   » Thu Jan 09, 2003 12:04 am


Truffles, Dr. N. prescribed Polycitra for both Cookie and Chippy.

The cosequin, which I've just started with Chippy, as I understand it, is to deal with any microbacteria that might be present, but not showing up on the cultures.

User avatar
Cara

Post   » Thu Jun 19, 2003 11:48 pm


I would like to add that I have learned two things regarding Polycitra from my vet. One, don't give polycitra when a UTI is present. It promotes bacteria growth making the infection worse. Second, use caution when giving polycitra to a pig who is also taking enalapril (Enacard). There is the potential for an interaction between the two drugs.

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