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Still incontinent after laminectomy cat.. advice

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Still incontinent after laminectomy cat.. advice

Postby Sweetie'sMom » Sat Aug 14, 2010 1:10 pm

3 weeks ago, my 8 year old cat "overnight" became incontinent (bladder and bowels) She is an overweight kitty. 16 lbs We noticed her tail area was dragging.. Our vet sent us to our "kitty hospital" and we tried Steroid treatment for 10 days. He diagnosed her with a ruptured disc #5 and 6. We ended up doing a laminectomy last Monday (6 days ago) and she is home now. She started eating immediately and walking around... but her incontinence is continuing. I have read all the posts on the site (actually well before surgery) and it has given me great hope. The day after surgery, she stepped into her litterbox and emptied her bladder maybe a tablespoon worth. That is the only time she has tried. She has always been an indoor kitty...So during the day, I let her in the main area of the house where I am... (with the bedroom doors closed due to carpet) She stays at night in a kennel in the laundry room. I put her litterbox in there with her,, but every morning, we have nothing in the litterbox, but she empties her bladder in the kennel (puppy pee pads) Now for the last 2 days, she has had massive diarrhea all over the floor,,, actually running from us, looking for a place to hide. It is overwhelming. I hate to keep her in her kennel during the day, because she spends so many hours there at night... but I really don't know what to do. Our vet suggested putting her down before he even referred us to the surgeon. Absolutely NO.. this is our Sweetie...We rescued her as a tiny kitten. I know that many people on these message boards are care takers for incontinent animals. This has been a full time job for me the last few weeks. I was able to express her during week 1 of this injury.. but now it is not happening. Before her surgery, she was leaking urine constantly. She does seem to hold it in longer now..and will not let me express her. I am assuming the diarrhea is from the meds. She is on prednisone, Buprenex for pain, and Clavamox, (which I am hoping is the cause of the bowel issue) My youngest daughter moves away to college next week. I will have an empty nest.. Hubby has sold half his business, and will now get 16 weeks a year off. We have very extensive travel plans,, which are put on hold due to an incontinent animal. Just major frustration... hubby is overwhelmed. does anyone have experience with cats with the surgery and how long we can anticipate this? I just keep thinking that you all are angels for caretaking for your incontinent animals long term... what if I can't do it?
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Re: Still incontinent after laminectomy cat.. advice

Postby critters » Mon Aug 16, 2010 7:20 am

:strobe: None of my monsters have ever had a laminectomy, but I currently have spinal cord injured boys 2, 3, and 4. I know the headache of poop blow-outs with a severely disabled one, and I suggest you call the vet for info on stopping the squirts. Normal poop isn't so bad, even if a nugget pops out once in awhile!! :D
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Re: Still incontinent after laminectomy cat.. advice

Postby Sweetie'sMom » Mon Aug 16, 2010 8:10 am

Has anyone out there had an incontinent cat gain back their continence??? If so,, what was your time frame? Sweetie's lost SO much weight... which is a good thing with a back injury...The diarrhea has stopped,,, assuming it was from the antibiotics....but it BREAKS my heart to kennel her every night because I wake up to her surrounded with pee every morning,, and into a bath she goes 3 x a day.... I'm so overwhelmed... and scared.
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Re: Still incontinent after laminectomy cat.. advice

Postby CarolC » Tue Aug 17, 2010 11:23 pm

I am really answering your earlier question. I am sorry you are not getting more replies. My best answer is, she may still regain bladder control, if I were in your shoes I would give it time. Right now she is still recovering from major surgery and even the swelling alone from having her back operated on can be affecting her neurological function. But aside from that, my experience is more with dogs. My dog's physical therapist said that after laminectomy, you need to give it 3 months to see if bladder control will return, and 6 months to really be sure. Usually whatever you have at 6 months is about what you are going to have. However, there are exceptions, someone on this site has a dog that began to regain bladder control about 10 months after surgery.

