My Experience With Blockages and PU Surgery

[nerdrock]

I just thought I'd post a timeline of my cat's (known) history of blockages and, eventually, PU surgery for anyone interested. Who knows, it may help someone that's considering the surgery for their cat. 

Back in April I posted about a cat that had come into work blocked. When I posted, he had been at the clinic for nearly a month. At that point, he had blocked twice (once when he came in, then again after this catheter was removed). I brought him home at the end of April/start of May. 

About a month later, about mid June, he was urinating small amounts again. Back to the clinic, he was recatheterized and was there for about a week. He pulled his catheter out (despite having a large ecollar on and it being stitched to him). Those were blockages 3 and 4.

About a month later, he was urinating small amounts again but more than the last time. We really didn't want to put a catheter in again - it was getting increasingly difficult insert the catheter due to scar tissue. He was put on antibiotics, valium and buprenex. It seemed to help and he seemed to be back to normal. Just before finishing the antibiotics, he blocked again. He was in the hospital for another week before he was able to come home. At this point, we decided to keep him in the bathroom so we could monitor him very closely until he was urinating completely normally again. 

About 3 weeks ago, I came home from work to find him very weak in the litterbox. It was not like the other times he had blocked, his bladder was huge, hard and very painful. He was growly, which was not like him at all. I rushed him to the after hours clinic. Two vets attempted to insert a catheter but were unsuccessful. I received a phone call with the options - I chose exploratory bladder surgery (to see if there were stones that weren't showing up on the xrays) and they would try to put the catheter in that way, if that didn't work, they could perform the PU surgery. 

Five hours later I got the call that he had made it out of surgery and was doing well. I could go visit him in the morning. 

I went in the next morning to give him his meds and clean him up. He looked like Frankenstein. The poor boy had a big cone on, stitches all along his belly and up his rear. I had seen a cat after PU surgery a few months before, but it wasn't like this. It's different when it's your own cat. He was happy to see me - all chirps and purrs. 

He's been home now for about two weeks. He has healed remarkably well and is starting to show his real personality. He's a wonderful boy and we're so happy to have him in our lives. He has roam of the house again and will be switching back to regular litter later today. 

 

[jcat]

Thanks for the helpful post. Blockages are something we probably all dread, and somebody whose cat is facing this surgery will be glad to know whom they can turn to with questions. :nod:

 

[goholistic]

Poor boy! He has been through so much! Thanks for sharing your experience.

I hope he continues to heal and thrive so that he can be himself again!

 

[nerdrock]

Thanks! I will admit that I was terrified at the thought of the surgery for him - first that he would not make it through, we were doing the exploratory bladder surgery at the same time, so it was much longer than normal, then what his quality of life would be like after - would he leak urine constantly? Would he be in pain?

One thing that I will mention, because I don't think a lot of people realize this before the surgery, is that most of the time they will dribble urine for a bit while they're getting used to everything. My boy only dribbled for a few days, then was back to using the box. He would sometimes go over the side, not sure if it was the pain meds making him a bit loopy or if he just wasn't sure where it was coming out. He is back to normal now, although he has become more particular about the cleanliness of his box, lol, and will go beside it if someone has already used it a couple of times.

IMO keeping them isolated while they recover is critical whether it's the only cat or there are multiples. You need to know where the cat is at all times and be able to monitor incisions, give medications, as well as monitor input and output. It's really not much different than monitoring after any surgery, perhaps a bit longer with the recovery. We kept him isolated in the bathroom for a week and a half until everything was completely closed, healing over well and sutures were starting to dissolve. I would bring him out and cuddle with him on the bed towards the end, during his isolation I would spend hours in the bathroom with him so he wasn't too lonely.

