Need Advice on PU Surgery Wound

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MoMoMeow

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Poor little guy has been through the ringer with this procedure. Hopefully this will be the end of it and he will heal properly now.
He really has. I'm going to be watching him like a hawk to make sure he doesn't get at these stitches and they stay put until the two weeks are up.
 

heatherwillard0614

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Yup! He still has his cone on. It won't be coming off until I get the all clear from the vet.
That's good. I hope little man heals well and fast please keep us posted. I feel bad he is going through this I wish he never had to have the surgery in the first place poor little guy. My love to him.
 
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MoMoMeow

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That's good. I hope little man heals well and fast please keep us posted. I feel bad he is going through this I wish he never had to have the surgery in the first place poor little guy. My love to him.
Yeah, it sucks that his issues led up to this, but he's been a little trooper. I'm extremely grateful that the constant blockages seem to have been alleviated. I'll update again soon for sure!
 
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MoMoMeow

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Update #3

It's been wild. So, initially he did well with not interfering with his stitches - but the other night, when he was unsupervised, he got the cone off and ripped them out (2/3). Escape artist strikes again.

Today I brought him to the vet for it, and to both the vet and my own pleasant surprise, the stitches and week of antibiotics have helped him form granulated tissue (scar tissue basically)! The wound isn't closed, it didn't fuse together like I had hoped, but instead it's beginning to heal openly as in my first pictures. At least it's healing, though. Finally.

As long as he keeps the cone on, and doesn't lick himself again (for the nth time) he'll be home free as it heals more. He also has more antibiotics as precaution against infection, and a recheck a week from now. For the most part, the wider cone I purchased has helped him leave the site alone, and the other night was actually the first time he tried to get it off even though he was successful with it.

Hopefully this exhausting journey is coming to an end and he can finally get some peace! I swear I've been to a vet every other week for five months straight o_O He used to be a nice guy to the vets but he's had enough and now needs three gabapentin tablets (50mg, he's a powerhouse) for them to even get near his site now.

Anyway, I attached a cute photo to celebrate granulated tissue! Yay!
 

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MoMoMeow

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Bad news.

His FIC is flaring up again. He's in and out of the box, and I can visibly see the massive chunk of mucus that is stuck inside his urethra. His vet is closed today and I don't know if I can afford another E-vet visit at the moment. He's passed large chunks of mucus after he had come home from surgery, so I don't know of I should just wait and see if this can come out - it looks very close to, I think.

What should I do? I'm at a loss.
 
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MoMoMeow

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He passed it, but I'm not sure what to do from here or if there will be more.

Here are pictures of the clots he gets, this is pretty small in comparison to ones he's passed before.
 

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fionasmom

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In #12 you mention mucus chunks as having been part of the blockages, if I am understanding correctly. Is he able to urinate? If there is any sign of discomfort, I would err on the side of going to the ER. Does he seem to feel better with the mucus passing or is he still agitated? I am really sorry that this has been such an ordeal for both of you.

I suppose that your vet is not reachable on the weekend, as most aren't? If the local ER is helpful, you might call them and ask what they would advise.
 

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Do you have any subcutaneous fluids at home? If I were you, I would call the ER where he was last seen and try to speak to a vet. They have your records there and should be able to advise you what to do next.

The hard part will be getting past the person answering the phone.
 
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MoMoMeow

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In #12 you mention mucus chunks as having been part of the blockages, if I am understanding correctly. Is he able to urinate? If there is any sign of discomfort, I would err on the side of going to the ER. Does he seem to feel better with the mucus passing or is he still agitated? I am really sorry that this has been such an ordeal for both of you.

I suppose that your vet is not reachable on the weekend, as most aren't? If the local ER is helpful, you might call them and ask what they would advise.
I've come to believe that his episodes of FIC are tied to his issues with IBD and or his EPI. Usually a flare up begins after he has a particularly difficult struggle with stool, diarrhea or constipation.

Yes, before the mucus chunk happened he passed a normal, large amount of urine, same as all the previous times before.

It's afterwards where he starts to struggle, because he keeps attempting to go to the litterbox and there's nothing really left in his bladder to pass. I was able to gently work the mucus out of his urethra because it's so open down there now, and I think that helped him because he only strained once more after that and then finally went to relax. I haven't seen any more mucus within the opening.

He is acting normal currently, has been napping and lazing around on his back in a comfortable/relaxed manner.

Fortunately, the E-vet I go to is very helpful and you can speak with a doctor for advice if asked, it's just the prices that they charge that are the issue at the moment. I've spent a lot of money these past few months, and though I really don't want to say it I'm afraid I won't be able to cover another bill of that magnitude.

If it's just a usual flare up like the others I'm hopeful that he'll be able to make it till tomorrow and I can call his regular vet for help. It's just very unfortunate that this is happening just as his wound is begining to heal - the irritation won't be any help at all.
 
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MoMoMeow

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Do you have any subcutaneous fluids at home? If I were you, I would call the ER where he was last seen and try to speak to a vet. They have your records there and should be able to advise you what to do next.

The hard part will be getting past the person answering the phone.
The E-vet I go to allows advice calls with the doctors there, and are very helpful. I don't have any subcutaneous fluids here, unfortunately. At the moment he seems calm, not in any discomfort like earlier, and hasn't gone back to the litterbox. If it starts happening again or more mucus shows up, I'll definitely have to give them a call. It's so disheartening that this poor guy can't seem to catch a break.
 

fionasmom

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A female cat, Graycie, had an FIC episode last year after a bout of constipation. Fortunately, she was treated and recovered.

I do understand what you mean about the cost of this level of emergency care and how much all of this has added up.
 
