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Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Neurological Disorders Resources. Treatment and care for pets having pain or trouble walking or standing due to spinal injuries or neurological disorders like IVDD, FCE and DM.
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JustinP
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Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Post by JustinP » Sun Apr 19, 2020 5:32 pm

Hi there my name's Justin. My apologies for the lengthy post but I'm desperately in need of some insight or advice.

My cat's name is Shadow. He's a rescue cat who we adopted when he was found in poor condition living near our home. We're unsure of his age but the vet estimated roughly two years at the time of adoption which was a little over a decade ago, so he is around age 12 - 13. He's my best friend and has been with me through a myriad of ups & downs.

Late the week of April 8th / 9th our family noticed Shadow starting to limp slightly favouring one leg. We planned to give him a few days to heal as he has had sprained legs in the past and we suspected it was a repeated case.

On the weekend my Stepfather found him on top of our garage which he frequently climbs to. Knowing he had an unsteady leg my Stepfather tried pulling him down from the garage but he struggled and to maintain balance my Stepfather had to reach for the fence and hold him with one hand. He wasn't dropped but he kicked furiously to try free himself. Soon after his condition worsened terribly and he no longer has the ability to walk on all four's.

We rushed him to the vet who said he likely has IVDD and had slipped a disc. I insisted I wanted an X-ray done ASAP but we were informed that in order for the X-ray to give us an indication of the extent of the injury, we need to allow time for the inflammation to reduce. He proscribed him anti-inflammatory medication called Metacam (active constituent Meloxicam) and told us to keep Shadow rested.

His current situation is as follows:
  • He is incontinent.
  • He does not appear in any pain.
  • He is in good spirits and seems quite content, especially with all the attention he's getting.
  • He LOVES his food (as he always has) and is drinking often too.
  • He has lost the ability to move his hind left leg.
  • He has lost the ability to move his tail.
  • He has lost pain sensation in his hind left leg.
  • His front legs and hind right leg have retained both movement & pain sensation.
  • He is unable to stand on all four's for more than a moment and we are discouraging him from doing so.
  • He has been confined to a closed off area of our kitchen for strict bed rest.
  • We are discouraging him from moving outside of the bed but he has moved around during night-time or occasionally when unsupervised.
  • He is only deliberately moved when giving him his medication, when he is bathed or when his bedding is changed. When moved he is held by the scruff of his neck and handled gently.
I've been trying to gather information about IVDD. From what I have read on vet websites, surgery provides the best chance of a good outcome if the symptoms are less severe and the surgery takes place shortly after the pet shows signs of injury. Unfortunately the ballpark cost provided by our vet was in the range of $7,000 - $8,000 which we cannot afford. I have also read that conservative treatment (crate rest) can be successful but the information seems to vary in regard to likelihood of a good outcome and the length of time required.

On a positive note we run a family business from home which means we have been able to provide better care than we could perhaps otherwise if we were commuting to work. I think we could continue to do so though my family disagree. We are struggling a little at the moment with COVID-19 and the strict lock down enforcement measures are putting a dampener on our business. A side effect of the reduced workload has been more time available to provide care for Shadow and at no expense to the business.

My family are not interested in the possibility of long-term care despite there being at-least one of us home most of the time. My Stepfather seems a little less resistant but my Mother is firmly against it and is already talking about euthanasia. I feel more optimistic but until we have the medical imaging completed and receive advice from the vet I am not sure what to think.

Sorry it's taken me so long to get to the point but my questions are:
  1. Do you have any advice for how to properly care for him whilst he is recovering? My Stepfather & I are doing our best but any input is welcome.
  2. Do cats who suffer slipped discs recover their nerve function? Can they regain use of their limbs? Can they regain the ability to toilet themselves?
  3. If so, can anyone provide account of the timeline for their own pets? I understand each case is unique and that if recovery is possible it would depend on the extent of the nerve damage.
  4. Is it safe for cat owners to manually express their cat's bladder?
  5. What would you do if you were in a similar situation with financial constraints? Bearing in mind Shadow does not appear in pain or discomfort. Is it cruel to keep him going or is it worth giving him time for a chance at some form of recovery? If indeed recovery is possible.
Our second vet visit is tomorrow morning and the X-ray has been scheduled. If you need any more information please do not hesitate to ask.

To anyone who reads this & replies thank you from the bottom of my heart. I love him dearly and want to do the right thing.

- Justin

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CarolC
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Re: Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Post by CarolC » Sun Apr 19, 2020 8:23 pm

Hi Justin,

:welcome: I am sorry for any situation where one person is willing to care for a disabled pet that is happy, and others in the family disagree. Since your cat is happy and not in pain, there is nothing to be lost by at least giving him some more time. It sounds like the accident was about a week ago, and it can take time for the swelling to go down and a nerve injury to improve.

I am not sure why the vet said an x-ray would do no good until the swelling went down, that's the first time I ever heard that, but I'm not a vet. I know people take recently injured animals to the vet every day and get x-rays. :?

I feel sorry for your stepfather, who was trying to help, he must feel awful. I am not sure if he even remembers, but if at any time during the rescue attempt on the roof when the cat panicked and began clawing his arm and finally fell, I wonder if he ever briefly tried to catch the cat by the tail during the skirmish. There is something called a tail pull injury that can result in incontinence in cats. Sometimes they do recover from it and regain bladder control. You might try to clarify with your stepdad, does he remember if he ever had the cat by the tail in an effort to prevent the fall. If so, this is information to give the vet. Also, we have information here about chances of recovery with tail pull injury.

