Fecal Incontinence Two Days After PU

[Heart For Cats]

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).

Why does he need a cone after all the stitches are dissolved? Their purpose is to prevent the surgery patient from breaking them apart. I would expect him to only wear it the first two weeks.

It could depend on how blocked he was at the time for all I know. Was the urine just dripping or a stream?

 

[fionasmom]

This is all very good news! Years ago, one of my cats had skin cancer in his ear, in being the operative word, as it was very deep in the canal and not on the tip as sunbathing cats might develop. He lost his entire ear and part of his scalp in the surgery but lived for years happily after that. The description of the dark blood and incision that you describe sound very much like Daddy Cat's experience but in the end it does all heal.

 

[Stargirl0623]

Why does he need a cone after all the stitches are dissolved? Their purpose is to prevent the surgery patient from breaking them apart. I would expect him to only wear it the first two weeks.

It could depend on how blocked he was at the time for all I know. Was the urine just dripping or a stream?

The PU essentially removed his penis and created a new, wider opening for him to pee out of; once it heals he'll be anatomically set up more like a female cat. The procedure uses his existing urethra as much as possible (and some of that tissue remains exposed), and the skin in that area is already VERY thin and delicate.

While the incision will be healed enough to have the stitches dissolve after two weeks, it needs a bit more time to get to the point where it can safely stand up to a rough tongue grooming it. A cat accidentally reopening their own incision when vigorously grooming after a PU will have absolutely devastating consequences for the animal, so it's best to err on the side of caution.

TL;DR - He hates the cone, but he'd hate a revision surgery infinitely more!

 

[Stargirl0623]

This is all very good news! Years ago, one of my cats had skin cancer in his ear, in being the operative word, as it was very deep in the canal and not on the tip as sunbathing cats might develop. He lost his entire ear and part of his scalp in the surgery but lived for years happily after that. The description of the dark blood and incision that you describe sound very much like Daddy Cat's experience but in the end it does all heal.

That's a relief, thank you for that insight into the healing process! I've got my own chronic illness but haven't ever needed a major surgery, so I've been flying blind to try and make sure everything looks good as he recovers (and obsessively texting pictures to his surgeon every day, haha).

 

[Stargirl0623]

Update:

He didn't have much of an appetite today and was sleeping a lot, seeming to be in some discomfort. No visible signs of infection and he's still pooping and peeing wonderfully, so for now I'm keeping a close eye on him. As this is the first day he hasn't been on any painkillers, I'm tempted to attribute it to that and not panic just yet (especially as he's been on some level of pain control for two and a half weeks!).

I've given him another dose of Gabapentin to ease the discomfort and stress, so he can rest, and will talk to the vet regardless of the outcome tomorrow.

 

[Tik cat's mum]

Update:

He didn't have much of an appetite today and was sleeping a lot, seeming to be in some discomfort. No visible signs of infection and he's still pooping and peeing wonderfully, so for now I'm keeping a close eye on him. As this is the first day he hasn't been on any painkillers, I'm tempted to attribute it to that and not panic just yet (especially as he's been on some level of pain control for two and a half weeks!).

I've given him another dose of Gabapentin to ease the discomfort and stress, so he can rest, and will talk to the vet regardless of the outcome tomorrow.

I think your right about the pain relief. Poor little fella. Brilliant news he's pooping and peeing fine still, that has got to be a huge relief for you. He's so lucky to have you bless, give him a ear scratch from me. And hopefully the vet will bring him off the pain meds gradually instead of just stopping them.

 

[Stargirl0623]

It's update time, end of day nine!

He was still rather sleepy today, but his appetite was back and he didn't seem overly uncomfortable other than when he used the box--lots of tail flicking and restlessness for about fifteen minutes after every time he pees, but then he's back to normal. I'm weaning him down from the gabapentin, a bit more slowly this time, and it seems to be going a bit better now.

After I noticed that he was drooling a lot during a nap, it reminded me that he's got seasonal allergies that kick in and mess him up for a couple weeks every fall and I've had the windows open the past two days to air the place out. This probably isn't helping his comfort levels and might explain the malaise I noticed, poor thing!