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MoMoMeow

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Yeah, I've noticed the correlation after the third time he relapsed. I try to manage the IBD and EPI as best I can, but it seems just random when he'll relapse from them.

Normally I would take him to the E-vet straight away, but I've been to doctors just about every other week and it's taking it's toll. Last time I went the emergency route, the doctor was kind enough to give me a discount on his medical care. One bill before the surgery was just shy of 6k. His regular vet has even waived some of his fees because they feel bad for him coming in so often.

He's my everything and I refuse to give up on him, but it's difficult at times to not get discouraged. This condition is relentless, and it breaks my heart to see him still having to go through this despite everything I've tried to alleviate it with.
 
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MoMoMeow

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Been a while since I posted here, but my boy is doing more or less okay now from the last post. Seems his flare up was caused from the extreme stress of a vet visit, and he hasn't had another since.

As for his wound, well, I wish I had better news to share.

It still isn't healed, even with the extra sutures and a cream I was given, as well as other forms of wound care aide. It has gotten smaller, a much more shallow, but that's all I can say about it. At the moment, he is still in a cone unless under supervision, because the wound bleeds everytime he licks it.

I've been meticulous about keeping it clean and dry, and there are no signs of infection and there hasn't been for a while.

I'm not sure what to do about the wound. His quality of life has taken a tumble with basically having to live in a cone and not being able to clean himself down there on his own, which is no way of living for a cat at all. I'm thinking maybe like a wound care specialist as a next step, but it's hard to find one, or I'm not looking correctly possibly.

I have to say, out of all the outcomes of this surgery I had researched and prepared for, the never healing wound was not one of them. It's a very difficult ordeal, for both him and myself.

(Edited:whoops, posted to wrong thread previously.)
 

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Can you post a picture? What kind of litter are you using? What is the name of the cream you are putting on it?
 

fionasmom

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I don't suppose that veterinary wound care specialists would be crawling out of the woodwork exactly, but you might find a few, or possibly some articles about very specific wound care. It might be possible for your vet to interface with a specialist, or a teaching hospital in order to get advice.

I googled "veterinary wound care specialists" and found some resources listed.

Wound CARE - California Animal Rehabilitation
This place is an example; it is in Los Angeles which is probably no help to you, but they do have satellite locations.
 
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MoMoMeow

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Can you post a picture? What kind of litter are you using? What is the name of the cream you are putting on it?
20231208_154703.jpg
20231208_154618.jpg

Here's a current look of the wound. Much shallower and narrow in real life, not sure if that can really be seen in the images. The red color isn't inflammation, that's just how it's always looked really, and the yellowing around the wound is staining from urine as he can't properly groom himself after using the box and he only lets me clean so much. The vet said his new urethra is completely healed, no stricture/shrinkage formed. So it's just that area being stubborn.

I use the paper pellet litter they recommend after surgery still, so nothing sticks to his fur or the wound itself, and because I'm a hypochondriac about his FIC, I scoop after every use of the box to measure his urine output. It's always clean for him.

I also keep the hair around the wound as short as he'll tolerate me trimming, and that's very difficult as he's really fed up/aggressive about the area being touched now. It's not infected, no discharge or odd smells, just tender on the red flesh parts.

As for the creams, last visit the vet gave me a silver sulfadiazine cream to apply, which is the time in which it got more shallow and narrow. I was told to continue for another week after the initial two because of the actual progress, but no more changes happened after that - and I noticed that during the treatment, he began to throw up randomly and seem very nauseous? His diet is as strict as I can make it because of his stomach issues, so I'm not sure of the cause, or if he had side effects from the cream.

Once that was over, I tried a few over the counter items people seem to have good success with for wounds of the same openness and depth. Manuka honey, I had read and tried, but that didn't do much besides maybe a slight change in the wound's depth? I tried it for two weeks like the sulfadiazine. The few pet wound gels that seemed safe didn't have any effect.

I've heard of some people using colloidal silver for stubborn wounds on here, and I looked into it some more, and decided it was worth a shot at this point - anything so that I never have to see his mood visibly plummet when I put the cone on him. I tested it on myself first, then on his arm for any adverse reactions before applying it to the wound itself. I'm a week and a half into it, but so far not much has changed. I'd like to state, there is absolutely no ingestion of it, I just soak it onto the fleshy wound bits 2 -3 times a day and keep him from licking there as usual.

I have to be very careful about the frequency of his vet visits now, as they seemingly trigger his really bad flare ups of FIC from stress. Happened twice. What's also bothered me about his usual vet is that they straight up told me they don't know why it won't heal, without much elaboration further. They're just, very vague, when I need information the most. They didn't give me much more insight at all in the last visit, or in emails/calls.

That's why I'm trying to do alternatives first. If the silver doesn't have any progress, my next step is probably a specialist vet. I'm trying to find one, but it's difficult. I want to make sure that if I have to put him through another episode of FIC, it's for a vet who will give me new insight on this issue and not kind of brush me off, I guess?

If anybody has any other alternatives they've tried or heard about for me to look into, please let me know. I'm desperate to get him healed up.
 
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MoMoMeow

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I don't suppose that veterinary wound care specialists would be crawling out of the woodwork exactly, but you might find a few, or possibly some articles about very specific wound care. It might be possible for your vet to interface with a specialist, or a teaching hospital in order to get advice.

I googled "veterinary wound care specialists" and found some resources listed.

Wound CARE - California Animal Rehabilitation
This place is an example; it is in Los Angeles which is probably no help to you, but they do have satellite locations.
Thanks for the info!

I'm not in L.A unfortunately. After a while, I have found one potential specialist at a place nearby, it says it in his Bio on their website, but I wanted to continue searching for at least two more people before making a decision since my boy is on thin ice with vet visits. Very stressful.
 
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