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Cat: broken pelvis+tail, eating+pee+poo problems, I'm scared

For those seeking advice on caring for incontinent pets and animals with kidney-related problems.

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby CarolC » Mon May 02, 2011 11:21 pm

I wish I had something else to suggest, most of my experience is with a female dog. I can tell you when I started out with Katie those first months, it took real strength in the forearm to do it. I think the man in the video who expresses his cat into the diaper is squeezing pretty hard,too, it looks like it.

Have you seen this part of the expressing article, and do you think it would help?

Male cat

It took me a long time to figure out how to express. He is a boy cat and apparently boys are harder because they have a long urethra. Finally I saw a different vet and they explained that with boys, you have to find the bladder and then gently move it up (in the direction of their head) for about 1/2 inch and then give it a squeeze. Moving it forward a 1/2 inch straigtens out the urethra so it is not kinked up and therefore the stream can come out without trouble or discomfort.


The worst I went through with Katie was a year after I got her (injured stray) she had to be spayed and I had to express her afterward. Her belly was tense from pain, it was swollen and hard, and she kept trying to get away from me when I would go to squeeze her. I ended up putting a wooden bar stool in the middle of the bathroom floor, I put her front paws on it, and there was noplace for her to run, and that was how I got her to stay still (nobody to help me hold her).
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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby critters » Sat May 07, 2011 9:01 am

maine_coonz wrote:
Critters: did your vet put your cat on Diazepam? No. We used phenoxybenzamine as his relaxer.And if so, what dosage? Do you think it's my imagination that his bladder feels sortof flabbier the last couple of days since we stopped the Bethanochol? No. It made Buddy completely impossible to express. The vet didn't believe it 'til she took him home for the weekend and tried a drug trial of her own. How long did you continue using Bethanochol (and Diazepam) for? We used beth. as little as possible and used PBZ long-term.

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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby maine_coonz » Thu May 12, 2011 9:48 pm

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.
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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby critters » Sat May 14, 2011 11:15 am

I really don't remember how long Buddy took PBZ; it was about 5 years ago, and we were trailblazing with lots of meds at the time, including gabapentin. He had been hit by a car, and he developed a spasm at the neck of his bladder secondary to having had crystals in his bladder. He had surgery to implant a tube in his bladder, but it failed. He was only able to pee into a needle and syringe, so we put him down.

Koi, my current most severe spinal cord injured boy, who was shot in the spine in LA, has recovered some of his tail action, much like your boy. He was shot some years ago but has continued to show some progess, including being able to jump.
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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby CarolC » Sat May 14, 2011 11:21 pm

maine_coonz wrote: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.

Well, perhaps you will be the person he tells others about as an example!

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.

OK, I'm going to remember this, that never would have occurred to me. Good one! :smart: You must be doing a lot of laundry...? I wonder if a baby burping pad might work, absorbent and waterproof?

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 :(

viewtopic.php?f=5&t=15358
In this thread they said Miralax is better than lactulose, it is now preferred by people on the feline megacolon yahoogroup. I haven't tried it, but I would if my cat had that problem. They say adding canned pumpkin (plain, no spices) to the food helps stool quality. I didn't enjoy using it, seemed like I'd waste half a can as it went bad in the fridge quickly and we were only using a little dab in every meal. Please don't do this without asking a vet, but I read that with a lactose intolerant cat (as many are), milk will act as a laxative, you might ask the vet before trying a home remedy like that. I've given cats milk in the past and they were fine, but lately you hear so many warnings about not giving cats milk, you wonder how cats survived all those years when we used to give milk without a thought.


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.

I get a little prolapse with my dog, tight sphincter, firm large stools, I never considered dryness might be part of the reason but it makes sense. If it was my cat, I'd be popping them, too.

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. Sounds like my dog.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. Ditto. 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.
Wish I could explain it, I'm not sure why that is either, but it's interesting.

