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Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Sun Apr 10, 2011 11:00 am
by critters
maine_coonz wrote:Hallo again,

The weather here is absolutely gorgeous, hot, sunny, lazing around type of thing. So I've been taking Raz out in the garden for supervised walks a few times a day - not the most interesting thing to do for a human :)
Yesterday he got seriously cross when it was time to come back inside, growling and hissing and generally making it known that he wanted to be outside!! He wouldn't eat, wouldn't drink, fought me a pee-expressing time, etc. etc. When I put him in his cage for the night (we bought a large hamster? cage 2 x 1 x 1 metre high, plastic bottom and wire sides+top so we could confine him), I plonked down 150 grams of food and left him to it. This morning I smiled to myself when I saw the plate was empty :)

Today is again beautiful, and he's constantly hassling to be out again (sigh). He's in a much better mood, thank goodness. Now for the really exciting bit: while we were sauntering around the garden, sniffing plants and rubbing his mouth glands along branches etc, he turned around, presented his rump to the bush, lifted his tail and cocked it to one side, and sprayed - I could actually hear the spray as well as see it, it wasn't one of your half-hearted sprays. I couldn't believe my eyes, so I rushed in and got my husband (who didn't believe me either), and we went round the garden again, all together. Yup, he did it again, it really happened.

So today's question is: does this mean anything? His tail still hangs limply, he still ignores it, he still can't poo or pee by himself. How can he have lifted his tail to spray, but doesn't move it at any other time? Hmm. Motivation, maybe? My Koi is a tail-dragger and a leaky boy, but that never changes. How can he spray if his waterworks aren't working? If they weren't working at all, I don't see how he could. Maybe he's getting control back.

I'm waiting for your reply with my heart in my mouth,

Donna

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Sun Apr 10, 2011 12:21 pm
by CarolC
I sure don't know, but it sure sounds very hopeful. His nerves may be improving due to swelling subsiding. Nerves also improve with time but there hasn't been much time yet. If he can lift his tail and spray, but is still not going in the box, I wonder if it might be because he still has trouble squatting. Male cats kind of hunker down to urinate in a litter box. I'm assuming in the garden he was standing up straight or even raising his hindquarters a bit. But that's great! Woohoo!!!!! :ecstatic:
My kitty got a tail injury from rocketing around in the house. There was a large houseplant on a stand, and someone knocked over the stand. At least that's what I think happened. When I came home, the plant was on the floor and his tail was hanging down like a horse's tail. The injury was mild in comparison to Raz or Koi. The vet said it was not broken. Gradually during the week, he became able to raise it more, and he never lost bowel or bladder function, however he never got to where he could raise it completely as he originally could. It was sad because raising his tail and kind of "twingling" (vibrating) it was part of his expressiveness and he lost that, but thank goodness he was OK otherwise. I guess all I'm saying is, it did improve gradually with time...though the cases are different. I am just thrilled to hear that your kitty can still spray, and I'll bet he's so pleased with himself!

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Sun Apr 10, 2011 4:40 pm
by cricketsmom
I haven't heard of this either, but I would take it as a great sign! If he can make his tail and waterworks function just for this, perhaps he's starting to get those functions back but it's too painful most of the time... fingers crossed!