If there was never any tail pull, then from your description it sounds like maybe he just fell and banged himself pretty hard when he landed, or fell on something. Do you know if he landed on something? An x-ray would show if anything is broken or dislocated. If it is just swelling from the fall or the way he landed, bruising, etc., that may improve given more time and rest (good that you are confining him) and anti-inflammatory medication. I hope you can get the x-ray.

Did your mother explain why she feels as she does, and is against giving him time? There are some people who were brought up to believe that if an animal is injured, it has no quality of life and it is inhumane or cruel or selfish to keep it alive. That may have been more true in generations past, when people lacked knowledge or ability to care for a disabled pet. Often vets would recommend euthanasia for the sake of the pet, because they assumed or knew the owner wasn't going to be able to give the proper care needed. Nowadays, things are better. It is now considered normal to express bladders or build ramps or buy dog wheelchairs or put a diaper on your leaky pet to give him and his family a good quality of life in spite of being disabled.

If you know your cat is not in pain and is happy, to me the humane thing is to help him just as he is. First give him time to see if he improves. But even if he does not recover completely, he can live a happy life as a disabled cat. So many people here have had disabled cats. Here is a video about a cat named Pookie who fell from a second story window. He still has a happy life, plays with his brother, and does not require a lot of extra care, and does not require the owner being home all the time.



Is your cat kind of dribbling or leaking 24/7? If your mother is objecting to a mess in the house, that is something that can be solved. You are right, a cat can be expressed, and it does not hurt to express a cat's bladder, though some cats will complain, but they forgive you as soon as you are done. They recommend expressing the bladder at least every 8 hours. Since you are home, this is easy to do. It will prevent or reduce him wetting his blankets, and will ensure he is getting completely empty so there is less chance for a bladder infection (stale urine remaining in the bladder can create an environment for germs to grow). If he leaks even after being expressed, he can wear a diaper. We have links here showing examples of how to diaper a cat, just ask if needed.

The video above showed one example of expressing the bladder. If you look at the end of this article, you will see other video demonstrations of expressing the bladder of a cat.

viewtopic.php?f=5&t=16027

If your cat is incontinent of feces, the bowel can also be expressed. One thing to watch with incontinent cats is constipation. It is something you need to be attentive to. Expressing the bowel will help prevent this. Some cats may also need a stool softener like Lactulose syrup or Miralax. Neither one is expensive. Here is an article on expressing the bowel, with videos at the end.

viewtopic.php?f=5&t=18586

I hope this helps a little. I hope you will post back what you find out at the vet. Again, I question why the x-ray was not done at first. Usually I might say something about the value of a second opinion, but since we are in the middle of a pandemic, I think we have to do the best we can. I hope it works out for you guys.

JustinP
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Re: Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Post by JustinP » Tue Apr 21, 2020 12:21 am

Thank you for your reply! I really appreciate the advice.

I'm not sure about the inflammation masking details in the imaging either but it was the vet's advice so we trusted it was best to wait. In any case it allowed us time to get an indication of the impact the injury has had on his movement and level of happiness.

I checked with my Stepdad. The only detail I got wrong was that he used a ladder to climb the garage and balance against, not the fence. When Shadow struggled he held him by one arm underneath his chest and below his front legs which resulted in Shadow kicking his hind legs like he was swimming. My Stepdad used the other hand to secure the ladder and moved down step by step, at no stage did he hold Shadow’s tail or drop him.

The detail I missed out in the initial post is that my Stepdad recalls one of the two cats stumbling when racing up our stairs (two story home). They both enjoy sleeping up there and run up the stairs frequently. He thinks it was Shadow that stumbled and that it may have caused the initial limping but the limping didn’t start until later in the week, for a few days he was walking on all four's fine. The stumble would have occurred about a week prior to Shadow climbing on top of the garage.

The X-ray was conducted by the vet this morning. They said that the imaging revealed compression of the spine and displacement of one of the vertebrae. They described the injury as "grave" and said he would refer us to a specialist clinic if we were interested but he believed the chances of recovery were slim to none and implied it would be a wasted effort. We received a referral and an appointment has been booked for early tomorrow morning (with this clinic www.arcvets.co.nz) where they will do more advanced imaging and hopefully we will be able to get advice from a neurologist.

It’s been difficult to get a grasp on all of this with the COVID-19 lock down because only one of us was allowed in the vet clinic on the initial visit and today neither of us were allowed in the door. Tomorrow we again are not allowed to enter the building when visiting the specialist clinic. There’s so many questions I want to ask and have answered. The vet also said Shadow has no deep-pain sensation in either of the hind legs. We thought he could feel pain in the hind right leg but we may have been mistaken, he still has movement in that leg and has been able to raise it to clean himself.

Euthanasia was again discussed by the family when we got home. I encouraged them to give things more time. Since the discussion we were contacted by the specialist clinic so we have at-least until tomorrow before revisiting the topic. I really just want us all to make the decision one way or the other with as much information at hand as is available. As stated in the first post we cannot afford surgery so any chance of rehabilitation would need to be by conservative treatment and perhaps other practices depending on cost (if spread out). I have read about treatments such as physiotherapy, acupuncture, hydrotherapy, lazer therapy, and that they may be effective in aiding recovery.