All the same, I'll talk to the vet when they open tomorrow about getting him in for a recheck, to make sure he's healing on track and there isn't anything to be concerned about.

His incision still looks about as good as you'd expect--lots of dark crust making it hard to see some of the stitches, it's rather grim to look at, but what is visible of the incision looks really good. He let me clean his butt properly today, too, which is a good indicator that his pain levels are finally starting to come down a bit.

We're both very tired over here, but hopefully he's well on the mend!

 

[Tik cat's mum]

That is good news he let you clean his butt. Definitely a sign he's dealing with the pain better. Thanks for the update and hopefully you'll both be able to get some sleep real soon. He's a champ and so are you.

 

[fionasmom]

This sounds as if he is really coming around. This all happens little by little, one day one part is better, the next day maybe another part, and they finally get to where they need to be.

 

[Stargirl0623]

Day eleven!

I had a really good follow-up chat with the surgeon this morning. We went over everything I've noticed with him recently, and my concerns. She's very pleased with how his incision looks, the amount of discharge and dried blood is well within what's expected at this point and I've done a good job keeping him clean. The scabs will fall off when they're good and ready to, and need to stay put until then.

She also confirmed that yes, they quote two weeks as the time for the stitches to come out, but a lot of cats are nowhere near fully recovered by then--their skin is generally healed to the point where the incisions aren't going to open up anymore, but it's a major surgery that was done on an animal who was pretty sick to begin with so there's still a lot of recovery happening behind the scenes. Because of that, it's normal at this point for him to still tire easily and not have his full appetite back due to still experiencing some pain. His Gabapentin was extended out another week to use as he needs, to mitigate that. I've only been giving it to him when he appears uncomfortable, his pain levels seem to wax and wane over the course of the day and he only seems to need it now in the evenings.

On the bright side, he FINALLY had a solid poop this morning! He's still peeing wonderfully, getting enough food and water into him that we're not concerned, and seems to be feeling well enough that he's starting to get bored with not being allowed to vigorously play or jump around. He's also way less clingy now and almost sleeping through the night, which is a good indication that he's starting to feel better!

 

[Tik cat's mum]

Thank you for the update, I'm so glad he's doing so well. It's fantastic news he had a solid poop. That will certainly help for you keeping him clean. Us humans are the same when we are recovering from surgery or illness. We have that I'm feeling better then try to do stuff we normally do. Then it's oh no I'm not better yet actually, I think I'm feeling worse. It feels that way because we was feeling better, it hits you harder. So the ups and downs throughout the day definitely fit with recovery. He such a star and so are you. Make sure you try to get some sleep while he's sleeping you need to look after yourself too.

 

[fionasmom]

 

[Stargirl0623]

We're almost at the two week mark now!

He seemed to be feeling significantly better for most of today: slept through the whole night, and his appetite was back this morning. I've been given an antibiotic to give him if he continues to have diarrhea, but the little stinker managed to have a semi-solid poop literally ten minutes before I gave his first dose so I held off. He's back on the probiotics to wait and see. Still giving him a low dose of Gabapentin in the evenings, to ease his discomfort.

He let me put a warm washcloth against his butt today for a bit, to try and soothe it, but it's really hard to dislodge most of the crud. We're at the point where a lot of the built-up dark scabs and discharge around the incision seem to be catching urine every time he pees, so I'm really leaning towards asking the vet to clean him up safely tomorrow as I'm concerned it'll trap bacteria. No stitches have fallen out yet, but the skin of his incision has closed into a nice healing pink.

I realized I've never actually shown a picture of the little guy, so here he is! For a dude who had an important bit of his anatomy removed two weeks ago, he looks really good.

 

[Tik cat's mum]

First of all sounds like he's doing really well. It's definitely a good idea to ask the vet to clean him. NOW those eye's oh my he's gorgeous. What a beautiful boy I did wonder what he looked like but didn't want to ask for pictures because you've had enough to deal with, without worrying about pictures. I can see why you love him so much, nobody could resist that lovely boy, such kind eye's. I'm smitten.