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Mon Apr 18, 2011 5:49 am
by maine_coonz
Hi there,
Life continues ... on a daily basis one can't really see much difference, but over a few days there's definitely improvement. I've been keeping a daily diary so I can keep track. I'm continuing to post details here in the hope that our trials and tribulations are of some help to other people.
Tue.Apr.12: we went back to the vet again for expressing help, and he tested Raz's anal sphincter and said there was a tiny reaction.
Wed.Apr.13: I can't get his bladder more than 75% empty, no matter how hard I try. Peristalsis is definitely working, and he knows when a stool is on its way because he's constantly going in the litter-box and licking his butt - but he seems entirely unaware of the stool actually coming out.
Thu.Apr.14: Raz was impossible to express this morning, he wouldn't relax, just kept on growling and snarling. Got about half of it out, then had to give up and let him go. The poo problem is clearly stressing poor Raz out too. He goes in the litter-box less and less, it must be incredibly demoralising to keep trying but nothing happens. After yet another go, I picked him up to give him a cuddle - and a poo fell out onto the floor, but he seems entirely unaware of that happening. He was very happy to 'help' with the bimonthly cat-food-making :)
Fri.Apr.15: Raz was actually impossible to express this morning, I was squeezing his bladder scarily hard, he was snarling and growling like fury, and had to give up. I was worried about a UTI, so back to the vet this evening. The vet also had enormous difficulty in getting any out for a urine test. She says one often sees this when feeling is starting to return. The test came back borderline, but she gave me antibiotics anyway, plus a muscle relaxant so I can really empty him this evening.
Sat.Apr.16: Another beautiful day. Raz spent most of the day in the garden. He's getting more and more bolshey every day, making his displeasure at being 'messed with' ever more apparent. Expressing him today was again unpleasant, with him constantly yowling, wriggling and struggling to get away. I tried a different tack this evening: my husband fed him tiny bits of treats one at a time, and the little rascal just lay there and let me express him with no trouble at all - he was only interested in the next tidbit. Whatever it takes is good for me. At least it's now clear I'm not hurting him, otherwise he would have yelped instead of scoffing.
Still no sign of him being able to pee or poo by himself, though. He hates the Lactulose, and I don't think it actually makes his stools softer. I think we are going to stop using it for a couple of days and see how we go. Another milestone: I was giving him a tummy and tail massage just before bedtime, and there's no question - he can move the end of his tail. Also, the tail itself showed some resistance, instead of being a limp, lifeless thing.
Sun. April 16: Again. gorgeous weather; again in the garden. There's no question: Raz's tail is no longer dragging on the ground, he holds it clear! Only by a centimetre or so, and he manages it by holding it slightly off to one side at the tail head.
I think we've found an amicable solution to expressing: the dish of treats sits on the table while we express him on the couch, and he is prepared to let me do it - but the millisecond we are done "Good boy! All done!" he leaps towards the treats and scoffs them. This is a solution I can live with, here's hoping it continues so.
The vet said (on Friday) that I should express Raz three times a day, but I am finding this impossible to do. I've been expressing him ca. 10am and ca. 11pm; and there just isn't very much in there at suppertime! I usually fail to completely empty Raz's bladder as he gets extremely impatient when it comes to the last 25%, and this worries me as I've read that bacteria can breed in stale urine. He still isn't showing any signs of peeing, and seems unaware when a poo comes out. He has completely stopped going into the litterbox to try to poo - I think he's just completely demoralised.
Mon.Apr.17: On the off-chance, I tapped Raz's anal sphincter several times this morning and there's no question - it visibly contracts hard every time.

I have a few questions I hope you can help with:
- Everyone says "express 3 times a day". Raz rarely drinks water, he gets it from his raw food diet. Is the "3 x daily" schedule for kibble-fed cats? I've searched the net for clues on how often raw-fed cats pee, but unfortunately found nothing.
- if he can hold his tail off the ground, does this mean anything in terms of pee and/or poo capability in the future? Do some incontinent cats nevertheless have use of their tails?
- what exactly does the anal sphincter contracting really mean in terms of continence? There's the 'push' element of voiding, and the 'pinch' element. Is it possible that he will be able to 'pinch' but not 'push'?
- will expressing his bladder stop him from trying to pee by himself, because there's no bladder-generated signal to do so?
- is there a danger he will became un-litterbox-trained? Expressing and massaging take place on the couch. Should I try to express him over a small litter-box so he does not disassociate?
- and lastly, are my detailed posts likely to help others, or should I keep them short and to the point?

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Mon Apr 18, 2011 8:46 am
by critters
Needing to use "a lot" of strength to express pee may mean that his bladder or its neck may becoming spastic or spasmy. My Buddy's did that, and it took massive doses of phenoxybenzamine to relax it at all.

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Mon Apr 18, 2011 9:56 am
by CarolC
maine_coonz wrote:Hi there,
Life continues ... on a daily basis one can't really see much difference, but over a few days there's definitely improvement. I've been keeping a daily diary so I can keep track. I'm continuing to post details here in the hope that our trials and tribulations are of some help to other people.

That is great, but also great for anyone (like me) who is pulling for you and wondering how it is going, always glad for an update.

Tue.Apr.12: we went back to the vet again for expressing help, and he tested Raz's anal sphincter and said there was a tiny reaction.
Wed.Apr.13: I can't get his bladder more than 75% empty, no matter how hard I try. Peristalsis is definitely working, and he knows when a stool is on its way because he's constantly going in the litter-box and licking his butt - but he seems entirely unaware of the stool actually coming out.

On the 75%, are you certain there is still urine left causing a feeling of 25%, or could it be the bladder itself is kind of thick and leathery? I get this with my dog. Normally when she is empty her bladder will be very small (I can express it "down to a nub"), but she has times where I assume there is some inflammation of the lining of the bladder, making the empty bladder have more size and shape than normal, but it really is empty, it's just kind of swollen in the tissues...if that is a way to describe it? I assume it's cystitis. I notice she will have this kind of swelling of the bladder tissue itself more often on the first express of the morning. I saw critters' post below about spasticity, and that might be a more likely explanation, but I thought I would mention this.

Thu.Apr.14: Raz was impossible to express this morning, he wouldn't relax, just kept on growling and snarling. Got about half of it out, then had to give up and let him go. The poo problem is clearly stressing poor Raz out too. He goes in the litter-box less and less, it must be incredibly demoralising to keep trying but nothing happens. After yet another go, I picked him up to give him a cuddle - and a poo fell out onto the floor, but he seems entirely unaware of that happening. He was very happy to 'help' with the bimonthly cat-food-making :)

With my dog, I'm in the habit of checking her bottom every time I pick her up, just giving it a little pinch to see if anything is there. It's an unconscious thing, kind of like checking a baby's diaper. If I find anything, I pinch it out by grasping the soft tissue on either side of the anus, pressing in slightly, and pinching. It pops out any poops that are near the exit and makes room for things to keep moving.