I also don't really know how to describe the area after surgery, when you bring them home and actually see the incision site with sutures and everything. It's very graphic and it's hard to prepare for. I had warned my SO because he has a sensitive stomach, he thought he would be fine with it. When we would visit at the clinic, our boy would be flip flopping all over for pets but never turned around for my SO to see, so it was quite a shock when I brought him home. I let him out of the carrier and the first thing he did was stick his backend up in the air - my SO ran out of the room and nearly vomited. He was fine with him otherwise, but if our boy turned around, he felt very sick.

If anyone has any questions about the surgery, recovery, or anything else, feel free to ask and I'll answer the best I can. It's definitely something that I think owners should be prepared for and I recommend starting to save for it as soon as you can - especially if they have blocked already. If you never have to use that money for it, that's great, but it is very expensive.

I don't have any pictures of the site right after surgery but I took some last night, if anyone is interested I can post them. They aren't bad at all now that everything has pretty much healed.

 

[pushylady]

I think it could be helpful if you posted those pictures. At least they'll show what normal healing should look like.
I'm glad he's healing so well and he's obviously in very good hands.

 

[goholistic]

You're doing a great job caring for your boy! 

 

[leeroy]

Thank you so much for your insightful post. My baby Leeroy has now blocked three times and it's now the pu surgery or over the rainbow bridge. He is only 5 years old so I feel we should give him every chance of a full life. He is scheduled for the surgery on Monday and I'm so nervous for him. I just want to be there holding him and telling him how sorry I am to put him through all this.

If I can, I would like to retain you for info in future as I don't know of anyone personally who has had a cat go through this.

What litter did you use for you fluff ball when he first came home? Also, we are planning on confining him to my son's room as it gives him space for tray, food, water etc but away from our other two cats. What do you think? Or do you think we would be better with a puppy crate for him.

Also, my boy is terrible for taking tablets and has to have them crushed and mixed into a paste before syringing it into his mouth whilst he's on his back like a baby lol. Any advice here as I'm guessing he'll be coming home on plenty of mess.

Sorry for all the questions. It sounds as if you're boy is doing so well and I'm just wanting the same outcome x

 

[leeroy]

Well, he's had the surgery and all went well. Still waiting on a phone call to see how he was when he came out of the anaesthetic but he's been under before so no too worried (who am I kidding, I'm sick with worry lol).

What I am concerned about is the fact that they are looking to discharge him into my care on Wednesday, is this not a bit soon?

Also, what food should I feed him, the vet says he wouldn't block on wet but he's been on nothing but wet food for about 4 months now, watered down like soup but he still blocked so I'm at a loss now. Any suggestions would be good, I'm in the uk though so not as much choice.

 

[nerdrock]

Thank you so much for your insightful post. My baby Leeroy has now blocked three times and it's now the pu surgery or over the rainbow bridge. He is only 5 years old so I feel we should give him every chance of a full life. He is scheduled for the surgery on Monday and I'm so nervous for him. I just want to be there holding him and telling him how sorry I am to put him through all this.

If I can, I would like to retain you for info in future as I don't know of anyone personally who has had a cat go through this.

 

[leeroy]

Well, he came home just 24 hours after the surgery, very small incision site and he's full of beans. Trying to keep him rested is certainly a challenge as whenever anyone goes in to the room he goes crazy, purring and jumping around for loving lol.

He goes back tomorrow for a check up and then in another 1.5 weeks for the stitches to come out. He's obviously been ill for quite some time as the vet had us put him on complete wet food back in March and said he should be eating 4 pouches a day, he would only eat 1.5 max. Well, now he can't get enough in him. He's on 3 pouches now and would probably eat more if he could but want to try and keep his weight down as this can contribute towards uti's.

Did some research and found that 2-3 doses a week of diluted apple cider vinegar (with mother) can keep the crystals at bay. Or, if they're already present and cat is having issues, just a few drops neat in their food can have the cat peeing normally again within hours. Also works if you put it on the scruff too.

How is your kitty now?

 

[goholistic]

Well, he came home just 24 hours after the surgery, very small incision site and he's full of beans. Trying to keep him rested is certainly a challenge as whenever anyone goes in to the room he goes crazy, purring and jumping around for loving lol.

