Hello from me and Harvey (hit by car, now incontinent)

[Clarabow99]

Hi,
I've been reading this forum for a couple of weeks now and it has given me positive feeling and some hope, thank you all for that.
Sorry this is so long.

On 13 December 2015 my beautiful 9 month old Harvey was bitten and chased by another animal into the path of a car and has been in the vet's since then. My vet practice is a university hospital which has top of the range facilities and some top vets and surgeons working and training there so I'm very confident in their abilities and opinions.

Main injuries were a collapsed lung, broken tail near base of spine, his pelvis was fractured and shunted up his spine by 1" and his abdomen was severely and extensively ruptured but thankfully the skin was intact.

On 14th they corrected his breathing.
On 16th repaired his abdomen which was a success.
On 17th the surgeon said his prognosis was very poor re incontinence and they asked if they should go ahead and operate... or not
They wanted to operate on his pelvis by pinning it but he said they should amputate his tail now while he was under anaesthetic as the break was bad enough that they believed it would be removed later on anyway so I agreed to the operation. I disagreed to euthanasia which wasn't actually mentioned but inferred by "do we go ahead with the operation or not, based on his poor outlook".

On 29th he regained external anal reflex though his bowel control is intermittent, sometimes in the tray, sometimes in his bed but his poop is healthy enough. He also did a pee by himself in the tray which I was delighted with, however he has not pee'd since then by himself.

On 30th his feeding tube was removed and he started eating albeit very little so they've topped up fluids etc and since then they've been expressing his bladder 2 to 3 times a day. They told me that his bladder has resistance internally which is good but the external muscle is weak, also that he's really difficult to express and it takes 2 of them to do it.

On 2nd January they told me he's really flat and sleeping lots which is a change from the previous days.

5th January, this morning, the vet called me and I've got an appointment to see the surgeon at 4pm and I am distraught as I feel there is bad news coming. Harvey has had a dragging limp on the rear left side which they are investigating further.

My problem is the future as I live alone and my family all live 100's of miles away so I have no-one around to help me express him. I have great friends but I cannot ask a friend to come over every 12 hours to help me.
I have another cat aged 7 who Harvey hates unfortunately and he attacks him but I think that may stop now.
My older cat is very placid, he's a Ragdoll, so he's all for the easy life. Harvey is a Ragamuffin and has the energy of a dozen kittens!
I work self-employed at home but I'm looking for a part-time job and I'm well aware that leaving him in the house, even with my other cat, is not going to be great for him.

I know there is no crystal ball but really what I'm wondering is how long do I do this for? I don't want this life for him but I know it's not impossible, he's so young and the thought of him living for 12+ years with this condition is unbearable as expressing is not without its own problems of UTIs etc. I have to be realistic for him... and myself.

The finances are a consideration too, my insurance maximum has exceeded by £2,200 already with more costs to come.
I would pay anything for my boy but the fact is I don't have that money and I'm already sinking into serious debt here which is why I'm looking for additional employment.

Needless to say I've been crying every day since his accident and I'm a mess emotionally, panic attacks, not sleeping, stomach upsets you name it. I'm a wreck

So is it too early to be thinking the worst?
It's 3 weeks and 3 days since this happened and I can see from some experiences that the bladder control can be regained or become easier to manage. I just don't want to put this little guy through many months of misery and pain only to find that he needs PTS later in the year.

Help
Claire x

[CarolC]

Normally you would expect him to have pain at first, I would even say perhaps for a couple of months considering the pelvic and spinal injuries. But things tend to get better with time. I guess you can only wait and see, and expect the first weeks to be hardest, but hopefully things will begin to smooth out for both of you. I would not expect it to be easy at first.

It is understandable if he is difficult to express right now. I think strong pain medication is going to be a must during the first weeks home. You have to be able to handle him.

I don't know if this helps much, but I am posting a link to the description of my dog after she was spayed and I had to express her. It is always awkward when you have to express around abdominal surgery, but it can be done. I remember Debbie_Spain said she found a way after abdominal surgery to express her dog by putting her hands on top instead of on the abdomen.

http://handicappedpet.net/helppets/view ... inent+spay

I would think having a medication to relax his urinary sphincter would be a big help. And the tail surgery should make things easier, too. Since you say it takes 2 of them to do it, and you are only going to be one person, I would think it would be best if they start the medication that relaxes the sphincter while he is in the hospital, and get him to where just one of them can do it alone, before sending him home with you and expecting you to do it by yourself.