I can't really speak to the situation of the vacation plans. I would say that of course you are bound to be wondering what you will do if she is still incontinent when you get ready to travel. I don't know, but a lot of people board their pets at the vet when they travel, and most vets can express bladders, so hopefully it won't be a problem as long as you explain to the vet.

Much as I am used to nursing my pets, it would be a lot for me to wake up to a wet cage, unhappy cat, and have to bathe her 3x a day when I have plenty of other things to do, so I can understand this is not a situation you would want to continue long term. I think the answer may be medication, or at least that might be the next thing to try. They have meds to relax the sphincter if she is too hard to express (you used to be able to but now find it difficult) and they have meds that can help the bladder contract, which might make her able to manage on her own. I think you might want to talk to the specialists who treated your cat and see if they think medication is worth a try. If you can express her before going to bed, you won't have this to wake up to.

I am kind of questioning why she has lost so much weight. I hope she is OK other than this bladder issue.

As for being overwhelmed, yes, very. Many people feel that way the first weeks or months with a handicapped pet, it sort of takes over all your time and thought for a while. Then you get into a routine you can handle. Right now you are trying to ride the waves while she has had various issues (diarrhea, etc.) and have not hit a calm spot yet. You are still working the bugs out of your routine or trying to see if there are changes that will make all of this workable. The intense searching for a better way is part of it. All I can say is, this is common, it can take weeks of fine tuning to get a program you know you can live with longterm, but keep at it and don't give up, you will get there.
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Re: Still incontinent after laminectomy cat.. advice

Postby critters » Wed Aug 18, 2010 8:53 am

Buddy went from 100% incontinent to 100% continent, but he wasn't a laminectomy boy--he was hit by a car. It took some months to do so. Koi is still a leaky boy some years after his injury, but he didn't have pred or adequate treatment in the early months.

I expect she's losing weight from the surgery and trauma; my Koi is still losing weight weeks after his surgery to fix the contractures in his foot.
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Re: Still incontinent after laminectomy cat.. advice

Postby cricketsmom » Fri Aug 20, 2010 10:23 pm

Hi there, thought I'd pipe in concerning the traveling issue. My incontinent cat Cricket goes with me when I travel. She hates the vet's after all the treatments she's had. Plus, she's a very chill cat and does well traveling. So I feel better keeping her with me and maintaining her routine personally. So far she's only traveled with me by car. Pets are not allowed on Amtrak or buses. Many airlines will take pets though. If you call around, many hotels accept pets, however, most do charge a pet fee, usually $10-30. I'm not sure what exactly you and your husband had in mind for your travel plans, but this can be done, whether she stays with good care or comes with. :D I know it's frustrating right now, but you're just starting out with a special needs pet. Like the others have said, after a while, you'll find what works best for you and get a comfortable routine going.
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Re: Still incontinent after laminectomy cat.. advice

Postby Sweetie'sMom » Wed Oct 20, 2010 11:32 am

Sweetie finally did regain her bladder continence. However,, after another hospital stay,, her colon is "neurologic".. The surgeon and the vet strongly feel that it will never come back to normal. Her bowels are completely blocked,, small/large intestine... they gave her an enema but only half was able to come out. For the last 6 weeks,,her bowels will empty in the form of diarrhea 2 times a week, always accompanied with large amounts of vomit. She just lays there and it comes out both ends.. it is heartbreaking.. She will not/can not use the litterbox for anything but bladder. They put her on cisapride (transdermal) to stimulate her colon but now she voids bowels and vomits daily.. of course, the side effects of cisapride is "stomach cramping" and diarrhea. So now she is cage bound because of this med.. the last couple of days I have taken her off of the medicine,,, this is no way for her to live. So after all this time, (and $6000+) we are scheduled to put my Sweetie to sleep next Monday. My heart is broken.
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Re: Still incontinent after laminectomy cat.. advice