Fri.Apr.15: Raz was actually impossible to express this morning, I was squeezing his bladder scarily hard, he was snarling and growling like fury, and had to give up. I was worried about a UTI, so back to the vet this evening. The vet also had enormous difficulty in getting any out for a urine test. She says one often sees this when feeling is starting to return. The test came back borderline, but she gave me antibiotics anyway, plus a muscle relaxant so I can really empty him this evening.

That would be so nervewracking.

Sat.Apr.16: Another beautiful day. Raz spent most of the day in the garden. He's getting more and more bolshey every day, making his displeasure at being 'messed with' ever more apparent. Expressing him today was again unpleasant, with him constantly yowling, wriggling and struggling to get away. I tried a different tack this evening: my husband fed him tiny bits of treats one at a time, and the little rascal just lay there and let me express him with no trouble at all - he was only interested in the next tidbit. Whatever it takes is good for me. At least it's now clear I'm not hurting him, otherwise he would have yelped instead of scoffing.
Still no sign of him being able to pee or poo by himself, though. He hates the Lactulose, and I don't think it actually makes his stools softer. Strange...it should. :? I think we are going to stop using it for a couple of days and see how we go. Another milestone: I was giving him a tummy and tail massage just before bedtime, and there's no question - he can move the end of his tail. Also, the tail itself showed some resistance, instead of being a limp, lifeless thing.
Sun. April 16: Again. gorgeous weather; again in the garden. There's no question: Raz's tail is no longer dragging on the ground, he holds it clear! Only by a centimetre or so, and he manages it by holding it slightly off to one side at the tail head.

Happy day!!! :yay:

I think we've found an amicable solution to expressing: the dish of treats sits on the table while we express him on the couch, and he is prepared to let me do it - but the millisecond we are done "Good boy! All done!" he leaps towards the treats and scoffs them. This is a solution I can live with, here's hoping it continues so.

:D

The vet said (on Friday) that I should express Raz three times a day, but I am finding this impossible to do. I've been expressing him ca. 10am and ca. 11pm; and there just isn't very much in there at suppertime! I usually fail to completely empty Raz's bladder as he gets extremely impatient when it comes to the last 25%, and this worries me as I've read that bacteria can breed in stale urine. He still isn't showing any signs of peeing, and seems unaware when a poo comes out. He has completely stopped going into the litterbox to try to poo - I think he's just completely demoralised.
Mon.Apr.17: On the off-chance, I tapped Raz's anal sphincter several times this morning and there's no question - it visibly contracts hard every time.

I have a few questions I hope you can help with:
- Everyone says "express 3 times a day". Raz rarely drinks water, he gets it from his raw food diet. Is the "3 x daily" schedule for kibble-fed cats? I've searched the net for clues on how often raw-fed cats pee, but unfortunately found nothing.

I don't think it makes a difference, total daily fluid requirement and intake whether by drinking or in food should be about the same, but can you stir some water into his dish when you give him his food? You probably already are, right? My vet recommended adding clam juice to the water for a cat that needed to drink more water. I have also heard adding tuna juice. Another option is always sub-Q fluids done at home. If you do them with a syringe rather than a drip bag, you're done in about 60 seconds.
viewtopic.php?f=30&t=12908&p=67205&hili ... nge#p67205


- if he can hold his tail off the ground, does this mean anything in terms of pee and/or poo capability in the future? Do some incontinent cats nevertheless have use of their tails?

I don't know but this article is what you want for explaining the different sets of muscles.
http://www.vin.com/VINDBPub/SearchPB/Pr ... R00442.htm


- what exactly does the anal sphincter contracting really mean in terms of continence? There's the 'push' element of voiding, and the 'pinch' element. Is it possible that he will be able to 'pinch' but not 'push'?

I may be about to say something wrong here, I hope not. The push element is coming from higher up, isn't it? Isn't that more abdominal muscle? He also has to be able to relax the sphincter, and preferably pinch it, which it sounds like he's becoming more able to do. The accident wasn't that long ago, could he still have some discomfort, though? When I see cats defecate, they really arch their backs, and they usually either squat, or sometimes squat on their tiptoes. Sometimes you will see the skin of their backs kind of roll or ripple during the process. Is he doing this? I'm wondering if he is still having trouble assuming the position comfortably with his broken pelvis still healing.
EDIT: See vet's explanation in next message.

- will expressing his bladder stop him from trying to pee by himself, because there's no bladder-generated signal to do so?

