Rescued cat with tail pull injury. Fecal incontinence + quality of life

[CarolC]

Replies Inline in blue, though I don't have anything very useful to add

Spot is pooping plenty GOOD so I don't think we need to break up her poop yet, but we will keep that option in mind. Most of her poop is getting in the litterbox, and maybe a small amount on the bathroom floor / her sleeping cardboard box.

The vet did take a stool sample at the vet initially. They found roundworm and she was given fenbendazole. The plan is to give her another dose in about a week (three weeks after the initial dose). We are hopeful that she has roundworm still (weird thing to say) and the second dose could offer more incontinency improvement.
I never heard of fenbendazole, but I see it's Panacur (I've heard of that). I hope the second round helps. Who knows how long she's had the worms. Roundworms can transmit to humans, but I don't know anyone it's happened to. Her little room looks very easy to keep clean.

She does have perfect bladder control as far as we can see. She has never peed outside of the litterbox in the two weeks we have had her home. It is encouraging that you believe this is very encouraging!
If she has perfect bladder control, I'd be inclined to be optimistic. There is an article that has been cited on this forum for many years. It was published in 2002 and first posted here in 2006 and I see it was just updated last year. It does not let you copy/paste but here is the link.
https://veterinarypartner.vin.com/defau ... id=4951820
It says some tail pull injuries may not show on x-ray if the bones are intact. It also says bladder control usually returns in a week to a month if it's going to, but tail function and sensation take longer. Your cat has bladder control and it hasn't been nearly a month, so that's what's encouraging, if this is a tail injury.
My partner is a doctor, YAY! so she would probably be good with the sub q fluids. The vet did say she was likely still dehydrated at her follow up last Friday. We have been only giving her the Royal Canin Gastrointestinal Fiber Response food (mostly the wet to address the dehydration).
It takes good hydration to have plenty of saliva to groom. I'm not sure why your kitty would still be dehydrated on follow-up if she has her own water bowl and is also getting canned food. It would be more expected in a senior cat, but she's young.
We believe that she is able to move the base of her tail very slightly. It is always limp when she is standing, but when she stretches, she is able to extend it. Here is a video of her "swinging" her tail away from her body during a stretch. But we have never seen the tail "up".

https://drive.google.com/file/d/1CxCNcO ... drive_link

Her tail is up better than my Mordecai's was right after the potted plant fell on him years ago. His was really hanging down like a horse's tail. It did get better though he was only able to get it to about 90-95% full height after he recovered. He must have just been bruised because he didn't have incontinence with his. I know it was a potted plant because I found the plant on the living room floor, and the plant stand tipped over.
We have been able to get her to react if we pinch her tail closer to the base, but we can't get her to react if we pinch it further down. The vet even said that the tail feels a little cold compared to the rest of her body. She suggested amputation as a potential option later down the line, but we want to see how she is once she is more stable first.

I'm not sure if her anus is closed all the time. We'd have to take a look. I feel bad for being so squeamish. My partner has been handling more of the dirty stuff lately.
Do you have disposable gloves? They might make the cleaning easier.
The vet did take x-rays initially to check out the obstipation situation when we first brought her in. Unfortunately, that x-ray doesn't capture her entire tail. However, the vet did say her pelvic area was healthy. Here are the two x-rays we have. The vet was kind enough to do these for free, but we're not sure if it's worthwhile paying >$500 for an x-ray of her tail.

https://drive.google.com/file/d/14DYDzS ... drive_link

https://drive.google.com/file/d/1xPJz1I ... drive_link
I can't see anything, but I'm pretty hopeless with x-rays unless it's something glaringly obvious. I can't even be sure if I'm seeing her colon or not, and I can't see any breaks or obvious irregularities in the tail area.
Thank you for your time and effort. I understand that nobody can confidently say where she will be down the line, or what her new normal looks like. But I sincerely appreciate the extra opinions and suggests for nursing care.
Everything you say makes her sound better than I thought. 100% bladder control, eliminating well and most of the poop in the litter box. Eating well I guess? There is a skin turgor test you can do to see if a cat is dehydrated. You pinch the skin and pull it up away from the body and observe how readily it snaps back. There are a lot of videos on it. Here is one (sorry about the music but the video part is good.) He calls it a "skin tent test". https://www.youtube.com/shorts/GBqXzPyqf9w. You can also learn to recognize kind of a hollow-eyed appearance in the face if they are dehydrated.

