Tail pull - short term bladder management

[purpleperil]

Hello everyone, I'm a newbie based in the UK.
My 7 year old kitty Tabitha suffered a severe tail pull injury three days ago. The xrays show a very large stretch at the base of her tail and the vet is being very negative about her prognosis. He doesn't think she will regain continence. She has no fractures and can walk fine, but her tail is completely limp.
She stayed at the vet for two days for observation but did no pee or poo in that time. The vet says she has poor anal tone but he did manage to express a little urine. He sent her home with me last night with no instructions on how to care for her. When I asked him whether I would need to express her, he said the urine would just leak out naturally when her bladder is full (!). He eventually agreed that I should take her back tomorrow (48 hours after she was last expressed) so that I can be shown what to do.
I have two questions:
1. The first thing she did when she got home was climb into her litter tray and try to pee. She did this four times in the first ten minutes. All day today she has been getting into her tray, scratching around, assuming the position to pee, giving up after a few seconds, scratching around some more, assuming the position to poo, giving up and then licking at her bottom. So, is this a good sign that she seems to feel an urge to go? It's only been three days but I'm clutching at straws here.
2. I'm terrified of expressing her. According to the magic internet it's quite usual for it to take up to a month for bladder function to return, if it ever will. I understand that expressing can be painful and traumatic and I'm really not sure I can do it. Does anyone have any advice on the pros and cons of temporary catheterisation instead? It would only be for a month maximum, after that I guess expressing is the only way to go.
I'd be very grateful for any reassurance or even realistic advice.
Many thanks in advance.

[CarolC]

Hello everyone, I'm a newbie based in the UK.
My 7 year old kitty Tabitha suffered a severe tail pull injury three days ago. The xrays show a very large stretch at the base of her tail and the vet is being very negative about her prognosis. He doesn't think she will regain continence. She has no fractures and can walk fine, but her tail is completely limp.
She stayed at the vet for two days for observation but did no pee or poo in that time. The vet says she has poor anal tone but he did manage to express a little urine. He sent her home with me last night with no instructions on how to care for her. When I asked him whether I would need to express her, he said the urine would just leak out naturally when her bladder is full (!). He eventually agreed that I should take her back tomorrow (48 hours after she was last expressed) so that I can be shown what to do.
I have two questions:
1. The first thing she did when she got home was climb into her litter tray and try to pee. She did this four times in the first ten minutes. All day today she has been getting into her tray, scratching around, assuming the position to pee, giving up after a few seconds, scratching around some more, assuming the position to poo, giving up and then licking at her bottom. So, is this a good sign that she seems to feel an urge to go? It's only been three days but I'm clutching at straws here.

It sounds like she can feel the need to go, it's just that right now she can't follow through as she would like. It is great that she can feel it. At present it does sound like she needs to be expressed.

2. I'm terrified of expressing her. According to the magic internet it's quite usual for it to take up to a month for bladder function to return, if it ever will. I understand that expressing can be painful and traumatic and I'm really not sure I can do it. Does anyone have any advice on the pros and cons of temporary catheterisation instead? It would only be for a month maximum, after that I guess expressing is the only way to go.
I'd be very grateful for any reassurance or even realistic advice.
Many thanks in advance.

Expressing is not painful and traumatic for the cat. It would normally only be painful if she had some kind of a medical condition, for example abdominal trauma or possibly a urinary infection making her tender. Normally it is not painful. Mainly it is just stressful to the owner the first few times you do it because you feel like you don't know what you are doing. But aside from the fact that cats in general don't like to be restrained just on principle, for expressing or anything else, it will be a tremendous relief for her to have her bladder emptied, she knows it's full, she will be so happy once it is empty. Don't be surprised if she complains while you are doing it, but also don't be surprised if she is friendly to you again as soon as you are done. The idea the vet suggested of just letting her leak is not a good idea. That is going to let her bladder become stretched from being too full all the time, and leaving urine in the bladder for too long will create an environment for germs to grow, which will cause an infection. Unfortunately temporary catheterization is not a very good option. For one thing, female cats are difficult to catheterize, the opening of the urethra is not easily accessible, cats are not designed like (for example) human females. Also she would have to wear an Elizabethan collar and be confined while catheterized. And it would be uncomfortable. And there is a risk of infection being introduced with the catheter. Expressing is a better option.

