Need Advice on PU Surgery Wound

[silent meowlook]

I wonder why that isn’t healing. I have to wonder if there isn’t something else going on that is affecting wound healing. I am sure you are careful about it and watch him, but do you think he could be rubbing that area on something to continue to traumatize the area? I once saw a cat use the edge of his e cone to remove a u catheter.

He is doing ok other than the wound and depression from wearing the cone?He isn’t diabetic right?

There is an over the counter product called Vetrosyn. I have heard people say they have wonderful results with it. I don’t know for sure, since I haven’t used it myself.

There are no sutures left there right? Hard to see in the picture. When he urinates is it getting on the wound? I am just grasping at straws trying to figure out why this hasn’t healed in this amount of time.

 

[Furballsmom]

I admittedly haven't read through your entire thread so I apologize if this has been mentioned already, but do you have home-visit veterinarians in your area?

 

[fionasmom]

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.

I posted that because sometimes these doctors know of someone in your area who may not be found easily online. They can't reasonably expect you to show up in Los Angeles, so might be helpful if they know of someone else. Please let us know how this all turns out.

 

[MoMoMeow]

I wonder why that isn’t healing. I have to wonder if there isn’t something else going on that is affecting wound healing. I am sure you are careful about it and watch him, but do you think he could be rubbing that area on something to continue to traumatize the area? I once saw a cat use the edge of his e cone to remove a u catheter.

He is doing ok other than the wound and depression from wearing the cone?He isn’t diabetic right?

There is an over the counter product called Vetrosyn. I have heard people say they have wonderful results with it. I don’t know for sure, since I haven’t used it myself.

There are no sutures left there right? Hard to see in the picture. When he urinates is it getting on the wound? I am just grasping at straws trying to figure out why this hasn’t healed in this amount of time.

I'm in the same boat with the confusion. It's been months, he got his surgery on July 25. I just can't wrap my head around it.

To my knowledge he hasn't done anything to it besides the infrequent lick here and there when he gets the cone off - which is inevitable, he's too smart. He's a lazy cat naturally, so besides his short bursts of energy for playtime he just naps and lies around in the sun.

His last workup tests showed no diabetes, no abnormalities besides some anemia. But they said that the machine messed up and the next test was normal. His mood is otherwise normal. He eats alright and plays just fine.

Last procedure he had they got all the stitches out. He does get urine on the wound when he pees, not nearly as much after I switched his litterbox to a lower one though. I always give him a wipe and dab him dry gently after so it doesn't soak on there.

As for the Vetrosyn, I'll look into it and possibly give it a shot. I'm willing to try anything.

 

[MoMoMeow]

I admittedly haven't read through your entire thread so I apologize if this has been mentioned already, but do you have home-visit veterinarians in your area?

I'm not sure actually. I would have to look into this some more.

 

[MoMoMeow]

I posted that because sometimes these doctors know of someone in your area who may not be found easily online. They can't reasonably expect you to show up in Los Angeles, so might be helpful if they know of someone else. Please let us know how this all turns out.

Oh, I see. I hadn't thought of that. I'll try it out!

 

[silent meowlook]

Can you post more pictures of the entire surgical area. This is not where he is urinating out of is it? Just need a picture of everything. Trying to wrap my head around this. ( not literally!

 

[MoMoMeow]

Can you post more pictures of the entire surgical area. This is not where he is urinating out of is it? Just need a picture of everything. Trying to wrap my head around this. ( not literally!

No problem! Here are some more photos - I tried my best but he's super squirmy.

I labeled one of them - his urethra at the top is completely healed, but the vertical incision where they removed his genitals is what makes up the wound. So any red flesh is that unhealing part of the incision, the dark little hole with the blue arrow is where he pees from and is all good healing wise.

Note: He had just used the bathroom prior to these, so he's a bit unkempt as I was still in the process of cleaning him up. Two birds with one stone

 

[silent meowlook]

Thank you for the pictures.
I really don’t like the look of that at all. I don’t think there is anything you can put on that which will help and most things may hurt.
I am worried about the slightly purple tissue. I hope it isn’t going to go necrotic. I am also worried that maybe he has developed a urinary tract infection since last checked. Even so, swimming in swamp water,(being facetious) he should have still healed by now.

