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Cat Tail Pull Injury/Incontinence/phenoxybenzamine

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

Cat Tail Pull Injury/Incontinence/phenoxybenzamine

Postby Scatman » Mon Jan 18, 2010 8:06 pm

Hi all,

I'm writing for information regarding a cat with a tail pull injury...well more of a tail-mutilating injury! This accident happened over a year ago and the cat is doing well, however incontinence is still an issue....

Long story short... about a year ago the big guy escaped out of the house and ran into the road and under the wheels of a minivan. I thought he was gone for sure, but it turns out only his tail was injured. A month after the accident the tail became infected and therefore was amputated without incident. It was not regaining function anyway, so it probably would have gone regardless.

The problem is his bladder. In the first week after the injury, the cat would not urinate on his own so the vet put him on phenoxybenzamine and taught me how to express the bladder. Within week or so he was emptying on his own, however it emptied wherever he was at the time...sleeping, walking, laying down, you name it. A few months after the accident and still on phenoxy he was going maybe 1-2x or more a week in the litterpan. I was hoping his nerve damage was slowly making a recovery. But now, over a year later, he is still on phenoxy and not peeing in the box. EVER. (I'm editing to add that he isn't constantly dribbling. When the floodgates open, its usually a big amount of urine. Again, I don't know if this means anything at all...other than the fact he was able to sit on my lap all through Willy Wonka completely dry).

The vet says that if he regained ability to control his bladder he should have been able to use the litterpan while on phenoxybenzamine. However I read online (I know, shame for trying to self-diagnose) that phenoxy will cause incontinence.

Does anyone have any ideas or info? Today the vet said to try cutting from 2 to 1 dose of phenoxy a day and see what's what. They also suggested it may, at this point, be a behavioral issue. He has anal tone (I know, TMI), walks, jumps, runs, poops (not always in the box...sometimes there will be an escapee that drops out after he leaves the box) and seems to be in perfect working condition aside from the peeing.

Has anyone had a similar situation? Any info will help. He is a perfectly healthy, happy Main Coon-now-Manx kitty who misses sleeping in the people bed. Luckily I'm able to provide him a washable room (aka kitty apartment) so regardless of his tinkle habits he has a place to live his life. I just don't know if the one key pee nerve was damaged, or is there anything else I can try or anything I should know?? Its hard for me and the vet to guess exactly what is going on. Based on the fact that he is otherwise so functional, everyone is surprised he still is peeing all over the place.


Thanks
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Re: Cat Tail Pull Injury/Incontinence/phenoxybenzamine

Postby sakelina » Tue Jan 19, 2010 5:44 am

Hi,
I can relate to your story since not long ago I found a cat with a similar problem. It had been beaten severely, was bleeding internally, had a broken tail and a spinal injury. In about a week the vet managed to stop the bleeding but in all that time it never urinated or defecated on it's own, at all. Soon enough it started dripping urine all the time, while sleeping, playing, eating and so on. (I have to mention also that other than the tail paralisys and the incontinence the cat is healthy.) The vet recommeded some pills from the human pharmacy for urinary incontinence in women, DRIPTANE. I've had her for two months on that treatment but nothing happened so we raised the dosage and now, while under the effect of the medicine, it doesn't happen that often even though the emptying of the bladder is still done unconsciously and so is the defecation. All in all, it's been almost 5 months and I really don't know what to do anymore. On one side I have the vet telling me that if the cat doesn't recover in 6 months it never will, on the other side everybody else is telling me to put it to sleep and the truth is I don't want to, I really can't give up. Good luck with your cat, don't lose hope!
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Re: Cat Tail Pull Injury/Incontinence/phenoxybenzamine

Postby critters » Tue Jan 19, 2010 6:15 am

:slant: you two!

PBZ is used to relax the bladder, so maybe you need bethanecol (sp?) to increase the tone. Koi, my worst SCI boy, won't let me express him, and he leaks. He's so ornery I just put clean blankets on the bed from the bottom, then pull off the top 1 or 2 every week for washing. Mattress pads work especially well, but I find old ones hard to find. His Orneriness wouldn't wear diapers, I'm sure. :twisted:
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Re: Cat Tail Pull Injury/Incontinence/phenoxybenzamine

Postby Scatman » Tue Jan 19, 2010 9:25 am

Thanks for the info. I'll ask about bethanecol. I've also read about acupuncture? Or is that just too crazy?!

Yeah, diapers are a definite no no...the cat is so mild mannered otherwise...at the height of his problems I had to give him about 14 pills a day....and never once has he bitten...he just opens his huge mouth and down they go. BUT the diaper situation brings out the devil in him and his meathook-like claws.