There are a number of videos showing different ways of expressing a cat.

http://www.youtube.com/watch?v=QdIBtw8_7No Expressing cat into the sink (Pookie: How we care for our paralyzed cat) (0:30-1:50)

http://www.youtube.com/watch?v=QQyHrjfBzsA Expressing large cat lying on his side into a litter box

http://www.youtube.com/watch?v=HVdJI-qsOus Expressing large male Persian (Sasha) in standing position (Part 1)

http://www.youtube.com/watch?v=KIFTKuR9-uc Expressing large male Persian (Sasha) in standing position (Part 2)

http://www.youtube.com/watch?v=wkG_hFgTIO8 Expressing cat onto paper

http://www.youtube.com/watch?v=uqSQkDTMTAQ Expressing cat on back while scruffing neck

http://www.youtube.com/watch?v=2Gxd7q3zEEo Expressing cat lying on her back before surgery (does not show surgery) (4:40-end)

http://www.youtube.com/watch?v=-UHpvLzoK74 Expressing obese cat lying on her side (language PG)

http://www.youtube.com/watch?v=LbVxdFyGKjs Expressing bladder and bowel of cat in standing position

http://www.youtube.com/watch?v=VH-4vryTra4 Expressing cat lying on his side

http://www.youtube.com/watch?v=jCVZdGms5oA& Expressing frightened cat with only one person

http://www.youtube.com/watch?v=iuMZ4hrijuY Expressing bladder and bowel of small cat in midair

http://v.youku.com/v_show/id_XMTczNjAzOTk2.html Vet expressing cat's bladder and bowel

http://www.youtube.com/watch?v=k9p5j9eXZ90 Expressing a male cat sitting on your lap

http://www.youtube.com/watch?v=OiMJGS2O46Q Expressing a male cat on his back or side

http://www.youtube.com/watch?v=HhReJqnuxOA Expressing a male cat using a combination of squeezing the bladder and external stimulation

http://www.youtube.com/watch?v=TBOosHCp9OQ Expressing a male cat in standing position

http://www.youtube.com/watch?v=CnFCwDp_fL0 Expressing a female cat with external stimulation

https://www.youtube.com/watch?v=2pl7j-FTsNE Expressing a female cat while holding cat over shoulder

[purpleperil]

Thank you so much!
I have watched the videos and I seem to be getting the hang of expressing Tabitha's bladder. She HATES it but seems to be grateful afterwards, as you said
Nearly a week after the accident she is sleeping a lot but is otherwise her usual self and is eating and drinking normally. Also, there was a poo in her litter tray this morning! The first vet she saw said there was no anal tone at all, but the second one said she thought there was some, and I'm hoping the fact that the poo was in the tray means that Tabitha knows what she's doing!
Unfortunately still no sign of a pee but I'm hoping the return of anal function bodes well for that too.
The vet thinks she should be PTS but I'm not giving up on her yet.
Thanks again.

[CarolC]

That is great news, both the expressing and finding a surprise in the litter tray. I think often vets say that because they assume the owner won't be willing or able to care for the pet. The thing I think they don't consider strongly enough is, we love our pets. Then when clients show they can and do care for their disabled pet successfully, you hope gradually the vet's opinion will change. Nowadays it seems like the majority of vets are more positive compared to the way it used to be, at least according to what I've heard from people here. If he continues to be unsupportive, you might want to think about another vet...? I feel like animals are smart and they can pick up on negativity even if they may not understand the spoken word. Nerve damage can take months to heal, unlike a broken bone for example, which only takes a few weeks. Regarding the 30 days, I would kind of plan on giving it more time than that (if needed). 30 days would be great but I might think more in terms of 3-6 months, and during that time things may continue to look much the same, but healing is occuring the background. My one vet said sometimes the best medicine is "tincture of time".

http://www.veterinarypartner.com/Conten ... ourceID=42

[critters]

That sounds TERRIFIC! Congrats on the expressing; vets tend to be VERY negative about it, like we're too stupid to learn how to do it. They forget THEY weren't born knowing how to do it, either!!!

