19 year old Manx cat incontinence

by **Corina** » Mon Sep 17, 2012 5:03 am

Hi everyone.

First, let me say I am SO grateful to have found this community! I have been lurking and reading here as much as I can for the past few days, trying to find a solution or two for my senior Manx cat, Max. I got Max when he was 5 weeks old, and like Nigel (in another thread) he was the runt of the litter. He is my baby, and we lost his 18-year old Siamese brother, Cleo (not a litter-mate, but they grew up together) back in April of this year.

Anyway, for about 3 years now, Max has been back and forth to the vet for bladder problems and what looks like advanced Manx Syndrome. He has always had the hopping gait of a "cabbit" but an x-ray showed that the last vertebrae between his hips and where his nub of a tail connects has completely disintegrated, making it painful for him to walk. He has severe arthritis, but still manages to get around, although somewhat 'gimpy'. Oddly enough, he can still jump up on the bed! He still eats and drinks like a pig, still has bright eyes and is still very loving, although he sleeps a lot more these days. We tried steroid shots and they worked for awhile, but they also had the unfortunate side effect of thickening the walls of his bladder. He is on a 'wet food only' diet to try and keep as much moisture in him as possible and keep his kidneys going since he is so old.

The problem is that Max will no longer use his litter box. He prefers something soft (like the bed or the carpet) and often goes in his sleep. It's like if he sleeps too deeply he completely relaxes and then goes, wherever he is. We express him several times every day by holding a newborn size diaper behind and under him and massaging his belly and also right around his anus on each side of his tiny bit of tail. It works, most times, and we can tell when he needs to go because he usually meows a certain way to let us know. Even so, there are still accidents. We tried crating him with a puppy pad during the day and he meowed incessantly and was miserable. We were sure he would get used to it eventually and even put in some old clothes that smelled like us thinking the people smell would comfort him, but after a week straight of hearing how much he hated it, we just didn't have the heart to keep doing it.

I'm having a heck of a time keeping a diaper on him. Despite being so old and gimpy, he has a rather wide backside (he still weighs almost 9 pounds!), so a sock isn't going to be big enough to hold it on him. When he does his bunny hop, the diaper slides down over his tail, even with a notch cut in it for his little bitty tail bump - it's like he purposely relaxes his tail nub enough to make the diaper slide off. I don't want to use tape that would stick to his fur, and he also has very sensitive skin around that area from a few urine burns. I've tried using antibiotic cream to soothe the rash, but he is still sensitive so I can't shave him yet because I'm afraid to hurt him.

I guess my question is if I'm doing the right thing, even trying to find a solution or should I just let him go and put him to sleep? Like I said, he still eats and drinks, still snuggles with me, still gets around and although he's slowed down a lot, seems like he still has life left in him. But I don't want to keep him around if he is in pain and just for my own selfish wants because I love him so much. I know 19 years is a long time for a cat, and I've been lucky to have him this long. I don't want to be blind to HIS needs. The vet has said that he will probably get to the point where he won't be able to walk and that it's likely the uti s will keep coming back. I just can't give up on him and am trying to find a way to keep him from peeing places where we don't find them until later. Even with expressing him several times a day and trying to be diligent, we don't catch it every time. (Nature's Miracle has made a small fortune off of us, I'm sure, but it works!).

Sorry to be so long-winded for my first post. I'm struggling with finding the right and best solution for me, but more importantly, for Max. Any help or ideas are greatly appreciated!

~ Corina

by **LisainCAN** » Wed Sep 19, 2012 8:47 pm

Hi Corina,

:welcomeblue:

I am sorry it took so long for one of us to respond.

I have had four Manx, one of whom is still alive and with me, and all have had varying degrees of Manx Syndrome. Some were diapered, some not.

Nineteen is a wonderfully beautiful age for a cat to reach, especially one with Manx Syndrome. On the one hand, it is confusing, because if Max is eating and snuggling, he seems to be doing okay. However, what personally gave me pause, and what would incline me towards letting him go, is when you wrote that "an x-ray showed that the last vertebrae between his hips and where his nub of a tail connects has completely disintegrated, making it painful for him to walk. He has severe arthritis, but still manages to get around, although somewhat 'gimpy'."

