The young lady had consulted Vet 1 about her young
guinea pig passing blood in the urine. Vet 1 had
done the ultrasound and other tests which the
young lady had not kept any records. The blood in
the urine came again after a few weeks and she
consulted me.
"Was a urine test done by Vet 1?" I asked.
According to her, it was not done. A urine test is
important when the complaint is "blood in the
urine". It can tell many things as guinea pigs and
rabbits may pass "blood-coloured urine" due to
dietary causes. However the owner sees the reddish
urine and thinks her pet is passing blood in the
urine.
How to take urine from a guinea pig? For
expediency, the vet usually gives the antibiotics,
suspecting Urinary Tract Infection (UTI) and that
would be the end of it. However Vet 1 apparently
did many tests including ultrasound and had cost
the owner a bundle. When the guinea pig passed
"blood" in the urine again, she came to me for a
second opinion.
In private practice, the clinical outcome is
important. Otherwise, the owner just go to another
vet as in this case.
Passing "blood" in the urine. Real blood. I used
evidence-based medicine to diagnose this case. I
hospitalised the guinea pig. As he was peeing
"blood" in large amounts, I was fortunate to
capture his urine and sent it to the laboratory
for a proper analysis. My method is described in
the images below.
Collect urine for testing. I
used a clean plastic tray
cover under the grating and
a sterile syringe to collect
the freshly passed urine. In
this case, the guinea pig
passes lots of urine and
immediately. So I was
fortunate enough to collect
a relatively clean sample.
He also pooped and this
showed he was in good
health. Weigh the guinea pig
always. His weight was 500
g.
The next day of
hospitalisation, the urine
was no more bloody. I
collected the urine in a
syringe to show it to the
owner and for this report. I
did not test this urine to
save costs for the owner.
The 2 X-rays showed some
radio-opaque material inside
the large intestines. Two
views of X-rays are best as
one view (lateral view) may
not give a mis-diagnosis of
the material as being inside
the bladder.
The
laboratory test showed "blood ++++" in the urine
but no bacteria or white cells indicative of an
infection. So, in this case, I was able to provide
evidence to show the owner that her guinea pig was
actually passing blood in the urine.
Practise evidence-based medicine. That is the way
to earn the owner's trust. I also did 2 x-rays of
the guinea pig's abdomen. There was some
radio-opaque crescent material in the intestines.
Could this be the "metallic" rust or some
radio-dense chewing of the guinea pig? This guinea
pig loves gnawing at everything and Dr Daniel was
of the opinion that he had chewed some toxic
matter.
(Later, in one photo below sent to me on Feb 27,
2012, you can see that the guinea pig was standing
in a cage that is actually rusting)
SECOND CONSULTATION WITH DR
SING VIA E-MAIL ON FEB 27, 2012
Other than that, please be careful about over-use of
disinfectants and chew blocks that may have chemicals
inside the wood. Toxins to the kidneys due to chewing of
blocks and fence may also damage the kidney and cause
blood in the urine.
On Mon, Feb 27, 2012 at 12:59 PM, ...@gmail.com> wrote:
He loves standing this way and the plastic screen is
placed before the fence. However, what I noticed is that
he's just grabbing the top edge to stand now. (You can
see in the photo that the fencing was really rusty
and the plastic fencing was used by the owner to
prevent him from gnawing it. Later, I guessed that
the young lady went to buy a new replacement
fencing as the other photo showed white fencing
(see photo below).
THIRD CONSULTATION WITH DR
SING ON SUNDAY, MAR 4, 2012
Haematuria. "The guinea pig passes blood in the urine
again yesterday," the young lady messaged Dr Daniel and
came to the surgery. Yet, the carrier's absorbent litter
showed just yellowish brown urine but the owner
confirmed that real red blood had been passed at home.
"There are many causes," Dr Daniel enumerated UTI,
stones that were not visible on X-rays, tumours. What to
do? Go for a 3rd opinion? "You were supposed to be the
2nd opinion," she said.