[ambie]

Hi PurplePeril, how's Tabitha doing now? We are in the UK also.
Our cat suffered similar injuries 5 months ago, the vet gave her 3 months for her tail to heal and she had no anal tone. We would have liked the tail off earlier but he would not. After 3 months no improvement so off comes the tail and within 1 week the Anal tone had returned and weeing more in her tray.
Unfortunately we were not shown how to clean Amber properly and now she has bad Urine scalds around her Vulva. The vet wants to PTS but we are fighting this although he tells us its his decision whether we like it or not! Hope Tabitha continues to recover but watch her skin to make sure she doesn't suffer the same as our Amber.

[purpleperil]

Thanks everyone for your support, it was so helpful to know that I wasn't just clutching at straws!
The great news is that after only about a week expressing her bladder, Tabitha started peeing on her own. Actually, she started vehemently fighting me whenever I tried to express her and I think that was her way of telling me she didn't need help any more!
After that we had a few weeks where she was fine when awake but she would dribble pee when asleep, so I had to put extra covers on the furniture and do a lot of washing.
Then recently she had a bout of cystitis that the vet thinks was due to the stress of not being allowed outside and having her tail flopping around after her, but that was easily treated.
But now... she is completely recovered! She's totally back to her normal self except that she still has no feeling in her tail and we are going to amputate it soon. Once healed she will be able to go outside again.
Big fat raspberries to the vet who advised PTS - I'm hoping I'll have my little princess in my life for many years yet.
Thank you so much everyone xx

[purpleperil]

Unfortunately we were not shown how to clean Amber properly and now she has bad Urine scalds around her Vulva. The vet wants to PTS but we are fighting this although he tells us its his decision whether we like it or not!

That's terrible!! Can you get another vet? It's certainly not his decision. It sounds like Amber is making progress and there must be something like a barrier cream that you could use? Tabitha and I were very lucky in that she wasn't dribbling wee for very long - she did lick herself raw trying to keep herself clean but that has now healed up. Maybe Amber just needs a little longer.

I really feel for you. Wishing you and Amber the very very best of luck. Try seeing another vet for a second opinion and whether they can recommend anything to help xx

[ambie]

That's great news about Tabatha. I think the missing tail gives the kitties a distinguished look.
We were using a barrier cream but have been told not to put in the scalds now, doesn't seem right to me. He says we cannot stop him putting her to sleep,We are thinking about another vet as we have lost all trust in our vet, we think he may put Amber to sleep anyway. Fingers crossed she will heal as she was making great progress. Would love to take the cone off after 5 months now and let her play outside with her sister and brothers.

[critters]

We were using a barrier cream but have been told not to put in the scalds now, doesn't seem right to me. He says we cannot stop him putting her to sleep,We are thinking about another vet as we have lost all trust in our vet, we think he may put Amber to sleep anyway.

I'd ABSOLUTELY find another vet ASAP!! And how about barrier spray (such as Cavilon)? it lasts longer. I'd use it over the scalds to keep them from getting worse, and spray doesn't have to be removed; it just wears off in some days, when you reapply.

[ambie]

Hi Critters we are using the Cavilon barrier cream on the legs and the cavilon barrier spray on the urine burn area again now. (we did use it for a good few days but stopped as vet said NO chemicals on area as it could be feeding it not healing area) We are booked in tonight to see another veterinary surgery vet so we will see what they say later. Thank you everyone that has commented & helped us. All support much appreciated.

[critters]

Sounds like an improvement!