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Discussion Starter · #1 ·
1. Little hedgehog's activity has decreased in the past week, from running 7-9 km per night to one night of running 4 km and all others running 100-200 m. All other activity seems normal.

2. This morning, I found urine crystals on his wheel.

From the archives:
- that it might result as urine evaporates off the wheel. This doesn't seem that likely to me as I found them in a puddle of urine.
- that cranberry-rich dry cat foods can help, but one of little hedgehog's blend already contains cranberries.
- that it's a major problem for cats. Specifically, male cats that consume a cat food that isn't "low ash." None of the foods in his mix list ash as an ingredient, but apparently (it used to be that) any food that doesn't market itself as "low ash" is actually high ash.

Does anyone have an experience, knowledge, or advice to contribute? This will likely be a vet-visit problem, but the more information I have, the easier it is for me to advocate for my tiny friend.
 

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Discussion Starter · #2 ·
Doing the research-rounds on this, it looks like the cause impacts the crystal shape, so I probably need to get a fresh urine sample under a microscope to figure out problem/no problem.

The link between ash & urine crystals is apparently debatable. Ash is all the trace minerals, and is higher in more meat (no-grain) kibbles than ones with lots of grains, and is higher in dry foods than wet foods. [from a cat-food forum] Instead, the newer thinking is to have low phosphorus (low in fish), and lots of water (wet food instead of dry kibble).

This seems in-line with G&P's experiences with Sophie and the numerous posts about switching off a dry-kibble diet. My small friend has previously rejected efforts at wet food, but I guess we're about to explore where we can compromise...
 

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Uh oh! No advice, just wanted to wish your little guy well. Definitely keep us posted on what the vet says!
 

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Discussion Starter · #4 ·
I asked my vet if this was a "change diet, wait to see what happens" problem, or a "vet, NOW!" problem. The answer he gave me was quite interesting, so I'm adding it here for future archive-diving reference.

TL;DR? "Bring hedgehog & pee sample to vet on next business day."

Urinary crystals/stones are a metabolic disease, meaning that if a patient is predisposed to it, and the conditions are right, then they form, otherwise they don't. The most common predisposing factors are infections, urine pH, and diet. Diet can further be broken down into it's influence on urine pH, water intake, and RS coefficient, which is in turn influenced by the mineral contain and ratio of the diet and affects the urine's saturation with minerals which may crystallize out of solution into stones or sand (crystals).
So, its not just water intake, but inappropriate diet does have a lot to do with it.

Some types of stones/crystals can be dissolved with diet while others can be prevented with diet, but not dissolved. The way to approach crystalurea is to do a urinalysis on a sample which allows us to assess the urine composition, identify the crystal type and check for concomitant infection. We should also do a radiograph to rule out bladder stones as they can exist with or without crystals in the urine. Then we ca treat the underlying problem (diet) and the urgent problem (rocks +/- UTI). If an infection is found we can also culture it to identify the organism and find out what antibiotics will work best.

So, I'd suggest coming down to the clinic and letting me sort it all out. Passing stones/crystals is no fun, and if one gets stuck and causes a urinary tract obstruction, the prognosis isn't great. It is hard enough to deal with in patients <1 kg .
In other news, tonight's pee was totally normal with no visible crystals.
 

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Discussion Starter · #5 ·
So, part of performing a urine analysis requires collecting a fresh, uncontaminated urine sample. My little friend is not nearly as cooperative as Herisson's legendary 2009 of story of "pee on command,", and he isn't litter-trained so I couldn't opportunistically collect his nightly deposit. I tried leaving wax paper on top of his liner where he usually pees, but he thought the crinkle sounded too weird and boycotted it. I really didn't want to have to go the sedate & needle-extraction route, so I had to get creative and exploit my small friend's particular repetitive behaviours.

To get my sample, I woke him up this morning, gave him a foot-bath, then deposited him in a sterilized, empty bin. We put a heating pad on low under the bin so he wouldn't get too chilly while waiting. Eventually, he did his traditional post-bath two-poops & a pee, with his humans standing watch to snatch the solid waste before it contaminated the urine. We took him back out, gave him cuddles & mealworms, made sure he was dry, and sent him back to sleep until his afternoon appointment.

For urine analysis, samples need to be fresh (<30 min), or else refrigerated (<24 hours). Refrigeration can cause the growth of a particular type of crystal, but it's visually distinct from the ones that grow in situ (ie, the ones that started this whole adventure). Collecting urine as the hedgehog extracts it is a "clean catch" sample, with the upside of being less traumatic to get, but downside of being more easily contaminated.
 

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Discussion Starter · #6 ·
I was so distracted by the ziplock of hedgehog-pee in my fridge that I forgot to do the "How's my little friend doing?" update.