I would say no. I have expressed my dog for 7 years, and after about 5 months of healing she regained partial bladder function and would use that ability to help with the express, making it easier. It was wonderful. There are pets who can feel they need to urinate, they just can't accomplish it, my Katie is like that. I believe the signals will still be transmitting, and I doubt you will have him so empty all the time that he never feels any need to go...

- is there a danger he will became un-litterbox-trained? Expressing and massaging take place on the couch. Should I try to express him over a small litter-box so he does not disassociate?

Good point....not sure...

- and lastly, are my detailed posts likely to help others, or should I keep them short and to the point?

I personally think the detailed ones are most helpful. When you are in this position, you are wanting to soak up every detail you possibly can. I hope you keep posting the way you are, someone is going to find this a goldmine and think "Thank God, here's someone else with the same problem".

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Thu Apr 21, 2011 3:50 pm
by maine_coonz
Hallo again,

Re thinking Raz's bladder still has 25% left in it: I think you may be right, and that what I'm feeling is a thick bag, but my paranoia about doing it all wrong is making me misinterpret what I'm feeling.
And thank you for the link re the various sets of muscles - very comprehensive!

Tue.Apr.19: It's getting very hard to express Raz. I feel like I had the knack and now I don't. I wonder if the Bethanochol is making my life difficult? I think I will take him off for a couple of days and see what happens. He is still off the Lactulose.
I was testing his tail this evening to see if the middle part 'belonged' to him yet, when I noticed that the long hairs at the end of his tail were definitely moving when I gently squeezed the middle part of tail. Yay!
On our walk around the garden this morning, when I saw him trying to spray I patted his rude bits with a paper towel - and sure enough, there really are a couple of drops of pee. Here's hoping ...
He is carrying his tail even higher off the ground, although he still holds it up and over to one side.
Raz can really run! Euclid caught a mouse (poor thing) and brought it onto the patio to play with it. He was having a great time, and Raz was watching him jealously. Euclid's attention was distracted by some birds arguing for a few seconds - and his mouse was heading down the path, firmly gripped by you-know-who.
I tried putting Raz in the litterbox when I saw him licking his butt, which is the signal a poo is on its way, but he was less than impressed, just fought to get out. He stomped back to his cat TV (smack in front of the see-through cat flap in the back door), growling and hissing. A few minutes later I heard him 'covering' something, and sure enough the poo was on the floor. I have a horrible feeling he is becoming un-trained. Tried again later, with the self-same result (sigh).
He had another acupuncture session this afternoon.
Raz can climb (a bit)! The cats were chasing each other in the garden, and one shot up the plum tree, and before he quite knew what he was doing, Raz was following, although he only got about 12 inches off the ground.

Wed.Apr.20: It was very, very hard to express him this morning, even harder this evening. What am I doing wrong? I'm so scared I'm going to damage him. I didn't give him any Bethanocol today either, but so far life isn't getting any easier.
He definitely had difficulty getting stool out today, and really doesn't want me to help. I think they actually are harder than they were a couple of days ago, so I've started him back on the Lactulose again. I tried again to persuade him to use the litterbox, but he didn't want to know. This evening he was sitting on the couch with his blanky and making bread like crazy on it with all four feet, and I noticed a poo starting to come. I think it was as a result of his hind legs working away. Surely this means he will get control back at some point, as it's clear the muscles are acutally working, although he doesn't have control of them yet.
Another milestone: I was messing with his rear end checking for poos coming, and he was growling and snarling, and the end of his tail was definitely switching back and forth!
Also, he actually managed to jump from the floor onto the highest stool in the kitchen this evening: he stood on the floor and made his "please pick me up and put me on it" noise, but I was doing something else and told him to wait; at which point he eyed the problem, shifted back and forth a bit as if he were going to try to climb up, but then jumped. Yay!

Thu.Apr.21: We went for the garden patrol this morning before expressing; I wanted to see if Raz was more successful at spraying with a fuller bladder - and he is! Only a couple of drops come out each time, but by the time he'd checked all the spray-spots his rear end was unmistakably damp.
However, expressing him this morning was incredibly difficult. We have an appt. with the Vet at 5pm this afternoon to discuss matters.
The Vet also had incredible difficulty expressing Raz (which made me feel less inept). He said he thinks the muscles are 'fighting back' and that it was a very good sign; I asked him about the bladder being spastic/spasmy and he said yes, it could be described so, but in Raz's case he didn't think this was a 'bad' thing. He also said he was very surprised (and pleased) that Raz's tail is alive and working, and that it was also an excellent sign. I asked him if it might be possible for a cat to have a functioning tail but non-functioning bladder and stool-voiding. He said in principle yes it was possible, it all depends on which nerves were damaged and to what extent - but he didn't think that was the case with Raz. He said it's still difficult to tell what the final outcome will be, but things are definitely looking very good. I also talked to him about the difficulty I have in expressing Raz three times a day, and he said that was an ideal, cats are individuals, and it was clear that twice a day was working just fine. The amount he had got out was about two teaspoons which he said really wasn't worth worrying about. He did say that he thought giving him extra water wasn't a bad idea, although of course it means more work getting it back out again. And he also told me to put him back on the Bethanocol asap. He also said that there was an awful lot of stool in the colon, and I should massage it out asap. But overall he was impressed and very pleased, and I got a job offer :)
Back at home, I settled down on the couch, draped with a towel, with toilet paper and latex gloves to hand, and started massaging Raz. This is normally something he loves (up to the point where I actually touch his butt), but he got cross almost immediately, and jumped down and stomped off back to his cat TV (the cat flap). I sat there for a few minutes looking at the wall and feeling rather low, then to my surprise I heard scraping noises coming from the litterbox. Yes, he was really in there, squatting and pushing, and produced a poo all by himself! Oh happy, happy day!!