Shadow is leaking often, he has occasionally showed signs of bladder control but we're not certain. A few times he seemed to intentionally move away from his bed before going but it's only been a few times. I wish cat litter boxes with lower ledges were available, then we could know if he has control and it's a mobility issue or if he simply has no control. I found one low wall litter box on Amazon but they will not ship to our country (New Zealand).

If you have any more general advice or specific advice regarding what to ask when we speak to the specialist I would really appreciate it. Thank you again for taking the time to reply, it means a lot.

- Justin

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Re: Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Post by CarolC » Tue Apr 21, 2020 1:39 am

It's great that you got the appointment. Advanced imaging will give more information than an x-ray. I just had to take a pet to the vet a week ago and they also had the rule of no customers in the building. They said they would take the pet inside, examine the pet, and then confer with the owner by phone while the pet is in the examining room, so the owner just sits in the car in the parking lot and waits for the call, and then they discuss it that way. It will work as long as one of you has a cell phone (charged).

I suggest you write down a list of things you want to make sure to discuss with the vet, so you won't miss something with all the confusion of trying to communicate by phone, if they do it that way.

If you have the ability to print, is there any way you can print up his case history and take it to the vet in advance of the appointment? Drop it off, let him read it before he sees your cat, and put it in his file. It may help.

Or if they are willing to give you their email, you could email it.

I think it is important for the vet to know about the previous limping. Also very important to point out that he can still kick up his one leg to clean himself. Also that he is an indoor-outdoor cat, and that he was over a year old when you got him so you don't know his whole history.

I have no idea what is going on with him, whether it is an injury or something else. It doesn't sound like your stepdad did anything at all, except get him carefully off the roof. He didn't fall and he wasn't dropped, even though the onset of paralysis was soon afterward.

It is possible he had some kind of accident previously you do not know know about. For example perhaps a broom was standing against the wall and fell on him. Or he could have been up high like he likes to do, and fallen. I had a cat hurt his back falling off the edge of the top of a crate about 6' up. It had something to do with playing or wrestling with the other cat. In spite of what they say, cats do not always land on their feet.

There was a friendly feral cat that lived near the back door where I worked, and he was in some kind of accident, possibly even a car accident. He showed up one day limping, with trouble walking and the topline of his back visibly out of line, you could see where it made a dip that shouldn't be there at a certain point. Somehow he gradually got it back into alignment, I don't know how he did it, but he did. It must have been some kind of feline isometrics he did, that's the only explanation I could ever find.

We had a cat here with something called hemivertebrae, which is a congenital malformation of one of the vertebrae. This was a younger cat, but the cat was OK until a certain age, then developed paralysis, then it eventually resolved to the point the cat could once again jump up on things.

What it sounds like the most (I am not a vet) is an old injury acting up, and if that is the case I feel hopeful maybe it will indeed improve, because it has come and gone to a lesser extent before, but I don't know. In my experience, it seems kind of unusual for a cat to repeatedly sprain his leg. It makes me wonder if this is an old injury that has flared up periodically over the years, as you have observed. Perhaps he kicked his hind legs so hard on the way down the ladder, he just aggravated it quite a bit.

At least you will have a better idea tomorrow.

The imaging is going to be a bit of an expense, they probably told you, but not nearly as much as surgery. The neurologist may possibly have a stronger anti-inflammatory to give him. It may possibly be something where it would be worth trying acupuncture or cold laser, you can see what he says.

In searching for a low entry litter box, you may want to try searching for a dog litter tray. Here is an example (they don't ship to NZ, I checked), so maybe something will turn up searching for a dog pan instead of a kitty litter pan. [NOTE: Click the button that says Large, not the small one]

https://www.chewy.com/puppy-pan-dog-cat ... /dp/167815

If you need such a litter pan and can't get one anywhere, I think I could ship one to you. I would need to order the tray from Chewy, which would probably come pretty quickly, and also get an appropriate sized shipping box. If they send it in a good box I can reuse that, and then take it to the post office. I have shipped the low entry litter boxes to other people with disabled cats in the past, including Canada and South Africa. It would be a free gift for your cat, if he needs one.

I hope you will post back what you learn tomorrow.

JustinP
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Re: Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Post by JustinP » Thu Apr 23, 2020 5:38 pm

Hello again. Apologies for the late reply. I wanted to post yesterday but I'd partially written up the post then realized I hadn't logged in, when I did I lost the information I'd already typed (whoops).

We got Shadow back from the specialist clinic yesterday after an overnight stay to complete blood tests & a CT scan. Like in your visit they instituted the same no contact procedure but we were able to consult with the vet by phone. Unfortunately I had not prepared questions for him but he did a great job of explaining everything on both arrival at the clinic and when Shadow was discharged. I recorded the phone conversations so we could revisit them later to better understand what the situation is too. They also prepared a report which detailed their findings. We did our best to explain everything leading up to his paralysis & incontinence as best we could.

You were correct, the visit cost an absolute fortune and all my savings are spent but I have no regrets. I hope I'm relaying this correctly but the information by the vet as far as I can recall is this. He was surprised by the first clinic's diagnosis of compression of the spine and a herniated disc as they said the timing of the symptoms was not consistent and they would have expected a much more rapid or sudden onset of symptoms rather than the slow progression from slight limping to paralysis & incontinence.

