Fecal Incontinence Two Days After PU

[Stargirl0623]

Hi all! First time poster, looking for some reassurance from other cat parents!

My three year-old cat had a PU surgery on Friday, to save his life.

We had a miserable run of things to get to this point. He blocked four times in a week, despite repeated catherization and every medical treatment we could think of, and when it happened again the only option left on the table was a PU surgery--he was so stressed and weak that we couldn't justify continuing to put him through the pain of blocking repeatedly with no sign of improvement and an inability to stay clear for more than 12 hours.

He's now two and a half days out, and the bulk of his healing has been beautiful. Minimal bruising, much less pain, healthy appetite, peeing like a champion. My only remaining fear is that, following a bout of diarrhea, he seems to have spent the last day leaking poop and not realizing he's doing it. I'm not surprised he's got the runs after what he's been through, but I'm worried all the same.

I was told to expect urinary incontinence following surgery, but a lot of what I'm seeing about fecal incontinence following this procedure is saying it's permanent nerve damage.

Has anybody had this happen and resolve, or had a cat experience leaky bum after antibiotics and/or stress? I'll be calling the vet in the morning regardless.

I'm also concerned for keeping his surgical site clean; I'd love any ideas on that front! Currently I'm gentle patting him clean with damp cloths every hour or so, trying to avoid the stitches, but I'm concerned.

 

[Stargirl0623]

(Before anybody goes off on me for having a PU done without first trying more conservative dietary and lifestyle management, please know it wasn't a decision I made lightly and we genuinely did not have that time! Due to the non-stop blockages, including weekend/after hours crises, he'd been treated by half a dozen different vets over the course of this nightmare and--at that point the surgery went ahead--all agreed it was the only remaining viable option to save his life. My buddy was hurting but he wasn't ready to give up yet, so I wasn't ready to give up on him.

Thanks!)

 

[Tik cat's mum]

I don't know about pu surgery but I have heard antibiotics can give a cat the runs. Like you said your speaking to your vet anyway so maybe you could get something for it. I don't think anyone on here would give you a hard time for saving your cat's life. We know the danger of cat's blocking and four times in one week I would think surgery was the only option. I hope your boy has a speedy recovery.

 

[Stargirl0623]

I don't know about pu surgery but I have heard antibiotics can give a cat the runs. Like you said your speaking to your vet anyway so maybe you could get something for it. I don't think anyone on here would give you a hard time for saving your cat's life. We know the danger of cat's blocking and four times in one week I would think surgery was the only option. I hope your boy has a speedy recovery.

Thank you so much! I spoke to the vet this morning and they confirmed that at this point they think the stress and meds are the issue, especially as he tends to mess himself after he's already been straining to use the box. He's being given a probiotic to firm him up a bit, and if keeping him sufficiently clean down there without disturbing his incision is impossible at home they're willing to lightly sedate him and properly wipe him up there.

And of course--thank you! A PU is a salvage procedure that's typically only done when there aren't other options. For cats in the hands of a skilled surgeon it's a literal lifesaver, but due to the difficult recovery and possibility of serious complications it's not a decision to be made lightly. There's some controversy over when it's best to do it, and it's generally best to try way more conservative management strategies first! Because he went downhill so fast and got caught in a spiral of reblocking the moment the catheter came out, I guess I just wanted to get ahead of defending the decision to ultimately go ahead with the surgery. Generally cats don't repeatedly obstruct so dramatically in such a short span of time, and my little guy genuinely ran out of other options.

 

[Tik cat's mum]

Thank you so much! I spoke to the vet this morning and they confirmed that at this point they think the stress and meds are the issue, especially as he tends to mess himself after he's already been straining to use the box. He's being given a probiotic to firm him up a bit, and if keeping him sufficiently clean down there without disturbing his incision is impossible at home they're willing to lightly sedate him and properly wipe him up there.