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Thu Apr 21, 2011 11:08 pm
by CarolC
maine_coonz wrote:Hallo again,

Re thinking Raz's bladder still has 25% left in it: I think you may be right, and that what I'm feeling is a thick bag, but my paranoia about doing it all wrong is making me misinterpret what I'm feeling.
And thank you for the link re the various sets of muscles - very comprehensive!

Tue.Apr.19: It's getting very hard to express Raz. I feel like I had the knack and now I don't. I wonder if the Bethanochol is making my life difficult? I think I will take him off for a couple of days and see what happens. He is still off the Lactulose.
I was testing his tail this evening to see if the middle part 'belonged' to him yet, when I noticed that the long hairs at the end of his tail were definitely moving when I gently squeezed the middle part of tail. Yay!

That was quick. Maybe he's healing quickly because of his age?

On our walk around the garden this morning, when I saw him trying to spray I patted his rude bits with a paper towel - and sure enough, there really are a couple of drops of pee. Here's hoping ...
He is carrying his tail even higher off the ground, although he still holds it up and over to one side.
Raz can really run! Euclid caught a mouse (poor thing) and brought it onto the patio to play with it. He was having a great time, and Raz was watching him jealously. Euclid's attention was distracted by some birds arguing for a few seconds - and his mouse was heading down the path, firmly gripped by you-know-who.
I tried putting Raz in the litterbox when I saw him licking his butt, which is the signal a poo is on its way, but he was less than impressed, just fought to get out. He stomped back to his cat TV (smack in front of the see-through cat flap in the back door), growling and hissing. A few minutes later I heard him 'covering' something, and sure enough the poo was on the floor. I have a horrible feeling he is becoming un-trained. Tried again later, with the self-same result (sigh).
He had another acupuncture session this afternoon.
Raz can climb (a bit)! The cats were chasing each other in the garden, and one shot up the plum tree, and before he quite knew what he was doing, Raz was following, although he only got about 12 inches off the ground.

Yikes! I wish he'd be careful till he's healed, what if he bumps himself and has a setback. I worry about everything.

Wed.Apr.20: It was very, very hard to express him this morning, even harder this evening. What am I doing wrong? I'm so scared I'm going to damage him. I didn't give him any Bethanocol today either, but so far life isn't getting any easier.

For sure, this has not been an easy one. I'm so glad he is improving.

He definitely had difficulty getting stool out today, and really doesn't want me to help. I think they actually are harder than they were a couple of days ago, so I've started him back on the Lactulose again. I tried again to persuade him to use the litterbox, but he didn't want to know. This evening he was sitting on the couch with his blanky and making bread like crazy on it with all four feet, and I noticed a poo starting to come. I think it was as a result of his hind legs working away. Surely this means he will get control back at some point, as it's clear the muscles are acutally working, although he doesn't have control of them yet.

Interesting. I've had 2 cats, I think, who would sometimes start to go, then reconsider and dig up a storm for an extra minute, then start again, then change their minds and dig again, and I never thought it was because they were dissatisfied with the hole, I thought the digging helped them physically, kind of like your cat.

Another milestone: I was messing with his rear end checking for poos coming, and he was growling and snarling, and the end of his tail was definitely switching back and forth!
Also, he actually managed to jump from the floor onto the highest stool in the kitchen this evening: he stood on the floor and made his "please pick me up and put me on it" noise, but I was doing something else and told him to wait; at which point he eyed the problem, shifted back and forth a bit as if he were going to try to climb up, but then jumped. Yay!

That is impressive, it's kind of amazing how quickly he's getting ability back. This is about the end of the 4th week, isn't it?