Did you see the videos on expressing? They show a number of different hand positions. Scroll to the end of this link and there are videos on cats.
http://handicappedpet.net/helppets/view ... =5&t=16027

Here is a helpful thing to keep in mind. Many cats do not like to be expressed, it is normal. That includes cats who have not had abdominal surgery and cats who are not recently injured. They will still yowl and cry, even though you are not hurting them, then they will be fine afterward and you will see that in reality it wasn't so bad. It is very common for cats to vocalize (complain) when you express.

The vet will need to show you the best way to express your kitty based on his injuries, but if you follow those instructions, then you do not have to immediately assume, "Oh dear, he is crying so much I must be hurting him." Just be as careful as you can, and remind yourself that this has to be done, it's for his health, and remember that it is normal for them to protest.

If possible, I hope they will release him to come home early in the week, so if you have any trouble expressing, you can take him back for them to help you. It is always inconvenient if you first take the pet home right before a weekend when there is no vet support available if you need it on the weekend. When he comes home, if you do have trouble expressing at first, do not hesitate to take him back and have them show you again and work with you. Don't feel bad. The vet techs and vets were not born knowing how to express either (as critters always says). You would not be the first owner to return for assistance. I had to go back to the vet for assistance when I was first learning to express.

And also if possible, see if they will let you come in a couple of times before he is released, so you can actually express him there. They need to see how you do single handed. And it will give you confidence knowing you are using the same approach they have been using, which they will teach you. If you get home and do it just like you did while the vet was watching you, you will feel more secure knowing you are doing it the best way medically. So, if you can find out what time they usually express him, you can go and be in the room and get some hands on experience. Then you will be properly prepared for when he is released.

https://www.youtube.com/watch?v=6kzwDjjnRX0

[critters]

Honestly, I can't imagine why it takes 2 people to express a cat. I did Buddy alone, but our vet took 2 people, for some reason. She didn't even believe I could do it. I scruffed him with one hand and held him on his back on a thick, folded towel. I then expressed him with the other hand.

And, yes, vets weren't born knowing how to express either, so I've given up trying to understand why it's so magical that they think the rest of us can't!

[Clarabow99]

Five weeks since the accident and I've had Harvey home for 4 days now and he's taken to the vet's for expressing once a day while they also show me what to do. I'm an utter failure so far....
I've tried so hard with him and found yesterday that massaging him on his rear end around the genitals made him pee a little which he was startled with and wriggled away, but it's not enough. I know where his bladder is as the vet and nurse held him while I explored and tiny bit of wee came out. He's on Hypovase twice a day and lactulose 2mg, twice a day.
Today has been a nightmare, I got him all relaxed and warm then tried to massage again, didn't work. So I put him in a basket with the pads and petted him until he was purring then as soon as I got down below he turned into a tiger, he was hissing and snarling, scratching and biting so had to give up. So now, I'm crying my eyes out because I feel that he's just going to be "one of those cats". Normally he's very easy to handle but I have a feeling that he's still got some pain somewhere - the vet says he doesn't, everything has healed.
At the vet's there are a few of them that have expressed him (it's a hospital) and he's the same. It takes two of them to do it and he's a nightmare for them. They get it done because they know it has to be done, however I live alone and I cannot hold him and express him at the same time.

My head is saying he should be PTS as I've been told he'll never regain his urinary function. The poops pop out randomly so he doesn't need the bowel expressing.
My heart is saying it's only 4 days and I should give him a chance. I cannot keep going to the vet's once a day to get him expressed, I don't think every 24 hours is enough. Plus I'm totally in love with this little guy and I don't want to lose him but this is impossible. I know it's only 4 days but I cannot have another 4 days like that, then it will be 4 weeks and we'll both be miserable as #### and in pain. Not to mention finances, I'm already about £2,500 in debt (over my insurance max of £4,000) with no way of paying it except credit card

Do you think he's just one of this cats? Or do you think he's seriously in the amount of pain he seems to be displaying - I'm attaching a pic showing the length of his scar, in which case I'd rather he had a catheter until his wound has healed.

On the pic the scar goes really far down, do you think this scar is causing him pain when being expressed?

Any advice welcome as I'm at rock bottom now and it's only 4 days in, bit pathetic really
x Claire

[critters]

Have you tried my way? It DOES take a good bit of hand strength to do it my way, and it also takes time to learn to listen to what your fingers are telling you, just like learning Braille. I wonder if using gabapentin might help? It would help if he's having any nerve pain, and it also tends to make them sleepy at the beginning.

[CarolC]

I've tried so hard with him and found yesterday that massaging him on his rear end around the genitals made him pee a little which he was startled with and wriggled away, but it's not enough. I know where his bladder is as the vet and nurse held him while I explored and tiny bit of wee came out. He's on Hypovase twice a day and lactulose 2mg, twice a day.

Here is a video of a male cat who urinates using both sqeezing and external stimulation.