Activity continues to drop -- 10m stroll last night on his wheel. When directly handled by his humans, he still happily explores, naps, tugs on pants, and gobbles mealworms, but seems "off." Nothing that can be directly pinpointed, but like everything happens a little slower with a little less gusto.

Eating and drinking continues as normal. Offerings of babyfood (pea & carrot; turkey & vegetable) were totally ignored. Between evaporation and drinking, he drank 20g of water and 5g of cranberry juice (a vitamin C source to increase pee acidity, helping combat some infections). Kibble-consumption was dead-on normal (5g), and he happily munched 3 mealworms last night, and 1 this morning. Related waste looks totally normal (with no more crystals or even suspicious twinkling), and weight remains in his steady 430-445g range (last night was 436g).

I wish I had photographed and collected the original urine crystals instead of noticing them, then merrily cleaning out his wheel anyway. Apparently, my analytical nature doesn't show up until after the first mug of coffee... I'm relieved to have one distinct, if fleeting, symptom to target instead of the amorphous, "His activity is dropped and I don't know why." (And will be more relieved when that odometer starts knocking off the kilometers again!)

When checking with the vet about if I should do minor dietary changes (offering wetter food & cranberry juice) and wait for a reoccurrence of the crystals, his response was, "Wait and see are the most dangerous words in vet medicine." Which, given the oft-repeated advice that hedgehogs can go downhill really quickly, is enough to feel like I'm being responsible instead of hyper-paranoid by running off to the doctor with so few repeatable symptoms.
 

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Discussion Starter · #7 ·
So, apparently urine crystal are microscopic, only identifiable to us as twinkling in pee, while stones are the macroscopic crystals that we can see naked-eye. Therefore, little hedgehog passed a stone on Sunday, not urine crystals, and the thread subject is minorly misleading.

The vet decided to anesthetize little hedgehog to take some xrays and look for stones. Apparently, in the last 4 months, little hedgehog has transitioned from "slightly underweight" to "slightly overweight," so it took multiple attempts to gas him as he refused to fall asleep. In xray, we saw no stones, no mineral buildup, or anything else. His penis did not suffer any damage from passing the stone.

Because I have such strong records that indicate a decrease in activity, the vet prescribed us a painkiller, Buprenorphine. It's chemically similar to morphine, but stronger and longer-lasting. When used in humans, it leads to the same colourful, intense, surrealistic dreams as morphine, so little hedgehog will be having interesting naps. We're doing 0.04mL per 12 hours for the first 5 days, then decreasing to 0.02mL per 12 hours for the next 12 hours. If activity increases while on the painkiller, fantastic, he passed the stone and life is lovely. If activity drops back off after the painkiller runs its course, bah humbug, an ongoing problem is continuing to cause pain and we go back for more diagnostics.

As for why he had the stone in the first place...
...if a hedgehog is predisposed to forming them, AND he is eating a diet with an inappropriate mineral balance, stones can form. Both situations have to happen.

So, our mix is not good for our particular tiny friend. In addition, we've been instructed to drop 8-10% of current bodyweight. The current plan for his new food mix will be a low-fat cat food (Blue Buffalo weight control); the vet is pushing a insectivore kibble popular with zoos (Mazuri insectivore), but the ingredient list has me pretty unhappy. Amongst other options, porcupine fats just seem like a downright demented thing to feed a hedgehog!
 

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I didn't know the bit about the difference between crystals & stones, so that's very interesting to learn.

I hope the painkillers help him feel better and that the stone was the only problem! Poor little guy. I wish it had been just the weather bothering him, but I'm glad he has such an observant human who caught the real issue. Good luck with the diet change!

Edit: Meant to add, agreed on the ingredients for Mazuri. I will never understand why vets don't do more research into food ingredients before they start pushing them at people left and right. :roll: I know they only have so much time, but...seriously, do a LITTLE reading before telling all of your patients that [X] is fabulous for their animal.
 

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Discussion Starter · #10 · (Edited)
When I pushed about the food (because, having never heard of it, I had a sneaking suspicion there was a reason why...) I asked why he was recommending it, and he said he'd looked it up on a zoo forum, and that it was popular with feeding zoo hedgehogs.

Which, if you're going to do research on the nutritional guidelines for an exotic pet, looking to what zoos do seems fair enough. Until you realize that some of the zoos mix it with Friskies, and that they describe their animals as "mildly obese and moderately active." Even more fun, the zoos list hedgehog lifespans as shorter than what owners report as hedgehog lifespans. So, I get why he recommended it, but I'm not filled with a great deal of confidence. He also said that most of the other hedgehogs that see him (about 50/year) eat low-fat cat foods, not the insectivore meals.

