Cat with hip dysplasia - tips for post-op care?

[OopsyDaisy]

We got easy-to-pass-stool today!! No blood, seemingly comfortable and normal looking in quantity (when it's dry it always seems like it's too little in comparison to what he eats, specially considering he's only been going every few days, but I know the moisture adds volume to it so it's hard to judge).

He ate a little bit less today (2,5 sachets) but we were heavy handed with the extra water we added to it, which I figure might have made him feel full. Great day, though, we're all happy after his litter box visit lol

Great news!

 

[gabicards]

Hello! Updates

So, it seems like intestinal transit time is at around 2 days now as opposed to 3 - in the last two times his stool wasn't dry and hard, it looked pretty healthy to me. As of yesterday he's getting 1/4 of a teaspoon of psyllium husk added to his meals twice a day (tbh it might be less than 1/4, but definitely not more) - we mix it with 2 tablespoons of water and add it to a sachet.

He seems to be comfortable at 3 sachets per day, 3,5 at most. That/s 3/4 of his pre-surgery amount, and he eats a lot slower than he used to. My father swears that's because he's moving less and getting less hungry as a result, but frankly I find it hard to tell now if he actually is moving less. He's always slept like 20 hours a day and he doesn't play for long, not since he was like 6 months old - he'll play with another cat, but gets easily bored of playing with humans. He walks, climbs into places and etc... so if he's indeed moving less, it's not by much. I'm not worried because this doesn't seem like an amount that would eventually result in malnutrition - it's still within the recommended quantity, but if he keeps it up he will definitely be a thinner cat than he was pre surgery (5.5kg).

Once he's in a more comfortable bowel schedule, in terms of passing healthy stools regularly, I'll try removing this extra water we're adding to his meals to see if this is the reason why he isn't eating as much - I suppose it's possible that they would contribute to making him fuller with less meals. But either way there's a huge difference in behavior around meal times, since before he would eat very fast and was unlikely to stop if you continued to give him food (it always seemed like high appetite as opposed to actual hunger, to me).

 

[fionasmom]

If he stays consistently at 2 days, and the amount and type of stool is normal, that would probably be okay. The cat I mentioned is on a 2 day schedule even with a total of 1/2 tsp of Miralax daily, and sometimes Laxatone. She seems to feel fine this way.

As for exercise, she had a hard life for 5 years in an alley and when she got to my house, she did sort of fluff out and stay put, so your dad might have a point, but what to do about it with a cat is much more difficult than with a dog.

 

[gabicards]

I'm back with updates! Probably the final one in this thread

Topaz has been consistently passing stool everyday, at around the same time, for the past 10 days. And it looks perfectly healthy!

He's on 1/4 teaspoon of psyllium husk twice a day, with 5 tablespoons total of extra water added to his meals - which I'm slowly reducing, since he's well hydrated and, as a result, just pees more often. I want to find a nice balance. I'll keep the psyllium, since it's great for the gut anyway, but might do it twice a day instead.

He's also being weaned off of prednisolone, and currently at 1/4 of a 5mg pill once a day, which I'll give him until the 19th, and then we're done.

As for his legs, it's all great! His jumping improves everyday, and we can tell he's more confident in all his movement. No signs of any type of discomfort anywhere, and he hasn't been given pain meds for over two weeks. He's doing pretty much everything he used to before the FHO surgery, like running around the apartment, climbing up to look out the window, and asking for food. He's still not back to 4 sachets/day, keeping to 3.5 at most, but usually just 3.I haven't bothered weighting him because he's doing so well, and it's interesting for him to stay on the thin side of the spectrum while he recovers from this type of surgery anyway (according to his clinical vet).

We're traveling back home to France on the 13th, so he'll get some gabapentine to keep him calm, and I figure it would probably help with any soreness that might come from being in the carrier for so long. Once we're there, another battle awaits us: my flatmate brought her dog from Mexico, a 6 year old poodle who I'm told is very docile, but we have no idea if she tolerates cats (Topaz doesn't care about dogs so long as they aren't massive, but he hasn't lived with one since he left the cattery at 5 months old). I'll open a new thread to talk about our plans to slowly introduce her to Topaz and get suggestions.

Thank you guys for the attention to this thread and for letting me rant. The past 5 weeks were intense and I'm so relieved things are looking up!

 

[fionasmom]

Thank you for posting this update. It is so good that things have improved; you have done a great job with all of this and Topaz knows that you were there every step of the way.

We look forward to hearing from you once you are back in France.

 

[gabicards]

Revising this thread to remind myself of the rough times we had immediately after Topaz's surgery.

But also to add, in case anyone has come across it while researching something for their own cat, that he has lingering GI issues because of this. No one knows why, but ever since the surgery he's never passed stool regularly again. He will go every 3 days for a few weeks, then every 4 or 5 days, then go back to 3 days, and so on. No signs of any other health issue.

