Hoping to Learn and Find Support

[BeccaJB]

Hi all,
My name is Becca and I have been a foster care provider for my local humane society for a few years. In October of 2013, I returned from an extended research trip and, still unemployed in November, offered up my services for a weeks-old orange tiger kitten with hind end issues, purportedly caused by a car door being shut on him. There were no fractures evident but he was paralyzed from the "waist" down, with a low-motor bladder and incontinence, as well as muscle contracture. His tail moves some, on occasion.
Fast-forward nearly a year later, and Pierre is still with us - we've fallen in love with him and will likely adopt. It HAS been a long road. It took some time to master nursing care but he now gets his bladder expressed twice daily and I will soon make some cloth diapers up (he currently uses Luvs). We tried some wheelchair creations but he is actually more mobile without, and seems to prefer it that way.
I guess the bottom line is that I am interested in hearing if any of you have experienced similar cases. There are a lot of unknowns remaining.
-I am hoping to get a better idea soon of what complications he may face down the road (perhaps joint- or hip-related as a result of his legs getting situated in odd ways).
-We have discussed holistic remedies with his current veterinarian. He is not expected to ever use his legs, clearly, but we are told that nerve repair while unlikely, is not out of the question.
Becca

[critters]

With my SCI boys I think contractures have been the worst part, and we tried everything with Koi--regular and custom splints, regular and custom shoes, and surgery. We've never had much skin breakdown, except with contractures.

Yeah, cats don't usually care much for wheels!

Do you know about pee meds, like bethanechol and phenoxybenzamine? They can help SCI critters pee better on their own.

[CarolC]

Are you managing his BMs too? It seems that paralyzed cats are more likely to develop complications with constipation (more so than dogs).
Is he in his diaper 24/7 or does he sleep bare bottom at night (can be a good idea, allows the skin to breathe).
Can you describe the angle of his contracture, or maybe post a photo?

[BeccaJB]

Thanks so much! I will post a picture soon. The adoption decision is final , all that remains is paperwork and whatnot.

He is in his diaper always, though sometimes I give him a little breathing time. Because of the nature of his paralysis, his penis would be in constant friction with the floor - the diaper also seems to prevent rawness there that we saw previously.

The biggest issue with the contracture right now seems to be diaper changes - he seems otherwise unaffected. I believe that he has one leg that is a bit more severe than the other and he gets upset (presumably discomfort) with the diapering process when I am fastening one side.

I have not yet been shown the bowel process and he hasn't had issues yet. The vet did not seem concerned with the frequency of it coming out on his own. I plan on asking him though, because it's something I want to know. When I do his bladder, it sometimes works some of his stool nearly out (I can see it) and I pinch it the rest of the way.

I'm pretty psyched to have found this place. In the first months we had him, I never expected to adopt him. I also never expected to be prepared to take on the work but, boy, now that I have done it, it isn't actually that much work! And he has adapted so well and developed such a personality. Thanks again for the input.

[CarolC]

Yes, it's not uncommon for expressing the bladder to result in some stool, too, while you are squeezing the tummy. Maybe you can learn to feel his colon since you are expressing him anyway. Then you will be able to monitor it. When you first do it, you may not realize what you are feeling. In my experience, I was expecting the colon to feel soft but it was actually very hard due to stool being in it. Some people use massage to break up the stool in the colon to help it pass. I'm hoping since your kitty is lower motor neuron he might have less problem but paralyzed cats really can get backed up, and people have used various methods to help regulate them, including lactulose syrup, Miralax, canned pumpkin, enemas, and manual expressing. There are several videos about expressing the bowel on cats. You can find them at the very end of this article.

http://handicappedpet.net/helppets/view ... =5&t=18586

[BeccaJB]

I've attached a picture of Pierre! I used my phone, so it's not super-high quality but it gives one an idea - his hind legs are pulled fairly close to his body. It was one question on a laundry list when I brought him to one of his appointments. All I knew at first was that he was paralyzed - but I also was pretty sure before asking that simple paralysis was not the explanation for this tightness - that's when he told me about the muscle contracture.

Also, I can tell when he has poop IN him, his vet did point that out. I was quite pleased with him because he got right down on the floor with us and actually showed me the process, answered all my questions (before I knew I was adopting him), and was very open to alternative potential treatment pathways.

The science background in me makes me so curious of the ins and outs of this injury. Due to a rotation of volunteer vets, the one I saw first saw Pierre a few months in. Based on everything he saw at THAT point, if he hadn't had the explanation, he said nothing in particular would have indicated that this was a result of trauma, and not congenital. Thanks again, I plan to check out that video.

[critters]

When I expressed Buddy, usually poop would precede pee, so it was pretty convenient. http://www.amazon.com/Buddy-Easy-Reader ... slow+buddy

[BeccaJB]

Tonight, I noticed a little possible blood spot on his diaper - it's by one of the pull-tabs, not near his genital area. He chews and pulls at the tab areas - I assume this is the cause. Does anyone have any advice to make him more comfortable? I'd like to make him cloth diapers, but I was going to base them on these, which seem to bother him.

