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Friday, March 16, 2012

909. Two guinea pigs not eating - white viscous urine, blood in the urine

Yesterday Mar 16, 2012 (Friday), I saw 2 cases of guinea pigs with urinary problems and reviewed the case with Dr Daniel as part of my mentorship program.

We had met an interesting and friendly experienced Australian banker who had travelled to all over the world to work, at Liang Seah Street at 11 am today. "How old are you?" he asked Daniel. He then told Dr Daniel that 20% of the young men of his age and new graduates are jobless in Ireland. He told me that my handshake was weak, compared to Dr Daniel. "Have you been to Timbuktu?" I asked him. "No," he said. "But I have been to various places in Africa. I was sad to see so many homeless children and the poverty."

P.S
I used to study English phases in primary school in the 1960s and there is a phase referring a distant place as Timbuktu which is actually present in Africa. I doubt I have a chance to visit it. One of the guinea pig cases is written and followed up below:

Case of the Guinea Pig squirting out white cloudy urine

March 16, 2012
Not eating. Abdominal swelling obvious. The owner had seen me some months ago. "No more skin infection," she said. "My guinea pig is not eating."
Dr Daniel palpated the swollen abdomen. I did that after him. The swelling covered almost 90% of the abdomen. Soft distended bladder, in my opinion. I don't know what Dr Daniel thought. Was he thinking of ascites? Definitely, ascites present this pendulous abdomen.

Before I could speak further, the guinea pig squirted out white cloudy urine onto the stainless steel consultation table top. "The urine is not normal," I said. "I would take some for urine test." I took a new syringe to suck up some urine. The guinea pig voided much more urine. Thick cloudy liquid. As if the bladder had lots of white sand.

"Is it possible that my guinea pig has bladder stones?" the lady asked. "My other guinea pig had bladder stones. The vet removed it but then said another surgery had to be done."

"Why was there a need for a second surgery?" I asked.
"The first one was not done well," she said. "So, another one had to be done."
"What happened to the guinea pig after bladder surgery?" I asked.
"She lived for a few days and then died."
"In this case, the guinea pig might have or might not have bladder stones. We will wait for a few days and get the urinary tract infection treated first."

A follow up the next 2 - 7 days would be needed. X-rays would be needed to confirm bladder stones.

March 19, 2012

This Guinea Pig was not eating and had a grossly swollen bladder. Dr Daniel and I palpated the abdomen. Looked so much like ascites although I could feel the faint outlines of a very full bladder as big as an orange. Suddenly whitish cloudy urine dribbled out. More and more urine was released like a storm flood. I got the urine inside a syringe and sent to the lab.

Lab Results: Amorphous phosphate crystals +++, bacteria + and urine pH = 9.0.

Evidence of urinary tract infection caused by amorphous phosphate +++. So what to do now?

"In dogs, amorphous phosphate is also known as struvites. Acidify the urine or give S/D diet," I said to Dr Daniel and Dr Vanessa. "What to do for a GP with struvites in the bladder?"

The lady owner returned my text message this morning. She had left all medication to the sister who stays at home. After 3 days, the sister stopped the antibiotics as the GP was eating and drinking.

"But he sits in a corner," the young busy career lady said. "When can I send him down for another check up?" I scheduled next week. She has only one GP and believed that her sister had increased the intake of Vit C tablets to 1.5 tab/day causing the GP to stop eating.

Overdosage of Vit C can lead to kidney stones in people. In this case, the GP had a UTI. Medication was not given for a sufficient number of days.

March 26, 2012
Now, the guinea pig is crated in the Toa Payoh Vets for urine collection (see images below). The urine has been collected and tested again to check for bacterial infection. Bacteria ++ were present. No more amorphous phosphate crystals. I advised oral antibiotics again for 3 days first. The guinea pig was eating normally now.