What to do when she comes home from the vets?

For those seeking advice on caring for incontinent pets and animals with kidney-related problems.
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LittleCillaBlack
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What to do when she comes home from the vets?

Post by LittleCillaBlack »

Hi, I'm after advice on how to look after my cat when she comes home from the vets.
She was hit by a car 2 weeks ago and had surgery to repair a hole in her diaphragm which she's recovering well from. Unfortunately she's dragging her back leg and can't seem to feel it but the vets can't see any physical damage so it may be to do with her nerves and therefore may fix itself. Time will tell but for now it's more about her being alive and comfortable.

Here's my main worry: They say she manages to use the litter tray in her cage for her poos but not for her wees. There's concern that she doesn't know she has to go. When she comes home it'll be on cage rest so I can wash any soiled blankets etc. but what about when she can start spending time out of the cage? How do people deal with a cat that doesn't know it needs a wee?

With talk of her potentially coming home in the next week it's suddenly becoming very real and I want to be prepared.

Any advice appreciated!!
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critters
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Re: What to do when she comes home from the vets?

Post by critters »

:slant: I suggest expressing her for lots of reasons. 1. She may not be able to get all of the pee out herself. 2. If it's already out it can't leak. It takes some practice, but many of us around the bb have learned! Expressing is when you squeeze the bladder with your hand/s to get all of the pee out. http://handicappedpet.net/helppets/view ... =5&t=16027
drakonka
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Re: What to do when she comes home from the vets?

Post by drakonka »

This is the topic we have had to educate ourselves about over the last few months. I would love to express our kitten, but unfortunately it has just not worked - multiple vets have tried, we have tried, we followed all the videos we could find and it just does not seem to work. No vet, vet surgeon, vet nurse, or specialist has been able to get that pee out of him as of yet. So over the last few months we had to learn to encourage our kitten, who has a large bladder with what seems to be nerve damage, to pee on his own. I really hope that experssing will be an option for you. But, just in case, here are some of the methods we have/do use.

First, our situation (feel free to skip this except for the part in bold which describes what they found out about the nerves in his bladder, which would let you compare to your own situation)

* Kitten was given UTI and blockage at a vet during neutering surgery
* Cathererization did not find stricture, so vets thought they were just dealing with a UTI
* Lack of ability to urinate and vets leaving it too long has resulted in major bladder distension. At one point he stopped TRYING to pee and no longer even felt like he needed to go, signaling distension and nerve damage. I asked to double check for stricture but they said as they have cathetarized him so much and never noticed one it was very very unlikely
* On our 3rd vet hospital nothing was helping - as he was not suffering they decided to do a bladder biopsy to try and get more information.
* They found no info from the tissue samples but DID find a stricture when passing catheter OUT of his bladder that did not present itself when passing catheter from outside in. It is possible he had a stricture this -entire- time. They performed a Pernieal Urethrostomy
* They also found that his bladder was very distended, not responsive, EXCEPT at the very "tip/end" where it contracted very slightly when touched

* After 2 days he still did not pee on his own - at this point they were draining him via ultrasound needle daily, under general anesthesia since his bladder was too floppy to get needle in when he was awake and moving. They sent him home to be put to sleep the next day saying there was nothing more they could possibly try. Expression still did not work. He miraculously peed on his own for the first time in a month the next morning.


Now, here is where we are in terms of geeting him to pee:

* He is on Myocholine and Alfadil to help contract his bladder. We have lowered the dose somewhat but lowering it any more reduces his peeing requency, so we bring it back up
* This does not seem to do the job on its own. We ended up accidentally "training" him to pee. It seems that even when he does not feel he needs to go, if he -wants- to go (like for a reward), he is able to make himself pee.
* We have always naturally gotten very excited, praised and petted him when he peed (not surprising considering he somehow managed to pee just hours before being PTS), so over the months I think he has learned to associate urination with a good response from us
* When he did not pee on his own during the day I started bringing him into the bedroom at night with two litter boxes, water, toys, and our other kitten. The reasoning was to be able to hear and wake up if he happened to go to the box at night, otherwise we don't know if it was him or the other kitten and subsequently do not know if he needs to go to the emergency room or not. If he peed while in the room I would just let him out, since then I would know he went, not have to worry, and any other pees at night would be our other kitten's. Often I would also give the kittens a small snack right afterwards. I think he learned to associate peeing with being let out of the room and fed. It got to the point where oftentimes we would just do this lock-in procedure and he would pee within 5 minutes. Sometimes he would wait a while, gurgle at the door in frustration (or what sounds like frustration anyway) and stomp off to the litter box to do his business.

This does not ALWAYS work. Sometimes he is just too tired to even want to be let out - he's happy just falling asleep in our bedroom. This is where...annoying him...helps. It sounds awful, but we have only had to do this a couple of times. Just taking a squeaky toy and squeaking it in the room repeatedly (not in his face of course, just in the same room) annoyed him enough to want to get the heck out of there. He would then, again, stomp off to the litter box of choice, do his business, and be let out. At this time we do not care how big the pee actually is - sometimes he pees a lot and sometimes just a small tennis ball. We let him out regardless and worry about the volume later to not break his association.

Then there is the morning. I get up at 6am to give him meds, then again at 7am to feed them. We do not lock him in this time - we prefer for him to pee twice in 24 hours but just once is enough and locking him in would be problematic if he decides NOT to pee as eventually both my partner and I have to go to work. He loves going outside on our enclosed porch in the morning. If he pees on his own in the morning before we leave he gets immediately let out. He has learned this and now bolts straight downstairs to the front door after peeing, looking up at us to open the door. If he does not pee before we leave we separate the kittens until one of us is back and able to monitor him (so that we can see if he pees during the day when we are gone)

This method doesn't ALWAYS work. Sometimes he just doesn't want to pee at night, in which case he stays with us in the bedroom all night and is finally let out for feeding in the morning. If he doesn't pee within a couple of hours we know we have to go to the emergency, as this would be 24 hours between urinations. We've had quite a few emergency trips due to this whole peeing debacle, but since finding the above ways to "cope" there has been no major incident (yet...I'm all about knocking on wood here).

Again, I really hope you can express your cat. Our little "routines" are very restrictive and uncertain. If he for some reason gets worse, the nerves get less sensitive, whatever, none of the above will help :( We just have to keep our fingers crossed and hope that since he's so young his nerves can regenerate, or at least not degenerate further.
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critters
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Re: What to do when she comes home from the vets?

Post by critters »

My Buddy had a spasm at the neck of his bladder, and they said a PU wouldn't help. He had a tube put into his bladder so he could pee out of a tube in his belly (this was 9-10 years ago).
drakonka
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Re: What to do when she comes home from the vets?

Post by drakonka »

critters wrote:My Buddy had a spasm at the neck of his bladder, and they said a PU wouldn't help. He had a tube put into his bladder so he could pee out of a tube in his belly (this was 9-10 years ago).
A permanent tube? Does this mean it constantly leaks? If this is an option for our kitten if he goes downhill I will ask the vets about this as well. Does this create an opening making him more prone to infections? I begged them to give us any possible option, including a permanent catheter or anything of the sort, but they were strictly against it and said there was no way :(
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critters
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Re: What to do when she comes home from the vets?

Post by critters »

Yes, a permanent tube, called a urethrostomy. It didn't leak all the time; I drained it with a syringe.
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