Managing incontinence in a paraparetic kitten (partial bladder control)
Posted: Wed Mar 20, 2019 9:39 pm
Hi Folks,
I really need your help trying to figure this out, because I love my little paraparetic kitten, yet this issue is driving me insane right now.
Bodie is a paraparetic kitten that came to us after a friend saw him fall out of a tree. At the time, he was somewhere around 4-6 weeks old, so I suppose he is now somewhere around 3-4 months. When we first found him, he had little to no movement in his lower limbs, and responded only to very deep pinching of his back legs (nothing from his tail though). Since then, he has made some good progress, with his back legs now responding to light brushing and scratching, and with some flickering of the tail when it is brushed as well (his tail also goes #### when I firmly brush above his hips). I fear however that we have hit a plateau in his recovery, and he is still not able to walk (well, I catch him standing and slowly crawling sometimes when heʻs sniffing around, but he generally drags/kicks around the house, and when he actually does walk itʻs incredibly gimpy and uncoordinated; he can only manage a handful of steps before he tangles his legs together and falls over. What little walking he does seems to be with all his weight shifted onto his front end).
Both of the vets he has seen so far seemed to think he still had good control of his bladder (they have both seen him urinate; the first one was able to fully express him at around 2 mo with a light pinch and release of his bladder, and then he fully emptied on his own. More recently, the second vet has given him a few enemas, and claimed that after the procedure he saw him fully empty on his own).
However, my experience at home has run contrary to this. He seems to have two different "modes" of peeing: ones where his back end drops down into something resembling the correct peeing position, and his back end "shivers" a little like heʻs trying to get it all out (usually he kicks his legs too, but sometimes he will lift them above his head and start sprinting around...), and another mode where pee just comes out with no sign that he is aware of whatʻs happening (sometimes just a few drops, sometimes a LOT though). The first mode usually occurs when something exciting happens (e.g. sometimes when I make his food, or when he finds his way to a part of the house heʻs not supposed to be in), the second generally seems to happen when thereʻs a lot of activity in his back end (e.g. I am making him practice running around in the yard, or when chasing his toys).
Unfortunately, he basically never pees in his litter box, other than the rare occasions when he decides to nap in there (he empties himself invariably while he is sleeping), which leads me to believe that he is either reluctant to go in the box, or isnʻt actually aware of when he is peeing. I feel confident saying that it is NOT an issue with the cleanliness of the box, because every morning one of the first things he does is crawl into his box, dig a little, and then roll around in the litter while making trilling noises.
I suppose I should also mention that he has been battling constipation since the day we got him, and that he became severely impacted with stool shortly after he came to us (vet actually had to put him under to get it all out and then kept him overnight; he is now on cisapride to combat this, but still has off days where things get stuck). He has also been on amoxicillin for the past 4 days as a precaution against a possible bladder infection (I thought I saw what looked like mucous in his urine, and doc decided weʻd just put him on the antibiotics w/o bothering to get a urine sample).
I have brought up the possibility of having to express Bodieʻs bladder with his current vet (who is an orthopedic specialist), but he has been reluctant to go that route, since he thinks he can control it. I HAVE however been giving his bladder a little squeeze when I catch him going, to try to help him empty completely (since this minimizes the chances of him having an accident later on). I believe the doctor when he says he thinks Bodie still has bladder control, but I am kind of stuck at this point with trying to figure out how to get him to go in his litter box (which is a low entry handicapped pet letterbox with rounded edges).
I really need your help trying to figure this out, because I love my little paraparetic kitten, yet this issue is driving me insane right now.
Bodie is a paraparetic kitten that came to us after a friend saw him fall out of a tree. At the time, he was somewhere around 4-6 weeks old, so I suppose he is now somewhere around 3-4 months. When we first found him, he had little to no movement in his lower limbs, and responded only to very deep pinching of his back legs (nothing from his tail though). Since then, he has made some good progress, with his back legs now responding to light brushing and scratching, and with some flickering of the tail when it is brushed as well (his tail also goes #### when I firmly brush above his hips). I fear however that we have hit a plateau in his recovery, and he is still not able to walk (well, I catch him standing and slowly crawling sometimes when heʻs sniffing around, but he generally drags/kicks around the house, and when he actually does walk itʻs incredibly gimpy and uncoordinated; he can only manage a handful of steps before he tangles his legs together and falls over. What little walking he does seems to be with all his weight shifted onto his front end).
Both of the vets he has seen so far seemed to think he still had good control of his bladder (they have both seen him urinate; the first one was able to fully express him at around 2 mo with a light pinch and release of his bladder, and then he fully emptied on his own. More recently, the second vet has given him a few enemas, and claimed that after the procedure he saw him fully empty on his own).
However, my experience at home has run contrary to this. He seems to have two different "modes" of peeing: ones where his back end drops down into something resembling the correct peeing position, and his back end "shivers" a little like heʻs trying to get it all out (usually he kicks his legs too, but sometimes he will lift them above his head and start sprinting around...), and another mode where pee just comes out with no sign that he is aware of whatʻs happening (sometimes just a few drops, sometimes a LOT though). The first mode usually occurs when something exciting happens (e.g. sometimes when I make his food, or when he finds his way to a part of the house heʻs not supposed to be in), the second generally seems to happen when thereʻs a lot of activity in his back end (e.g. I am making him practice running around in the yard, or when chasing his toys).
Unfortunately, he basically never pees in his litter box, other than the rare occasions when he decides to nap in there (he empties himself invariably while he is sleeping), which leads me to believe that he is either reluctant to go in the box, or isnʻt actually aware of when he is peeing. I feel confident saying that it is NOT an issue with the cleanliness of the box, because every morning one of the first things he does is crawl into his box, dig a little, and then roll around in the litter while making trilling noises.
I suppose I should also mention that he has been battling constipation since the day we got him, and that he became severely impacted with stool shortly after he came to us (vet actually had to put him under to get it all out and then kept him overnight; he is now on cisapride to combat this, but still has off days where things get stuck). He has also been on amoxicillin for the past 4 days as a precaution against a possible bladder infection (I thought I saw what looked like mucous in his urine, and doc decided weʻd just put him on the antibiotics w/o bothering to get a urine sample).
I have brought up the possibility of having to express Bodieʻs bladder with his current vet (who is an orthopedic specialist), but he has been reluctant to go that route, since he thinks he can control it. I HAVE however been giving his bladder a little squeeze when I catch him going, to try to help him empty completely (since this minimizes the chances of him having an accident later on). I believe the doctor when he says he thinks Bodie still has bladder control, but I am kind of stuck at this point with trying to figure out how to get him to go in his litter box (which is a low entry handicapped pet letterbox with rounded edges).