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Help Needed: New incontinent cat

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Barbara Miller

Help Needed: New incontinent cat

Post by Barbara Miller »

I am looking for advice and suggestions re: Mordecai, a cat I have had for about 5 weeks now. Mordecai lay in a ditch for 3 days before he was picked up by the police. Eventually I got him and took him straight to the vets where he remained for a week. He was dehydrated, malnourished, flea & mite bitten, scarred on the face, had patches of hair missing on his neck (probably from scratching towards his ears?) had a hematoma on his ear, and smelled horribly of urine. When I took him home I was told he was probably hit by a car, was not neutered, about 4-8 years old, and I discovered he was incontinent of bowel and bladder. His tail was removed a week ago. At that time the vet (not my usual vet) implied that it might be best to put Mordecai down, as the prognosis was not good. Oh yes, I forgot to say that M is blind also. (We have a sanctuary for blind cats, which is why we happed to get M to begin with.) One eye is dilated, the other eye is sunken, milky, off center, and seems to have a sore at the edge, which heals and then re-scabs. I have gotten diverse opinions on M's chance of healing. One is that it could take several months, the other is that any healing would have been noticeable in a week, though not complete. I am willing to give this guy a chance over the summer. We have a fenced courtyard and when he tinkles on himself, I wait until he is on the deck and then pour warm slightly shampooy water over his back end. I have to scruff him to do this. Every couple days, if my husband is around, we can give M. a hind end bath together, but it takes all my husband's strength to hold him. I have an appt. on Monday for the vet to show me in person how to express M's bladder. She described it to me without M being present, and I have not been able to do as she described. M will not stand up nicely for me. I can scruff him and put him on his side and rub his belly a bit and get some urine to come out, but I am far from emptying the bladder. Poop falls out everywhere and I am doing a lot of laundry, which I am willing to continue to do. However, on Tuesday, there were 10 drops of blood on the floor. I was hoping it was from another cat that got a claw stuck in the screen. Today I realize it must have been from M. He was fine at breakfast. Then he dripped blood all over the deck and steps. He did not drip walking about 20 feet across the tiled floor and is now resting it a chair with his bottom and the back of his legs bloody dirty. No fresh blood. I called the vet who put him on Amoxi, with the instruction that if he is not better promptly (by morning) to bring him in. I figure it would be best to withhold food for the rest of the day. M is not a feral cat and he can walk, although all the rest of the cats do not want to eat or be near him. He allows me to pet him, but there is usually a short time after which he has had enough and swats me, or tries to bite. I forgive him--he is obviously not well. Even when he is scruffed he eventually tries to bite or scratch. I bought diapers for him, but am hesitant to try them. I keep thinking that with poop pouring out of him, the diapers will only hold all that mess against an already tender area. Usually he has some feces half-in and half-out of his bottom. This morning there were none, but his anus looked like ground beef. With feces in the canal (?) only the very edge of his skin looks red. Today a circle almost an inch across is red. It does not look like outer skin that is irritated, but inner skin swollen out. I fear there is something else going on inside that has not yet been diagnosed. Does anyone have experience with healing from M's type of injury? Have you seen the nerves regenerate? How do you keep a cat like this clean when he may be testy and uncooperative? The vet said he was in bad shape long before I got him. I don't know if she meant the 3 days he was in the ditch, or longer. I am not fast on my feet and didn't think to ask. I have to collect my thoughts and questions and write them down before going to the vets. Yes, M was on a steroid at the vets, but is no longer. He is on Bethanechol Chloride for his kidneys/bladder. I would like to help this poor boy if he is salvageable, but I don't want him to suffer in any way. My goal is a good quality of life, even if that life is "different." His lack of being maleable is the biggest hurdle to the physical care. Not only do we have personal pets, but we have about 14 others in the sanctuary, and foster bottle babies for a local feline rescue (currently have 2 bottle babies + 9 other rescues under roof.) What type of time commitment am I looking at? I know I am not doing a good job of keeping him clean as he is losing hair at his hind end. I need to do right by this guy or have him put down. Any help you can offer would be great. Barbara
Carol T.
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Re: Help Needed: New incontinent cat