Cats and animals in general have a remarkable ability to mask pain. I recently realized this when my recently rescued ShihTzu, Olive, had such a terrible compression of her spine that she could only have been in excruciating pain for years. I knew that she was sensitive in her hind end and walked somewhat 'gimpy' as well, but when she would jump off of our bed which is very high off of the floor, you would never know the extent of the damage to her spine and what her subsequent MRI would show. Now that we had surgery to repair her spine, she is a different dog: carefree and happy .... and she runs! Max may also be used to the pain, as Olive was, and manages, but that does not mean that he does not suffer.

In the end, it is a personal decision. I just want to commend you for taking such great care of your cats.

by **Corina** » Wed Sep 19, 2012 10:39 pm

Thanks so much, Lisa, for your response!

I realize now that I probably shouldn't have asked the question about holding on or letting go, as most people probably feel it's way too personal to attempt to answer. I have not decided what to do yet, but I also know that you're right about cats being very good at being able to mask pain. I had not considered that he might just be "used to" the pain and actually suffering much more than I could see. The last thing I want is for Max to be in constant pain. As much as I love him, I truly believe in quality of life over quantity.

I am so glad that the surgery worked for Olive.

I know that had to be a huge relief for you and for her, too. No one wants to see their fur-baby in pain. I can't afford surgery for Max, and there really isn't a whole lot they could do for him at this point anyway. I do think one of the best things we can do for them is make sure that they aren't in pain. Sometimes letting them go to the Rainbow Bridge is the last, best gift we can give them.

Thank you again for your kind and thoughtful response. I really do appreciate it.

by **Jean** » Thu Sep 20, 2012 1:27 pm

Are you truly expressIng his bladder ? If you would have a vet help you to learn to locate it and adequately express it you wouldn't have the clean up problems you are describing. He may not have that much feeling and he may be tolerant of expressing.

by **Corina** » Thu Sep 20, 2012 5:52 pm

Thanks, Jean.

We did have the vet show us how to do it, but at the time she showed us, he had already pretty much emptied his bladder in the cat carrier, as he hates going to the vet, so there wasn't much that came out. You may be right that we're not getting "all" of the urine out when we express him. After about 5 minutes of us trying and him 'seeming' to be empty (he usually fills up about half a diaper each time we do it), he starts squirming and rabbit kicking, sometimes even trying to bite, clearly letting us know he is "done" with it for now. I have thought about trying the method of holding him vertically so that his back end hangs down and maybe having gravity help us empty him completely, but wasn't sure if this would be extra hard on his back and hips, so we haven't tried it yet. I plan to ask the vet if she thinks this will help and maybe it will. I'm not ready to give up on him, but want to be realistic about his pain level. I don't want to do the steroids again as they were so hard on him the last time.

Thank you for taking the time to read and comment. It is very much appreciated.

by **Jean** » Thu Sep 20, 2012 6:25 pm

I guess if mine were eating well I would question if they were in a lot of pain. In my experience I know they hide pain but if they are eating well I would question if they are in that much pain.
I express 8 paralyzed fur kids. All are expressed in different positions (lying down, facing away from me and to the
side standing up) find which way is best for him .
Have your vet teach you to express . Have the techs work with you.
Expressing takes awhile to learn but your boy will be cleaner and it will be less stressful on your family.
Do you need the links for expressing?

by **CarolC** » Thu Sep 20, 2012 9:15 pm

I have heard pets hide (conceal) pain, but I don't know if they mean both cats and dogs or mainly dogs because of the pack instinct to attack a weak member. My experience with cats is more that they "go hide" if they are in pain, for example under the bed, and I would not expect bright eyes. If he is eating well and jumping, I don't see how he can be in that much pain. I also think it's possible that the sort of condition of the vertebra they saw on the x-ray might be very painful for a normal and younger cat, for example if a cat sustained a similar injury being hit by a car, but due to age related spinal changes at 19 he may not be feeling it as much as a normal cat would. On the problem of keeping the diapers on, I have not actually put a diaper on a cat, but I did on a rabbit. It sounds like from your description the diaper does not come up far enough on his waist. Different brands of disposable diapers are made with different "fits" and possibly you could find another brand that will fit his hips but come up higher on his waist? It is also good to try the diaper both ways, with the tapes to the front and the tapes to the back, as you get a different fit that way. When I ended up with several packages of diaper "rejects", trying to find a brand that would fit, I had no trouble finding a young co-worker who would use them for his baby. They do make overalls to keep diapers on, I have never really wanted to go that far, but you can look at http://www.joybies.com. At 19 I would probably rather not stress him with overalls.