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. Katie would, too. She definitely does better with help. I don't know if this has anything to do with it, but you might try to notice if a certain area you are squeezing bothers him more than others. It's possible if you move 1/4" you might not be on whatever spot bothers him. I would think--totally guessing--it is not his anus being opened that bothers him, it may be soft tissue around it. And if you consider the anus as a center point, with a little area above it before you get to the root of the tail, and an area below it before you get to the urogenital area, possibly squeezing in the area near the tail bothers him more than from below. Or it could be a case of discomfort on the left hand side, or on the right hand side. There may be a way you can pinch that does not hit right on that sensitve spot, if you could only identify it.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.
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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby maine_coonz » Tue May 17, 2011 8:37 pm

Critters: I'm sorry to hear about Buddy, I had thought he was still with you. But nice to heard that Koi is still improving. Way to go!

CarolC:
> You must be doing a lot of laundry...?
Afraid not, I'm a real slut :) I have three ancient hand towels which I rotate; I rinse them out thoroughly after each use, hang them on the line to air and dry, and then re-use them. They go into the washing-machine once a week only!
> you might try to notice if a certain area you are squeezing bothers him more than others
I had a prod around with various spots and you are right - there are a couple of places which definitely hurt him quite a bit (= hissing+snarling+growling).


Week 8, Sat.May.14: MC came over for another acupuncture session today, which didn't go at all well. So we have decided to stop them completely for the time being.

Week 8, Sun.May.15: I am getting worried about the difficulty in expressing Raz, this "fast dribble" just doesn't seem right. But apart from that, he's so happy!

Week 8, Mon.May.16: We took Raz to Vet #1 this evening for a checkup (he hasn't seen him for about a month) and to talk to him about the weird "fast dribble", Miralax and Phenoxybenzamine.
He was extremely pleased with Raz's progress, and said that he really expected that Raz would eventually pee by himself. He gave him a physical check-up and said that Raz's bladder felt completely normal and had good tone.
There wasn't enough urine in Raz's bladder for him to express to get an idea of the "fast dribble" problem, but he asked us to bring in a urine sample for analysis.
He also said that phenoxybenzamine would have pretty much the same effect as bethanochol, so he didn't see the point in using it, and anyway Raz shouldn't be put back on these meds. I was somewhat puzzled as this info contradicted what Critters had said.
I asked the vet about Miralax, and he said that since Raz is almost pooping by himself (I haven't helped him at all for the last 3 days) I shouldn't bother changing but rather slowly cut down on the Lactulose over the next fortnight. Nevertheless, I think I will keep on with it for another week first, just to make sure Raz is voiding ok.

Week 8, Tue.May.17: The "fast dribble" problem continues. I took the urine sample into the vet's at lunchtime. He phoned later on and apologised for giving me incorrect info. re the PBZ and said that in fact he thought it was a good idea, and would write a prescription for me.

He also said that he had found struvite crystals in the urine sample and that we should immediately put Raz on Hills Prescription Diet Feline S/D. I went to the Hills website to read the ingredients list and was appalled. Raz and his brother have been 100% raw-fed since they walked through our door at 4 months of age. So I did some web-surfing. Unfortunately, I have ended up rather confused. Below is some of the info I found, together with my questions. Obviously I want to do the best thing for Raz (despite my "religious convictions" about raw feeding), and I am terrified of him "blocking". What to do?