And of course--thank you! A PU is a salvage procedure that's typically only done when there aren't other options. For cats in the hands of a skilled surgeon it's a literal lifesaver, but due to the difficult recovery and possibility of serious complications it's not a decision to be made lightly. There's some controversy over when it's best to do it, and it's generally best to try way more conservative management strategies first! Because he went downhill so fast and got caught in a spiral of reblocking the moment the catheter came out, I guess I just wanted to get ahead of defending the decision to ultimately go ahead with the surgery. Generally cats don't repeatedly obstruct so dramatically in such a short span of time, and my little guy genuinely ran out of other options.

I'm so glad for you that the vet's aren't concerned and your boy is getting something to firm him up. You must of been so worried. He's lucky to have such a caring owner who has his best interests at heart.Thanks for the update. Sending healing vibes for your boy and hugs for you.

 

[fionasmom]

Welcome to The Cat Site! In your situation, I would have done exactly the same thing. Four times in one week is so definitely not the occasional blockage that you had no choice. As I work with ferals, I have seen two untrappable males die from the end result of a blockage and it has made me hypervigilant about my own male cats.

You are understandably very stressed by all the recent events. I would definitely try to do what the vet is suggesting. Don't jump to more serious possibilities that probably did not happen like nerve damage. Please keep us posted. Members of TCS often post about electing to have PU surgery done on their male cats and no one criticizes them for it.

 

[Stargirl0623]

Welcome to The Cat Site! In your situation, I would have done exactly the same thing. Four times in one week is so definitely not the occasional blockage that you had no choice. As I work with ferals, I have seen two untrappable males die from the end result of a blockage and it has made me hypervigilant about my own male cats.

You are understandably very stressed by all the recent events. I would definitely try to do what the vet is suggesting. Don't jump to more serious possibilities that probably did not happen like nerve damage. Please keep us posted. Members of TCS often post about electing to have PU surgery done on their male cats and no one criticizes them for it.

For sure, and thank you so much for the reassurance! When trying to research the PU surgery I came across a lot of very heated debate about when it's warranted, but I know that moving ahead with it was the correct decision for the situation he was in and saved his life.

I know I'm still on high alert, too! It was an absolute nightmare and I nearly lost him several times, so it's going to take quite a while before I fully exhale. I think part of my worry is just from the fact that he kept having the "this probably won't happen, BUT--" outcomes land him back in the ER, haha. A reality check is always helpful!

His vet wasn't concerned at all, which is also incredibly reassuring. Said his incision looks beautiful, I'm keeping it clean well, and his poop should resolve itself over the next few days as he finishes up a course of antibiotics, heals a bit, and gets used to being back at home.

I'll keep the forum posted as he recovers!

 

[Stargirl0623]

An update on my little dude:

The vet reviewed some photos of his incisions and say they look great. He's still peeing just fine, and his appetite is good!

His stool seems to be firming up, too. Last night he did have diarrhea again, but he was able to go to his box and consciously decide to use it, which is a relief. It was significantly less runny than last time, too! His tummy made SUCH angry noises beforehand, I think he genuinely is just working through some GI distress after the ordeal he's had.

Yesterday was day three after surgery so he was visibly sore when moving, and slept a lot. Everything looks really good on the whole, though, and I'm starting to feel optimistic that we've gotten him out of this crisis and on the road to recovery.

 

[Tik cat's mum]

That's excellent news so glad he's doing well. Thanks for updating us.

 

[di and bob]

ANY improvement is good! I would put my money that the diarrhea is caused by the meds, stress, and anesthesia. He's been through a lot. I would give him at least a month before you start thinking about nerve damage. If he has even a little improvement I think he is on his way to recovery!.

 

[Heart For Cats]

A PU is a salvage procedure that's typically only done when there aren't other options. For cats in the hands of a skilled surgeon it's a literal lifesaver, but due to the difficult recovery and possibility of serious complications it's not a decision to be made lightly. There's some controversy over when it's best to do it, and it's generally best to try way more conservative management strategies first! Because he went downhill so fast and got caught in a spiral of reblocking the moment the catheter came out, I guess I just wanted to get ahead of defending the decision to ultimately go ahead with the surgery. Generally cats don't repeatedly obstruct so dramatically in such a short span of time, and my little guy genuinely ran out of other options.

