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Ideas for injured cat?

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

Ideas for injured cat?

Postby cocosmom » Wed May 06, 2009 4:13 pm

Hi everyone. My 2 year old cat Coco was badly injured this weekend, in a fall we think - possibly trying to climb out of the cat fence. He has a large swelling on top of the base of his tail. The nerves to his tail are apparently torn and the nerves to his bottom are almost certainly permanently damaged as well, according to the neurologist. He was blocked up Sun so he had an enema then. Now the poop comes out whenever, especially if I am trying to express him. He presently has a catheter since I have been unable to express him successfully yet -- thank goodness, the catheter has give me a moment to breathe. The vets have struggled with expressing him a bit too and last night the ER vet was worried about rupturing him, hence the catheter. Coco has a urinary infection and is on clavamox. Coco has a fentanyl patch for pain relief, and seems okay that way. He is on a new med to try to relax the bladder a bit. He ate a decent amount of raw rabbit last night and then some canned food with added water this afternoon. No pee since this morning but he did poop a little first thing. I am supposed to go to the vet the next couple mornings for hands-on training with expressing Coco. The ER vets and neurologist are telling me that his tail will need to be amputated at some point because it just drags and he will start to attack it.

The first set of baby diapers were too small so I need to buy the next size up and try again, but he bites at them so I don't know if that will work. Should I get the overpants at PetSmart? I want to buy some liquid skin stuff for him. What sort of clippers should I get so I can keep him shaved properly?

So much to think about and do. I am sure I have missed a lot of things. What else should I be thinking about? Thanks!!
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Re: Ideas for injured cat?

Postby critters » Thu May 07, 2009 4:22 am

:whale: What med are they using for his bladder? If he bites his back, legs, or tail he needs Neurontin/gabapentin; my Koi is a tail-dragger and doesn't bother it at all.

Buddy always pooped when I expressed him, and it annoyed him no end. :D
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Re: Ideas for injured cat?

Postby cocosmom » Thu May 07, 2009 11:25 pm

Hi critters!

Coco is taking 1 capsule phenoxybenzamine once a day for 21 days, then 1/4 tablet bethanechol every 8 hrs for 21 days. The neurologist specifically said he should not get any prednisone nor any other steroid at this time.

He hasn't shown any sign of wanting to bite his tail. He was washing it earlier today, which I thought was a good sign.

I've got him set up with doggie pants for while he walks around, and a large crate for resting during night and we're away. Right now he has to be supervised; I just found him trying to climb a cat tree.

Today he had bloody urine which appears to have been from the diaper irritating his catheter. His IM vet took out the 'tomcat' style catheter put in at the ER and found a short very soft catheter for him. Coco still hates having his bits messed with, but I'm hoping this is gentler on him while I learn how to express his bladder.

Thanks for asking!

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Re: Ideas for injured cat?

Postby critters » Thu May 07, 2009 11:34 pm

Buddy did a lot better with PBZ, but he had a spastic bladder. I'll try Koi with beth. in June, because he has a floppy bladder.
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Re: Ideas for injured cat?

Postby CarolC » Fri May 08, 2009 10:56 pm

I wonder if the medication has anything to do with being unable to express. Bethanechol can help the bladder contract.

Pill Book Guide to Medication for Your Dog and Cat wrote:Bethanechol should only be used when the urethra is open, as when a catheter is in place, or with urethral relaxants because bethanechol can cause contraction of urethral smooth muscle as well. Theoretically, the bladder could rupture if bethanechol is given when the urethra is blocked, or in spasm


I have seen where they use Valium or Inderol to relax the urethra in conjuction with bethanecol (urecholine).

I am glad the veterinary staff are wanting to help you learn to express and so on. You're fortunate there. I do not have an incontinent cat, but thinking over all the photos that have been posted here, I believe most people with incontinent cats do not put a diaper cover over the diaper.