So what was the cause of bleeding in the urine? Bladder
or kidney problem? Hard to say. We did not actually see
the "bloody urine" as the guinea pig came without
having passed blood in the urine in his carrier.
"An exploratory
laparotomy would be highly risky," Dr Daniel advised. The guinea pig was now
650 g compared to the earlier visit some 10 days ago.
I gave the following advices:
1. Feed the guinea pig organic vegetables, fruits and
hay for one month.
2. No treats and pellets.
3. Feed the medication as before.
"How about dried raisins?" the lady asked. "They are his
favourite."
"No raisins too."
Could raisins be the cause since the guinea pig had
recovered the next day when hospitalised at Toa Payoh
Vets and fed only vegetables and apple? Not a drop of
blood. He went home and the cage was screened to prevent
him climbing and chewing the wires (pictures given by
owner).
Photo
(left) is the photo of his new enclosure. You can see
that instead of wiring, its the blue plastic on all 3
sides within the enclosure.
In the Photo, you can see that the blue piece is before the
wiring. Also, you can see the small rubber tubing (fish
tank cleaning rubber tubing, sliced along an edge) that
I have just added to cover the top-most horizontal
wires. I noticed that he doesn't bite this material.
In the Photo, it
shows the clear plastic sheet on his
enclosure door. It is also placed before the wiring,
from Bean's perspective when he is in the enclosure.
Noted the possible toxins from the cleaning items, chew
toys and cage wirings.
Thank you!
Regards,
Name of owner
I will wait and see
whether the guinea pig is OK. "Blood" in the urine
may not be actual blood this 3rd time. The urine
could be "discoloured" urine due to the raisins
and diet. To save the owner vet expenses, I did
not advise more urine testing and sent the guinea
pig home on antibiotics and pred medication for
the next 7 days. Three days later, I texted her
and was told that the guinea pig did not pass
blood in the urine. Then on March 9, 2012, I got
the phone message below:
FOURTH CONSULTATION WITH DR
SING VIA E-MAIL ON MAR 9, 2012
Hi,
I just gave B.B a tablespoon of pellets as his
weight is 500gm now. He stopped eating the
veggies that he usually likes. I tried apples,
carrots, romaine lettuce, butterhead lettuce and
cucumbers, all to no avail. He just ignores them
or just take a few bites. His consumption of hay
has also gone down.
He's not peeing blood and since the protein
content in his pellets aren't high, I reintroduced
it. He went straight to eat it and seems to be
happier. For the past few days, he's been going to
the pellet bowl and looking into it even though it
was empty.
Sent from my iPhone
REPLY
FROM DR SING, MAR 9, 2012
Monitor n record amount n type of food daily.
Wait n see.
Comments: It seems that the guinea pig has not
passed "blood-coloured" urine since March 4, after
replacing the rusty fencing (as seen in an email
picture from the owner) and not giving raisins.
Only time will tell whether the guinea pig will be
fully recovered. The interesting aspect of this
case is that there is no way the vet can know that
the guinea pig had gnawed on the rusty fencing
till the picture was received. So, could the rusty
fencing be the cause of "blood in the urine? Rust
could damage the kidneys and cause bleeding. This
is one possible cause.
It is really difficult for a vet to diagnose this
case if the vet does not do urine analysis and
speculate that it is always a urinary tract
infection. The guinea pig is a valuable family
member to the younger generation and it is
imperative that a correct diagnosis be made and in
this case, urinalysis is mandatory. There is no
point doing ultrasound and other scanning when the
urinalysis can provide clues and is much less
expensive and more useful. But guinea pigs don't
pee a lot and it is extremely difficult to collect
the urine. Therefore, hospitalise the patient!
Tips for Dog Owners
The best time to spay your dog is 2 months after the end
of heat
TOA
PAYOH VETS