I have read stories about cats blocking again weeks or months after having a PU. It seems catheters need to stay in their bodies forever whether they have surgery or not sometimes. That probably is why some people disagree on whether PU surgery is even a good idea. If it worked perfectly for your cat, don't worry about what other people think you should have done. The vet saved his life.

 

[Stargirl0623]

I have read stories about cats blocking again weeks or months after having a PU. It seems catheters need to stay in their bodies forever whether they have surgery or not sometimes. That probably is why some people disagree on whether PU surgery is even a good idea. If it worked perfectly for your cat, don't worry about what other people think you should have done.

For sure! It was explained to me that the PU doesn't fix the underlying urinary tract issues. Those will still need lifelong treatment, but a properly-performed surgery does make it WAY less likely (not fully impossible, but INCREDIBLY unlikely) that he'll develop another life-threatening obstruction if they flare up. He currently doesn't have a catheter in at all, and is peeing like a champion.

There weren't any GOOD options with where we were at before the surgery, so taking the one that kept him alive was the correct call.

 

[Stargirl0623]

Another update, end of day five after surgery! I'll continue to document his recovery here, in case any other pet parents need another account of healing from a PU procedure.

He's continuing to heal well--eating, drinking, peeing! Bit of pain last night, but nothing unmanageable. His stomach remains difficult, poor baby has gas and the runs to the point where his butt is starting to get raw from it and I caught him trying to scoot it on the carpet. Needless to say, I put a stop to that very quick! The vet is fairly sure it's from the antibiotics, so it's a necessary evil until his UTI is gone (he'd developed one after needing repeated catherization prior to surgery and I have life-threatening allergies that prevent us from changing him to a different drug, as I can't safely administer the other option). I'll be picking up a cream to soothe the irritation in the morning. The probiotics have also helped a lot with the consistency of his poop, and he's no longer passively leaking.

The incision looks about as rough as you'd expect--lots of dark, clotted blood that I've been told to leave alone as he heals. It's alarming to look at and try to keep clean with his butt situation, but I'm told it's healing well with no signs of infection. He's had very minimal urinary incontinence, usually when he's sleeping. I'm sending pictures to the vet every other day to make sure he's staying on track!

He's still rather sore, but with every day he gets back a bit more pep! It's a bit of a mixed blessing, since he had the energy to shred up a doggy training pad in the 1.5 hours I was asleep last night. I don't think he ate any of it, but I called both my vet and the pee pad manufacturer to make sure nothing in there was potentially toxic. He'll be monitored for the next 48 hours just in case, to make sure if he accidentally swallowed anything it passes without issue. He's keeping me on my toes!

 

[Tik cat's mum]

Another update, end of day five after surgery! I'll continue to document his recovery here, in case any other pet parents need another account of healing from a PU procedure.

He's continuing to heal well--eating, drinking, peeing! Bit of pain last night, but nothing unmanageable. His stomach remains difficult, poor baby has gas and the runs to the point where his butt is starting to get raw from it and I caught him trying to scoot it on the carpet. Needless to say, I put a stop to that very quick! The vet is fairly sure it's from the antibiotics, so it's a necessary evil until his UTI is gone (he'd developed one after needing repeated catherization prior to surgery and I have life-threatening allergies that prevent us from changing him to a different drug, as I can't safely administer the other option). I'll be picking up a cream to soothe the irritation in the morning. The probiotics have also helped a lot with the consistency of his poop, and he's no longer passively leaking.

The incision looks about as rough as you'd expect--lots of dark, clotted blood that I've been told to leave alone as he heals. It's alarming to look at and try to keep clean with his butt situation, but I'm told it's healing well with no signs of infection. He's had very minimal urinary incontinence, usually when he's sleeping. I'm sending pictures to the vet every other day to make sure he's staying on track!