Post by Carol T. »

I'm not an expert on this, but there are many posts on this board re: incontinent cats and dogs. You might want to check them. Sounds like he needs to see the vet to determine the source of the blood. I have read here that it is advisable to shave the kitty's rear in order to keep him clean, and to use a 3M product, listed not too far down on this board to prevent urine burns. As far as managing him, I have a "cat bags" for when I need them. One I bought from a vet years ago, and one I made. If you've never seen one, it's a sturdy canvas bag that encloses the cat completely except for his head. A hook and eye secures it around the neck. There is a small zipper at the tail end that allows access to the rump and hind legs. It's sort of a straight jacket for cats, and works pretty well!!
I'm sure someone else will have some good advice for you. Good luck! If he makes it, I think once you establish a routine it will become easier. Carol T.
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P.S.

Post by Carol T. »

Forgot to mention that there is a zipper the length of the bag, too! You fasten the hook and eye around the cat's neck, and then wrangle his struggling body into the bag, zip it up, and voila! He's rendered almost helpless while you unzip the little zipper and clean his butt!!!
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Barbara Boehmer
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Re: Help Needed: New incontinent cat

Post by Barbara Boehmer »

Here are links to a couple of good articles in the wiki on this site. CarolC and some other members have put a lot of work into gathering various pieces and photos and putting together the comprehensive articles.

Bowel management in incontinent pets

Express a dog or cat
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critters
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Re: Help Needed: New incontinent cat

Post by critters »

The blood was probably from a UTI; with one, pee can be almost as dark as Kool Aid. Please scour the links Barbara B. gave you; I STRONGLY suggest expressing and poop-on-demand. His skin may be becoming irritated by poop and pee; you've already heard about shaving and Cavilon spray, now widely available as 3M first aid spray (CarolC did a wonderful thing digging up that piece of info!).

As for recovering in a week, that's WAY wrong. It can take months or even years.

My feeling is that if you and he can't come to some sort of agreement about expressing and poop-on-demand, as in he'll let you do what you need to do, that would be a signal for me. Constant UTIs, sores, etc. would NOT be a good way to live, for him or for you.
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CarolC
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Re: Help Needed: New incontinent cat

Post by CarolC »

Hi Barbara,

I have not read what others said yet so please forgive me if I duplicate. First, here is a link with *very important* information on bethanecol.

http://www.handicappedpets.com/cgi-bin/ ... read=16566

I think your cat is at risk for megacolon, which is when the cat has trouble emptying the bowel in a timely manner and waste builds up inside the colon and it stretches, making it harder for the cat to eliminate. Your vet should be able to feel if there is an accumulation of waste in the colon. I would consider getting him on lactulose syrup, a safe stool softener. Also, if he will allow it, I would pop those stools out of his rectum for him when you see one halfway. Here is a link on bowel management, including a section on squeezing stool out of rectum, and some information on mobilizing stool in the colon.

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

Also, here is some information on expressing the bladder.

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

I agree with your idea of not diapering him while he is raw. Do you have to worry about fly strike where you are?

I will read your message again this evening as I think there may be more to add. I hope this helps for a start. I think you can get past his current condition and he can have a good quality of life, however you give a really good picture of what you are coping with. Part of it is going to depend on him, and you both have my very best wishes.
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CarolC
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Sorry I duplicated Barbara Boehmer's links

Post by CarolC »

Oops! I'm sorry, Barbara B., usually I read other responses before I post mine, I was in a hurry to go somewhere--I see you gave the pushbutton links already. :)

Barbara Miller,

Here is a link to see Fripple, another cat who can walk but lacks b/b control.