- "Prescription diets work by removing magnesium to prevent crystals from forming" - but magnesium is essential for health.
- "Prescription diets mostly contain grains" - but grains cause alkaline urine.
- "Genetics plays a huge role in urinary health" - so what can one do?
- "Hard tap water has high magnesium levels so use distilled water" - but this has most minerals removed. Would bottled spring water be better? Or rain water?
- "Hypovase relaxes the muscle in the penis so allows the crystals to easily pass" - should I ask the vet to prescribe this rather than Hills?
- "Hills Prescription Diet Feline S/D takes 6-10 months to remove an existing problem" - no way do I want my boy on that rubbish for that amount of time.
- "Once outside the bladder, a free-catch urine sample can form crystals in 30 mins ... also the pH may not be accurate" - the sample was given to the vet ca. 2+ hrs later, so maybe Raz doesn't have crystals at all? Surely the vet would know about this?
- "Prodoca Guardacid pills acidulate the urine and regulate the pH value" - perhaps we should think about using these?
- "A small amount of crystals is not an abnormal finding in cat urine and the cat should not be automatically put on a prescription diet" - surely a vet would know about this?
- "Urine pH becomes more alkaline after eating a large meal" - we feed twice daily, should this be 3 or 4 times instead?
- "Bladders are happier with more water flowing through them" - I add a good dollop of water to his meals, and he has fresh water available at all times. He gets 1.5ml of Lactulose am and pm, plus ca. 3ml of extra water each time to compensate.

Assuming that there are indeed struvite crystals present, is it possible that they formed because his urine is staying in his bladder too long, as I only express twice per 24 hours, and perhaps his pH is fine? Or does a high pH always go hand-in-hand with struvite crystals? Or perhaps I am not giving him enough extra water, so his urine is too concentrated?
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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby CarolC » Wed May 18, 2011 10:49 am

How long was it between the time you collected the specimen and the time the vet anaylzed it? When I take a specimen to the vet I use a marker and write the time of collection on it. One time the vet tech came out from the back room and said the vet had found crystals, and we were discussing that, and then she heard the vet saying something from the back room and it turned out she had noticed the collection time of the sample and determined it had been sitting there long enough for the crystals to form in the sample. (It had been maybe an hour since collection.) I later asked the receptionist about it and she said, when you collect a urine specimen, if you are just looking for bacteria you can put it in refrigerator overnight and bring it in the next morning and the tests will still be effective for bacteria. But with crystals, the urine needs to be tested within about 30 minutes of collection or it can start to form crystals even if your pet did not have crystals. That would be a false positive. The urine can forms crystals right on the microscope slide.
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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby critters » Sun May 22, 2011 11:34 am

You're very wise to be concerned about blocking, and not only for its own sake. Buddy's urethral spasms began in response to crystals when I stopped giving him extra water because the vet said his pee need to be MORE concentrated. :roll:
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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby Philacatshia » Tue May 24, 2011 12:23 am

maine_coonz wrote: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.


Bully's tail was far more damaged than Raz's, but perhaps an extreme example will be helpful...

Bully's tail completely separated from his sacrum, and the lower half of it actually died. (I figure that a car tire ran over his tail while he was running across its path.) Even after the dead half was removed, Bully was annoyed by the now stiff, disconnected, free-swinging remainer of his tail. It didn't bother him so much when he was heading upwards (though it would throw off his jumping aim). But on the downward jumps, his tail would bounce around wildly (often hitting his heels) and he'd turn around as though something had bitten him, and frantically lick the base of his tail.

I was sure that his tail needed to be amputated, but was worried that the surgery would cause more nerve damage. After 5 months, though, I figured that the bouncing tail was probably causing its own nerve damage, and had it done. Within minutes of his return from the vet, he had jumped onto my shoulder with perfect accuracy, and jumped down from a chair with perfect ease.