Postby Bendy Kitty » Wed Oct 20, 2010 12:34 pm

that is, indeed, heart breaking :(
I'm not sure I understand what they mean by a neurologic bowel. th eonly other thing i can think of is that there might be some surgery to remove the affect portion of bowel, but that is not going to be cheap.

i don' tknow what kind of diet you have her on, but a low residue diet coudl also make a difference.

poor girl :(
poor you :(

bendy
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Re: Still incontinent after laminectomy cat.. advice

Postby CarolC » Wed Oct 20, 2010 3:21 pm

I can only post something short right now, but I would NOT give up. Just for a point of reference, the symptoms of diarrhea and vomiting are not a usual part of paralysis at all. In addition, cats who are not paralyzed can become blocked (obstipated) and in some cases may need to be unplugged under anaesthesia, but if your cat evacuated half the stool, that is great and I would be optimistic and hopefully that would not be needed. I agree with your earlier assessment that the mess you have been dealing with is related at least in part to the medication. Clavamox will make cats vomit, it made my Teddy vomit. It can also cause diarrhea. I would try some acidophilus to help her recover normal intestinal flora that was probably killed off by the antibiotic.

You can use other milder meds than cisapride. Cisapride might be useful for the short term, but for long term you can try lactulose syrup. This is commonly given to a cat with a history of blockage, it is easy to give, inexpensive, and my pets like the flavor. When a cat is chronically blocked, the intestine can become stretched (a condition called megacolon) and that can require surgery, however you would need to do an exam (probably x-ray) to see if that is what you are dealing with. In some cases, when a cat is very constipated, the only thing that can pass is any "diarrhea" that goes "around" the blockage, hence the diarrhea, and the vomiting from being overly full. I would be hopeful she is just simply very constipated (obstipated) through inactivity and meds.

Something you can learn to do pretty easily, is massage the colon to mobilize waste toward the exit. You shape your hand into a lobster claw, place it on her abdomen, find the colon (you will find something surprisingly hard) and squeeze it a little. You will find the long single "chain" of waste will actually break into shorter pieces within the colon when you do this, and it won't be surprising if something comes out in the process. There was a person here who had a cat show up paralyzed and very backed up (constipated), that with help voided 13" of feces, and after that the caregiver got her regulated. You do not have to give up.

EDIT: Correction, here is the link, it was 16". She found the cat already injured, it was dragging itself and had not had care, so she had to get the bowel regulated. This is a description of how she cared for it and got it emptied.

http://www.handicappedpet.net/helppets/ ... =10&t=5033

Please don't feel sad. I know you are only thinking of her happiness and you trying to do what is best for her, but I believe this situation can be remedied.
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Re: Still incontinent after laminectomy cat.. advice

Postby mumpkees » Wed Oct 20, 2010 7:27 pm

Dear Sweetie’s Mom:

I’m so sorry that you and Sweetie are going thru this. I know it is a scary thing for both of you. Try to stay calm as Sweetie will pick up on your stress. I know it is hard right now, but try to be patient because it often takes a long time for things to get better, especially for an older cat. You’ve already seen her urine continence return. Give the bowels time to heal.

Right now, you may need to have Sweetie sedated and have her cleaned out. As someone said, the diarrhea may not really be diarrhea, but rather she is so impacted right now the only thing that will pass is what little water is in her colon. Constipation is not a good thing to let go for very long because it can lead to mega colon.

Diarrhea can also be caused by antibiotics – for my cats clavamox is almost always a problem by the 3rd dose. Some cats if given too much cisapride can also have diarrhea and cramping.
http://www.veterinarypartner.com/Conten ... A=2014&S=2

Side Effects If too great a motility effect is created, diarrhea and cramping may result.

There are two excellent yahoo groups dealing with megacolon and irritated bowel disease (IBD) but both groups address other gastro-intestinal issues. Both groups are very compassionate and very up to date on treatments, suggestions and tips. They also offer the emotional support that cat parents going thru something like this need.