Here is a great webpage Dianne found which explains about tail injuries.

http://www.veterinarypartner.com/Conten ... ourceID=42

I think you are going to want to read up on megacolon as well as expressing the bladder. There is some information on expressing here:

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

More info on diapers is here:

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

:gang:
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Re: Ideas for injured cat?

Postby critters » Sat May 09, 2009 5:35 am

CarolC wrote:I wonder if the medication has anything to do with being unable to express. Bethanechol can help the bladder contract.
:
Indeed, Beth. made Buddy impossible to express. PBZ tends to relax the bladder, which is why it worked so well for Buddy.
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Re: Ideas for injured cat?

Postby cocosmom » Thu May 14, 2009 3:08 pm

thanks for that info. I am still unable to express Coco's bladder but have stopped the bethanechol. I hope that makes it easier to express him. I have been getting more lessons and seeing different ways to express. I am starting to think part of the problem is kind of weak hand strength due to physical limitations.

Coco had another catheter placed today. The vet said he seemed to feel a little of the stitch or two for the catheter, so that's a good sign. Once or twice a day, he goes in the catbox and tries to pee but hasn't had any luck. Maybe he will be able to get his urine control back some day. Or if not, hopefully I will be proficient at expressing him by then.

thanks!
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Re: Ideas for injured cat?

Postby cocosmom » Mon May 25, 2009 8:45 pm

well, I have had zero luck with expressing Coco. He has considerable bladder tone so it's very difficult. Since I have had to go to the ER (an hour away) many times for his daily expression, I have seen multiple vets. The vets are able to help him for the most part - sometimes the bladder resists further urination after a certain amount of expression and so today he had to be catheterized to get the rest out. Aside from that, as careful as they are, I am very afraid someone will rupture his bladder.

This can't go on, especially since I'm not finding any real local support for his care. I am getting multiple suggestions from the ER vets:

- keep on trying to express (only one vet, but he expressed his own cat for 12 years)
- get a perineal urethrostomy to widen/shorten the urinary tract. One vet said he thought Coco might be able to urinate volunatarily after a PU due to the level of bladder tone
- get a cystostomy to drain urine manually

I need a long term solution. Coco is only 2 and otherwise very healthy.

My understanding of the PU is that it's very tough on the cat with a long hospitalization. It seems to me I could still have problems with expressing him afterwards, and certainly he would be so tender after. The cystostomy appears to be not as serious a surgery and I have read there are permanent ones.

Right now Coco is catheterized again this week, while I consult his IM vet, the neurologist who evaluated him just after the injury, and then a surgeon(s) this week. Any experience with any of these? Any ideas or suggestions? Thanks!
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Re: Ideas for injured cat?

Postby critters » Tue May 26, 2009 5:29 am

Does PBZ help? Buddy had a spastic bladder too, and a PU wouldn't have helped because his worst spasm was at the neck of his bladder. He ended up having his bladder tacked to the front of his belly and a tube inserted into it which came out his belly. Being so far from that (awful) place was the pits when the tube fell out.
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Re: Ideas for injured cat?

Postby cocosmom » Sat Jun 20, 2009 10:51 pm

thanks for the info. Due to the difficulty of expressing him, recently Coco had surgery like your cat -- a tube inserted in the bladder to help it drain. That worked great until he got his cover (dog's male wrap) off during the night and pulled it out. We had it back in with a shorter tube, which seems to be working better. The doc says we will be able to express him once the surgery heals so that gives lots of time to practice. That is, if he ever got full enough to express. The tube seems to irritate his bladder so now he's dribbling constantly, especially if he bends to wash a hind leg. He keeps getting out of his washable diapers, unfortunately. Of course I don't like him laying in wetness so I'm changing his bed many times a day. He keeps trying to go to the bathroom but no luck.

Has anyone tried the diapersfordogs.com diapers for cats? I am going to call their customer service in hopes they can make a diaper that is long enough to cover up to where his tube enters the tummy. I may or may not need to get diaper suspenders. Any other suggestions?
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Re: Ideas for injured cat?