 

[Stargirl0623]

First of all sounds like he's doing really well. It's definitely a good idea to ask the vet to clean him. NOW those eye's oh my he's gorgeous. What a beautiful boy I did wonder what he looked like but didn't want to ask for pictures because you've had enough to deal with, without worrying about pictures. I can see why you love him so much, nobody could resist that lovely boy, such kind eye's. I'm smitten.

Aww, thanks! He has Disney eyes, for sure, and he emotes with them in a way that's always felt human. There was a point three weeks ago when an emergency vet tried to tell me that since he wasn't allowing them to touch him he must be fine, and he gave me a Look that had me driving him directly to a different one across town, who informed me his bladder was actually about to burst and he needed emergency surgery to relieve the blockage. When he kept blocking and needing to be unblocked or expressed every twelve hours after that, the PU happened a week later. It sounds strange, but he told me with another Look when he was getting too tired to keep doing this and needed more help. We'd done everything we could to avoid putting him through this tough recovery, but in that instant I knew in my bones that the surgery was the only right move and took him in the next morning to have it done.

Needless to say, it's a relief to see him now feeling well enough to make that e-collar look good, haha.

And of course I love the little man! I adopted him when he was under a month old--he was discovered abandoned hiding in the wheel well of a truck, and when no mama cat could be found I took him in. I'd just moved into my own place three months earlier, living alone for the first time, and ended up weaning him onto solid food by hand. It's been the two of us ever since, he bonded hard and fast with me! I've got my own chronic health problems, so he's been the best companion and friend, especially as the pandemic took away most of my other supports.

Promised him when I adopted him that I'd always do my best to take care of him and make sure he has everything he needs, and I'm just relieved that over the last month since this all started I've been able to do that. Hopefully he's past the worst now, and this has given him a shot at a long and happy life.

 

[fionasmom]

I think you are living up to your promise. He is such a handsome boy who clearly adores you and knows you saved him. I agree that you want to watch the dried poop as it is irritating to the skin if it sits there and it can be oddly difficult to soften it enough to get it off, plus you are dealing with an incision in that general area.

 

[Stargirl0623]

And that's two weeks!

After a chat with the vet and sending in some photos, he did end up going in for a two-week recheck today. We'd initially planned to let the stitches dissolve in their own sweet time, but upon looking at him they found that the discharge built up around his new opening was irritating his skin. Since the incision itself has closed over beautifully, he had the stitches removed at this visit. He handled it like a champion, and they cleaned him up. He already feels visibly better, laying in his normal sprawl on the floor instead of curled up tight--I think it was the right move! Currently his incision looks pink from the cleaning, and there was the expected small amount of blood from removing the sutures, but now that we can see the whole situation back there it's clear that he's healed well.

I'm ordering takeout and popping a bottle tonight, haha. It's a relief to know that he's recovering!

At this point he needs to continue with the cone and restricted movement for at least another week. This will allow the delicate skin to gain some strength, the internal repairs to finish up, and the sites of the sutures to stop itching so he won't overgroom. That said, he's well past where we'd need to worry about most of the scary outcomes. I'll still be watching him for signs of stricture for months, and he'll need lifelong follow-up to make sure his urinary health stays good, but based on how easy the surgery was and how he's healed so far they don't anticipate that complication being likely.

I'm sharing this in case anybody else is put in that impossible position of trying to decide what's best for their pet and finding horror story after horror story--the last two weeks were absolutely brutal on both of us, but having a PU surgery has undoubtedly saved his life. I know he wouldn't be here right now if we hadn't done it.

 

[Stargirl0623]

(As a related note, I'll keep this thread watched, so even if it's been a while since my last post, I should receive notifications--if you're a pet parent trying to navigate this surgery and healing process and want to speak with somebody who's been there, please feel free to reach out. )

 

[Tik cat's mum]

Thank you for the excellent update. I'm so pleased for you both. Enjoy that takeaway and bottle you've certainly earned it. . It's so good to see such a great outcome, and Thanks for sticking around to help others.

 

[fionasmom]

You have become a complete professional in the area of PU surgery and certainly could be a help to others, so thanks for that. He is going to be much more comfortable without those stitches even with the cone for a while longer. You both deserve a bottle of something....maybe his should be catnip?