The radiologist after examining the CT scan determined there is no visible signs of damage to the spine. His symptoms are not consistent with a back injury or IVDD. They haven't come to a diagnosis but said the most likely items on the list in order of likelihood are:
  1. A tumour pressing on the spine.
  2. A blockage of the spinal cord blood vessels.
  3. An infection.
The best way to diagnose the issue is to perform an MRI. Unfortunately no veterinary clinic in our country has an MRI machine. Animal patients are referred to private clinics for people but due to the COVID-19 lock down measures all access to MRI machines in private clinics has ceased and there is no timeline for when they will be made available again. Once they are in use human patients obviously will be taking priority. The only diagnostic option is a scan called a myelogram but they said whilst the test would provide more information there is still a chance that they would not be able to confirm a diagnosis and it is more invasive than a CT scan or MRI.

We have opted to begin medication which has a good chance of improving Shadow's condition in any of the above three explanations. He has been prescribed Prednisone & Clindamycin. Even if we see an improvement they said to have guarded optimism as instances where the patient has cancer things will get better then again deteriorate. If it is a blockage of the spinal cord blood vessels they stated "there is a chance Shadow will improve given more time and care". There is also the possibility he will remain the same in which case we have to consider seriously his quality of life.

Thank you for the offer to ship the litter pan but I have heard people are seeing delays in goods shipped from overseas. We're not certain the incontinence is due to a lack of mobility either, it's just as likely he has no control and wouldn't use it. It's very kind of you but we'll continue to try find ways to make him more comfortable.

Do you have any advice on how we can give him the best care possible whilst he's in recovery? He's taking his medication in food thankfully so we don't have to force him to. Unfortunately he is very uncooperative when it comes to bathing which we need to do several times a day. We're also looking at solutions to bring him into the lounge room in the evening as he gets lonely in the separate kitchen. I try to spend as much time with him as I can but I think bringing him into the living room with us would be a great comfort to him. We're looking at waterproof seat covers for use in vehicles or office floor protectors. Our house is rented unfortunately and my family don't want messes on the carpet.

Once again thank you for taking the time to reply. It's been a tough couple of weeks and I'm just glad we have him home where he's happy.

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Re: Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Post by CarolC » Fri Apr 24, 2020 1:19 pm

Replies inline in blue... :)
JustinP wrote:
Thu Apr 23, 2020 5:38 pm
Hello again. Apologies for the late reply. I wanted to post yesterday but I'd partially written up the post then realized I hadn't logged in, when I did I lost the information I'd already typed (whoops).

Aargh! It is so frustrating when that happens, and usually it's when I've taken the time to compose a long message I really care about. It has been known to happen even logged in. The session length is 60 minutes, but I don't think I've usually gone over 60 minutes when this happens, so I'm not sure why it does. I'm sorry it happened to you. My self defense is to copy/paste the post I'm working on into Word from time to time as I work, so if I lose it I don't lose all of it. :roll:

We got Shadow back from the specialist clinic yesterday after an overnight stay to complete blood tests & a CT scan. Like in your visit they instituted the same no contact procedure but we were able to consult with the vet by phone. Unfortunately I had not prepared questions for him but he did a great job of explaining everything on both arrival at the clinic and when Shadow was discharged. I recorded the phone conversations so we could revisit them later to better understand what the situation is too. They also prepared a report which detailed their findings. We did our best to explain everything leading up to his paralysis & incontinence as best we could.

I'm glad you were able to get the CT, and I'm glad they communicate well in spite of the circumstances. I wonder if they got all the results on the blood tests yet.

You were correct, the visit cost an absolute fortune and all my savings are spent but I have no regrets. I hope I'm relaying this correctly but the information by the vet as far as I can recall is this. He was surprised by the first clinic's diagnosis of compression of the spine and a herniated disc as they said the timing of the symptoms was not consistent and they would have expected a much more rapid or sudden onset of symptoms rather than the slow progression from slight limping to paralysis & incontinence.

The radiologist after examining the CT scan determined there is no visible signs of damage to the spine. Woohoo!!!!! His symptoms are not consistent with a back injury or IVDD. They haven't come to a diagnosis but said the most likely items on the list in order of likelihood are:
  1. A tumour pressing on the spine.
  2. A blockage of the spinal cord blood vessels.
  3. An infection.
The best way to diagnose the issue is to perform an MRI. Unfortunately no veterinary clinic in our country has an MRI machine. Animal patients are referred to private clinics for people but due to the COVID-19 lock down measures all access to MRI machines in private clinics has ceased and there is no timeline for when they will be made available again. Once they are in use human patients obviously will be taking priority.

The news has been saying they will be relaxing restrictions there soon. How much they will relax them I don't know, but your virus status has been better than most countries. That being said, an MRI is another useful but expensive test. I think he'd have to be sedated again if you did an MRI, and if it was my cat I would want them to explain to me what they can see on the MRI that the CT did not show, and why.

I wondered about a tumor when you wrote before, but the way this started right after being carried down from the roof kicking made me think an injury of some sort. I thought you could see tumors on CT. This link gives the impression the CT is a very good sort of imaging to identify tumors.
https://www.vetmed.ucdavis.edu/hospital/diagnostic-imaging/small-animal/ct wrote: CT imaging is:
• one of the best tools for studying the chest and abdomen because it provides detailed, cross-sectional views of all types of tissue.
• often the preferred method for diagnosing many different cancers, since the image allows a veterinarian to confirm the presence of a tumor and measure its size, precise location and the extent of the tumor's involvement with other nearby tissue.
• invaluable in diagnosing and treating spinal problems and injuries to the skeletal structures because it can clearly show even very small bones as well as surrounding tissues such as muscle and blood vessels.
The only diagnostic option is a scan called a myelogram but they said whilst the test would provide more information there is still a chance that they would not be able to confirm a diagnosis and it is more invasive than a CT scan or MRI.