He goes back tomorrow for a check up and then in another 1.5 weeks for the stitches to come out. He's obviously been ill for quite some time as the vet had us put him on complete wet food back in March and said he should be eating 4 pouches a day, he would only eat 1.5 max. Well, now he can't get enough in him. He's on 3 pouches now and would probably eat more if he could but want to try and keep his weight down as this can contribute towards uti's.

Did some research and found that 2-3 doses a week of diluted apple cider vinegar (with mother) can keep the crystals at bay. Or, if they're already present and cat is having issues, just a few drops neat in their food can have the cat peeing normally again within hours. Also works if you put it on the scruff too.

How is your kitty now?

That is GREAT news that your cat is frisky and eating a lot!!! 

Please do a little more research about ACV and ask your vet. ACV is very acidic and can alter the pH of a cat's urine, and sometimes not for the better. Not all alternative therapies are safe or effective, so please use caution when considering something like ACV.

 

[leeroy]

I've not started him on the AVC, I'm going to speak to the vet first. He's still doing really well and eating loads. He's not had any symptoms of cystitis as yet, I think because he is now eating as he should and with all the added water I give him there's no crystal build up. He's peeing like there's no tomorrow lol. I add about two tablespoons of water to every pouch of meat I give him and that seems to be doing the trick. Forgot to give him his pain meds tonight and he didn't appear to be needing them but gave them as soon as I remembered just in case.

 

[stewball]

What is done during this operation? I'm getting worried as I've got 2 little boys. My lotto never had problems.

 

[molldee]

My cat Buddha has had the PU surgery. He's had a history like your cat - recurrent blockages and week long stays at the vets. After his third time blocking, we all thought he was going to be fine, but he blocked again the very next day. So my vet recommended the surgery, which I agreed to. He had to stay at the hospital for several days, and he wasn't used to not sleeping with his mommy! I went in daily to coax him to sleep and pet and love him. When he first came home from the surgery he was very groggy and traumatized. He never liked going to the vet in the first place, so being forced to go to the vet and then get catheterized was very scary to him. He never stopped clinging onto me and slept like a baby in my arms at night.

A year later, he's doing perfectly fine! His sutures healed up nicely and you can hardly tell he's had surgery. I can only tell when he goes to the bathroom because he squats really low to pee, like he doesn't know where it's going to come out of. He's been a good boy throughout all of this, very clingy and loving. I've been feeding him Royal Canin Urinary SO wet food mixed with about a 1/3 cup of water. He doesn't mind the soupiness and laps it right up. From time to time, I give him Vet's Best Urinary tablets in his wet food. Soon I'm going to buy Cosequin for cats and give him that nightly because it's supposed to help his bladder. He did get a UTI or sterile cystitis (the vet couldn't tell which) and was given antibiotics and pain meds. He got over that really quickly, which is a blessing. I think he gets stressed out easily, especially from being traumatized at the vet so many times, so I use the Feliway plug-in. I also from time to time give him Pet Naturals Calming treats. They work like a charm!

It's important to keep his urine pH slightly acidic. I bought pH test strips on Amazon and test his urine once a week. He's at a steady 6-6.5 right now. Also, look for wet foods that have low phosphorus. There's a great chart on catinfo.org that lists all the low phosphorus wet foods.

 

[nerdrock]

I haven't been on much in a little while so I'm sorry about the late reply. I'm also very sorry to the lady that sent me a PM on here, because of work and other commitments, I stop in on my phone but I'm not logged in (phone won't leave me logged in). I'm very sorry that her cat passed away, I would like to avoid this in the future and would like to PM my personal email address to one of the regulars so that if something comes up with PU/FLUTD/UTI/whatever and they think I can be helpful then I can comment much earlier - I didn't see the lady's PM or her thread until over a month later and feel completely terrible about it. Is anyone willing to do this that's on here more often than myself?