Most cats will hold still by being scruffed on the back of the neck, and if you are lucky, some cats will hold still by clipping clothes pegs (clothes pins) on the back of the neck, as if they were being scruffed by hand. On this link, scroll halfway down and there are photos.

http://felinecrf.org/subcutaneous_fluids_tips.htm

It can be done with binder clips, too.



Other videos on expressing are at the end of this article, including doing it with just one person.
viewtopic.php?f=5&t=16027

[Clarabow99]

Thank you so much for your replies, they are supportive and helpful. Love the videos Carol - I tried the clip method with him but it did nothing He's a feisty and strong character!

Critters - 4 vets at the hospital expressed Harvey and all did it in different ways, 3 of them not good but the 4th vet managed to do it gently and without him howling and hissing and wriggling quite as much. She also explained exactly how she did it and on Sunday I gave it a go and managed to express about a third of his bladder

Today (Monday) I tried again and got some out but no way near enough - more practice and confidence.
My method of keeping him calm and still was to use a wide fleecy scarf as a sling, I tied it in a knot at the back of my neck and I put him in it with his back end hanging out, paws just brushing the table for sense of security - he was supported underneath but his front legs not touching the table. I could then squeeze him with my right hand and tickle his chin with my left! In fact I also fed him while he was like that but it didn't last long. I may have found my solution lol! I just need more practice now and I need to re-design my "sling" -unfortunately he's a very difficult, wriggly and impatient little boy

I need to remember that in only a week I've managed to express him twice

love
Claire xx

[LittleMo]

Hello Clarabow99; I'm new here but experiencing a very similar situation to yourself, one of our three lively 10 month kitties was involved in an accident (no idea for certain how it happened), she was found on 19th December with a limp tail and walking low on her rear legs. The vet confirmed a "Tail Pull" injury, she spent the Christmas period at our local vets, before we pushed for a referral, she was taken to SCVS on 30th December and her tail was amputated the same day (we were told the tail was dead and little Nismo had already licked it raw as it had no feel!

Nismo returned home on 6th January, and much to our delight her brother and sister (Same litter) accepted her back into the "circle of trust" straight away. She currently has fairly good anal tone although she does lack some sensation, she sometime poop's in the tray although this is hit and miss. She drops urine patches and wee's when she licks herself or in her sleep. We are currently managing her at home, which I have to say in one of the hardest things we as a family have ever done, myself and my husband both work f/t and we have two young child (6 & 10), We are currently waking at 6am every morning to give her meds (2 x 5mg Prazosin) before expressing her 30 mins later, then giving her breakfast with 2.5 Lactolose, cleaning her cage (vets thankfully in a way recommended cage rest for at least 4 weeks), then same process repeated each evening. The expressing in horrible and very hit and miss, I'm completely useless, my husband is far better but this is tough as she hates it, I have tried getting her to wee by stimulation which again is hit and miss.

I feel that she's beginning to hate us, as she's certainly a more wary little soul than before, although does still love to play with her sibling and our children which is lovely to see. Realistically though I am not sure how long away 6 weeks at home we can give her and I am beginning to question if we made the right choice when we refused to PTS as the vet suggested on 22nd December!

She started Acupuncture last week with a qualified veterinary acupuncturist (lucky the cost is yet to be an issue as we have good pet insurance and lifetime cover, up to 7.5k per year). I just wish I could see some light at the end of this tunnel. I just hope she realises we are doing this all because we love her and want her to get better, my nightmare is she believe we are punishing her and being mean

[Clarabow99]

Hi LittleMo and Nismo,
I'm so very sorry to hear about your situation as I know exactly what you're going through, it's a living #### and torture for the kittens, especially difficult as they're both so young, pretty much the same age in fact.
I'm also believe that all this expressing etc is changing their feelings and personality. I hate torturing him like this and it's causing me to weep almost every day. In some ways (thinking with my head) I kind of wished that he hadn't survived, because if this incontinence continues I cannot manage him as I live alone and have no-one to help me - that leaves me basically becoming a murderer
How can I decide to end his life when in all other aspects he's doing really well, considering his extensive injuries. Harvey HATES being expressed, he howls, wriggles and hisses and bites, it's terrible to witness and experience, as he's a strong willed little guy which makes it 10 times worse. Five different vets have now done this for him and so far 3 of them were awful experiences - he was literally pinned down and squeezed beyond belief, he was howling and crying and it broke my heart Two vets were amazing and there was hardly a peep out of him BUT it took a nurse to hold him still, petting him and feeding him treats, while the vet gently and slowly expressed him.
I've managed 4 times myself but it's nowhere near enough and it was a miserable experience for us both. So I'm still trekking off to the vets every day at 5pm for his expressing. He's started to get really nervous now and trembles at the vets which I hate seeing as he was such a confident little man beforehand. He forgives easily though and appears happy again within 5 minutes - BUT is this the life he deserves or even wants?
At the suggestion of the vet, I've put a time limit on this of another month to see if his ability to urinate returns as I simply cannot afford to keep going to the vets. I asked one of the nurses if she'd consider coming to my house and I'd pay her directly as I felt that Harvey would be best off in his own home, but she said it went against her employment contract