Again, I would want them to explain what "more information" it will show, that the CT did not. At least for spinal issues in dogs, the CT is greatly preferred. And when they say invasive, it carries more risk than the CT or MRI because they are injecting dye into your pet and in some rare cases a myeolgram will cause seizures. Again, I am not a vet, but you could ask your specialist about the degree of risk. The myelogram is cheaper than a CT or MRI, but I still am not sure what it would show that the more advanced imaging (CT scan) did not.
:?


We have opted to begin medication which has a good chance of improving Shadow's condition in any of the above three explanations. He has been prescribed Prednisone & Clindamycin. Even if we see an improvement they said to have guarded optimism as instances where the patient has cancer things will get better then again deteriorate. If it is a blockage of the spinal cord blood vessels they stated "there is a chance Shadow will improve given more time and care". There is also the possibility he will remain the same in which case we have to consider seriously his quality of life.

Prednisone is really helpful where swelling is causing spinal issues. It can make pets thirsty so it may make him drink more and urinate more.

Regarding quality of life, if he is happy and you can manage the incontinence, that is quality of life to me.


Thank you for the offer to ship the litter pan but I have heard people are seeing delays in goods shipped from overseas. We're not certain the incontinence is due to a lack of mobility either, it's just as likely he has no control and wouldn't use it. It's very kind of you but we'll continue to try find ways to make him more comfortable.

OK, well the offer stands in case maybe he gets to the place where you think he could use one. Here is a crate I made for one kitty with mobility problems. I recessed the litter box for even easier entry (see the last picture).

https://www.handicappedpets.com/mediawi ... _litterbox

Do you have any advice on how we can give him the best care possible whilst he's in recovery? He's taking his medication in food thankfully so we don't have to force him to. Unfortunately he is very uncooperative when it comes to bathing which we need to do several times a day.

The best suggestion I have on his care would be expressing his bladder. With everything happening so fast I do not know if you had a chance to watch any of the videos on expressing linked earlier. When you express his bladder, it may solve, or at least partially solve, the leaking. Whatever you can express now won't leak out later. Possibly it will reduce the need for bathing and improve the health of his skin.

On the bathing, have you tried just putting his rear end under running water and doing a "butt bath"? You can use your own judgment but he may not need shampoo, or at least he may not need it every time. All that gets wet is bottom, tail, and hind legs. At my house the easiest place to do this is the kitchen sink, but if your mom does not want her sink used in this manner, then you may have to use a different location.

However if he is scared of the sound of running water, then a dishpan of standing water may be more acceptable. When I used to wash my small dog, I had 3 dishpans, one with soap mixed in and 2 with plain water to rinse, and I moved her from pan to pan. If you do not put shampoo directly on the fur, but rather stir it into the water, it comes out of the fur better. Using 3 dishpans, you can then dump the water down the toilet.

If he is inclined to fight, perhaps you could lie him on a thick folded towel and swab him with a washcloth.


We're also looking at solutions to bring him into the lounge room in the evening as he gets lonely in the separate kitchen. I try to spend as much time with him as I can but I think bringing him into the living room with us would be a great comfort to him. We're looking at waterproof seat covers for use in vehicles or office floor protectors. Our house is rented unfortunately and my family don't want messes on the carpet.

I agree, I wouldn't want urine on the carpet even if it was my own. Waterproof mattress protectors are another idea. If he is declawed (most are not) a playpen would be convenient. Another option might be an x-pen (kind of a circular fence) where you can put him near you and only have to cover a limited area of the floor instead of an extensive area. Cats can also wear diapers.

Once again thank you for taking the time to reply. It's been a tough couple of weeks and I'm just glad we have him home where he's happy.

I am glad you were able to get him examined and could rule out an injury. Yes, there is a lot of stress in the first weeks of having a disabled pet, trying to get a diagnosis, and trying to make adaptations for his care. It does get easier in time and it becomes routine, but right now you are still figuring out what your individual pet needs and how best to accomodate that. Glad he is back in his own home!

:catbed:

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critters
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Re: Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Post by critters » Fri Apr 24, 2020 3:47 pm

:whale: Prednisone is a good drug for cats, so it'll be interesting to see what happens.

I was going to suggest a cats-only vet, if you have one around. Cats are well known for injuries--falling and the like, particularly. With spinal cord injuries of any sort there's usually improvement. I had a big fella, Koi, who had been shot in the spine and who still carried the pellet. He, too, improved over time.

JustinP
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Re: Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Post by JustinP » Tue Apr 28, 2020 5:00 pm

Hey Carol, hey Critters.

Sorry for the delay in responding. It's been a really busy time since getting Shadow back.

Still no word on the results from testing for infectious diseases with the blood test but they did say they needed to send the blood to a different lab in order to have it tested.

Regarding quality of life, I'm in agreement. If he is happy and we can manage the care side of things then I don't see reason to euthanise him. It's been a really difficult discussion with family. They say because he has always been a mixture of an outdoors cat & an indoors cat that his quality of life will be diminished not being able to explore outside the way he's always been accustom. They also think that providing care for him will be extraordinarily difficult given how busy our work schedules are even though we do work from home.

I'm hoping & praying he shows significant signs of improvement. I think any good chance of swaying them will come down to how well Shadow is able to improve over the coming weeks and also how easily we can manage his care. We're doing our best right now but he does require a lot of time to keep himself & his surroundings clean given he is still incontinent.

