Nerve damage following RTA... Problems with toileting

[RagdollsMummy]

Hello all,

My beautiful cat Ragdoll (who is 2 years old today!) was involved in a RTA some time around 15/12/13. To cut a long story short, she sustained significant nerve damage and consequently had to have her tail amputated, as well as a fractured pelvis and fractured jaw, both of which require cage rest. She has been to two vets, the first gave a very bad prognosis, as did the second, but a couple of days of staying with the second vet they were very pleased with her progress (she had started eating by herself, had passed a small stool and urinated a little) and so they allowed me to look after her at home. I was told that she should pass urine by the morning and if not to take her to a vet more local to me to get her checked out. She has been home since 20/12/13 - since being home she has not been able to urinate or defecated by herself. She has defecated once but it was a very hard and small stool. I took her to the vets who said she must be constipated and perhaps still sore (particularly as she only had her tail amputation op on 20/12/13) - they gave her an enema and she did go. I was sent home with microlax (aswell as more lactulose) and was told that if she doesn't start toileting by Friday she would need to be hospitalised again, and there was little chance of her regaining control if she hadn't succeeded by this stage (personally, I think that's ridiculous considering nerve damage takes so long to repair itself) I've given her a microlax today but she hasn't gone as of yet. What I've noticed is that, although she isn't going by herself, she does have some 'activity' going on down there. Although I express her bladder, she will occasionally go into the litter tray and do a small wee. I'm inclined to think it's not bladder overflow as her bladder isn't full, and her vagina 'contracts' as if the nerves down there are working and trying to push the urine out. Also, she does always attempt to defecate, and her anus will contract etc, but it seems like she doesn't have the strength to push it out. Is it possible, particularly with the bladder, that she is half-conscious of wanting to urinate, but the 'message' isn't quite getting there? Do these signs indicate that she is on the road to a full recovery? And is it just constipation that is stopping her passing stools?

I have been going out of my mind with worry since it happened, and all I want more than anything in the world is for her to get better. I would appreciate any advice. I have read similar topics in this forum but I feel Ragdoll's case needs independent scrutiny. Thank you all so much and Merry Christmas!

[critters]

So she has nerve damage in her tail? The pelvic and jaw fractures should be OK in a few weeks. Is her jaw wired? Pelvises usually do fine; the hard question is whether or not there's room enough for her colon.

You're QUITE right about the ridiculousness of a Friday deadline.

If you ask me, any activity is good. I've never expressed a girl, but my boys always had activity down there when I expressed.

Do you know about Poop on Demand? It can be really useful. https://www.handicappedpets.com/mediawiki/?title=Bowel_management_in_incontinent_pets Since you said she had a hard poop, I think I'd up the laculose a good bit. Is she taking any pain meds? Some of them are constipating.

Yes, it's very possible to have partial control, or to feel the need to pee, while not being able to get the deal done. Sometimes they can even help you express them.

[RagdollsMummy]

So she has nerve damage in her tail? The pelvic and jaw fractures should be OK in a few weeks. Is her jaw wired? Pelvises usually do fine; the hard question is whether or not there's room enough for her colon.

You're QUITE right about the ridiculousness of a Friday deadline.

If you ask me, any activity is good. I've never expressed a girl, but my boys always had activity down there when I expressed.

Do you know about Poop on Demand? It can be really useful. https://www.handicappedpets.com/mediawiki/?title=Bowel_management_in_incontinent_pets Since you said she had a hard poop, I think I'd up the laculose a good bit. Is she taking any pain meds? Some of them are constipating.

Yes, it's very possible to have partial control, or to feel the need to pee, while not being able to get the deal done. Sometimes they can even help you express them.

Hi Critters Yes, her tail was completely wrecked apparently. Her jaw is wired and she eats and drinks fine. What do you mean regarding room for the colon? It's not just that she only has activity when I express her, but when she pees or attempts to pass a stool in the litter tray it seems like there is a lot of nerve activity. Her lactulose dose has already been upped from 3ml to 4ml. Yes, she's taking metacam and vetegesic.

Still waiting on the miralax to take effect. She was only given an enema yesterday so is it possible her bowels may not even be full enough yet even though she has been trying to go? Thank you for the link.

[critters]

With pelvic fractures the pelvis might be crushed enough to not allow room for the colon to exit. My Beauty was majorly crushed, but there was enough room.

[RagdollsMummy]

She passed some stools last night/today - the latter ones looked more healthy too, so hopefully that means her pelvis is fine in that respect. She's also been urinating quite a lot in her litter tray though I've still had to express her a little.

[critters]

Sounds good!!

[RagdollsMummy]

Hi everyone, just a little update on Ragdoll.

She is pooing fine now, and she urinates very often but not very much at a time. I know she's consciously weeing but is it normal for her not to completely empty her bladder? I still express her bladder occasionally.

[critters]

It's not unusual that they can't empty completely early on. Continuing expressing is a good idea; leaking isn't unusual early on, either, and expressing can keep leaking to a minimum.