It's not really feasible to rekey your UUIDv4 keyed database to int64s after the fact, imo. Sure your new tables could be integer-keyed, but the bulk of your storage will be UUID (and UUIDv4, if that's what you started with) for a very long time
If you have too many UUIDs, throw more DBs at the problem. Hopefully you haven't tied yourself to any architectural decisions that would limit you to only using a single database.
Yes, sure. My point is, it may never be necessary.