We're not sure whether he has any control, occasionally it seems he is toileting away from his bed which is a good sign but just as frequently he goes where he's resting then moves away from it. We've tried making access to the litter box as easy as possible with a ramp but it remains unused. Coming from the streets it took a long time to toilet train him in the first place so this might be an additional factor, not entirely sure.

The videos on expressing the bladder were helpful, thank you for that. The vet told us we shouldn't need to but I am thinking it's best. We attempted it once and he did seem more relaxed afterward. Importantly if it makes life easier in terms of cleaning accidents throughout the day then it may help convince the family that long-term care could be manageable.

The bathing hasn't been easy. We've tried a few different methods and he struggles with every type of approach. Unfortunately we don't have a laundry sink which I think would make things easier. I'm going to look at buying some large containers to place him in when bathing because we're presently using clean litter trays and they are too restrictive. We're finally able to purchase non-essential goods which is a relief so hopefully we have better luck with large containers.

Really we're needing to streamline the care process as much as possible. I'm looking into cat diapers if he does not recover control of his bladder & bowels. Do you have any specific recommendations? No idea what to look for but this listing seemed like it might be good?
https://www.etsy.com/nz/listing/6382112 ... er-pull-up

Also in the video about Pookie they mentioned food with ground up bone. Food that digests the same way would be useful because cleaning the poop has been a real challenge. The vet originally thought he might have been constipated but he passed a lot of firm poop shortly after getting him back from the specialist. Since then he has had really bad diarrhoea which reading up on clindamycin is a common side-effect, my sister's cat was prescribed the same medication at one stage too and it had the same effect.

In terms of improvement there have been some small signs. The first week I did not see his tail move once. Since starting the medication his tail wags a little when patting his lower back and when giving him chin scratches. Only in the past day or so it seems to wag a little on it's own but only seldomly. He also went from being unable to stand in the first week to being able to stand and make a few steps, though he is relying very heavily on his hind right leg and it's a very unnatural kind of limping. His hind left leg which appeared totally paralyzed with an occasional twitch reflex is just now showing some slight signs of movement but only very rarely.

Do you have any idea on what a timeline might be if he is able to recover use of his hind left leg, bladder or bowels? I'm certain there is no information that could help and it's unique to each situation & each diagnosis, even anecdotal accounts would give us some hope though. Trawling through reddit I've been able to find stories of recovery ranging from one month to six months but they usually remark on paralysis & not on incontinence, even then there aren't many personal accounts to be found and they are usually resulting from back injury.

Many thanks and hope you're both doing well.
-Justin

:thankyou:

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Re: Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Post by CarolC » Wed Apr 29, 2020 3:34 pm

JustinP wrote:
Tue Apr 28, 2020 5:00 pm
Hey Carol, hey Critters.

Hey Justin! :D
In blue below...


Sorry for the delay in responding. It's been a really busy time since getting Shadow back.

Still no word on the results from testing for infectious diseases with the blood test but they did say they needed to send the blood to a different lab in order to have it tested.

Regarding quality of life, I'm in agreement. If he is happy and we can manage the care side of things then I don't see reason to euthanise him. It's been a really difficult discussion with family. They say because he has always been a mixture of an outdoors cat & an indoors cat that his quality of life will be diminished not being able to explore outside the way he's always been accustom. They also think that providing care for him will be extraordinarily difficult given how busy our work schedules are even though we do work from home.

Even if he did not improve at all (although it sounds like he is improving), the care should not be extraordinarily difficult. Right now it seems like a mess because he's leaking and has diarrhea and you are doing extra laundry and it's all taking quite a bit of attention. Once you get your routine figured out for you particular pet and circumstances, normally a paralyzed pet only takes a few (very few) minutes a day. If you express his bladder 3x a day, expressing is under 5 minutes each. Diapering is also under 5 minutes, if you need to do that. You could probably express and diaper in 5 or 6 minutes total. (You saw how quickly it can be done in the Pookie video.) It soon becomes so routine you hardly think about it. The only time it's normally hard is if you can't be home. For example, I got called for jury duty and that made it difficult getting home at lunchtime to express, but since you work from home you are super lucky. I can imagine a possible situation where you yourself learn to express and perhaps other members of the family do not, and then it is always left to you. Again that is OK except when you might need to be away from home for a length of time. Pets can actually go quite a few hours without expressing. They recommend expressing every 8 hours, but on the odd occasion they could go a little longer and you'll probably get away with it, you just don't want to make a habit of it if possible. Regular expressing is tidier, and helps prevent crystals and infections.

I'm hoping & praying he shows significant signs of improvement. I think any good chance of swaying them will come down to how well Shadow is able to improve over the coming weeks and also how easily we can manage his care. We're doing our best right now but he does require a lot of time to keep himself & his surroundings clean given he is still incontinent.

We're not sure whether he has any control, occasionally it seems he is toileting away from his bed which is a good sign but just as frequently he goes where he's resting then moves away from it. We've tried making access to the litter box as easy as possible with a ramp but it remains unused. Coming from the streets it took a long time to toilet train him in the first place so this might be an additional factor, not entirely sure.

The videos on expressing the bladder were helpful, thank you for that. The vet told us we shouldn't need to but I am thinking it's best. We attempted it once and he did seem more relaxed afterward. Importantly if it makes life easier in terms of cleaning accidents throughout the day then it may help convince the family that long-term care could be manageable.

