Post Pu Surgery

[PJBoy]

I re-read your whole thread, and I really think you should ask the vet about an anti-inflammatory. The fact that they couldn't catheter, the fact that they had to make the opening bigger than usual, the fact that he still has not had a "full" pee, the fact that he needed the surgery in the first place. I really think he has pretty bad cystitis.

Have you noticed at all if his "opening" twitches or spasms at all? Even if he's not trying to pee?
Along with the medication for muscle tone and control, you could also ask about a relaxant, he could be experiencing muscle spasms which would also impede his urination.

I will make sure my boyfriend mentions getting him anti-inflammatory medication. You're right, i think it would be very beneficial and is very necessary for him. I really hope the vet does not shrug it off like all other vets have.

And I haven't noticed his opening twitching, as its hard to see down there, but theres a good chance it is and I still cannot see. I will also ask about a relaxant as well.

 

[Jem]

I hope you're not stressing too much with all of these "ask you vet about..." "maybe he needs..." things. Especially because you have to rely on someone else passing this information on for you. (I'm sure your boyfriend is quite capable though) We all want to help, but it can be overwhelming.
I know I was a mess when my little one had cystitis, but he came thru just fine. I hope you keep us updated on his results from this next vet visit.

 

[PJBoy]

I hope you're not stressing too much with all of these "ask you vet about..." "maybe he needs..." things. Especially because you have to rely on someone else passing this information on for you. (I'm sure your boyfriend is quite capable though) We all want to help, but it can be overwhelming.
I know I was a mess when my little one had cystitis, but he came thru just fine. I hope you keep us updated on his results from this next vet visit.

I am so glad your kitty came through fine, that's so great to hear. It's definitely hard to not be stressed when the vet hasn't been helping out very much and knowing something is not right with PJ And all the points you guys have made, all the medications and what-ifs have been very reasonable, and I just want this vet today to have something to go off of so that we can find more answers. I so appreciate this thread and everyones support for each other! I don't know what I would have done without the Internet and being able to research and learn so much through others experiences. I will most definitely update when my boyfriend leaves the vet and gives me a call!!

 

[PJBoy]

So, the vet my boyfriend went to was apparently a lot kinder and compassionate then my other vets. She listened to everything he had to say and considered it all, which I am so grateful for. Rather than being in and out in 15 mins he was there for 1.5 hrs... She gave him her full disclosure immediately saying she honestly doesn't have much experience with PU surgery (seems to be the case with every vet I've gone to), but she did a urinalysis and culture with PJ to see if there is a UTI. I will get the culture results in about 3-5 days.. The urinalysis showed that he is apparently crystal-free now (which is shocking as right after his surgery it said he had numerous crystals), and that the test showed bacteria in it which could be a UTI. We won't know until the culture what the bacteria is exactly. She said she has no concerns about there being any stricture or swelling otherwise. For now, she put him on a new antibiotic as well as a mild pain medication. She said we should see improvement by tomorrow, and if we don't then they will try another medicine on him. When we mentioned muscle relaxants and what not, she said she doesn't want him on those since he is crystal-free and since she sees no swelling it doesn't seem necessary. She thinks the pain medicine will help enough (although now I am quite nervous about him either being constipated again or getting runny poo from it...)

Another thing she mentioned is that since my cat is quite overweight (he was 18 pounds pre surgery, 17.5 now.. we've been trying to get him to lose weight and it has proven quite difficult with another cat in the home. now that we will be doing separate feedings I hope its easier), we shouldn't be continuing to feed him the Royal Canin Urinary SO food much longer, as it is very high in calories. She said he is at a high risk for diabetes and arthritis which really scares me, so she wants us to touch base in about a month to put him on a new food. I assume it will still be of the urinary type as he needs to be on that for the rest of his life... Does anyone know of any good urinary foods that are also good for weight loss?? Quite concerned about this.

 

[FeebysOwner]

So far, so good!! I so hope this new vet and her ideas work out! Perhaps, she has other vets in her office that she can consult about anything she doesn't have a whole lot of experience with - I would hope that, as it would help not only her but you as well.