The weight loss bothers me, but some of it could be from just the stress of surgery recovery. However, if she is impacted, she is very uncomfortable and cats with constipation will not want to eat. The cisapride is to help move the food thru the digestive system, but usually it is used in conjunction with lactulose which is a stool softener.

What diet do you have her on? Each cat is different when it comes to diet and keeping things moving – some do better on a high fiber diet, others find that a low residue diet making smaller feces passes thru the colon easier. Either choice should be the highest quality diet you can afford. The food should be preferably without grain, but most especially corn. The food should have no dyes or preservatives in it. Canned food is much better than a dry diet because of the higher moisture content. Many people on the IBD and megacolon groups have found that a ‘raw’ diet almost totally clears up their constipation and/or diarrhea problems. It used to be you had to make it yourself, but now many pet stores offer a high quality frozen variety that you just slice as needed.

It is imperative that the stool be kept from getting hard and dry. If Sweetie is dehydrated I would talk to my vet about giving her subQ fluids for awhile. (you know how to check by liftin skin at back of neck. The skin of a hydrated cat pops right back. But if it goes back slowly Sweetie is very dehydrated. )

I know you’ve seen your vet and a surgeon. Surgeons are very good at what they do – surgery – but they are not really good with ‘after care’ suggestions. You, I’m sure, like your vet very much, but all vets can’t be good with all things. Possibly Sweetie’s condition is not one of his strong suites and he is at a loss of what else to suggest. Maybe you could consult with a second vet that he might be able to recommend who is more versed on cats with paralysis and intestinal issues.

I know you are frustrated right now and very worried, You are scared and upset that Sweetie is so uncomfortable. It seems like it has been a long time for her to recover, but it’s only been a little over 8 weeks and it doesn’t sound like you’ve been helped much with the different things that might help Sweetie and you.

As others have said, there are different medications you can try, low residue foods that Sweetie might pass more easily, extra hydration if she is dehydrated. You can have her little bottom area shaved by your vet, especially if she is long haired, and that will help with odors and ease of giving her a bath and drying her. She can wear baby diapers part of the time when she is out having family time so that your home is kept cleaner. She can spend the night in the kitchen or a small tile bathroom that is easy to mop if she has an accident. There are many things that can be done and people here will help you with that by letting you know things that have worked for them.

Please give it some more time. Talk to your vet and if he doesn’t know, ask him to suggest another vet who may have more experience with Sweetie’s condition. Consider joining the mega colon and IBD yahoo groups. Even if you aren’t comfortable posting at first about Sweetie, it gives you access to their archives which often are a wealth of information and links posted by others.

Do stay here with us and do post of your concerns. This is a very compassionate and experienced group of people all of whom have been where you are now. It was hard at first and we too were scared and frustrated, but thru the friendship of the posters here we made it thru it. Now many of us care for several cats or dogs with paralysis or incontinence. (Sweetie is walking, right?).
/mari
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Re: Still incontinent after laminectomy cat.. advice

Postby critters » Thu Oct 21, 2010 6:00 am

FWIW, I think Carol and Mumpkees may be onto something. I've heard that human kids who get blocked by constipation can get diarrhea around the blockage, and can, therefore, have both at once.
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Re: Still incontinent after laminectomy cat.. advice

Postby MissWhiskers » Sat Oct 23, 2010 11:54 pm

Hi,
I do not have the kind of knowledge and experience the above people have, but I wanted to say that if the cat does not absolutely have to be put to sleep, I, or perhaps someone else like me that lives closer to you (since I don't know where you live?) would cat sit for the trips you mentioned if that is one of the main problems. If I live too far perhaps there is a forum on this website where someone else could be found? I would certainly try the theories mentioned above and if finding someone to cat sit for the upcoming trips helps afford you the time to pursue these ideas I hope you will consider that. Feel free to private message me. I live in Reston, Va.