My ancient kitty, Betsy, got to where she did not want to climb into the litter box (and she was also blind) so she would go beside it, so I kept puppy pads under it to make clean up easy.

Betsy, had such bad arthritis. She could not jump up on a chair or raise her legs to groom. She LOVED having her own heating pad, which I kept on the bed. I kept it on low whenever I was home and unplugged it when I was gone. I made a bunch of different flannel covers for it, or you can wrap it in a towel. This might work for you, too. The thing is, if your cat loves the heating pad and sleeps right there, and does happen to wet when he sleeps, it is less of a problem because you can keep something waterproof under the area where the heating pad is. My favorite thing, which I used with Betsy, was the kind of quilted cotton underpads they make for bedfast humans. They are usually hospital green on the back and white on the front and diamond quilted and are about 36" square. They cost about $12 each at the pharmacy, but so worth it. The reason I think this might work is, you can't very well have waterproofing all over the whole house if you don't know where he will nap next, but if he has a heating pad he really loves, then you will know where he is and where to put the waterproofing. I think Critters uses mattress pads over the top of the bedspread at her house, so all the kitties can sleep on the bed. :catbed:

: Betsy_2006-04-27.jpg (35.71 KiB) Viewed 763 times

by **Corina** » Sun Sep 23, 2012 7:09 pm

@ Jean, thank you for offering the links! I found some in the other threads which led me to quite a few to watch and they were helpful. Like you, the fact that Max is still eating and drinking and not going off to hide makes me less inclined to think he is in a lot of pain, but I'm not an expert, either. He is tolerant of us expressing him up to a point and then he gets irritable and sometimes downright mean. It usually takes about 5 minutes to get him to that point, but as others have said, we sometimes take a break and give a go within a half hour. Sometimes there is more to come out, sometimes not.

@ CarolC, what a sweet picture of Betsy! I had an applehead Siamese (Max's "brother", Cleo) and they are such smart kitties. Your comment about the diaper and where it hits on the waist was exactly right! I tried turning it around and that seems to work better, but I think I am going to have to experiment with some other diaper brands. What you said about the heating pad made sense to me, too. We did try that (heating pad wrapped in a towel) at one point, but even with it on low he seemed to get tired of it after awhile and found another place to sleep. I don't know if he got too warm or if he just needed a change of scenery, but it wasn't like it became his all-time favorite place to be. BUT the thought of giving him some place which would become his favorite place (and thus eliminating the worry of finding accidents in unexpected places) is a very good idea! I have ordered a special bed which heats up and plan to put either puppy pads or the washable mattress pads over the top so that if he does have an accident, at least his bed will still be clean. Here's keeping my fingers crossed that he might take to it better than the heating pad. Since we lost Cleo, he has been sticking to me like glue and always wants to be in whatever room I am in. Maybe the bed will make it easier to know where he will be, regardless of what room I'm in at home.

Thank you again, both of you, for your wonderful ideas and suggestions! I am so glad that I found this forum/community!

It gives me hope to know that there are others out there who do very well with their aged and handicapped pets and that I'm not a horrible person for not just automatically putting him to sleep. Thank you!

by **critters** » Sun Sep 30, 2012 8:55 am

CarolC wrote:I It sounds like from your description the diaper does not come up far enough on his waist. Different brands of disposable diapers are made with different "fits" and possibly you could find another brand that will fit his hips but come up higher on his waist? ]

I had that problem with Buddy's diapers and ended up having to go with a size 3. A size 2 landed at his hip bones so he couldn't walk.