Thu.Apr.21: We went for the garden patrol this morning before expressing; I wanted to see if Raz was more successful at spraying with a fuller bladder - and he is! Only a couple of drops come out each time, but by the time he'd checked all the spray-spots his rear end was unmistakably damp.
However, expressing him this morning was incredibly difficult. We have an appt. with the Vet at 5pm this afternoon to discuss matters.
The Vet also had incredible difficulty expressing Raz (which made me feel less inept). He said he thinks the muscles are 'fighting back' and that it was a very good sign; I asked him about the bladder being spastic/spasmy and he said yes, it could be described so, but in Raz's case he didn't think this was a 'bad' thing. He also said he was very surprised (and pleased) that Raz's tail is alive and working, and that it was also an excellent sign. I asked him if it might be possible for a cat to have a functioning tail but non-functioning bladder and stool-voiding. He said in principle yes it was possible, it all depends on which nerves were damaged and to what extent - but he didn't think that was the case with Raz. Ok, thanks, I wasn't sure. He said it's still difficult to tell what the final outcome will be, but things are definitely looking very good. I also talked to him about the difficulty I have in expressing Raz three times a day, and he said that was an ideal, cats are individuals, and it was clear that twice a day was working just fine.

You might want to express him onto an incontinence pad so you can see and sniff (sorry) the urine to monitor it.

The amount he had got out was about two teaspoons which he said really wasn't worth worrying about. He did say that he thought giving him extra water wasn't a bad idea, although of course it means more work getting it back out again. And he also told me to put him back on the Bethanocol asap. He also said that there was an awful lot of stool in the colon, and I should massage it out asap. But overall he was impressed and very pleased, and I got a job offer :)

You deserve it! :lol:

Back at home, I settled down on the couch, draped with a towel, with toilet paper and latex gloves to hand, and started massaging Raz. This is normally something he loves (up to the point where I actually touch his butt), but he got cross almost immediately, and jumped down and stomped off back to his cat TV (the cat flap). I sat there for a few minutes looking at the wall and feeling rather low, then to my surprise I heard scraping noises coming from the litterbox. Yes, he was really in there, squatting and pushing, and produced a poo all by himself! Oh happy, happy day!!

Happy day for him, too, I'll bet! That must have been so intensely frustrating for him when he couldn't do it. What a smart kitty! He must be delighted!
litterbox.gif

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Sun Apr 24, 2011 3:14 pm
by critters
Our vet didn't believe the beth. was making Buddy harder to express either, until she took him home one weekend and found out it was totally true. :lol:

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Mon Apr 25, 2011 8:51 pm
by cricketsmom
I've been away a few days, and look at all this progress happening! :cheer: Hopefully it is just a matter of time before he can pee on his own too. Hang in there! Have you considered moving his litter box or adding another one near his kitty window? Seems like he tends to gravitate to that area when he's frustrated with getting a BM going. Just a thought to try to encourage him that his litter box is a good place to be....

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Wed Apr 27, 2011 10:20 pm
by maine_coonz
Week 5, Fri.Apr.22: It's still really difficult to express Raz, plus he is getting ever more uncooperative. I have got to find a solution to this.

Sat.Apr.23: I tried a different way of holding him today, which definitely seems to make life eaiser. Rather than lying him on his side with his head facing away from me (and his rear end pointing towards me), I reversed it so that his head is pointing towards me. And unbelievably, it was incredibly easy to express him. I don't know if it's due to the different position, or whether his bladder is relaxing somewhat. I used the same position this evening, and it was again easy to express him, but he did struggle somewhat. It's very puzzling: if he gets treats during the expressing process he absolutely ignores what I'm doing, but if he doesn't, then it's just one big fight (sigh). The down side is that his tummy muscles become very tight when he's munching and/or looking for the next treat.
His back is definitely straighter, and he is running across the garden without hesitation now. His tail no longer forms a 'loop' when he sits down; he can switch it when he's cross, and arrange it tidily. But still no sign of him being able to pass stools easily or pee by himself.

Sun.Apr.24: Raz is definitely easier to express using the new position, but the down side is that he is daily becoming less co-operative, and struggles to get away pretty much non-stop. It is very wearing, and I worry that I am hurting him - but then he lets me get on with it if he gets treats. I wish I could be sure that he isn't in pain when I express him. No change today that I can remark on.

Mon.Apr.25: Again, no change today that I can remark on.

Tue.Apr.26: Today I noticed that when I was massaging Raz's tummy (which I always do before expressing him to get him to relax) a few drops of urine appeared on his penis. Does this mean anything? I have no idea.
I had a lot of trouble with him today, the new position does make expressing his bladder easier, but he struggles all the time which makes life difficult. I don't like it when I can't get visual feedback that I am pressing his bladder in the right way+place, but eventually I had to give up trying to do it with him lying on his side, and allow him to lie on his tummy. It is very trying. Still no sign of him doing poos easily or peeing by himself.

Wed.Apr.27: Expressing Raz today was a trial: he did not want to co-operate at all. Eventually Julian had to hold him down by force both times. However, it is much easier to actually get the pee out, it doesn't seem to require any real strength at all.
He isn't passing stools as easily as I could wish - he does try in the litterbox from time to time, but gives up pretty quickly, and just waits for them to fall out.
Also, I don't know if it's my imagination, but his back seems to be more hunched than it has been for the last week. However, he's in good spirits, and is eating well.
Jumping seems to be becoming easier for him too - this evening he jumped from the windowsill onto the top of the fridge, albeit somewhat awkwardly. I worry that he's pushing himself too far too soon.
The acupuncture session this afternoon did not go at all well - he seemed cross and anxious, and did not relax - after about 10 mins he jumped out of his basket and hid his head under my arm, then jumped down and ran away, biting at the needles as he went. Very odd, he has always responded very well and been very relaxed.