Fripple

I mentioned megacolon earlier, I think that is going to be your main issue and may be one now. Here is a webpage about megacolon--you can find much more searching the internet. This webpage is archived so I hope it opens properly for you. Also, it mentions Ivory soap and I think Ivory has been reformulated, I'd check with the vet before using it. The webpage also mentions Propulsid (cisapride) which might be a good idea, at least short term.

Bunny's story

Is he eating OK?

With a spinal injury you have to give it at least 3 months to see if bladder control will return, and 6 months to be sure. Whatever you have at 6 months is probably pretty much what you're going to have. Whoever said a week was wrong.

I just want to say that I understand what you are saying about being conscientious and wanting to do a responsible job of providing him a decent quality of life, and that is only right of course. But please don't fault yourself if you feel you have not got all the bugs worked out yet. A pet care routine for a disabled pet is something you develop as you go along. It certainly isn't perfect at first. DON'T LET THE PERFECT BE THE ENEMY OF THE GOOD. In other words, you may feel it is not perfect yet, but it's better than it was, and it's going to get better because you care enough to figure out what is needed.

I hope you will take some time to read up on megacolon before you go back to the vet. I'm a little worried the vet is going to say he is very constipated (obstipated) and needs expensive treatment, or at least an enema and cisapride. Are you by any chance in Texas?
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Jean
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Re: Help Needed: New incontinent cat

Post by Jean »

Dear Barbara,
It sure sounds like you have a full house. Bless you SO much for caring about homeless "furry kids".

I have a paralyzed cat named Jaime who was HBC at 6 weeks of age. She is now 7 years old. She has never regained her bowel or bladder control. I have to express her bladder every 6 hours and assist her with pooping. She has a very tight urinary spincter so she never leaks urine unless she develops an infection. I am very careful about keeping her clean or she would likely develop an infection. She drags herself around on our floor and carpeting. Mordecai needs to be watched very carefully. I would suggest that you bring him inside. Could he be kept in a tiled small room or a crate so that he can be monitored and watched closer and kept clean. By being in an enclosed area and closer to you it might help him to become more relaxed and less nervous when being handled.

Mordecai (That is a very unusual name but I like it!) is different from Jaime in that he is able to walk. However, that is probably where the differences end. It is important that you work with the vet and learn to express him. From your discription I can't tell if Mordecai would leak urine if he was adequately expressed. Like I said previous, Jaime does not leak urine but some cats do and must wear a diaper. It depends upon the site of their injury. However, Mordecai may be leaking urine because his bladder is so full and distended.

At first, I had doubts about whether I could adequately care for Jaime. It took me weeks to become proficient at expressing her. I nearly lived at the vets office. LOL However, with a routine as Carol mentioned, it can become manageable. However, Mordecai will always be a lot of work. Like you, I have a lot of special needs cats, etc. However, due to all the care that Jaime requires I have developed a bond with her that is so strong. She is my baby and I wouldn't trade her for anything. When I first found her one of the vet technicians said to me that they could never devote the amount of care necessary to adequately care for Jaime. But Barbara you know what, YOU CAN and it will change your life when you see the bond that can develop between you and Mordecai. As you become more proficient at caring for him it will get easier. He will always be a lot of work but it is manageable and so very fulfilling.

Please keep us updated on Mordecai's condition and what the vet suggests. We are very willing to give you ideas and suggestions concerning his care. We want you to succeed. Mordecai is counting on you. Sincerely, Jean
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CarolC
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I'm sorry for 3 separate posts (long)

Post by CarolC »

This case really stikes a chord with me. Barbara, earlier I mentioned popping the stools out when you see one halfway. Yes, I really meant it. I used to do that with one of my cats for a different reason. He wasn't incontinent but he was longhaired and sometimes things just got hung up in his fur halfway out--unpleasant for him. I used to grab the visible end and simply pull it out. You would think a cat would turn around and swat you when you did that, but just the opposite happened. When I removed the stool, it made him rocket a few feet away in a short dash, leaving me holding the stool. I don't know how much sensation your kitty has in his bottom, he may scarcely notice, although I'm sure it would be polite to let him know you're there since he's blind. Some people have misgivings about grabbing waste in that manner. I got to where I did it bare-handed and then washed afterward. If it bothers you, I guess you could get some disposable gloves. You could also take a kleenex and use that to pull the stool out. I wonder if he was scooting on his bottom trying to get stools out.