8-10% weight loss isn't a big deal, especially as we were on a deliberately high-fat diet with a kitten mix and an excess of daily mealworms. At the moment, I'm thinking of ignoring the specific brand food suggestion, transitioning out the kitten food and in the weight control food over the next month, then switch out the normal-foods for another diet food next month. After all that is sorted out, I'll try again with the babyfoods (ignored on every introduction thus far), and introduce a few different insects (crickets were a torturous failure, but maybe bloodworms will succeed...).

Edited to add:
The first vet we visited for mites in the springtime really bothered me with how he physically handled my hedgehog, and lost my trust when he pushed Invectin. When I had to argue for Revolution, teach him that it had different concentrations in the cat vs dog formulations, and do the dosage math for him, I realized I couldn't go to him with any health problem that I wasn't already confident of the answer.

So this time, I went to a different vet that I know from reputation is caring and competent, but can push for more expensive treatment options. I was dismayed to learn he considers it standard-practice to anesthetize hedgehogs for every exam, but otherwise he's clearly comfortable and keeps up-to-date on best-practice as well as he can. He took a long time explaining the xrays to me and talking through what he saw. But the instant default to recommending an insectivore diet, skipping the urine analysis, and skipping over any drug side-effects (yay for being an obsessive researcher!) again leave me feeling like I better be a hyper-vigilant advocate on behalf of my quilly friend.
 

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Discussion Starter · #11 ·
Oh! And because I thought it was interesting, one of his xrays:


Head is to the left, tail is to the right.

The grey shades are effectively density contrasts: black is gas, white is bone. Organs are the brighter grey, while the darker grey is skin and fat. Of course, his testicles are making it difficult to see his bladder, because that's my boy...

As for the whole, "My boy is slightly fluffy..." weight-issue:
- he balls up tight just fine.
- his skin doesn't look tight
- he has no fat-folds (on legs, chin, whatever)
While it's normal for hedgehogs to be slightly round and have that skin-fold along their ribcages, his fat-skin layer is apparently thicker than it should be. This is noticeable when holding him because he has a squishy side-belly, but it's pretty minor.
 

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Discussion Starter · #12 · (Edited)
I woke up to that dreaded of sights: a completely clean wheel, with no poo or pee anywhere in his cage.

It's been 11.5 hours since last time he produced waste, but it all looked normal. I'm going to (temporarily) write this off as a side-effect of a disrupted schedule for being woken up one million times yesterday, being sedated, and being on new drugs. He gets woken up in a half-hour for his next dose of painkillers; I'm debating if I should give him a morning foot-bath to encourage pooping, or wait until tonight (his usual habit). I think I'll wait until tonight to disrupt him as little as possible, as changes in his routines could impact his behaviours, extending this whole bout of confusing misery.

Vet-instructions are to give tiny friend painkillers every 12 hours. This guarantees I'm disrupting his sleep. The alternatives are to skip a dose (so the painkillers would wear off, leaving friend uncomfortable), or catch him at wake-up and bedtime (which is less than 12 hours apart for tiny friend). For now, we're doing the regimented clock, and I'll get a chance to poke little hedgehog to ensure he's actually alive.

...I hate this.


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Eating & drinking remains normal:
regular (old) kibble mix: 8g (tiny bit more than usual, but within normal variation)
new (diet) kibble: 0g (I'm going to keep offering both, but not push the switch until current health issues are resolved)
water (drinking + evaporation): 26g
cranberry juice (drinking + evaporation): 11g
 

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Has the vet not done a urinalysis? If not, what is the reasoning not to? The urinalysis will show crystals, bacteria, infection, blood etc. If I remember correctly, the urinalysis will also show what type of stones are developing. As they pass a stone, it irritates the urinary tract usually causing bleeding and often starts an infection which could be treated in it's early stages rather than waiting until there is blood showing.

A urinary health food changes the ph of the urine making it less hospitable to infection and is also designed to help prevent crystals and stones. I'm surprised the vet didn't suggest one rather than mazuri which is not a good food and most hedgehogs won't eat it anyway.

Poor little guy. Stones are painful. Our Kenya used to get them and we always knew when she was going to be passing one as she'd sit at the bars of the cage and huff. We found one and I don't blame her for huffing. I would huff too passing that.

Hugs to your wee fellow.
 

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Discussion Starter · #14 ·
Nancy: Thank you for chiming in. I've been debating PMing you, but it feels silly with the, "So, symptoms are... nothing?"

I delivered a urine sample, collected as instructed, treated as instructed (refrigerated), within the timespan allotted (told 24 hours, delivered within 6 hours), and then was told it was too old to be useful (more than 4 hours). They attempted to extract urine from his bladder, but couldn't since it was empty.

I'm really doubting myself, that I saw a stone when I thought I saw one, and that it wasn't some artifact of blurry morning-eyes and evaporation on a dark-coloured wheel, or ... I don't know what. An inability to come up with alternate hypothesis is part of what is driving me crazy.

