Opinions On Sick Cat (bladder & Intestinal Issues)

Hi everyone! I'm now on month 4 of constant vet visits for my boy Tuck and I'm starting to get worried. I'd love opinions on prognosis since I'm beginning to wonder whether he will ever get better and whether I'm being selfish by continuing to try...

Here's the background:

- I took him in a year ago. Originally supposed to just be TNR but he already seemed unwell and didn't appear aggressive so I made the choice to keep him indoors. I was told he was around 3 years old. He's an absolute sweetheart and evidently not feral like we originally thought
- He's FIV+
- He has arthritis in his back and an old fracture on his hind leg that has apparently not healed properly. He's always stayed fairly low to the ground and doesn't really play much (I don't blame him)
- Starting in maybe fall he began to lose weight. Very slowly so it wasn't noticed at first
- In December the constipation began. He went to the vet and had an xray which revealed a lot of impacted feces. He was boarded there for a few days receiving enemas which solved the problem
- In January/February we tried medications to help him while we tried to figure out the cause of the constipation (thought to be because of his arthritis). He was on cisipride, lactulose & restoralax/miralax during these months, eventually weaning down to just restoralax
- Stool has ranged greatly since then, but he typically does have small tarry stools
- After the stool started to get regulated, I noticed his pees were smaller and I saw a little blood so back to the vet we went. He stayed another couple days there. There were some crystals so he went on antibiotics. They did a urinalysis. Figured it was just a UTI
- Last week: my boyfriend and I noticed a really big lump near his belly. After some Googling and realising that maybe he hasn't been peeing (I have 4 cats so it's not easy to notice little box changes) we rushed him to the e-vet assuming his bladder was about to burst. It was. They expressed his bladder very easily as there was no blockage. Urinalysis was done and came back clear.
- He's now been at my vet since last Thursday which is breaking my heart. They found more impacted stool so he's been receiving enemas. His bladder requires manual expression. He's peeing, but not emptying his bladder

This is where we are now. The most recent diagnosis for his intestines is IBD. He's on prednisone and an antibiotic I can't remember the name of (starts with an M).

The vet is stumped about his bladder. He's not blocked at all but he's still unable to pee. Might be nerve damage from his old fracture? He's being put on a medication that apparently helps stimulate the bladder. I'm calling the vet this morning for an update and I'm praying I get to take him home for the weekend.

If anyone has had experience with any of this I would absolutely love opinions! It wasn't until I spoke with the vet yesterday that I started to consider that maybe my boy won't ever come home. My vet's tone implied that if this bladder medication doesn't work, we're out of options. Tuck doesn't deserve this. He's finally living a great life indoors and now his future seems so bleak. I'm absolutely heartbroken, but I don't want to give up just yet.

Thank you!!

Hi. so sorry for Tuck - and you. A lot of stuff going on.

Even if the constipation is related to some sort of nerve damage (does the vet mean neurological damage from the FIV?), I would think there should be ongoing treatments that could be given to Tuck to help limit it. Is he still on restoralax? If it is not working, what other options has the vet given you in terms of alternative treatments? What tests, if any, did the vet do to determine he has IBD? Could his intestines be inflamed from the constipation, or from FIV related neurological issues?

Could any of his constipation and peeing issues be tied to his arthritis, and is there any plan to try to treat his arthritis? I will say, if some of his other issues can successfully treated/managed, expressing his bladder is something you could routinely do at home.

You can see, I don't have anything concrete to offer you - just a bunch of questions that you probably already have thought about.

Have you considered getting a cat only vet or a specialist involved? Perhaps, even a vet university should you have one nearby? Copies of his records could be provided to any new vets, to help try to reduce redundant tests/costs. Also, has the vet considered trying any anti-viral therapies (e.g.; interferon, AZT), like those used on humans with HIV?

I hope other members will soon find time to log on and read your post, so that those who have some experience with FIV related issues can offer you some tips. Be patient, and check back often for new responses.

I really think your boy needs a specialist, if you can locate one that's close enough to be feasible.

I'm also wondering if the peeing issue could be related to bladder spasms. We have another cat going through that right now, and with his damage from his time on the streets, that's a possibility.

You might ask your vet to train you in how to express his bladder at home, which would save a considerable amount of time, money, and stress on BOTH of you, once you learn the procedure. I'm told that it isn't that difficult to learn, and LOTS of people manage it. It isn't uncommon to have to do this with cats who have various types of nerve damage.

I can't offer any insight but let me just say that I know a cat that requires manual bladder expression. His human slave does it twice daily and she says it's easy, not gross at all, and she's glad that she can save on litter :-) The cat is cooperative now, the beginning was difficult but the cat was successfully bribed into being calm.

My first German shepherd had degenerative myelopathy. It is MS in dogs and proceeds from the tail to the brain stem, paralyzing everything along the way. Most owners need to let go when the front legs give out due to management issues of a big dog. When the nerve damage/paralysis hits the bladder the dog either has no control at all or the bladder freezes and will not empty. However, if the problem your kitty is having is due to nerve damage alone...no signs of any blockage....I would say that the vet needs to show you how to express the bladder. As She's a witch said, it is not as bad as it sounds and can give you a lot of control over where the urine goes. With GSDs most people put a bucket under the dog and position the dog across their lap which expresses the bladder into the bucket. It is not at all hard to do but I assume that with a cat the placement might be different or the catch for the urine. I would definitely look into this.