He lives on a porch with a sheet linoleum floor and wicker lawn furniture with washable cushions. Also lots of windows and sun. I put towels down for extra protection. Overall it works well and washes well. He's allowed out when peeps are home to watch him...he's more like a dog and follows us around so accidents can be cleaned up quick. Oh and BTW, no carpet in the house now. :( Overall though this system works out well for everyone, in case anyone else has an incontinent cat.
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Re: Cat Tail Pull Injury/Incontinence/phenoxybenzamine

Postby CarolC » Tue Jan 19, 2010 1:07 pm

Scatman wrote:I just don't know if the one key pee nerve was damaged, or is there anything else I can try or anything I should know??


Here is an article that helped me understand the process of urination better.

http://www.vin.com/VINDBPub/SearchPB/Pr ... R00442.htm

I like your description of the kitty apartment you have for him. So you are saying even when he is in his apartment with a box nearby, he still does not use his box? I was going to suggest (did you try this already?) putting additional boxes around. Maybe when he feels the urge to pee, he has little time between the signal and the time his bladder releases (especially on medication relaxing the bladder) so if there was always a box handy, he might have a better chance to make it? But if he doesn't use it even in his own room, maybe that won't help.

I agree with your idea of checking to see if the medication is contributing to this problem. I wonder if you have a referral hospital in the area? Perhaps your vet could refer you to a specialist who could determine what would work best in terms of medication. I'm not sure what to think of your vet when he puts the cat on PBZ, then kind of shrugs his shoulders and doesn't try anything else when that doesn't work.

I do not think your idea of trying acupuncture is silly, it has helped a lot of pets here. I would only want to be sure the person doing it was qualified. If you have a vet in your area who is trained in acupuncture, you might just call them and see if they think it would help. But I think I'd want to try to get the medication straightened out before I tried that.

sakelina wrote:Hi,
I can relate to your story since not long ago I found a cat with a similar problem. It had been beaten severely, was bleeding internally, had a broken tail and a spinal injury. In about a week the vet managed to stop the bleeding but in all that time it never urinated or defecated on it's own, at all. Soon enough it started dripping urine all the time, while sleeping, playing, eating and so on. (I have to mention also that other than the tail paralisys and the incontinence the cat is healthy.) The vet recommeded some pills from the human pharmacy for urinary incontinence in women, DRIPTANE. I've had her for two months on that treatment but nothing happened so we raised the dosage and now, while under the effect of the medicine, it doesn't happen that often even though the emptying of the bladder is still done unconsciously and so is the defecation. All in all, it's been almost 5 months and I really don't know what to do anymore. On one side I have the vet telling me that if the cat doesn't recover in 6 months it never will, on the other side everybody else is telling me to put it to sleep and the truth is I don't want to, I really can't give up. Good luck with your cat, don't lose hope!


Did the vet show you how to express the bladder? Here are some instructions, and in particular here is a video demonstrating it.

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

http://www.youtube.com/watch?v=QdIBtw8_7No (you'll love this video)

There have been a lot of cats in diapers here. :) You might be able to put her in diapers for free play around in the house, and then give her her own easy-to-clean room or kitty condo at night and leave her without diapers during the night. Here is some info on diapers, with a chart to give you an idea of what size to buy.

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

Here is a story about Fripple, looking very cute in his diapers. :wub:

http://www.handicappedpets.com/gallery/ ... /index.htm

I don't know anything about the medication you mention. I would keep an eye on her and monitor her colon to be sure she does not get constipated, it can be a problem with this type of injury. I know you are seeing her eliminate, but I think it might be a good idea to learn to squeeze her abdomen and feel her colon to check it for size from time to time. (It's really easy to do with a cat.)

:gang:
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Re: Cat Tail Pull Injury/Incontinence/phenoxybenzamine

Postby Scatman » Tue Jan 19, 2010 1:51 pm

Hi Carol,

Thanks for the information. Luckily I live in North Jersey and have access to specialized hospitals within driving distances. The phenoxy was prescribed by a specialist...we were referred there from a regular vet after the accident.

I think the issue is really that nobody can be sure of what his status would be off of medication. Remember, the meds were prescribed shortly after the accident because he wasn't peeing at all. Better to have the pee come out anywhere than to not come out, right. So I'm curious as to where he would be now without meds but wouldn't want to possibly hurt him by stopping cold. I'd bet the vet feels the same way. I think that's why we're trying cutting phenoxy dosing in half....I'll monitor his peeing closely and hopefully he can manage at least the same on a smaller dose...or perhaps even gain some control to use a litter box. Worst case I'll have to express him and then go back to the 2x a day dose.