Absolutely.

When you attempted the expressing, did you release some urine? Yay if you did! What you say is true, it is a relief for the pet, especially in cases where they can feel that they need to go, but just lack the control right now to do it. I would continue to express him 3x a day. When you get up, sometime in the middle of the day, and then at bedtime. Some people express every 6 hours. I found that worked better with my schedule when I was working. In some cases, a pet is able to stay dry for a certain number of hours, then wets. If you can figure out how many hours your cat can go before he leaks, then you can anticipate that and express him as often as needed. However, there are some pets (like my dog Dolly) who dribble 24/7 and for them you just need a diaper, but that does not sound like your cat.

The bathing hasn't been easy. We've tried a few different methods and he struggles with every type of approach. Unfortunately we don't have a laundry sink which I think would make things easier. I'm going to look at buying some large containers to place him in when bathing because we're presently using clean litter trays and they are too restrictive. We're finally able to purchase non-essential goods which is a relief so hopefully we have better luck with large containers.

That's good. The only thing I might consider is, if the sides are too high, it may freak him out if he can't see out...? He'll probably be more cooperative if he doesn't feel claustrophobic or trapped.

Really we're needing to streamline the care process as much as possible. I'm looking into cat diapers if he does not recover control of his bladder & bowels. Do you have any specific recommendations? No idea what to look for but this listing seemed like it might be good?
https://www.etsy.com/nz/listing/6382112 ... er-pull-up

That diaper looks pretty nice because it has a tail hole and is supposed to allow defecation. I am not sure if it will cover his male anatomy which is usually pretty close up under the tail. You can probably insert an adhesive bladder control pad and position it so the pad covers his p*nis. You'll be able to experiment once his diarrhea/medication is done. You would want several diapers, or at least 2, one to wear and one to wash immediately after you change him so it dries in time for the next change.

I used disposable diapers with my bunny. I had to get the preemie size and I cut a hole for the tail. Below is a link to an article about diapers. It may give an idea on sizes, however different brands of disposable diapers vary in the way they fit, just like different brands of blue jeans vary on humans, so if you think (for example) he might need an XS size and you try one brand and it doesn't fit, it is still worth trying a different brand. Also, if you think you have the right size but it doesn't seem to fit, try putting it on him backward with the tapes to the back. Often they fit better that way.

At the end of the article is a video showing how to cut a hole in a disposable diaper. In my experience, there are 2 kinds of disposables. The old (or perhaps inexpensive) kind spill out some filling when you cut them, you end up with something like silica on the table (and they are hard on your scissors). With that kind it may be a good idea to reinforce the tail hole with tape. The newer kind with gel filling (I think that's what it is) do not leak sand and you may not have to reinforce the hole. You won't know what kind you have until you cut into one.


:arrow: :arrow: https://www.handicappedpets.com/mediawi ... male_wraps

Here is a nice video showing a reusable cat diaper. You can see it comes up pretty high on the waist, which looks right. Her cat needs to have the bowel expressed, which I think is why the small tail hole is not an issue.



Also in the video about Pookie they mentioned food with ground up bone. Food that digests the same way would be useful because cleaning the poop has been a real challenge. The vet originally thought he might have been constipated but he passed a lot of firm poop shortly after getting him back from the specialist. Since then he has had really bad diarrhoea which reading up on clindamycin is a common side-effect, my sister's cat was prescribed the same medication at one stage too and it had the same effect.

I have no experience with feeding that kind of diet, but it certainly does seem to work for them. Having less bulk in the diet could also be helpful insofar as some cats can be prone to constipation. Antibiotics can definitely cause diarrhea in some pets, hopefully it's only a few more days.

In terms of improvement there have been some small signs. The first week I did not see his tail move once. Since starting the medication his tail wags a little when patting his lower back and when giving him chin scratches. Only in the past day or so it seems to wag a little on it's own but only seldomly. He also went from being unable to stand in the first week to being able to stand and make a few steps, though he is relying very heavily on his hind right leg and it's a very unnatural kind of limping. His hind left leg which appeared totally paralyzed with an occasional twitch reflex is just now showing some slight signs of movement but only very rarely.

This is a lot. That sounds very good. This is how recovery from a nerve injury occurs, by tiny little baby steps. You see function coming back gradually, like what you are describing. If he is getting any movement back in his tail, that is very encouraging. It sounds like maybe the prednisone is helping, that plus giving him time. :D

Do you have any idea on what a timeline might be if he is able to recover use of his hind left leg, bladder or bowels? I'm certain there is no information that could help and it's unique to each situation & each diagnosis, even anecdotal accounts would give us some hope though. Trawling through reddit I've been able to find stories of recovery ranging from one month to six months but they usually remark on paralysis & not on incontinence, even then there aren't many personal accounts to be found and they are usually resulting from back injury.

You're right, there is no hard and fast rule on it. One to six months is reasonable. Some pets regain continence before mobility, some regain mobility before continence. They say whatever you have at 6 months is probably pretty much what you're going to have, but there have been a number of exceptions to that here, so there really is no timeline on this, after all each injury is different. But if you are already seeing a little movement in his tail, that is encouraging.

One of the things with an pet recovering from nerve injury is trying to be aware of what his status is as it changes. In other words, what you are seeing right now does not predict what you will be seeing a month or 3 months from now. It is very helpful to keep in mind that his nerves are recovering a tiny bit more every day in the background where you can't see it, even if he looks much the same.