There is a calico at the local no-kill shelter that I visited, and she has a tail injury--she was kicked and the tail was amputated and he gets expressed every day. While I was there, the kennel worker put her up on her shoulder so she was looking over her shoulder and her rear end was in front where she could reach it. She could tell by feeling that there was stool in her bottom and she popped it out.

The same thing occurs with my paralyzed dog. She has trouble pushing enough to push stools out. By the time she finally goes, it is bigger than what my golden retriever leaves in the yard, yet she is only 7 lbs. Therefore I help her every day. I do not know how Jean does it with Jaime, but I can tell you how I do it with my dog. I stand in front of the bathroom sink with a layer of kleenex lining the bottom of the sink. (That's our drop zone!) I hold my dog hugged against my chest so her spine is against my chest and we are both looking into the bathroom mirror. Her hind feet and tail are dangling down in a ragdoll position. Then I reach down and pinch the area around her bottom. If I feel stool, I pinch it and it comes out. Then we repeat. I feel like having her in the ragdoll position, we get a little advantage of gravity, maybe it's my imagination. Anyway, usually after the first stool is out, another one moves into position and by the time we've done this 3 or 4 times she is nice and empty. It would be great if you could do this with your cat. If not, it would help somewhat to at least remove what is easy to grab as often as you can. That will let the next bit of stool move forward unhindered. I am not sure how tender his bottom is right now. I would think he'd still be in some pain because of the amputation. It might be very uncomfortable for him to be dangled in a ragdoll position a week after a tail amputation, but maybe later you can try it that way.

What does Mordecai look like? I hope you will give an update, expecially if you go to the vet tomorrow.
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Barbara, is there any news on Mordekitty? *NoMsg*

Post by CarolC »

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Another cat with a similar condition

Post by CarolC »

Hi Barbara,

There is another rescuer like yourself who has a cat with a similar condition. I sent her an email a little while ago and hopefully she will be able to respond to you in the next couple of days. Here is a link to a message about her cat.

<a href="http://www.handicappedpets.com/cgi-bin/ ... ad=9187</a>

I am having trouble finding another message by her at the moment, but I remember she said that since the sphincter is permanently open, the leading end of the stool tends to dry out. She has taken wonderful care of this cat and even started an email group called Kat's Club where she helps disabled animals. Here is a link to Kat's Club with a picture of Kat.

<a href="http://groups.msn.com/ElClubdeKat/katsc ... sh.msnw</a>
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Jean
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Re: Another cat with a similar condition

Post by Jean »

Hi Barbara, Did the vet give you any information about helping Mordecai? People on this bb really care and would like to help you with any concerns. Please post and give us an update. Jean
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Re: Another cat with a similar condition (KAT) *PIC*

Post by Debbie-Spain »

Hi Barbara

I'm sorry Mordecai has been found in such poor shape. I hope that little by little he is improving.

My cat, Kat (spinal cord injury from being hit by a car), has the same type of incontinence problem, i.e. her anal sphincter is permamently dilated and the poop just kind of oozes out of its own accord. She also has urinary incontinence and that also tends to come out on its own but I express her at least morning and night to ensure she doesn't get too full because sometimes she does retain urine.

I can't comment on the blood because it could have many causes and the vet will need to see it to find out the cause.

If you want to be able to manage his incontinence problem one of the most vital things you can get is the 3M Cavilon spray (Carol C. knows of a cheaper brand you can get in the USA) which you use to cover his rear end and around his urinary opening if he gets irritated by urine too. It will help his rear end to heal and protect it from further damage. If he has actual sores you can use honey which is a bit messy but heals well.
Important to remember to keep him de-wormed, because the slightest hint of worms can cause severe irritation (I tend to forget worming sometimes because I have animals with much more severe problems but it is important, especially so with incontinent animals).