He had a lot of exams done back in March, when he already had this problem, and there was nothing out of the ordinary anywhere. Xray, ultrasound, blood panel, everything was well. They did notice the slight thickening of his intestinal walls, which he's had since he was 7 or 8 months old, before he was ever constipated.

It's been 7 months and I am constantly trying out new things to help him (currently removed everything but malt paste + egg yolk powder), as I haven't given up finding a solution. He seems fine for now and the vets are annoyingly unconcerned, but it makes me very anxious as I don't know what it means for him in the longterm. It doesn't seem common to have a cat poop every 3-5 days without other symptoms of constipation, so the internet hasn't been much help, either.

Well. If anyone sees this and is going through a similar thing with their cat, please feel free to message me. I'll listen to your rant because I know very well how stressful it is! <3

 

[fionasmom]

Thank you for updating this. These ongoing issues are very frustrating, especially when the vets seem to be less concerned.

 

[silent meowlook]

I have to wonder if it is pain related. There is no way to prove pain in cats and they are so good at hiding it. Just a thought.

 

[gabicards]

I have to wonder if it is pain related. There is no way to prove pain in cats and they are so good at hiding it. Just a thought.

We've thought about it. He had a mild bladder issue months ago and when the vet prescribed him pain meds, she brought it up "keep an eye on him to see if he will poop more while on this" - he took it for 8 days... and nope. Same as always.

I also took him to a vet that does acupuncture and physical therapy, and she said his pelvic muscle is a little tense and he feels some discomfort when she stretches his leg completely, but she said it wasn't pain or else his reaction would have been different. She didn't feel the need to have ongoing sessions with him because he seemed like he was in good health.

So far, evidence points to this not being pain related.

Thank you for updating this. These ongoing issues are very frustrating, especially when the vets seem to be less concerned.

Yes. I wanted to leave a note here because I often look at threads and get frustrated by how there was never an update about how things turned out or how the cat is doing currently... I haven't been able to find anything about this type of situation online, and vets also don't see how this low motility could be related to surgery, while I don't see how it couldn't since he pooped everyday up until he had it.

The thread is already here, I might as well keep sharing in case other people go through it with their cats.

 

[fionasmom]

As we know, anesthesia can slow down the digestive track. I have even known humans who had extended episodes of constipation after surgeries; one notable example was after a corneal transplant, so go figure.

Do you think that there was pain after the surgery which he related to pooping? That would mean that he voluntarily holds it, which may or may not make sense. That might go along with the acupuncture and pelvic muscle discomfort.

 

[gabicards]

As we know, anesthesia can slow down the digestive track. I have even known humans who had extended episodes of constipation after surgeries; one notable example was after a corneal transplant, so go figure.

Do you think that there was pain after the surgery which he related to pooping? That would mean that he voluntarily holds it, which may or may not make sense. That might go along with the acupuncture and pelvic muscle discomfort.

I was told this about anesthesia back then, as well as opioids medication. But I don't know whether it could last this long?

I have no doubt it was straight up painful for him to poop following surgery. I mean, I don't know how it wouldn't have been when he removed the femur of both legs and absolutely needed to sit in order to pee and poop. Even on heavy meds I'd imagine that hurts. Plus, the first time he pooped was after 5 days and you could tell it was awful for him - he meowed in a way he's never done again, there was blood, and he went twice in one hour - both times it was hard as a rock and very large. I remember I had taken him back to the vet clinic a few times and begged them to help and they told me they couldn't do anything and we had to wait - to this day I don't understand why they didn't try giving him an enema, and I resent them for it.

I do have to say that he had periods of time where he pooped more often, though. So it just makes zero sense. The last post I had made to this thread was about how he was pooping everyday (which I don't even remember). A few months back I tried egg yolk powder for the first time and he was pooping every 2 days - but there was blood, so I stopped. I am now trying it again... no blood, but it's wildly inconsistent. After starting on the powder, he pooped, then 2 days later he pooped again and I rejoiced, I thought we were on the right track... then the next time was 4 days later and very dry. Nothing changed. So... what????

At least here we can brainstorm about it, maybe someone else will notice a pattern I am missing.

I should also add that a couple of weeks ago I tried Miralax - I've had it for a while, thought it would be good in case of an emergency, and I knew it would take me a while to have it shipped from the US - and it just made his stools soft, he didn't go more often than "usual" because of it (I feel like he doesn't even have an "usual" at this point, but I mean more often than 3-4 days).

 

[silent meowlook]

That’s tough. I am just thinking in writing here. Of course anything mentioned, check with a veterinarian first.

I wonder if there could have been some damage to the nerves or muscle structure of the intestines? I wonder if a motility drug such as cisipride could work? Although it can only be given if stools are not hard and it isn’t without side effects.

Have you had a recent abdominal ultrasound with a specialist??

Could it be a hydration issue that maybe sub cutaneous fluids given regularly might help?


Do you have any integrated holistic veterinarians where you are? Sometimes they can be helpful.

 

[gabicards]

That’s tough. I am just thinking in writing here. Of course anything mentioned, check with a veterinarian first.