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Re: Still incontinent after laminectomy cat.. advice

Postby Sweetie'sMom » Sun Oct 24, 2010 9:01 am

I really really appreciate everyone's advice. I cancelled the appt for tomorrow to put my Sweetie to sleep. You all are right, and I was feeling a little pressure from outside sources. This week,, Sweetie has not had any bowel blow-outs....actually nothing has come out at all. She is eating well though.. I am still using the cisapride transdermal,,,and metamucil in her food. Tomorrow I will call the vet and put her on the lactoluse syrup. I have been staying home with her during the daytime so she doesn't have to be cage bound. I can tell if she is going to have any episodes. She sleeps in the large cage at night,,this is normally when she has blow outs, if she does at all. She hasn't been on antibiotics since her surgery in August. And she is not paralized,,matter of fact she can run across the house like nobody's business! This has been such a confusing time in our lives. We have hired a caregiver for her when we travel. We live in Central Florida. I am hoping she does not have mega colon. 2 weeks ago when she was back in the hospital, they sedated her and gave her an enema. She has on voided one other time since then. I know we have to do something immediately. The cisapride doesn't seem to be working. But I am going to continue seeking advice and hopefully will hit on something that works. The surgeon said she has "neurologic colon"... Her colon is not working. She has nerve damage and doesn't feel the urge to void her bowels. Her bladder did come back, though, after many weeks,, so I'm not giving up and hopefully something will happen soon. I've tried to upload a picture of Sweetie,, but haven't been successful so far.
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Re: Still incontinent after laminectomy cat.. advice

Postby MissWhiskers » Sun Oct 24, 2010 12:49 pm

I know it is all very difficult and just want to assure you the people here are Great!! and while it might be hard to believe it - some of them may in fact have more hands on experience with some of these conditions than some vets! (as was previously touched upon above). I myself don't - but am constantly amazed at the knowledge of the very people who have been sharing here about your cat. :smart:
They have helped me with my own issues in the past and their help has been invaluable!! Sounds like you are feeling a little more hope...You can always come here when you need more, or have any questions at all! Glad you found someone to help with care when you travel - I figured there had to be others willing to do that whether professional or a friend or local young person who loves animals and can be taught whatever is involved...
Anyway, good luck to you and your sweet cat :wink:
I for one would love to see a photo! If you need help maybe go to the technical forum and they can help. I know they helped me with that sort of thing before.
best wishes,
Karen
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Re: Still incontinent after laminectomy cat.. advice

Postby janew » Sun Oct 24, 2010 7:12 pm

Hi, I am so sorry for Sweetie & you all for having to go thru this, it is overwhelming at first & you all are probably not getting anything but negative feedback except for here. I am so glad you have decided to try some more.
All the suggestions you got above are great & proven to work a lot of the time. I am glad you are going to start her on lactoluse. Since she has not passed any stool in a week, I think a return to the vet is prudent to see if she needs a 'clean out' & ask for some Sub Q fluids. Then start her on a raw "BARF" diet(google it) available to make at home or purchase premade or a no grain diet, ie Wilderness by Blue Bufflo or Taste of the Wild. Both available as can food & dry. I'd stop the Metimucil as she is blocking up with it, maybe not drinking enough. Try the lactoluse with the raw or grainfree diet, try putting an ice cube wrapped in a damp paper towel to her anus & keeping it there for a couple of minutes to see if that stimulates her to poop, if not, the 'lobster claw' manual manipulation does great ( I had a cat that was a stray that had been hit by a car & I expressed his bladder & about 75% of the time his bowel, he lived 13 yrs with me until he got lymphoma, responded to chemo. gave me another great year of company had a reoccurrence of lymphoma that did not respond to chemo., nothing to do with rear paralyisis or incontinence, he was estimated to be 17-18 yrs). Hopefully you will find the routine, diet & meds that work out for Sweetie & you all. Maybe mixing some probiotics in her raw or grain free can food would help...
Best of Luck & Wishes,
jane
Ps. Let us know, before her issues are 'older' like no poop in 2 days rather than a week. There are as Karen said, some very experienced, knowledgable & compassionate people on this forum to help you, if at all possible with Sweetie.
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