Stewball - in short, the penis is removed, the urethra is made wider and shorter by rerouteing it closer to the anus (like a female cat). Depending on where the blockage is/was in the urethra and how many times they've blocked the surgery may or may not be successful. IT IS NOT A CURE ALL AND THE CAT SHOULD STILL BE KEPT ON A URINARY DIET. If they reblock after the surgery, sometimes there are no other options because of the amount of scar tissue, other times they can be recatheterized. With my boy, if he blocks again that's it, he cannot be recatheterized and will have to be euthanized. 

Molldee - I'm so glad your cat is doing great! Moww has been doing very well as well, although he has gotten extremely picky about the lltterbox - he will only use the one in the bathroom and won't urinate in it if the others have (we have three boxes through the house - 2 upstairs, 1 downstairs). The bathroom box is the one they all like the most, go figure, lol. He also prefers non-clumping litter. Moww is also on the Medi-Cal Urinary SO, he's on the dry because we had a lot of problems keeping weight on him with the wet. When he first came into the clinic he was just over 16lbs, he dropped to almost 8lbs just before the PU surgery and has now settled at a healthy weight of about 9lbs. I have all of my cats on the urinary food for convenience, but I'm considering adding in the Calm food to their diets as well (I'm going to write another post about this), we're running a urinalysis before I do this though and will continue to monitor for 6-12 months after if we do add it in (it's not an SO index food). We do give them canned Urinary SO and I also give them C/D (both flavours) and UR for variety. Moww was on Cosequin before the PU surgery, we stopped it shortly after though - he was on so many medications that we decided to eliminate that one (he was getting difficult to give them to and stopped eating his food with meds mixed in). Now that he is not on any meds, I will restart it if we decide to mix in the Calm food. I was using Feliway but we discontinued it (this will be in my next post as well). 

We use the PH test strips on one of our dogs that has urinary issues, but haven't figured out a way to do it with Moww yet - he likes privacy and I can't think of a way to get just his urine. 

 

[laura ochoa]

My Nicholas is in the hospital right now, his 3rd time blocking in 2 months. I believe they are considering the PU Surgery. I'm actually waiting for the phone call right now. He has been through enough. I am going to go ahead with this surgery. Thanks for your post.I would like to see those pictures you were talking about to help me prepare. I am very nervous and worried about my Nicholas. He means the world to me.

 

[molldee]

 
My Nicholas is in the hospital right now, his 3rd time blocking in 2 months. I believe they are considering the PU Surgery. I'm actually waiting for the phone call right now. He has been through enough. I am going to go ahead with this surgery. Thanks for your post.I would like to see those pictures you were talking about to help me prepare. I am very nervous and worried about my Nicholas. He means the world to me.

The surgery is considered for cats who continually block, like my Buddha. I'm guessing your vet thinks this is the way to go, because your cat has blocked more than 3 times in a short period of time. The surgery is scary, because there are complications, but luckily my Buddha came out well. It's been a year and about 6 months and he's completely back to normal except for when peeing (he pees a little to the side). Recovery takes about a couple months because they get traumatized from the vets and the surgery.

 

[laura ochoa]

Thanks for replying. Nicholas is having the surgery in the morning. I am a nervous wreck! I see him everyday since he has been there. I am hoping that I am helping him stay strong and he will get through this without any complications. I will keep you posted. Laura and Nicholas =^;^=

 

[nerdrock]

I'll see if I can find them, they were on my old cellphone that died but when I get home from work I'll see if I can pull them up and post them. 

 

[laura ochoa]

Well, you don't need to go through all that trouble. I was just wondering and wanted to compare to what my Nicholas now looks like after his surgery. 

Dr. Anderson did the procedure today, it went well without complications. He is resting quietly after pain medication and a small dose of tranquilizer. I will be there tomorrow and visit again. Hopefully he will get to come home at weeks end.