I wonder if there could have been some damage to the nerves or muscle structure of the intestines? I wonder if a motility drug such as cisipride could work? Although it can only be given if stools are not hard and it isn’t without side effects.

Have you had a recent abdominal ultrasound with a specialist??

Could it be a hydration issue that maybe sub cutaneous fluids given regularly might help?


Do you have any integrated holistic veterinarians where you are? Sometimes they can be helpful.

I appreciate the brainstorm! Any thoughts of what might be going on are genuinely welcome, because my brain is just fried at this point.

I think the nerve damage is an interesting possibility. Right after the surgery I chased the surgeon for weeks about this - not necessarily thinking there was something wrong with the nerves, but that something might have gone array during surgery that resulted in it. I was repeatedly dismissed as he blamed it on the presumptive IBD, which made zero sense to me since he had the intestinal inflammation before the surgery and had never been constipated before.

As for the motility drug, I've been intrigued, but no vets in France have offered me that option. The vets didn't find a problem with his intestinal motility back in March (when he already had this issue, so I have no reason to believe there has been a change), which threw me off completely.

Digestive Tract
- Stomach: Walls, content and peristalsis are normal
- Small intestine: Walls, content and mobility are normal
- Colon: Walls and content are normal. Presence of well defined milimetric hypoechoic nodules within the submucosa: lymphoid follicles.

Their conclusion is a bit wonky, but that's on me because the reason he did the exams in the first place was that he was vomiting due to having been exposed to a chemical product, which at the time I wasn't aware of. So they were trying to find a cause for that and didn't, and their best guess (naturally) was that this was an acute episode of his inflammatory condition, and the recommendation was a hypoallergenic diet to "further stabilize it". They wrote down that his recovery at the hospital was remarkable - which makes sense since he was just recovering from having inhaled something, and not an actual IBD episode, which I'm sure would have been much trickier as we don't know what causes the irritation.

So there is a mild inflammation of of his colon - mild enough that a lymphoma was never brought up, only a possible food intolerance. But also... a surgery wouldn't cause cancer, and I figure he wouldn't start showing symptoms of that so suddenly, too. They didn't see any structural changes whatsoever, certainly nothing that would justify "chronic constipation" - the debate is also whether this is even actual constipation or not, considering the absence of any other symptoms.

I don't know how they would assess any nerve damage, but I'm wondering if that wasn't what the physical therapist looked at when she did the palpation exam during the consultation, prior to the acupuncture session. The one thing she did remark was a tension of the prepubic tendon, but she associated that with his recovery process and him having had the surgery on both sides of the hip at once. She didn't think it was concerning, so all she asked me to do was exercises where he would go up and down the stairs, for instance - when we talked, her stance was that she didn't believe his slow intestinal transit was due to pain (so, in agreement with the vet).

And then we also have another point - if it was due to muscle tension, would it react to stool softeners or food changes? Because, for instance, when I tried giving him N&D Skin & Coat a few weeks ago and he reacted poorly, he pooped everyday, very soft and with blood, and that was resolved once I changed his meals back to the home cooked food. In the past, when he reacted poorly to food, I'd change him back to Royal Canin Kitten in sachet and once again it went back to "normal" - which was passing stool once every 3 days, at least. So in that case it couldn't have been due to the food being lower in residue, either - unless he's having a bad reaction to food, it seems he just goes back to that schedule. But, to me, it shows he *can* poop everyday, structurally speaking. It's just... odd, I don't know what to make of it.

Unless when it's soft enough he can't "hold it back"?... and I guess if the reason is muscle tension, it could also explain why his appetite is really great, and there's no vomiting or anything else commonly associated with constipation?

 

[silent meowlook]

I wonder if they would consider having him do a Gabapentin trial to see if that helped. Gabapentin helps with neuropathic pain. I know they don’t think it’s pain, but how do they know?

Another thing that maybe they might consider is a low dose steroid trial to see if that maybe could help?

I am just guessing at this point. But it seems like something isn’t right and needs to be figured out to help him.

I am truly sorry you both are going through this.

 

[gabicards]

Today, 8 months after his hip surgery, was the first time Topaz has ever jumped from the floor up to a kitchen counter.

His lack of interest in doing this was my main clue that he could have hip dysplasia. At first, I thought he was just too young and unsure of how high he could reach... but, back in November 2022, I had to catsit for a friend that has Topaz's biological aunt, River, who would jump to the counter a million times per day, and not even seeing her do it seemed to make him want to try.

I moved to this apartment 2 months ago, and the counter is the same height as every other counter I've had since I got him. In this place, he has other ways of reaching it that don't involve jumping up from the floor, so he's usually up there. I thought he'd never bother trying it, and was over the moon when he did it! It seemed so easy for him, too, so hopefully this will give him a confidence boost and I'll get to see more of it in the upcoming weeks.

(With love, the only cuckoo around who gets excited about having a cat up on a kitchen counter.)

 

[fionasmom]

Thank you for letting us know! I would also be overjoyed that he was on the kitchen counter.