Feeby is on urinary care food, but the only one in my area that is also diet related is Royal Canin SO. She also eats Hill's C/D, but I have seen a diet formula for it. Purina also has urinary care foods, but I don't know anything about them and whether they offer a diet form.

Feeby does have arthritis, but no diabetes - she is 14+ yo and weighs 17.5-18.0 lbs.

I know other members on this site might be able to offer some alternatives...

 

[PJBoy]

So far, so good!! I so hope this new vet and her ideas work out! Perhaps, she has other vets in her office that she can consult about anything she doesn't have a whole lot of experience with - I would hope that, as it would help not only her but you as well.

Feeby is on urinary care food, but the only one in my area that is also diet related is Royal Canin SO. She also eats Hill's C/D, but I have seen a diet formula for it. Purina also has urinary care foods, but I don't know anything about them and whether they offer a diet form.

Feeby does have arthritis, but no diabetes - she is 14+ yo and weighs 17.5-18.0 lbs.

I know other members on this site might be able to offer some alternatives...

Yes, I'm so glad to have a vet who seems to genuinely care and want to help! She said if we can't figure it out she is referring me to a specialist, but I hope all goes well with her. I think she will be our new normal vet after this.

And oh I didn't know Royal Canin had a diet version of the Urinary SO! I will also look into the diet version of Hills C/D. I think in general he will lose some weight going off dry and being on this overall, although I was surprised to hear that it had a lot of calories.. I thought wet was definitely going to help a lot with weight loss!

Thanks for the info! Sounds like Feeby and PJ are very similar in size. Although PJ is only 3 so hopefully arthritis doesn't hit too soon! Did Feeby get it earlier on in life?

 

[FeebysOwner]

No, it didn't. Feeby has been overweight for a lot of years. She was 2+ when I found her and terribly emaciated. Apparently, she has never forgotten that time of her life - 12 years later. She really didn't start showing any signs of arthritis until the past year or so.

BTW - I meant I have NOT seen a diet version of the Hills - maybe I need to look harder...

 

[PJBoy]

Feeby is lucky to have a wonderful owner like you to take her in and love her!! I'm glad it didn't come until later in life for her either.

 

[Jem]

The urinalysis showed that he is apparently crystal-free now (which is shocking as right after his surgery it said he had numerous crystals)

One thing to keep in mind, and this may not be something you want to try until he is completely healed and peeing normal for a few months, but...
the crystal formation could have happened because he could not pee/void his bladder completely. He may not need the prescription foods for the rest of his life. You could try him on a low carb, high protein canned food only diet. Talk to the vet of course, but I find that a lot of vets tend to stick with the foods they know (prescription stuff) simply because cat nutrition is not something most are well versed in (believe it or not).

When mine had cystitis, he developed crystals because of the blockage, they formed because he had "stagnant pee" in there. We did not have to put him on the SO or CD. (It was a different cat who had to eat the CD that I mentioned earlier)
Did the vet who originally did/recommend the surgery tell you WHY he blocked in the first place? (UTI gone bad, stones, crystals, cystitis....)
A cat can have a combination of all but it's kind of a "chicken or the egg" scenario. If the crystals were not the initial cause but only a secondary development, you might not need the prescription foods long term.

Again, this may not apply to you, but just so you know.

 

[PJBoy]

One thing to keep in mind, and this may not be something you want to try until he is completely healed and peeing normal for a few months, but...
the crystal formation could have happened because he could not pee/void his bladder completely. He may not need the prescription foods for the rest of his life. You could try him on a low carb, high protein canned food only diet. Talk to the vet of course, but I find that a lot of vets tend to stick with the foods they know (prescription stuff) simply because cat nutrition is not something most are well versed in (believe it or not).

When mine had cystitis, he developed crystals because of the blockage, they formed because he had "stagnant pee" in there. We did not have to put him on the SO or CD. (It was a different cat who had to eat the CD that I mentioned earlier)
Did the vet who originally did/recommend the surgery tell you WHY he blocked in the first place? (UTI gone bad, stones, crystals, cystitis....)
A cat can have a combination of all but it's kind of a "chicken or the egg" scenario. If the crystals were not the initial cause but only a secondary development, you might not need the prescription foods long term.