I watched the 3 videos in the other post. Thanks for fixing the Google Drive permissions. I agree it looks like there might be a mobility issue in her hindquarters. She is walking well enough but it takes a lot of careful maneuvering to get into position to groom her bottom. In one of the videos it looks like she is weight-shifting to have more weight over her front legs, but I can't be sure. If her hips and pelvis are OK, then I'm not sure what it is, but I saw something in the article linked above that said 46% of cats with tail pull injuries also had either pelvic fractures or sacroiliac dislocations. The vet ruled out a pelvic fracture...don't know. I don't know if you have an option to have the x-rays read by a radiologist. Maybe they would see something a regular vet would not. I don't know what kind of extra charge that might incur.

The only real suggestion I can think of would be to maybe get her something soft to sit on for grooming? You could enclose it in a garbage bag (if you have any that are unscented) and put a towel over it or something. I'm just thinking if her hindquarters are sore from an accident, she might be able to settle into grooming position better on something soft? The little sherpa kennel mats are padded and machine washable and have a loop to hang dry. Here's an example. https://www.chewy.com/midwest-quiet-tim ... e/dp/45717

EDIT TO ADD: I just found an old thread about Miralax and lactulose and part of it is pretty funny. The cat in the thread is Libby, who I mentioned before. You might get a smile out of this (if you have time) or be able to relate to some of it. I was trying to go back and see what happened with the cisapride. She didn't stay on it but I can't remember why, and it looks like I didn't post about why we quit cisapride, so I don't know.
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[Actuadoc94]

Hello,

Thank you all for your helpful messages. It is extremely appreciated. I am posting a brief update on Spot.

Our vet has initially put Spot on Miralax. We have been weaning her off of it (now she just gets one dose every three days). This has helped her incontinence, although there is still a little bit of leakage in her bed.

We would like to eventually get her to the point where she doesn't take any stool softener. But we have to make sure that it doesn't cause her to get backed up again. I hope that she was originally backed up because she was dehydrated / unable to find water with her injury.

Because Spot still cannot move her tail pass the base, and doesn't groom it, it often gets dirty. We are likely going to get it amputated. Is there any chance this will help her incontinence? I tried searching this forum but couldn't really found too many past experiences.

Thank you - just curious if anybody has any had improvement with fecal incontinence by ceasing medicine / tail amputation.

[CarolC]

just curious if anybody has any had improvement with fecal incontinence by ceasing medicine / tail amputation.

I've never heard of improvement in fecal incontinence as a result of tail amputation. I am not a vet but would think the incontinence is likely due to nerve injury from the tail pull. That is likely still healing as it's only been 2 or 3 months, hasn't it? You said she can move it from the base. That's pretty cool. I don't know how much healing will occur or whether she'll be able to lift it someday, but nerves heal very slowly, so I would guess some healing is still occurring, even though she looks much the same. Sometimes people do a tail amputation to prevent the cat catching it in a door and possibly doing more damage. If she's not grooming, it might help to shave her bottom and tail area anywhere she's getting soiled. It would help prevent cling-ons and make bathing her easier if you are doing "butt baths". Is she not grooming because she has a hard time getting into the position to reach her bottom? Does she have someplace very soft/padded/cushiony to be on while she tries to lift her leg to groom? Someplace comfortable for her lower back. I am glad to hear she's needing less Miralax now, that sounds good.

[critters]

I agree that the damage is probably from the original injury, but if her tail is a problem it can certainly be bobbed. My Razz is a bobtail, probably from birth, and has about 3 inches of tail. Less tail makes for easier diapering if you should do that, too.

[FYI]

https://www.kestrel.ws/erasmus.html