Postby critters » Sun Jun 21, 2009 5:55 am

Theservs (I think that's how she spelled it) has a pupper with a urethrostomy, and she and a seamstress designed special diapers for her Dolcezza at http://www.pouchpanties.com/ . I call them Dolcezza Drawers. :mrgreen:

The place that did Buddy's surgery was AWFUL, and we couldn't get the ginormously long tube replaced when it fell out. :x I wish we still had the more angry emoticon on here; I'd use several of them.
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Re: Ideas for injured cat?

Postby patsy » Sun Jun 21, 2009 8:01 pm

hi, i hope i've added a drawing of some suspenders that i made for my dog. suspender clips are available at fabric stores. the straps are made with 3/4" elastic. they could be wider, or thinner, if you desire. estimate lengths, tack or safety-pin together 'til you find what works best. my dog is not able to stand or walk, so i have found other suspenders useless. one end attaches at the back (just to the side of the spine), and the other at the front (belly button). the head goes through the diamond in the middle. i was not able to attach this to the diaper-it tore-i put a pair of baby's panties that i got for $1 at a thrift strore on over the diaper. you may or may not choose to cut a slit for the tail. don't really need to bother with a circle, slit works (VERY long buttonhole, if you sew). see also incontinence products on this site, or the one on e-bay referenced on this site look pretty good. i've also used sweatshirt and t-shirt sleeves (the cuff end goes around the kid's neck) w/holes cut for legs, and hook-and-loop closures on the end. for larger pets, use sweatpants, or flannel or cotton pj pants. i just dare a dog to try to get out of a sleeve or pants leg! my other dogs wear them in the winter, without the velcro, the end cut at an angle to facilitate urination, as sweatshirts, and never even try to get them off. they love them, and they're cheap! get them at the thrift store.
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Re: Ideas for injured cat?

Postby critters » Mon Jun 22, 2009 5:38 am

patsy, LOVE the sleeve/pantsleg idea!!! My always-frozen megasevere permakitten CHer who hates clothes WILL be sporting one of these when Winter comes again. :thankyou:
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Update on injured cat

Postby cocosmom » Mon Nov 30, 2009 3:20 am

Hi everyone,

I thought I would update you on Coco's situation. I never was able to successfully express his bladder, and most of the many vets that expressed him had difficulty as well. Pbz and bethanecol were no help. He had a pezzer tube put in several times, but hated it. Because of the tube placement, it was extremely difficult to keep a diaper on him and he pulled the tube out at the slightest opportunity.

I read about a study on the use of low profile gastrostomy buttons for pet cystostomy, and after much research and effort, I was able to get Coco's surgeon to install one in the opening created for the pezzer tube. This has worked really well. With a little practice, clicking the removable tube into the button's one-way valve to drain the urine is easy. Plus, he doesn't mind the button at all and never pulled at it. So, he doesn't have to wear the diapers and protective onesies, wraps, etc. He's so much happier without those. The button is so small that he looks perfectly normal, aside from his bobbed tail which had to be partially amputated. We have had some trouble with urinary infections, and some bloodiness from irritation when Coco is too rambunctious, but overall we couldn't be happier with the cystostomy button.

As far as his bowels, Coco hasn't regained any capability there either, but Miralax has been amazing in helping keep him regular - it's SO much easier to administer than the lactulose. And, because of the button, Coco's able to freely go out in our large fenced yard, so almost all of his poop pops out while he's running and jumping and climbing out there. If he does get a bit blocked up, then a dose or two of bethanecol stimulates the intestines so that clears him right out.

I really think the buttons are an awesome option for long term bladder issues, and it's a real shame that more people don't know about it.

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Re: Ideas for injured cat?

Postby critters » Mon Nov 30, 2009 6:43 am

They talked about a "button" for Buddy "later." I'm familiar with Mic-Key, having used it to feed kids, and, indeed, it's WONDERFUL!!!! :thankyou: for the update!
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