Again, this may not apply to you, but just so you know.

That's good information to know, thank you! He never said exactly why PJ blocked so severely in the first place, he just said that he did have numerous crystals and that is urethra was very small cause of being neutered so I believe the mixture of those two causes are why. So it seems as if the crystals were the initial cause rather than a secondary development, but I'm not 100% certain on that.

 

[PJBoy]

I was also wondering, does anyone have any experience with their cat taking
Gabapentin? That is the pain medication he was put on. She said it can be quite sedative, which is ok if it helps him calm down, but I'm worried that I won't know if he's TOO sedated and when to worry. Just was wondering if anyone else had experience with how their cat reacted to it.

 

[bear]

As Jem suggests "the crystal formation could have happened because he could not pee/void his bladder completely."

Holding urine can cause a concentration of the minerals that make up crystals.
Additionally the PH may also come out of balance as the concentration changes.

Distilled water has a PH of about 7.0. The PH scale goes from 1 (very acidic) to 14 (very base). Felines normally have a urine PH of 6.0 to 6.5. This is slightly on the acid side. Having this slightly acidic urine helps control bacteria.

Urine Ph, Why It Matters

A pH above this range of 6.0 to 6.5, leads to the growth of magnesium ammonium phosphate crystals. A pH lower than 6.0 causes formation of calcium oxalate crystals.
Cat Urinary Tract Health | Kidney Health and Urine pH Level in Cats

Notice that the PH goals to help dissolve one type of crystal is different than the other. Prior to choosing the correct food to target dissolving the crystals, the Vet will need to determine which crystals are forming. Moving the PH in the wrong direction can cause more crystals. This is why there are different types of feline urinary tract food. Work with your Vet(s) to get the correct one for your cats diagnosis.

Increasing water intake (primarily by increasing water content in food) can help with throughput and keeping urine mineral concentrations down.

 

[FeebysOwner]

I was also wondering, does anyone have any experience with their cat taking
Gabapentin?

I have not used it, but have heard a lot of talk about it on this site. Hold tight, you will hear from other members about this - I hope soon!!!

@Kieka - know who to direct this question to that can help P PJBoy ? Thanks!!

 

[FeebysOwner]

Sorry no one has responded to your question about Gabapentin. Below is a link to an article about it in case it might help you any. The only thing I remember hearing about it is that it has 'knocked some cats of their ass--". I am guessing because the dose is more than what the cat probably needed. So, you might want to ask about the best lowest dosage to start with.

Anti-anxiety medication for cats (and their owners): Gabapentin:

 

[Kflowers]

Ask your new vet if your old vet sent his records to her. Some vets feel it's perfectly all right when sending your cat's records to only send a list of what shots he's had. They don't bother to mention illness, like pneumonia or surgeries.

If you try again and again only get the list of shots or an incomplete record. Go to the first vet's office and demand a copy of your cat's records. Tell them you don't mind waiting, no, there's no need to mail them to you or the other vet, you'll just stand here in the middle of the waiting room while they get them copied. No, don't worry, you'll explain to people why they don't have to worry about you taking up the vet's time. This is a front desk job.

Your new vet can work without the records, but why should she? You paid for the records with each office visit.

 

[PJBoy]

Hey everyone, just wanted to post an update on the situation. PJ hasn't had any change in his behavior and is still unable to pee normally. He's still on the antibiotics and pain killers the new vet prescribed, as we aren't able to touch base with her until earliest the 27th due to holidays. I just got home from Christmas dinner and noticed his stitches that they have some, what seems to be, puss, and are inflamed. (I attached some photos, sorry to anyone squeamish! The part I am concerned about is up closer to his butt with the discharge.) I am assuming this is an infection.. does it look like one to you? I tried to clean it with warm water and a clean cloth but unfortunately it didn't really do anything, as I don't want to irritate it any further by touching it too much. Unfortunately my vet isn't open at all tomorrow since its boxing day, so earliest I could even contact them is 27th. Do you guys think this is something worth going to an emergency vet for tomorrow, or it can wait? From what I've researched it seems like something that can wait the extra day or so, but just wanted to know if everyone else agrees.. doesn't seem like quite an emergency situation to me. He is *supposed to* get his stitches out Friday or Saturday morning, although I wonder if this is an infection if that'll post pone that. Anyways, just wanted to ask your guys input as I've never seen an infection on him before and wasn't certain how to react and how severe this situation is. I'm really worried that nothing is changing, despite being on antibiotics. It's definitely looking like it may be that we'll be going to the very expensive specialist shortly...

