New - Injured kitty can't pee, tough to express

[TrinaL]

Hi everyone! I'm new here but I've been devouring as much info on this amazing site as I could over the last few days. I was hoping to get some feedback from those of you who are much more familiar with this than I am.

On Monday my 10 yo cat, Serene aka Beanie, was injured when she got stuck between a bed and the wall. We think the injury occurred from her twisting and trying to drag herself up onto the bed, or from her sliding back down onto her butt. She had X-rays which are clean so currently it seems to be nerve damage since she can't pee on her own. She can however have a bowel movement on her own.

Her feet work, she can shuffle along and move them fine, but she can't stand up in her back end, likely due to swelling in her lower back. She's seen a few different vets in the past few days. Some of them are quick to say things like "this may be permanent" and "quality of life" which doesn't help us feel positive. Beanie is still herself and still happy overall.

We live in a small town and it seems the local vets are struggling to express her bladder. They wanted her to be admitted to the big city animal hospital to lay in a kennel with a catheter. We tried as well and could not do it, but we're afraid of hurting her. So we were sent to a big city animal hospital where the vet there did express it quite quickly and didn't really want to stick her in a kennel with a catheter at this point. Sent back to the local vet the next day and again, they struggled and said she was too difficult to express fully. So back to the animal hospital tomorrow. She does have an appointment for Monday with a holistic vet that has rave reviews. Hoping for a good visit there.

Currently Beanie is on Buprenorphine, Prazosin and an anti-biotic in case of UTI from not being able to pee. She just started these meds 24 hours ago. She was only on an anti-inflammatory before that. Any idea how long it should take the Prazosin to work if it's going to help? She seems to be making progress each day with her movements and I feel confident she can recover from all that I've read and studied. She is still herself, still content and alert. It's just this lack of ability to urinate that's standing in our way. And I hate that some of the vets are so quick to imply we shouldn't give her the necessary healing time needed.

So sorry for the long post. I was just hoping for any tips or feedback you may be able to give. We've had this cat since she was 3 days old when her feral mother abandoned her in a garbage pile behind our house. We can't give up on her. Thank you so much for taking the time to read this. I've found this forum to be filled with some pretty darn awesome pet parents and I'm happy to have discovered this site.

[CarolC]

This is from Plumb's Veterinary Drug Handbook 4th ed (not the newest ed).

Prazosin HCl
Pharmacokinetics - The pharmacokinetic parameters for this agent were not located for veterinary species. In humans, prazosin is variably absorbed after oral administration. Peal levels occur in 2-3 hours.
***
Doses
Cats:
To decrease urethral resistance:
a) 0.5 mg (total dose) PO q8h(?) OT 0.03 mg/kg IV (Lane 2000)
b) 0.03 mg/kg IV (Osborne, Kruger et al. 2000)

So this information is not really definitive, but it might be worth trying the expressing about 2-3 hours after her dose of prazosin? Can you remember what time she had her dose when the big city vet successfully expressed her?

Can she lift her tail or is it hanging down?

Did you see the videos about expressing a cat? They are at the end of this article (scroll to the end).
viewtopic.php?f=5&t=16027

[TrinaL]

Thanks for the fast reply Carol!

Actually she was not yet on the Prazosin when the big city vet had success expressing her. She was put on it after that. I almost wonder if that vet simply has more experience with such injury cases than the local vets do. Today when the local vet tried to express her they said they squeezed so hard they may have bruised her bladder. And that makes me feel they just aren't the right vets for this.

My husband and I have watched the videos linked on this site and read everything we can about expression. We made a few lame attempts at it but I think maybe we're not applying enough pressure because we're scared to hurt her. The local vet said she thought Beanie was clenching against the expression while the city vet said she felt like Beanie was trying to assist. So these conflicting experiences definitely have me confused. And since the vet today said Beanie's bladder is likely to be sore, I'm more worried about trying it myself.

She can't lift her tail but she does have feeling in the end of it and can move it around somewhat.

Trying an expression a few hours after the Prazosin is a good idea though. I'll keep that in mind. Thank you so much for your reply. I appreciate it.

[TrinaL]

Quick update. Beanie saw a holistic vet who did acupuncture. He feels positive about her progress. She's not able to stand all the way up but she can stand about halfway and is able to walk somewhat when she couldn't at all before so things are healing in there. Unfortunately, still not peeing on her own yet, but there's been some dribbling. Keeping fingers crossed.