At the moment, I'm going to keep giving the painkillers tonight and hope for some activity (since yesterday was a wash between disrupted sleep & sedatives). If he doesn't produce new waste (still nothing, now for roughly 18 hours) and doesn't run, I guess I make another vet appointment for Wednesday. Of course, the question then is do I go to the first vet, who is nearby & I had to argue with for mite-treatment, or the second vet, who I went to yesterday, gave me instructions he later revoked, and I argued with about food?
 

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I've only had confirmed stones with one hedgehog and another probable but not confirmed. If those two were typical, passing a stone is accompanied by blood. Kenya suddenly started peeing what looked like pure blood. I would think you should have seen some blood. Kenya's stone was obvious. It was a little granual grey/brown about the size of a small pin head sitting in the middle of a pool of blood red urine on white paper towel.

If he were mine, I would get a urine sample and take it into the recent vet and see what is found. I'd also start giving a bit of a urinary health food with his regular diet. I keep a couple cans of Hill's C/D on hand to immediately start anyone who shows blood to get a jump start if it turns out to be a urinary issue. Kenya was on Medical Dissolution but her stones were confirmed and a dissolution formula should not be given unless stones are confirmed.

I like white or light coloured wheels. Dark wheels are good at camouflaging any blood or off coloured urine or feces. With a dark wheel, your little guy might have had a blood tint that you were unable to see.

:)
 

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Discussion Starter · #16 ·
Again, thank you. Co-keeper was arguing that we should give the drugs a chance to work, while I was arguing that we learned absolutely nothing yesterday, and the drugs are painkillers so treat symptoms but not causes. Now I have Internet Person on my side, but an Internet Person who has extensive hedgehog experience compared to our 9 months of experience. ;)
 

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Discussion Starter · #17 · (Edited)
Woke up my tiny friend, gave him his painkillers (which he accepted without needing the syringe jammed in him this time, thank you little hedgehog!), then accidentally scorched him with a too-hot footbath. Cut the bath short (less than a minute) after realizing the temperature problem, and still feel guilty.

His post-bath ritual of creating messes produced a nice, healthy poop, but not the second poop, and more worryingly, no pee. I now have him on my lap, hoping he'll leave a smelly wet spot. :(

Weight is 436g, dead-on normal for him.

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He slept in an enclosed fabric hut last night with fleece strips that makes it difficult to spot pee-circles, but he smelled a bit like he peed on himself during his sleep. Assuming he didn't, he's at 24.5 hours since last confirmed urination.
 

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Discussion Starter · #18 ·
Squishy poop with a tiny bit of clear mucus, followed by eating (normal mix; he is continuing to boycott diet food), drinking, taking a 20 m run on his wheel at real-pace, and a teeny, tiny pee. Now he's back on doing the clunky half-run he's done during the week thus far.

Oh, little hedgehog, why do you give me a new reason to worry at the same time you're giving me a tiny bit of relief? I'm guessing it's just the painkillers coming into play, but I'm so hopeful to have a real solid run while we're sleeping tonight.
 

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Discussion Starter · #19 ·
Little hedgehog ran for about 2 hours last night in his slow, "something is wrong" gait that is only slightly faster than a walk, but he did run! He also managed to wiggle his wheel off the odometer, so I can't report distance.

He peed again, smaller volume than normal, and too saturated-yellow. Again, no second poop of the night.

Regular kibble consumption: 7g
Diet kibble consumption: 0g
Cranberry juice (drinking + evaporation): 5g (fairly certain this is 100% evaporation)
Water (drinking + evaporation): 21g

Talking to the vet again:

Skip the next dose of bup and let me know if there aren't any bm (bowel movements) by morning

The bup dose might be too high for him. It is a moderate dose, but if his liver isn't working normally it could increase the functional dose.

Also, I was reviewing his xrays with a colleague today and he thought the colon looks a bit full. Could be some constipation, often seen in urinary cases because the often get dehydrated. If he eats cucumber, that's a good way to rehydrate these little guys.
I didn't have a chance to tell him that we've already been skipping the morning dose, on the premise that if little hedgehog is sound asleep, waking him up to give him painkillers so he can sleep seems counter-productive. For the past two days, medication has been 0.04mL at night only.

So, we're heading back in to the vet today, this time with a full bladder, and I'll likely give him a foot-bath at the clinic to collect an on-site sample.
 

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Discussion Starter · #20 ·
And more from the vet:

That's an improvement over 100 m but still abnormal. Let's give him 1/2 the bup dose tonight (0.02mL) and offer some lettuce and cucumber and see if we can super-hydrate him. Some diarrhea may occur if he eats too much, but it's not terrible. If diarrhea and reduced energy persist 24 hrs I can give you medicine to resolve out.
So I guess little hedgehog gets to sleep away his afternoon uninterrupted (no vet visit), while I go shopping for the wetest fruits and vegetables I can find.
 
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