Another short FYI, he pees anywhere: he could be laying down and gives no indication that he knows he's doing it at first. The one sticking point in everyone's mind is that at one point, about 3ish monts post accident he DID use the box (infrequently). To the vet this said that he had at least SOME control at that time. The million dollar question: where did it go???!!

Would anyone have any idea how long levels of this medicine take to drop off in the kitty body? A week or so? (as in, after a week or so if he is still peeing freely on 1/2 dose could I assume he is ok on 1x per day?)

And btw, I looked at the Red Bank animal hospital site and it says they do have accupuncture there.

Thanks again.
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Re: Cat Tail Pull Injury/Incontinence/phenoxybenzamine

Postby Scatman » Tue Jan 19, 2010 2:39 pm

Also a question for Salekina:

Is your kitty always dribbling urine? I was told that this could be a sign of the bladder being too full and urine is now just coming out for lack of anyplace else to go. It's not good for a kitty's bladder to be too full for too long.

I think it's better for urine to be released without the cat's knowledge than to withhold it. The owner can express if the cat won't go on his own but that is a lot of responsibility and needs to be done regularly and frequently.

Also, there are a lot of meds that might help out. My regular vet was not up on what was avaiable, however the specialty vet was and wasn't scared to use them. If you can it might be worth looking into.

And as far as long term, as long as the cat can pee or poo, whether on his own or with help, there is opportunity for a good life. Just think creatively and you can figure a way to minimize mess and still keep the kitteh happy. There are a lot of good suggestions on this board...mattress covers, diapers (if you dare), washable floors and cushions, maybe even expressing regularly will help control mess.
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Re: Cat Tail Pull Injury/Incontinence/phenoxybenzamine

Postby critters » Tue Jan 19, 2010 5:22 pm

Yes, PBZ is dropped off slowly because it can change blood pressure, but I don't remember what reducing schedule we used for Buddy. Buddy had a spastic bladder, and beth. made him IMPOSSIBLE to express. He was taking the biggest, honkingest doses of PBZ allowable and was OK with it.
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Re: Cat Tail Pull Injury/Incontinence/phenoxybenzamine

Postby sakelina » Wed Jan 20, 2010 6:15 am

Thank you so much for the info... it really helped. Truth is I never managed to express the bladder but I frequently express the colon, that's really easy compared to the bladder and for some reason it doesn't bother the cat as much as the other procedure. Well, I think it's about time I learned, I'm gonna read carefully and try again.

The diapers don't really work on this cat, it's a stray cat, very very agile and i guess it feels really uncomfortable with the diaper on,it loses it in 5 minutes tops. It was always such a torture for me to watch it while it was so nervous, twisting and turning until it was off... I stopped making the cat wear it and also I really needed to see what was happening, if it kept losing urine or if the medication was starting to work.

Another thing, it constantly goes to the litter box I installed in her "condo" and does everything a cat does before peeing except nothing comes out... it does that all the time... I also noticed that the cat's sphincters tremble sometimes, do you know anything about that?

Oh and I really loved the video, Pookie's life is still exciting and beautiful even after the injury, you're doing a great job!
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Re: Cat Tail Pull Injury/Incontinence/phenoxybenzamine

Postby critters » Wed Jan 20, 2010 5:19 pm

When I'd express Buddy, even for pee, I'd always get poop if he had any. :mrgreen:
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Re: Cat Tail Pull Injury/Incontinence/phenoxybenzamine

Postby cricketsmom » Fri Jan 29, 2010 8:27 pm

I would just like to add that acupuncture can help in the right pets. I was skeptical to try it with own incontinent cat, but I agreed to try the vet's recommendation. We've done four treatments once a week for a month, and my cat has gained back a lot of her sensation and it has helped her injury site to heal. It also made a big difference in her attitude. She was a kitten but very quiet all the time when I got her. I didn't even realize after a couple treatments and she started actually acting like a kitten, how much her injuries had suppressed her natural behavior. She is on a break to see how things will go, and then we'll re-evaluate. But so far, I've been pleased. If you can find someone with experience and compassion, it might be a good option to discuss and decide if it could help your pet, too.
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Re: Cat Tail Pull Injury/Incontinence/phenoxybenzamine

Postby critters » Sat Jan 30, 2010 7:32 am

:whale: cricket's mom! Every time I see your handle I think of Connie, the other Cricket's mom!! :mrgreen:
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