So my suggestion (probably obvious) is that it might possibly be the tail itself that's bothering Raz when he jumps down.
Bully: 10.5 year old male cat, at age 2 his tail was run over by a car, causing incontinence. His tail is amputated, bladder & colon are expressed 2x/day. Household livability depends on firm-ish poops and no bladder leakage.
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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby maine_coonz » Fri May 27, 2011 8:44 pm

Week 10: Fri.May.27: After everyone's supportive comments and helpful suggestions last week, we decided that Raz did not have struvite crystals, and just soldiered on. We got the phenoxybenzamine prescription from the vet (Dibenzyran), and I was horrified to see that he recommended 3/4 of a 5mg capsule twice per day - that seemed like an awful lot! I read on the web that the max. recommended daily dose for a cat is 2.5mg!! So I started him on 1/4 of a 5mg capsule twice daily, and waited to see what happened, which was a big fat nothing.
So every few days I've been slowly increasing the dose, and in the meantime Raz has been getting increasingly harder to express. I don't know why exactly, but I really get the idea he is fighting me with his muscles at pee-time. It's scary how hard one has to squeeze to get things started, so I boned up on where the bladder sphincter is and I've been trying to massage it at the start rather than just "lean" on the bladder. I don't know if it helps or not, but it makes *me* feel better. The other odd thing is at the half-way mark - we take a break to (a) allow my arms/hands a rest and (b) to allow his bladder to reform. It is definitely much easier to express him after the break, and we sometimes get a real stream, instead of the awful slow dribble.

He finally got up to the 3/4 twice daily dose yesterday, and I really hoped that today would be different - but it wasn't. It's taking us about 45 mins to express him, and it's really hard work the whole way. His pee has slowed down to practically a drop-by-drop exercise, and our hearts are very heavy. This evening was really trying, and I had to give up before we were done as he was clearly extremely unhappy. I've been sitting at my desk working (it's 3am here) trying not to think about it all, and all three cats are asleep on their cat tree. I heard Raz licking himself, so I went over to give him a cuddle - and found him sitting in a puddle of pee on his cushion!!!! I have no real idea how it happened, or why, but I was never so glad to see a mess in my life - my guess is that he was asleep, and the bladder relaxed - is this possible? I cleaned up the pee (while he was trying to bury it), and wiped him down, and gave him a few treats and a cuddle. He happily curled up and is now sleeping. Please god, let this be some kind of breakthrough.

Other news: I think I can definitely say Raz has 95% tail function. I deduct 5% because he still has a tendency to hold it slightly kinked to one side, and when he really runs down the garden it still "flaps" slightly. But apart from that, he holds it out well and truly high behind himself, wraps it round himself when sittiing/lying, sticks it high in the air when he rubs himself on my legs, etc., etc.

And on the poo front: I haven't helped him at all for ages. I was checking his butt all the time up till the middle of last week (which he didn't appreciate one bit) but I was worried about impaction. Since then, the space between his pelvis and his anus is always empty, yay!! And I've been watching him poo, it's clearly still difficult, but he gets there without help, does all the correct "pinching" stuff with his rear end, etc. A couple of times he hasn't been 100% successful with the pinching and when he turns around to inspect the results they aren't there! He does look surprised and digs furiously to find the stools, it's so funny to watch. So I pluck it off him and put it in front of him in the litterbox and then he's delighted and buries it all.

The mouse-breeding season is now well under way - the silly things are living and breeding behind the compost bins, and we call it the "Maus Laden" (mouse food-shop). We let the cats out about 7am for a run while we make coffee etc., and most mornings he brings back a mouse for his breakfast. It's a really nice sight to see him walking down the garden with the current catch firmly grasped in his mouth. Our friends say he is unrecognisable from the sorry cat of a few (very long) weeks ago.
If anyone had told me a couple of months ago that I would be yattering on about pee and poo in such gory detail I would have told them to go boil their heads - but just listen to me drivelling on! Sorry guys, I can't help being happy about the puddle of pee, and it's perhaps making me a little light-headed :)

Does anyone know if it's possible for a cat to both regain tail function and poo function, but still have a locked-up bladder? I've been surfing like fury trying to find out, but without success. I can't help hoping and praying.
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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby Christine » Sat May 28, 2011 6:00 am

