Week 8, Fri.May.13: Quite a while since I last posted - goodness, doesn't time disappear. Things are now changing very slowly, not much is different from one day to the next, it is only when one looks back that one can see the differences.
Life is definitely easier these days. We have a schedule now, and all three of us (Raz, my husband and me) know what to expect and when. Life seems positively simple now when I compare it with a month or so back!
Raz is definitely regaining tail use, but the jury is still out as to the final percentage. He still mostly holds it with a funny left turn at the very top, but I think even that is slowly disappearing. He holds his tail out from his body now, and sometimes it is even horizontal, though not for long. He even curls it up tidily beside himself when he sits down.
He is climbing trees quite happily, and has no problem making the initial leap onto the trunk, then climbing right to the very top. We can't help worrying and standing under the tree 'just in case', but he is very agile; it is clear he is using his tail for balance. However, he still has issues jumping down - he used to take a flying leap off the trunk from about 4 ft. up, but now he carefully climbs 90% of the way down. His aversion to jumping down is illustrated in the house too - he will choose to eg. hop from the sofa to a stool, then carefully hop off the stool to the floor. We assume that this is pain-related in some way.
He is running like fury, chasing around with the other two cats. It is noticeable that he doesn't swerve and dodge with the same ease that they do, but neither does he keep in a straight line like he did a couple of weeks ago. Now he is happy to turn, crouch and spring-ambush, which usually results in a rolling over-and-over pile of fur. I can't tell you how great it is to watch. In fact, I'm sitting here typing with a foolish grin on my face remembering earlier on this evening in the garden
We went to the Vet on Wed.May.04 for a "control" visit. The vet gave him a thorough check-up and said (a) he didn't have much stool in him and (b) his bladder was in great shape, no thickening or anything (phew). But he then pulled a long face and said he didn't think the prognosis was good, and that Raz wouldn't make much more progress. Annoyingly, Raz refused to demonstrate his "tail prowess" and just let it hang like a piece of rope (grr).
The vet also said that it wasn't recommended to keep on with the Bethanocol and the Diazepam for much longer than one more week.
I tried to put him on the spot re an expected final outcome, and was amazed when he shrugged and said "I don't know". What?!?! It turns out that he has no experience with this kind of injury past the 5 week point. He said that most owners whose cats have this kind of injury just cannot cope, and that the cats were either euthanised, died of a ruptured bladder, or got a horrible bladder-thickening problem due to bad expressing technique and had to be euthanised. I was flabbergasted to hear all this and just stood there with my mouth open spluttering "But what ... but why ..." He said he hadn't mentioned it before because if one doesn't tell people what they are trying to do is difficult, then they succeed more often. I guess that's a fair point.
Anyway, we have agreed that we will take Raz to the 3-month point and then re-evaluate the situation.
We stopped the Bethanochol and Diazepam on Mon.May.09. I guess it will take a few days for them to completely leave his system. I am really interested to see how he is without any chemicals in his system.
Pee: We got really fed up with the twice-daily struggle and decided to try and analyze what was going on. We always start with a purring pussycat and end up with a snarling one, so clearly there was something going on. It turned out that what Raz had been objecting to all this time was getting pee on himself!. So now we drape a towel lined with a piece of thin plastic over his underneath leg, so not even one drop of pee touches His Majesty's fur, and all is well - no more struggles, no more arguments. How I wish we had discovered this sooner! All this time the arguments on his side were completely reasonable. We have been the stupid ones.
On a different note: when it gets near to expressing time, he often sits with his lipstick out and licks it. I can't help thinking he knows he needs to go, but can't get it out.
Poo: I am still giving him Lactulose, and I still think it isn't terribly effective. Does anyone have any dietary suggestions on how to make his stools softer? I do give him lots of extra water during the day, but I think it's all ending up in his bladder
He has managed to go a couple of times in the litterbox. He clearly knows when he needs to go, but mostly just gets fidgety and licks his butt. I usually end up "popping" the stool out for him, which he hates.
The chief problem is that his anal sphincter is shut tight, and he cannot open it at will. This means that the stool sits near the exit for quite a while, drying out. When it becomes hard, it hurts him when it is forced out by pressure from within. I've seen that part of his anal tract sometimes comes out with the stool, it looks sortof stuck to it. So I often pop his stool for him when I feel it, in order to save him grief later.
We are now at the end of Week 7, and I think all the meds have left his system. What I think is now clear is that his bladder sphincter and anal sphincter are pretty much clamped shut.
When I pop a stool for him, it is very difficult to get it out, and it clearly hurts him.
When I express him, even though I massage him quite a bit at the start, I have to squeeze quite hard to get things started. Since stopping the Bethanochol it usually comes out in a sortof fast dribble. But when we get about half-way through, it often starts to come really quickly and easily. I don't understand that at all.
Critters: when you say you used phenoxybenzamine long-term, how long is/was that? And does it relax the anal sphincter as well as the bladder? I feel sure Raz would happily poo by himself if only he could open his sphincter. From your experience with PBZ, do you think Raz might benefit? And I've been meaning to ask you for ages: what was the final outcome with your Buddy? I've tried to find your posts relating your Buddy story, but without success. I assume he had a tail-jerk injury too?
We are going to try another acupuncture session tomorrow - we stopped them for a little while as he clearly wasn't enjoying it.