Between holistic vet visits in the city I'm taking her to a local town vet for bladder expression. The regular local vet is so unsupportive and seems to almost be annoyed that I took her to the holistic vet for treatment. He is very negative and not at all encouraging. He didn't even seem happy about her healing progress. It's hard to find a vet around here who will help out and be supportive. So that's discouraging. But overall her progress seems to be good since the injury happened just a week ago. Just waiting on that pee now.

[critters]

Personally, I'd want her taking pred for a while to lessen the spinal cord injury.

It took me a good bit of pressure to express Buddy--more than I'd guessed. I agree that the local vets just don't seem right, and, in fact, it's not unusual in my experience. Many vets don't want to deal with handicappers, but some do. Sometimes you have to kiss some toads before you find the right one.

PS--There DOES tend to come a time when they get enough control to be able to resist expressing, and it's usually a good sign. I would guess that her SCI is rather mild, much like a tail-pull injury, etc., because it's not like she was hit by a car or shot in the spine, etc. I think it'll take time, and she'll make a full or almost-full recovery.

PPS--In my experience, phenoxybenzamine (PBZ) is terrific for a spastic (tight) bladder. Bethanechol was good for a flaccid, floppy bladder. If hers is tight, a trial of PBZ may help.

[TrinaL]

Thanks critters for replying. I mentioned the PBZ to the vet and they wanted to try Prazosin instead. But I'm keeping it in mind in case I have to push them to try something else.

But I do have a happy update. She peed last night. A few decently sized puddles between the time I went to bed and woke up. I saw her do one of them and she was sitting up properly and actively peeing so she was controlling it. I'm ecstatic! Never thought cat pee could make me so happy. I took her in to the vet today to check the size of her bladder. The vet said it was definitely not full even though some pee was in there so she expressed the rest, as much as she could, and this vet who is new to me was so positive and encouraging we're going to keep seeing her between our holistic vet treatments.

We go back for more acupuncture tomorrow and though it may be too soon to tell I feel I saw a huge difference in her the day after her first treatment. She was energetic and feisty. She even wanted to climb the furniture, which I did not let her do of course, but seeing her think she could felt like a good sign that she's feeling better. Her walking is getting better too. She can take several steps that are almost normal before pausing to rest. So we're hoping to continue seeing progress with the injury and the bladder.

My husband and I have referred to this site more times than I can count throughout this ordeal. Your stories and info have helped us greatly to stay committed and positive even when the vets were talking doom and gloom. Thank you all.

[critters]

Yes, liquid gold is a FINE thing!! Congrats on the next step!

[TrinaL]

Beanie has had 3 acupuncture treatments now. A day or two after each one she seems to get a surge of energy and liveliness. It's been just under 3 weeks since her injury and she's walking again. Hurray! Her back end is still weak and a bit shaky but she is walking. I'm thrilled. She's also still peeing on her own. She seems to be going in small amounts but plenty of them since she seems to struggle a bit in the squatting position. She'll go a little, then take a break, then go again. But she is getting enough out on her own that her vet thinks we may be done with having to express her. We'd gone down to every second day but at his recommendation we're giving it a test run this weekend to see how she does on her own. Will be monitoring closely. But phew! Such a relief to have him say that.

The holistic vet has been a Godsend. He's offered us so much hope and positivity when other vets seemed intent on taking it away. I plan to send a video of Beanie walking to the vet who said her paralysis was probably permanent. Shame on him for never giving her a chance. I highly encourage anyone dealing with a negative Dr. Doom type vet to seek out a holistic vet who genuinely wants to heal.

During that first terrifying week this site kept us going. I know I keep saying that but you all are so inspiring. Many of you are dealing with far more intense situations and I'm in awe of you all.

[CarolC]

The holistic vet has been a Godsend. He's offered us so much hope and positivity when other vets seemed intent on taking it away. I plan to send a video of Beanie walking to the vet who said her paralysis was probably permanent. Shame on him for never giving her a chance.

Good idea, it may help him with his next patient. I'm glad she has shown so much improvement in such a short time.

[critters]

The holistic vet has been a Godsend. He's offered us so much hope and positivity when other vets seemed intent on taking it away. I plan to send a video of Beanie walking to the vet who said her paralysis was probably permanent. Shame on him for never giving her a chance.

Good idea, it may help him with his next patient. I'm glad she has shown so much improvement in such a short time.

VERY good idea!! Maybe he'll change his tune next time (or eventually).