We are now at the end of Week 5. I read on the marvistavet page (http://www.marvistavet.com/html/body_ca ... tails.html) "most cats who do not recover urinary control after a month probably will remain incontinent" and "Tail function and sensation tends to take longer". Well, Raz definitely has both tail function and sensation, but no urinary control; he also has quite good anal tone now. I guess this just goes to prove that we are all different!

But on a more serious note: if Raz is going to recover bladder control, is there some sort of timescale that I can look to? I should add that my husband, who is very supportive, is nevertheless adamant that a permanently incontinent cat has no place in our lives. He says he's prepared to do absolutely everything and anything that's necessary to help him recover, but not long-term. So you can see I'm extremely concerned! It doesn't help that Raz is so uncooperative - expressing him usually takes at least 30 mins, and leaves everyone feeling upset, with pee everywhere.
Is it likely that he's still in pain? Although he's jumping a bit, it's not much really. He is still very careful, and chooses to climb rather than jump when he can. For some reason, I sortof think that when he can jump properly again, he will probably pee and poo. Does this idea have any medical foundation?

It's so great to know that you guys are out there rooting for Raz (and me). It really, truly helps to know that one is not alone in this. I must confess to days when I almost despair :(

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Thu Apr 28, 2011 11:23 pm
by cricketsmom
Hi maine_coonz
I'm glad you found an easier position to express Raz. It's too bad he's still wanting to struggle so much.
Cricket used to twist and scratch when I would go to express. I found that holding her by the scruff when I express works best for her. I hold her facing me with my left hand and hold her up so her front feet don't touch and just her back feet are on the pad. For some reason, if all four paws are on the ground, she thinks she's supposed to push off with them and run. :) Then I palpate her belly and express with my right hand. She gets fed breakfast/dinner right after she's done. I don't know if that helps at all, but that's our routine.
When you were massaging Raz, since he's had some spasms closing off his bladder, the relaxing message maybe just let some pee out. Either that or you put a little pressure on his bladder. I'm not sure how to take that either.
The veterinarian I took Cricket to when she had her acupuncture said it can be irritating when the nerves are trying to heal and work again. The needles are designed to direct the body's attention to a particular area that needs stimulated, so the pet can get a prickly sensation is what they think. Perhaps that was Raz's experience at his latest appointment.
I would not set a time limit on Raz to recover urinary control. I know you're anxious and have your husband telling you he can't do this forever. But I would hold out and give him the benefit of the doubt. And if he doesn't get control back, I'm sure you'll eventually settle on a routine that works smoothly for you and that your husband won't object to.
He may still have some pain, yes, but he should be on the mend. Broken bones take several weeks to fully heal. So I would attribute the jumping comfortably more with the pelvic fracture alone and not being related to being able to urinate. My girl Cricket has no bladder control but all four legs are fully functional let me tell you!
Keep up the good work! :trophy:

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Fri Apr 29, 2011 11:08 pm
by CarolC
Just want to highlight what Critters said above...bethanechol made her male cat impossible to express. Here is some information on the medication (highlighting added):
Pill Book Guide to Medication for Your Dog and Cat wrote: Bethanechol should only be used when the urethra is open, as when a catheter is in place, or with urethral relaxants because bethanechol can cause contraction of urethral smooth muscle as well. Theoretically, the bladder could rupture if bethanechol is given when the urethra is blocked, or in spasm
I have heard of using diazepam (which you had in the beginning) and inderol with bethanechol. Jean used Robaxin, which is a relaxant, but I don't know if she was using with bethanechol, I think it was just but it'self.

I don't know about cats, and I am talking about common paralysis, not a tail injury, but my dog's physical therapist said you need to give it at least 3 months to see if bladder control is going to return, and 6 months to be sure.

I have told this story before, but not to you. When I first got my paralyzed dog, she was extremely hard to express. It wasn't just that I wasn't experienced at it, she was just hard. I remember one Sunday morning, several months into her paralysis, I was desperately tired, completely exhausted, but I dragged myself out of bed to express her (was being careful about every 8 hours) and planning to go back to bed. It took 23 minutes to get her done, and by then I was so tense I hardly felt like going back to get the sleep I so desperately needed. It would take 20-25 minutes most times in those early months, and you're doing that several times a day. But amazingly, at about the 5-month point, something changed and she began to be easier to express. I believe she regained partial control, and used it to help me when I squeezed. And it continued to get better after that. Now I still express her, but it takes about 15 seconds, literally. But I'll never forget those first months when it was so hard and took forever. I used to say, "corded veins on the forearm" trying to get it done. I should have gotten some medication to relax her, she had so much tone, but I didn't know.