I just want to say a much belated "Welcome" and how in awe I am of your dedication and care. The fact that you are dcumenting this journey so meticulously is going to be so helpful for others, if not already. I am just a cheerleader on this subject and I wanted to do just that. Sending you prayers and healing thoughts for continued success with that sweet baby!
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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby critters » Sun May 29, 2011 11:13 am

maine_coonz wrote:
The mouse-breeding season is now well under way - the silly things are living and breeding behind the compost bins, and we call it the "Maus Laden" (mouse food-shop). We let the cats out about 7am for a run while we make coffee etc., and most mornings he brings back a mouse for his breakfast. It's a really nice sight to see him walking down the garden with the current catch firmly grasped in his mouth. Our friends say he is unrecognisable from the sorry cat of a few (very long) weeks ago.
If anyone had told me a couple of months ago that I would be yattering on about pee and poo in such gory detail I would have told them to go boil their heads - but just listen to me drivelling on! Sorry guys, I can't help being happy about the puddle of pee, and it's perhaps making me a little light-headed :)

Does anyone know if it's possible for a cat to both regain tail function and poo function, but still have a locked-up bladder? I've been surfing like fury trying to find out, but without success. I can't help hoping and praying.

:hysterical: Yup, we get excited about weird stuff around here!

Buddy recovered tail and poop but still had a locked up bladder.
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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby maine_coonz » Sun May 29, 2011 3:55 pm

Week 10: Sun.May.29: Raz has been getting steadily more difficult to express over the last couple of weeks, despite first Diazepam, and then Phenoxybenzamine. The moment I had been watching slowly draw closer finally arrived last night, when I entirely failed to get one drop of wee out of him. After 90 mins we gave up, and decided to try again this morning.

Well, this morning was just the same - as dry as the proverbial desert. So we made an appt at the emergency vet and off we went this evening at 6pm. After every test under the sun, including ultra-sound and x-rays, the results are: he has great kidneys, a normal size, very healthy-looking, no stones etc.. He has a great spleen, ditto. He has a great bladder, no crystals, stones, plugs or anything else (except a lot of urine). And so on. The vet absolutely failed to get a single drop of wee out of him as well, and finally took a urine sample for analysis via a hypodermic through the bladder wall. The results (can you guess?) were 100% great: super Ph, no blood or anything else that doesn't belong there, etc., etc. The blood test came out ditto, 100% super. He's a very, very healthy cat - who can't pee!

The vet said we should leave him there overnight so he can be catheterised, plus she wanted to see if the catheter went in easily, or if there was some kind of blockage. She said that she has seen cats who hold their sphincters shut tight, but she didn't know why this should be so. She did suggest that perhaps he still had some pain, or that the nerves were sending signals which he found uncomfortable/painful. Who knows. Anyway, we left him there with heavy hearts, because actually, we have no choice now. We shall see what tomorrow brings - she said she would phone us in the morning to let us know what happened re the catheter going in easily or not.
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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby CarolC » Sun May 29, 2011 7:45 pm

Hi maine_coonz,

I am sorry I did not reply to your last message, I was travelling and then doing all the things you do when you come home from being gone for a week.

maine_coonz wrote:We got the phenoxybenzamine prescription from the vet (Dibenzyran), and I was horrified to see that he recommended 3/4 of a 5mg capsule twice per day - that seemed like an awful lot! I read on the web that the max. recommended daily dose for a cat is 2.5mg!! So I started him on 1/4 of a 5mg capsule twice daily, and waited to see what happened, which was a big fat nothing.


I looked this up in 2 reference books. One is a layman's paperback that says pretty much what you said:
The Pill Book Guide to Medications for Your Dog and Cat wrote:Usual dose
Cats: 0.25mg/lb once a day, or 0.12mg/lb twice a day.