[CarolC]

I don't know, just thinking out loud. I have used diapers with a dog and a bunny but did not have this problem. I wonder if it would make any difference if after you put the diaper on, you work your fingers inside under the tab area and be sure all the fur is smoothed down the right direction, and see if you can feel any rough spots inside where the diaper overlaps? I have no idea why he's doing that. If it is just a matter of keeping it fastened, more than one person has used masking tape...but I don't think that is what you're talking about. Is it possible he might have slightly cut his mouth chewing the edge of the tab, though they are really pretty soft in my experience?

I like the idea of cloth diapers but I kind of wonder if they will be harder to keep on, due to increased friction with the flooring and no elastic for snugness...or do you have uncarpeted floors throughout? With my bunny I used Huggies preemie disposables, and with my dog I am using denim diaper covers with a Poise pad inside (she is paralyzed and bounces on the floor with her bottom). I do think sometimes the elastic waist of the denim diaper begins to bother her at the end of the day.

EDIT TO ADD: I am looking and looking at your photo. It is a good quality photo, I can see it well enough, and those diapers sure are cute. What I am not sure about is, does the diaper leave one leg out because of the contracture? There is someone here who posts as Mumpkees (her name is Mari) and she has a cat who has to be diapered a special way due to the hips being fused. Let me find that post, and I will also send her an email to see if she has any ideas, since she has actual experience with this.

http://handicappedpet.net/helppets/view ... per#p91745
http://handicappedpet.net/helppets/view ... r&start=15 (see the photos of Dallas in a diaper)

Dallas did not think she should have to wear diapers and would immediately disappear only to reappear moments later with no diaper. This is where masking tape or duct tape comes in handy. With Dallas we used duct tape tabs over the diaper tabs because it is difficult for them to get a well stuck down duct tape tab up. Besides because of the way her legs are we couldn't masking tape wrap her. (Her legs are fused straight out along the right side of her body). We actually turned her diaper sideways running it thru the space between her legs and her body.

My bunny had contractures and I had to diaper him with his knees inside the diaper. Here is my post about that.

http://handicappedpet.net/helppets/view ... side#p8578

[BeccaJB]

I think the big problem is that, due to the contracture, his legs are pulled right up tight to his body (kind of the opposite almost, of what you describe, with legs straight out stiff) and perhaps it causes him discomfort to have the diaper there. I think it could be too small in the leg holes - it fits great around the waist but less-so around his legs.

My plan was to do some light elastic ruching in the legs and waist and maybe even the tail hole, so that it gives a little. I am also considering a bit of padding in the rump.

My thought was exactly like you suggested - he chewed and pulled and it was a tooth or gum thing.

[BeccaJB]

Also, both legs stick out of the diaper. I'm not certain if diapering them in would work - the "thighs and knees" seem to help keep it on, I think it might otherwise slip off? Also, it's funny reading your post about your bunny being treat-picky - Pierre doesn't seem to care about ANYTHING that doesn't involve catnip.

[critters]

My Buddy, about a 10 pound cat, had to wear size 3 diapers because he was so long-waisted. You might try different sizes and brands to see if one suits him better than another!

I've decided that my Baby will be going into diapers at night, starting tonight. It'll be interesting...

[BeccaJB]

I returned an unopened pack of size ones and got some threes, which seem to work better so far! I love this cat. He's tearing around the room right now and it's such a clumsy sound.

[critters]

If you want to try more, you might ask neighbors, coworkers, etc. to give you a diaper or 2 to try if they have kids in their worlds. They can write on the diaper what kind and size, because it really is hard to find the right one for a critter butt! I used to sign up for loads of diaper freebies from Walmart and anybody else that had them.

[BeccaJB]

Well, I have an update. First off, size 3 Luvs have worked great. Things happening in Pierre's world: he has a FB page now and I am considering building him an accessible window seat/bookcase/thing for holding plants (out of his reach).

The reason for the update though, is that I had to get him to the vet. I noticed maybe Tuesday morning that he didn't seem himself - usually chirpy, rowdy, playful, eager for a treat. I leave bright and early in the morning so I called on my break to see how my mother felt he was (I live with them to save money). She said he was up and about, so I felt better. Long story short, over the next two days, we all felt that he seemed "off." I was able to get him squeezed in to the vet at 3 PM Friday and almost worried I was over-reacting - but I was actually right on. All I had had to go on were these behavioral cues, no other symptoms, but they ended up treating him for a urine scald and resulting dehydration and possible infection, noting that he had swelling in the areas above and below his penis. He was given subcutaneous fluids and an antibiotic shot. He had a severe urine scald as a kitten but it didn't cause this sort of change and it was considerably worse in appearance! Other than a little swelling this time, I wouldn't have even known. So they sent us home with chlorhexidine wipes (to be continued on occasion as a preventative measure). They have also made recommendations for digestion based on his condition. Though it is not currently a problem, it appears to be an effort to keep it that way. He now gets a bit of Laxatone daily and they have recommended a little bit of wet food in his diet. So. . . questions:
-I went to feed him the wet food and my brother happened to be over. I left the room and heard, "Uhhhh, does he usually try to bury his food?" Both times I have tried now, he seems VERY interested for just a moment, then picks at it, then paws around it. I have read that this is normal but are there ways of getting him to actually eat it? My only guess is to switch from free-feeding to scheduled.
-When I run out of wipes, are there any alternatives to keeping him clean that are safe, effective and maybe even eco-friendly?

I heard some light purring this morning while I gave him loves, so I think he is on the mend.