On visual feedback, I express on the bathroom counter and have the reflection of the mirror to go by.

There are some pets, and it would be amazing if you are this lucky...some that will urinate by external stimulation. You can find out by wiping his male area with a warm washcloth or a baby wipe, possibly while massaging his stomach.

This is going to sound off the wall, but you might want to consider a B-vitamin supplement, since stress uses up your B-vitamins.

On the question of still being in pain, I wonder if it's more of a situation where he's not in pain, but areas are still sensitive to the touch.

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Sat Apr 30, 2011 10:18 am
by FYI
http://www.marvistavet.com/html/bethane ... oride.html
http://www.veterinarypartner.com/Conten ... tID=228974
http://www.veterinarypartner.com/Content.plx?P=A&C=301&A=2153&S=0&EVetID=228974 wrote:If the patient’s urinary tract is not obstructed but has excess tone, it is helpful to combine bethanechol with a medication to relax the lower sphincter and urethra: diazepam or phenoxybenzamine.

Re: Cat: broken pelvis+tail, eating+pee+poo problems, I'm sc

Posted: Mon May 02, 2011 6:59 pm
by maine_coonz
Week 6: Thu.Apr.28: No change today that I can remark upon.

Week 6: Fri.Apr.29: No change today that I can remark upon. Raz is still really hard to express, and seems to dislike the process more and more. We have stopped giving him Bethanochol as of today lunchtime, to see if it makes any difference.

Week 6: Sat.Apr.30: Raz was still difficult to express this morning; I think I only got him half empty. He desperately needs to pass a stool, but won't let me help him. Starting this morning, we have upped his Lactulose from 1.5ml twice a day to 1.5ml three times per day.
He is definitely carrying his tail higher, and even starting to switch it when he's excited or annoyed.

Week 6: Sun.May.01: Raz bounced around all day in the garden and had a good time - he even caught a mouse all by himself, and ate it loudly with every evidence of enjoyment. Expressing him was just as difficult as ever; stopping the Bethanochol doesn't seem to have made any difference. However, upping the Lactulose has definitely helped him to pass stools a bit more easily.
Raz has completely stopped going in the litter box and trying to poo, he just waits for it to come out. It's weird - sometimes when we are sitting on the sofa he starts making bread with all four feet, and really pushes to get a stool out, so it's clear he can do it, so why isn't he doing it all/more of the time?

Week 6: Mon.May.02: We got the prescription for Diazepam filled, and started Raz on a 1/4 tablet twice a day. The Vet said "Give 1/4 or 1/2 tablet twice daily". I forgot to ask Julian to specify Valium (see http://www.marvistavet.com/html/body_valium.html). Raz definitely seems a little stoned, but was nevertheless difficult to express this morning. This evening he was more laid back, was prepared to lie down and lift his leg, he even purred a bit - but overcoming the bladder's resistance was just as hard as ever. I don't know if it is my imagination, but his bladder feels somehow flabbier - I wonder if this is a result of him not taking the Bethanochol?
Raz had a good time in the garden this afternoon - he even played football with Euclid and Heimdall.
We have decided to stop the acupuncture for the moment, so no session today.
We will put him back on the Bethanochol tomorrow morning.

Guys, it's really helpful to read your replies and comments.
Can anyone tell me what exactly a spasmy bladder means? Spasm' to me means "the muscles relax and contract at irregular intervals". Is this correct? Why does it happen?
It seems to me that this muscle spasm thing might also be affecting his anus, as it is always tightly closed, and the stools are definitely forced out by pressure from the "traffic jam".

CricketsMom: No way can I express Raz by myself, he's 8.5 kilos of rumbunctiousness, and it's all I can do to hang on to his rear end, never mind the front end at the same time! I think Julian would think more positively about a long-term problem if Raz wasn't such a pita about the whole process.

Critters: did your vet put your cat on Diazepam? And if so, what dosage? Do you think it's my imagination that his bladder feels sortof flabbier the last couple of days since we stopped the Bethanochol? How long did you continue using Bethanochol (and Diazepam) for?

CarolC: it's good to be able to give Julian some kind of time frame, thank you for that. He looked a bit happier when I told him "3 months min. wait-and-see time". I think he didn't like the open-ended time frame.
I tried to express Raz in the bathroom yesterday, but unfortunately this is also where he got showered a lot in the first few weeks to try to deal with urine scald and soiling. So he was very anxious about being in there and wanted to leave immediately. A shame, because the bathtub looked like a good idea, and we have a nice soft squishy rubber bathmat I could put in it, which would save a lot of towel washing. But I will try again another day.
Way back in the beginning I did read someone's post about getting their pet to pee by external stimulation, and I have tried this a few times. Although he definitely likes this (rude boy!) unfortunately it doesn't have the desired effect.
B vitamins: that doesn't sound off-the-wall, I agree with you, and in fact have been taking vit.supplements for the last few weeks.