I'm also in deep trouble financially because of this and even though I'd like to say I'd spend anything on my cats (heart talking), I must be realistic and I cannot do it at the detriment of my finances - I don't have any money to pay my mortgage this month so it's overdraft time and credit card time for other shopping, yet again
If I can't keep him then I'll try to rehome him but who would be willing to take him on? I'm not religious but by god I'm praying every day that he regains his ability to urinate, but as you well know for each day that passes it's less and less likely.
I hope you can hang in there and remember that you're managing him at home which is nothing short of a miracle as some vets who are trained to do this simply cannot manage it, so keep up the good work, stay strong and positive for the future. Nismo is so lucky to have you both caring for him and remember also that although he howls it's not hurting him. I've had a vet prove this to me by gently feeling around, prodding a little bit here and there with no reaction.
Give Nismo and little nose-kiss from Harvey and take care yourself. PM me if you ever want to chat.
x Claire

[critters]

I'll post a link in a while, I hope, if you should want to place him; it's a Facebook group. I can't do it from this computer, and mine is in the middle of upgrading to Windows 10.

[Clarabow99]

Today has to be the worst day on this journey, two weeks he's been home and I've managed to express a small amount on 4 occasions. Today Harvey turned into a tasmanian devil and lashed out at my face and arms, howling and spitting - as a single person with no person to help whatsoever to hold him, I cannot do this on my own. Please don't say that ONE person can, I'm sure it can with another type of cat and human, because with this cat and human it's not happening. Harvey is a very strong-willed and feisty cat and can not be subdued - he even attacks my older cat when he's feeling like it, although that's been since the day I got him. His "character" is what's making this impossible. Five different vets ALL needed a nurse to hold him and take the time to calm him down enough to be expressed.

I am sobbing my heart out now as the future is bleak, I'm praying that he starts to wee by himself, otherwise I'll need to make the decision to basically murder him. I hate myself, I hate today and I just can't go on. Two hours I've spent with him on a cycle of playing, calming, soothing, trying again.... So it's off to the vet's again later for daily expressing. Life sucks, big time.

[LittleMo]

Hi there Clare,

Not sure it'll help but have you thought of trying to used a feliway plug is or spray to help him stay calm? Also trying wrapping him in towel we do with Nismo (her front paws and head) and it seems to make her calmer with the whole process. Do you have anyone to help you, maybe whole the front end (head / paws) in a towel whilst you deal with the business end?

This weekend will be an interesting one as we have house guests.

[Clarabow99]

Hi there Clare,

Not sure it'll help but have you thought of trying to used a feliway plug is or spray to help him stay calm? Also trying wrapping him in towel we do with Nismo (her front paws and head) and it seems to make her calmer with the whole process. Do you have anyone to help you, maybe whole the front end (head / paws) in a towel whilst you deal with the business end?

This weekend will be an interesting one as we have house guests.

Thanks - I can't use Feliway as my older cat takes a bad reaction. harvey can be sweet and purring in my arms, I covered his head with a towel but he just goes off the deep end and pushes his way out of it.
I've tried him in the sink, distracting him with toys, in a box, wrapped up, not wrapped up, when he's sleepy, when he's awake fully, whilst feeding him, giving him treats - but these back legs have the strength of a pony.
I've watched the video links on here and they dont work with him. I have no-one at all to help, all my friends live further away in the city and they work... no family nearby to help either. On my lonesome with this one.
I'm just back from trying again, he was all relaxed, lying in the sun on a little blanket, I picked him up wrapped in the blanket and when I went to the tabletop he went berserk I'm not one to give up, specially not on my cats as I love them so much, but this is impossible... for me. All the vets explained it to me and I've learned well from 2 of them so I can express him at the vets while they're holding him and calming him.
####, I shouldn't have got divorced, really crap being a singleton, in more ways than one.

I hope you have a lovely weekend with your guests and that Nismo is on best behaviour
x Claire

[CarolC]

I think you would like this website

http://www.kestrel.ws/erasmus.html

and you would be able to relate to this thread by the member who made the website

viewtopic.php?f=5&t=15599

[critters]

Oh, I thought I'd posted the link, no thanks to Microsoft. Here it is. https://www.facebook.com/groups/CatsWithParalysis/