 

[PJBoy]

Ask your new vet if your old vet sent his records to her. Some vets feel it's perfectly all right when sending your cat's records to only send a list of what shots he's had. They don't bother to mention illness, like pneumonia or surgeries.

If you try again and again only get the list of shots or an incomplete record. Go to the first vet's office and demand a copy of your cat's records. Tell them you don't mind waiting, no, there's no need to mail them to you or the other vet, you'll just stand here in the middle of the waiting room while they get them copied. No, don't worry, you'll explain to people why they don't have to worry about you taking up the vet's time. This is a front desk job.

Your new vet can work without the records, but why should she? You paid for the records with each office visit.

I will be sure to ask my new vet when I see her next! I'm actually not sure certain , I had assumed old vet sent surgery records even but you're right, maybe that wasn't the case.. (wouldn't be surprised after everything else with him..)

 

[PJBoy]

Sorry no one has responded to your question about Gabapentin. Below is a link to an article about it in case it might help you any. The only thing I remember hearing about it is that it has 'knocked some cats of their ass--". I am guessing because the dose is more than what the cat probably needed. So, you might want to ask about the best lowest dosage to start with.

Anti-anxiety medication for cats (and their owners): Gabapentin:

Thanks for the info! Turns out, knocking him on his ass wasn't even close to how he responded. He seems almost completely unaffected by it..

 

[PJBoy]

Oh, I forgot to add in my update that this morning he puked for the first time this entire situation. He had a very tiny hard poo and a couple minutes after vomitted, so I am quite certain its due to him straining from that. I have been trying to stay calm and not overreact as it seems that can be quite normal but hopefully it was not due to anything more serious.

 

[Jem]

There seems to be an area that looks like it has a yellowish something or other, I assume that is where you think the infection is?
If you want to try and clean the area where you see pus. Use Q-tips (cotton swabs) and saline solution. You can make your own saline solution by boiling distilled water and dissolving salt in it. I can't remember the ratio of water to salt but I'm sure you can find that by just googling it. Also, if you can, use epsom salts over table salt as I have heard that it does not sting as much.
Once your saline solution is cooled you can use it to clean the area, and using a cotton swab makes it more precise and gentile. Non-contaminated saline solution can be stored in the fridge for several days, so pour just what you'll need in a small bowl for every cleaning, and let it warm to room temperature before you start.
You could also use brewed and cooled chamomile tea, from the tea bags, to do the same. It has some antiseptic properties but it helps with inflammation and soothes the skin.
After you've cleaned the area, make sure it can dry. Air is the enemy of infection.
But if you notice that it seems to be abscessing (lump full of infection under the skin that is trying to drain) you'll need to bring him in to have it reopened so it can drain properly.

If he is still eating, drinking and seems in good spirits, I PERSONALLY would wait but only if I could bring him in on the 27th, so make sure your vet WILL take him right away. He may need a different antibiotic. They could take a culture of the infection to make sure he is getting the right one. and while they wait for results they will be able to tell you how to keep it clean and if you should apply ointment in the mean time.

When it comes to his pooping, has he been going OK? you mention the throwing up after having to pass a hard stool. Is he pretty constipated?
Plain pumpkin puree can sometimes help with constipation, just add a tsp of it to his wet food, but make sure he is getting plenty of water as well.
In a pinch I have also let my cat lick a small glob Vaseline off my finger, it helps to pass things along as it lubes up the intestinal tract.