Leaking Urine / Incontinence After Pu Surgery?

dutchy

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Hi there,

I've posted a little on this board a while ago about our two beautiful cats, one of which is our now 6.5 year old neutered Siamese mix male Bunker.
Bunker has had several health issues since birth, the main one being epilepsy, but as we found out very recently also severe urethral problems.

Last week one morning he started crying after peeing and washing himself frantically. At that point I immediately made an appointment at the vet for that same evening. He was still peeing at that point. Later that day he went to his litterbox constantly, but no pee anymore, so I called the vet and drove there right away.
They immediately tried to cath him, unsuccesfully. It was impossible to get it in, and as it turned out, his urethral opening wasn't were it was supposed to be! It was actually below the tip of the penis, on the underside.... So his bladder was emptied through the abdominal wall using a needle. No crystals found in his urine, but it was bright red with blood. We were told right away that they wanted to get him to a large clinic (nearby fortunately) to have him checked out and possibly have surgery done.
Took him to the clinic and the next day we got a call, no crystals, no stones, but his urethra was blocked from infection. And because of the defect they recommended surgery. They would explore, and do a PU if needed and possible.
It turned out he had a very narrow urethra with diverticula (small pouches probably caused by straining and not being able to pee properly ever), and scarr tissue. That he had never blocked before was a miracle. PU was really the only option, so he had the surgery.

The surgery was last wednesday, we picked him up again on tuesday. That seems early, but he refuses to eat or drink at the vet's, and the stress makes him have seizures, so it was better for him to be at home where he is much more comfortable.
The surgery went very well, no complications, he woke up quickly and was back being grouchy to the staff in no time. He's a VERY sweet cat, but hates the vet. He doesn't swat or bite, but growls the entire time anyone comes within 10 feet of him there, and pees and poops himself in fear.
At home he seems comfortable, hates his cone though, but is otherwise himself. He's friendly and awake, eats like he hasn't seen food in weeks and drinks well too.

But there is a serious pee problem. The first day he would pee where he was lying or sitting, and his pee was red. Not pink, but really red. Called the vet off course, told me not to worry as long as it got better. That first day home he would go to his litter box literally every 5 - 10 minutes, straining and producing very small pees. Pooped a lot too that day. In the evening he had a bigger pee, but still lots of urine where he was lying, and as he walked there was a trail of urine behind him.
It has gotten somewhat better, now 4 days post op he pees around 8-10 times a day, but whenever he pees he keeps leaking afterwards and his whole bum is wet. The skin is getting irritated too from urine scalding. He really likes it when I clean it for him tough.
His urine is still bloody too, he leaves light pink urine stains where he lies or sits, and he really hates it. He has actually taken to scratching the area with a front paw, and rubbing his bum back and forth on the puppy training pads we have covered everything with, both of which are not a good idea.....

Is this normal 4 days after surgery? And is it normal to still have blood in his urine? He did have a bad infection too, for that and the surgery he is on antibiotics, and he has novacam for pain meds. No bladder relaxants.

Sorry for the wall of text, but I'm just really worried about him... He's been through so much in his life, and despite everything he's always been a very happy playfull and active cat, I feel so sorry for him now. He's really bothered by the incontinence.
 

foxxycat

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Wonder if the pain meds should be changed to buprenorphine-it's an oral liquid absorbed through the mouth. The vet always had me give this to my girl when she had bladder infections.

I would be very concerned with red bloody urine. Did they culture the urine to match the proper antibiotic? maybe he needs a different one.
I am sure he's uncomfortable. Poor baby. I would call the vet and let em know again that things are not improving.
 

charchar

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Please be assured that this is normal. My baby Charsy and I went through six weeks of illness at the start of the year, PU surgery saved his life. The poor darling cried for around three days every time he peed after surgery. It's very painful but it does get better. Charsys toilet patterns were sporadic and strange for the first few days after surgery but he recovered in time. He bled, he scratched, he lost his bowels a few times. Hang in there! I actually stayed at home for three full days following Charsys surgery to supply him with extra TLC. Lots of love sure does help!
 
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dutchy

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Foxxycat, I can't give him buprenorphine as it can lower the heart rate, and Bunker also has (idiopathic and non-symptomatic) bradycardia. We found that out when they were trying to diagnose what was causing his epilepsy. It is not the cause of his epilepsy by the way, his epilepsy is most likely hereditary (his mom and another litter mate are epileptic too).

He doesn't seem to be in very much pain from the surgery, he walks around fine, jumps on everything, eats and even plays a little (his favourite game, dumping small toys in his water fountain and then fishing them out, splashing water everywhere...).
But the leaking issue is what is driving him crazy. I use puppy training pads on everything now, including his bed, and as soon as there are 2-3 urine spots on it, he will cry untill we come change it. He also cries when he wants his bum washed (I dab it with a damp clean cloth), and constantly tries to get into the shower.
As for the shower, when he has a seizure, he pees everywhere and then flails around in it so he is covered in pee, and we always give him a shower when that happens. He walks into the shower himself and waits, so he's probably thinking he should get a shower now too. But with the incision and all I'm not doing that.
He's on clavubactin for antibiotics, a culture has been done.

Charchar, Thanks for the reply! He didn't cry for the first couple days when he peed, he started doing that since this morning (it's early evening here in the Netherlands now).
Maybe it's because he is getting some feeling back and/or the urine is starting to burn at the incision which is where it is running over it.
The blood is a lot less than it was, from red to light pink in 4 days.
And he does need lots of love! He demands cuddles every 5 minutes, and tries to get through the door to our other cat for snuggles, unfortunately our other cats acts aggressively towards him now, he's scared of his buddy smelling weird and sporting a giant pink cone. So they are separated and will remain so at least until the stitches come out.
 

charchar

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It's a tough time. Recovery is slow but it gets better. Charsy leaked all the time and it took around a week for his urine not to run red or pink. I did rush him to emergency one evening but it was all in vain! They told me I was stressing out and that all these symptoms are normal after having his "manhood" removed. The hard thing is not being able to explain or communicate. My boy was so distressed, I took the cone off! Not sure if others agree, but removing the cone reduced stress and I just sat with him so he didn't lick his incision so much. He did lick a lot when the scars were healing, it wasn't an issue. Hope things are improving. Ask me anything as we went through a tough period and I've become very experienced on the matter!
 

lalagimp

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Is there any issues with prescribing prazosin in his condition? It's anti spasm and is supposed to help control the urges to go so often. Tommy had it every time they catheterized him and then stayed on it for maybe a few days afterwards. When he had his PU I don't believe they gave him any, and we were lucky that when we got him home his urine was already clearing up from leaking blood a few days before. I kept him on a white sheet on the loveseat and watched for changes. He never had any issues with incontinence and would go pee about once a day.
The timeline was Tom blocked his second time. Then he went to the ER for a day and a half on a catheter while taking buprenorphine and prazosin. He came home. Then he blocked again the next day while bleeding. Then he stayed in the ER for at least 48 hours on a catheter with buprenorphine and prazosin and then we took him straight to the surgeon while he still had the catheter in. He had surgery on a Wednesday and the very next day he had peed for them so Thursday night we brought him home. No additional meds. Just a 3 day injection of Buprenex for pain. He wouldn't poop for up to three days at a time. He hated pooping with the new plumbing.
 
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