Many thanks and hope you're both doing well.

You guys, too! :D

-Justin

:thankyou:

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Etsy Barkertime diaper shown in video

Post by FYI » Wed Apr 29, 2020 4:01 pm


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Re: Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Post by critters » Fri May 01, 2020 8:46 am

I agree that he's improving. Anything moving is better than none!

I wonder if you could get away with using wipes sometimes, rather than a bath? How about a butt bath, although you'd still have a similar pan problem?

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Re: Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Post by JustinP » Sun May 10, 2020 8:11 pm

Hey guys. Sorry it's been a while, I thought I'd wait until we had more news from the specialist clinic before providing you with an update. Also thank you for that video FYI.

So the results came back from the blood tests. They did two sets of tests two weeks apart and were able to confirm a diagnosis, he has a bacterial infection called toxoplasmosis. The first blood test showed an abnormally high antibody count associated with a T. gondii infection. Because you never truly eliminate the infection they follow up with a second blood test to determine if the levels are stable, rising or declining which gives them an idea of how recent or active the infection is. In cases of recent infections they typically see the antibody count rise as the body mounts a response. The antibody levels have indeed risen over the two week period. Apparently it is a very common infection and in most cases animals are asymptomatic or are not severely effected but in a small few there can be very serious neurological issues as a result.

We have had him on clindamycin since visiting the specialist which was 13 days after the onset of paralysis. I wish we had started sooner but the local vet thought it was a spinal bone issue so we couldn't have known. The specialist said that toxoplasmosis is one of the better outcomes in terms of explanations for the onset of his symptoms but cautioned us that recovery of neurological function could take a very long time. We were advised the clindamycin course should be taken for between 4 - 6 weeks, we're currently on day 18, he is still on prednisone as well.

Unfortunately since last posting he has lost the ability to stand or walk in any fashion and has become accustom to pulling himself around using mostly his front legs with some support from the hind right leg which he previously relied on to stand or attempt walking. We're unsure if this is a progressive deterioration due to the infection or if it's a behavioural adaption after learning he can no longer rely on his hind quarters to support his weight when standing / walking. The onset of muscle atrophy won't help matters either. On a more positive note we are slowly seeing more frequent activity in his tail. I think there is improvement but it's such a slow change it's hard to tell.

Most importantly is that he still seems content with life. His appetite remains the same, he purrs often and loudly when petted, he's still very vocal and despite loss of the hind legs is making every effort to get around. We're anticipating another call from the specialist as the second set of blood test results confirming the diagnosis were provided by the local vet clinic. I'll be sure to let you know if we receive any new information.

Again thank you all so much for taking the time to help me here. It's meant a lot to me and I'm truly grateful. I will post again soon when we here back from the specialist.

:thankyou:

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Re: Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Post by critters » Mon May 11, 2020 10:24 am

I wonder if he'd be willing to use a cart (wheelchair)? Many cats aren't willing, but it's not so hard to try one made of PVC and see what happens. It's not expensive, either. Just a thought... It usually takes at least a couple of tries to get it right.

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Re: Advice for Shadow would be truly appreciated (Cat, 12 - 14, supected IVDD)

Post by CarolC » Tue May 12, 2020 12:13 am

JustinP wrote:
Sun May 10, 2020 8:11 pm
Unfortunately since last posting he has lost the ability to stand or walk in any fashion and has become accustom to pulling himself around using mostly his front legs with some support from the hind right leg which he previously relied on to stand or attempt walking. We're unsure if this is a progressive deterioration due to the infection or if it's a behavioural adaption after learning he can no longer rely on his hind quarters to support his weight when standing / walking. The onset of muscle atrophy won't help matters either. On a more positive note we are slowly seeing more frequent activity in his tail. I think there is improvement but it's such a slow change it's hard to tell.
If you are seeing his tail move even slightly more often, that is very encouraging. If he starts to get more feeling in his tail, then hopefully he will begin to get more function in his bladder, too.

Muscle atrophy is inconvenient in the short term, but the muscles improve again when the nerves improve, so just because he loses some muscle mass now, does not mean it can't come back. It can.

Since you now know he does not have an injury, I would think you should be safe to do PT with him. I would massage his hind legs and paws daily.

You could try laying the palm of your hand under his hind paw and pushing to see if he will push back. It is a resistance exercise that may help maintain muscle mass to some degree. If you can get him to resist, you can do a number of reps every day.

Another exercise is to either dangle a string or use some kind of teaser toy with a feather or a mouse on the end or something like that, with him lying on his side. He will bat at it and try to catch it with his front paws, and it may stimulate him to try to use his hind paws to catch it, too. You may think of other ideas to give him a reason to send signals from the brain to the hind paws. For example, with dogs you can try scratching their neck, to see if they will kick their hind leg in response (some will) and it works as an exercise.

You could also try assisted standing. He may not be interested, but getting him up on all 4 and just standing with a little help would probably be good for him, even if it is mostly you holding him.

I think you might enjoy this video of a paralyzed kitten recovering with PT. (The facebook link, you don't have to log in.)

viewtopic.php?f=4&t=18185#p93713

You mentioned reading about hydrotherapy. Here is a post with some videos as an example.

viewtopic.php?f=4&t=20082&p=103300#p103300

I'm very glad you have a diagnosis now, and I'm glad the medication they had him on turned out to be appropriate for the condition, considering that they didn't even know what it was at first. That's good news.

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