The other is a professional prescribing reference manual for vets that supports a higher dose:
Veterinary Drug Handbook, Fourth ed, Donald C. Plumb wrote:Cats:
Treatment of detrusor areflexia:
a) 2.5 - 7.5mg/cat PO once to twice daily (Osborne, Kruger, et al. 2000)
b) 1.25 - 7.5 mg (total dose) PO q 12-24 hr (Lane 2000)



maine_coonz wrote:I've been sitting at my desk working (it's 3am here) trying not to think about it all, and all three cats are asleep on their cat tree. I heard Raz licking himself, so I went over to give him a cuddle - and found him sitting in a puddle of pee on his cushion!!!! I have no real idea how it happened, or why, but I was never so glad to see a mess in my life - my guess is that he was asleep, and the bladder relaxed - is this possible?


Maybe...but my first guess would be external stimulation. There are pets who can be stimulated to urinate by swabbing the external genitals. Jean has a cat who is very, very, very difficult to express and she emptied her using external stimulation during their first year together. Here is the information. I think it should have been written with a more positive tone, for example this is the way Connie has been emptying Cricket for years! :D

http://www.handicappedpets.com/mediawik ... _urination

You are now in an area I'm not familiar with. He is mending and happy in every other way but for this one issue, I wish I could do anything to really help. I want to share some information I came across earlier this year, just so you have that anyway. I have said many times, and it is true, that there has never been a case of someone rupturing a bladder during expressing that I know of on this message board with so many, many people expressing pets, but in theory it is possible. I found the circumstances it is most likely to happen in a reading from googlebooks, which I will link and copy here, and I am only providing this, not to scare you, but because I know you have to squeeze pretty firmly (like I do) and your cat has just had cystocentesis.

http://books.google.com/books?id=DtIIjF ... cat&f=true

Problem-based feline medicine - Rand (click to enlarge)

rupture.PNG


Also, I found some recent information that may help you. I will give you the link but I think you will have to log in to read it (I just checked, maybe you don't), so I am sending you the login by private message, please check your PMs...

http://www.ivis.org/proceedings/bvna/2010/bvna2010.pdf

On this article, use

CTRL+F urinate

to get to the part that may be helpful. This will take you to a section called Management of the cat with cystitis, by Angie Hibbert, I would read the whole piece. She mentions other medications not mentioned here. Again, this is outside my experience but maybe it will help.

I want to check to be sure you have tried the tip given earlier in this thread (from someone with a male cat) about moving the bladder toward the ribs to unkink the plumbing before squeezing. (No need to answer, just wanted to repeat it in case you maybe haven't tried it, I forget whether you did or didn't.) You guys have my very, very best wishes, if that helps at all, you've got them!
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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Postby maine_coonz » Mon May 30, 2011 8:01 am

Week 10: Mon.May.30: The Vet called back this morning: he found absolutely no obstructions in the urethra. They observed him trying to urinate this morning, without success. He said that his guess was the detrusor muscle was clamped shut, and that the urethra also had high resistance. He also said that he thinks the nerves are trying to regenerate (and possibly sending painful signals), and that the puddle I saw on Saturday was very symptomatic of this, and this could also be why expressing him causes him pain. The depressing part is that there is no way of telling how long it could take for the nerves to regenerate, or indeed to what extent they would regenerate. Because he is now "locked up tight" the only way to get the urine out of him is via catheter, and he says this isn't something I could do at home. Is this true? Has anyone done this themselves at home?

He told me that there are no surgical procedures available for the problem, and the only thing we could try was medication. He said he was going to keep him for another 24 hrs and give him Myocholine (Bethanochol) together with Diazepam, to see if this would help. But he said he has seen this kind of problem several times before and the outcome is usually euthanasia.

I can't bear it, I really can't. After all this time, effort, money, etc, to fail at this point is just unthinkable. Especially when he is so healthy and happy in every other way. Is it really not possible to catheterise him at home for a few weeks to give these #### nerves a chance to regenerate? Surely there must be some other solution? Somebody help please! I refuse to give in - his quality of life is so great, except for this one £$%^&* show-stopper. Arghghgh!
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