He's still rather sore, but with every day he gets back a bit more pep! It's a bit of a mixed blessing, since he had the energy to shred up a doggy training pad in the 1.5 hours I was asleep last night. I don't think he ate any of it, but I called both my vet and the pee pad manufacturer to make sure nothing in there was potentially toxic. He'll be monitored for the next 48 hours just in case, to make sure if he accidentally swallowed anything it passes without issue. He's keeping me on my toes!

So glad he's doing well. You must be exhausted though sending hugs. It definitely sounds like he's getting better and causing trouble. But I'm sure you are not really bothered you'll just be glad his energy is coming back. Even though he's keeping you on your toes. Thank you for the update and posting on his progress I'm sure will help people in the future going through this.

 

[Stargirl0623]

So glad he's doing well. You must be exhausted though sending hugs. It definitely sounds like he's getting better and causing trouble. But I'm sure you are not really bothered you'll just be glad his energy is coming back. Even though he's keeping you on your toes. Thank you for the update and posting on his progress I'm sure will help people in the future going through this.

Haha yeah, I'm very tired! It was exhausting even getting him to the point where he had the PU, let alone recovery!

I live alone with him, am working from home full time and still have deadlines to meet, and his meds for the first few days out of surgery were on an every-two-hour schedule. He's finished with most of those, but I'm still crating him when I sleep to keep him out of trouble and staying on the couch nearby so I can hear if he needs anything!

 

[fionasmom]

Thank you for the updates and glad to hear that you are both holding on! It is very intensive to nurse an animal through a major surgery like this which has so much follow up to go along with it.

 

[Stargirl0623]

Time for another update!

His vet says the incision is still healing well. One of the stitches looks like it's come a bit loose, but the incision is still holding together beautifully. As we are a week out now and there's nothing else alarming with the incision, she's not super worried about it. I won't post pictures, as they're rather graphic (if you're going through this with your own cat and want to compare, please message me and I'll be willing to send them privately!), but this point the lower stitches are really starting to heal over and he's got a large dark scab around the raw parts of his new opening. The area around the scab still bleeds lightly once or twice a day if he's straining the area, but it resolves itself and there's no pus/heat/other signs of infection.

I'm starting to wean him down from the pain medication (as he'd needed to tolerate being gently cleaned up in a tender area with his upset tummy, we'd extended it out a couple days past initially intended), so after the next day or so the only other remaining medications will be the probiotic and antibiotic.

The puppy training pad he shredded and possibly ingested doesn't seem to have caused any issues, as his appetite and poops are consistent!

He's still sleeping quite a bit, but seems overall happy and in good spirits. Yesterday after work we curled up on the couch and took a nap together, and I nearly cried--two weeks ago, I'd been so sure we'd never be able to do that again. Obviously he's not out of the woods, and there's still a ways to go, but this surgery has been a literal lifesaver and he's looking really good so far!

 

[Heart For Cats]

Does the vet think he is recovering on or ahead of schedule?

 

[Stargirl0623]

Does the vet think he is recovering on or ahead of schedule?

She said she's pleased with where he's at, and has no concerns! As long as he's peeing, eating, drinking, alert, in minimal pain, kept as clean as reasonably possible without disturbing his stitches, and his incision is not infected, she's happy. These surgeries are going to look ugly as they heal; there's only so much to be done about that.

My understanding was it's hard to come up with an exact schedule for these recoveries, as the cats usually have some level of physical trauma going into them from developing urinary obstructions that makes it hard to predict exactly how fast they'll bounce back. The stitches will start to dissolve around the 10-14 day mark, and she'd like him to wear a cone and have somewhat restricted movement for a month (even after the stitches are gone, the area will be delicate for a while).

 

[Tik cat's mum]

I'm so pleased for you sounds like you both needed that cuddle.