I generally bath Kat (morning and night) by putting her rear end under the shower and cleaning using a "non-soap soap" (the kind they use for children with sensitive skin) and baby wipes. Every so often I get the vets to shave her rear end to try and keep it cleaner (her tail is amputated completely). I have also found that if she is irritated, aloe vera gel helps soothe, but you have to be careful with cats that lick their rear quarters, Kat doesn't, so I put it on at night and wash it off in the morning in the shower. Kat has never particularly liked being showered but she tolerates it. She does like the hair-dryer afterwards if the weather is cold! I also have a kind of square bucket or bowl with high sides, just about cat-size, and sometimes I bath her in that. Once she is in the warm water she purrs and seems to enjoy it, but you may find you have a scrabble with Mordecai to dip him in the water. I still have to finish off with the shower, but she relaxes in the warm water so she doesn't mind the shower so much afterwards. Obviously bathing does not get them as clean but it may help Mordecai get used to the water because he is going to have to get used to it.
I don't diaper Kat because of the reasons you mention and also because originally she suffered problems in her rear legs, and although she walks with a funny gait, when I try and put a diaper on her she just falls over and squirms about. So in her bed she has liners that I change every morning. During the day she spends most of her time in the garden.

The most important thing once you have the initial situation under control is controlling their diet. If Mordecai has other issues then you may need to use something specific, but then you have to try and get the faeces of the best consistency. Not too soft to make a great mess and not too hard so as for him to get constipated (megacolon is a risk if the colon does not have good motility). If his stool is hard there are several things you can add to his diet to soften it. When it is softer it is more difficult, especially if they won't eat dried food.

As for expressing, it is more difficult with an uncooperative cat, but if you persevere I think you will get the hang of it. Probably you are nervous at the moment when you try it and he will sense that. If you can I would try and get him into a small room with plenty of Feliway and just try massaging him first, gently, try and find out what he likes and what makes him relax, then carry on doing that while you express. It took me 2 visits to the vet to learn to express Kat's bladder, the second one was 45 minutes until I got the hang of it. Now I can express her bladder and her bowel if necessary. Expressing the bowel helps a little with avoiding mess, but you can only really do it if the stools are quite firm, if they are soft there is nothing to express.
I also wanted to mention that although I was quite dubious, I have had good close-hand reports about the use of Bach flowers in animals that are particularly traumatised and not very trusting of humans, and also for help with incontinence. If you want to try that route let me know and I can ask the vets I know that use them what they recommend. Acupuncture can also be very helpful (the one day we had a successful acupunture session with Kat she not only enjoyed it but was dry for 8 hours afterwards, the other times we tried it she could smell the scent of other cats at the clinic and got very nervous), but it may not be a possibility in a blind, frightened cat.

I think you are great for trying to help him, many people faced with that scenario would PTS straight away.
If I can help at all please don't hesitate to contact me at clubdekat @ gmail.com (remove spaces) and I will do my best.

I really do hope that Mordecai makes a good recovery. When I took Kat in she was 3 months old, my vet told me that if I wanted her to live she could live with my help but that I would be her slave. She is nearly 4 years old now, and my vet was right to a certain extent because when Kat has additional problems (urine infection, megacolon) the care has to be more intensive, but on normal days it is just part of the routine now. I bath her first thing when I get up and last thing before I put her to bed (she sleeps in a big transport box because it avoids mess everywhere in the morning). She is always dirty both times but at least her skin seems to be able to stand up to that routine, and so she doesn't get sores or irritation.

Sorry for the long post but hope you can get something useful out of it.

Thanks Carol for advising me, will try and post with updates on the others soon!

Picture attached of Kat taken this month, April 2006...

Debbie



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She is just beautiful! *NoMsg*

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