Thank you all so so much for your responses!! This is really making me feel more at ease.

FeebysOwner I think the vet was referring to nerve damage from the old fracture, but maybe I'll have to clarify. I had no idea that there were neurological issues associated with FIV! No tests have been done to determine the IBD, I think he's assuming that's what it is by process of elimination and due to the success of the prednisone? Not sure...

We had originally thought maybe the constipation was due to the arthritis. Tuck doesn't fully squat in the litter box I'm sure it's really painful for him. He used to scream in pain any time he was in there. I've noticed a HUGE difference ever since went on the prednisone last month. So much less pain when using the litter box.

I'm going to ask about the FIV therapies! I'm really not too familiar with FIV (and unfortunately it seems neither is my vet....) but I've had a suspicion that all of his issues are stemming from that.

I'm also going to ask about whether my vet knows a specialist. I live in a small town so there are no options nearby, I'd have to travel out of town. I've done a little Googling and nothing is coming up, is there a certain term I should be using when searching?

It's so great to hear that others have been successful with expressing a bladder at home!! I'm so terrified about hurting him but it sounds like it's not that difficult which is such a relief. I just want him home he must be so miserable at the vet.

is your cat using cosequin for arthritis? it was very effective for HK, not prescription and not expensive. the catch for us is that it gave him diarrhea, but if your cat needs a laxative anyway, perhaps you could start small and work the dose up gradually - maybe it could take care of two problems instead of just one.

btw, the pred might help the arthritis a bit - have you seen any difference?

Cosequin gave my current dog diarrhea as well, but it was not the uncontrollable kind, so it may double as a laxative.

Just thought I'd give an update on my boy.

He's been home for a couple of days now. I'm gradually getting the hang of the bladder expression. I'm struggling to fully empty the bladder but I'm doing better each time so I have faith that I'll become an expert soon enough!

When I went to pick him up the vet told me that what he thought was impacted stool may actually be another type of mass. It's a fairly hard lump, so he thinks whatever it is it may be calcified. Hoping not a cancerous growth. Could be from his previous injuries, but given he only started getting sick in December and has been getting progressively worse, we can assume that the mass is growing. His xrays are with a radiologist now and we're just waiting for an opinion.

Since he's been home his stools have been better than they've been in months! The bladder issues may have been causing the constipation. Hoping that with consistent expression of the bladder he continues to poop well! He's unfortunately doing it all over the house (I'm thinking he associates the litter box with pain) but at this point I don't even care, just happy he's going!

basschick said:

is your cat using cosequin for arthritis? it was very effective for HK, not prescription and not expensive. the catch for us is that it gave him diarrhea, but if your cat needs a laxative anyway, perhaps you could start small and work the dose up gradually - maybe it could take care of two problems instead of just one.

btw, the pred might help the arthritis a bit - have you seen any difference?

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I've read about cosquin - definitely considering it! He's got so many issues right now if I can at least get rid of any arthritis pain at least that's one less thing to worry about.

I did notice a difference with the pred. He seemed a little more active and definitely had a better appetite! He's been consistently losing weight (started at 10 lbs now he's down to 6 lbs) so the increased appetite was a welcome change.

Glad to hear he seems to be doing better!!! Keeping Feeby's paws crossed about the radiologist's findings NOT being anything to do with cancer!

The pooping outside the litter box might stop once he gets to feeling a little less 'out of sorts'.

Btw, when you get a chance, show us a pic of Tuck!!

I am glad to hear that you are able to express the bladder. You will get used to the exact right spot to do it and it will get easier. You are doing everything that you can for your baby and I hope that you get good news.

If worse comes to worse, try a different-looking litter box in a different location...no bad associations!

Unfortunately Tuck didn't make it.

I brought him back to the vet yesterday as his appetite decreased, he seemed weak, and he suddenly went from requiring bladder expression to complete incontinence.

They were setting him up for an ultrasound when he passed. My vet has offered to do an autopsy free of charge, though I'm really not sure how much it will help me. For now the assumption is cancer.

Thank you all for your helpful suggestions. It's nice to know for the future that there's such a wonderful community here if I need it.

Wish I could have showed pictures of him fully recovered and healthy, but these memories will have to do:

I m so sorry. RIP little Tuck.

When/if you are ready, please consider paying tribute and homage to Tuck in our Crossing the Bridge section. It is where we all go to pay respects to our lost loved ones, and share pics/stories that our dear to our hearts. Tuck deserves that considering the little trooper he was!

I am so sorry. He is adorable and you both fought the good fight. I hope in time that happy memories will replace the more recent ones. You took impeccable care of him and he was so blessed to have you in his life.

my condolences to you. he was a beautiful cat, and you'll always have all sorts of memories of him.

I am so, so sorry. I know you miss him horribly. I will look for a post in the "Crossing the Bridge" thread later on. Meanwhile, my heart with yours.

I am so sorry for your loss. Threads are locked after such a loss as a sign of respect. When you feel up to it, please consider starting a tribute thread in our Crossing the Bridge forum.

Rest in peace, Tuck.