I think you need to have a polite but very serious and direct conversation with who ever did the surgery. This is a major complication that needs to be addressed by them. To continue to have you just wait and try this and that is not acceptable. Have they done a culture of that tissue? Even as an open wound it should have healed. There is a reason it hasn’t completely granulated in yet. They need to figure out what it is. Is it too much tension on the skin? Is it infection? Fungal? Necrosis starting? It is up to them to get answers, but this cannot just continue to be this way.

Just to clarify, you have done nothing wrong and have done everything in your power to help your cat. I am just kind of shocked that this hasn’t been fully addressed by the surgeon yet. It is a surgical complication.

 

[MoMoMeow]

Thank you for the pictures.
I really don’t like the look of that at all. I don’t think there is anything you can put on that which will help and most things may hurt.
I am worried about the slightly purple tissue. I hope it isn’t going to go necrotic. I am also worried that maybe he has developed a urinary tract infection since last checked. Even so, swimming in swamp water,(being facetious) he should have still healed by now.

I think you need to have a polite but very serious and direct conversation with who ever did the surgery. This is a major complication that needs to be addressed by them. To continue to have you just wait and try this and that is not acceptable. Have they done a culture of that tissue? Even as an open wound it should have healed. There is a reason it hasn’t completely granulated in yet. They need to figure out what it is. Is it too much tension on the skin? Is it infection? Fungal? Necrosis starting? It is up to them to get answers, but this cannot just continue to be this way.

Just to clarify, you have done nothing wrong and have done everything in your power to help your cat. I am just kind of shocked that this hasn’t been fully addressed by the surgeon yet. It is a surgical complication.

I appreciate the honesty, really, as I'm thinking more or less the same.

I'm not sure of the signs of flesh going necrotic, but I imagine there's probably an odor? I haven't smelled anything when I examine it. I did have a flashlight pointed towards the area to have more light there, but in the daylight the flesh is more of a raw meat kind of pink, or sometimes red. Maybe the lighting darkned some areas more? This is how it's looked even when he was going to the vet once or twice a week, and they didn't mention anything besides concerns of a staph infection I recently compared new photos to old ones and based on how damp the fur around it used to be constantly, I think it looked better nowadays. I won't rule out the possibility, though.

As for a possible UTI, the last time he had one he had classic signs. Frequent bathroom trips, blood in his urine, visible amd audible discomfort. Right now he's peeing on a strict schedule, at the same time everyday. The output is good as well.

He hasn't had a culture done on the wound, I was never offered one and I didn't know that was an avenue I could take actually.

I feel guilty about the surgeon I chose. Everything happened so quickly with the rapidfire emergency vet visits, and random but powerful flareups of the blood clots that blocked him. He couldn't even sleep because he was going to the bathroom every 5 seconds, and was living off gabapentin and antibiotics, and so at that point they were telling me that he needs the surgery ASAP.

I didn't have time to sit down and think and choose a surgeon, and my regular clinic (the one he got the surgery at) told me a doctor there could do it for a reasonable price in a good time frame, and I had to more or less choose between surgery by them or risk him having another block and most likely having to euthanize, because I had already spent close to 10k in E-vet bills and another just wasn't viable.

I've had him since he was a baby, and all I could think of was keeping him with me. I didn't want the way we part to be under such horrible circumstances, still at such a young age. He's only 8.

But now that all that is settled and he's back to his usual self, sans the wound, I regret choosing this surgeon wholeheartedly. She is completely vague, and comes across as difficult to talk to. She told me she doesn't know why it won't heal, and didn't even offer to look more in depth or brainstorm with me, I don't know. I was expecting different complications, the ones I had read up on in the short amount of time before his surgery date, but I never thought this could be one of them.

I'm not even sure how to communicate with this person, as I'm pretty introverted, or if I even want their help. Would it be better to find a different vet/specialist to work with that will actually try to find his issue, or should I attempt another go at getting through to his surgeon, as she was the original to perform it? I'm not sure what to do.

 

[Furballsmom]

Would it be better to find a different vet/specialist to work with that will actually try to find his issue

Not to jump in, but yes, I think so. I wouldn't spend any more time, since you've already tried communicating with her.

She told me she doesn't know why it won't heal, and didn't even offer to look more in depth

From what I'm reading, for whatever reason this current surgeon isn't vested in following up or following through.

 

[silent meowlook]

I’m sorry if I was to direct. When I read posts I feel for the cat and person involved and it gets personal for me. Sadly even writing I don’t have much of a filter and usually post before reading what I wrote.

if the area doesn’t look purple, or black, it most likely isn’t necrotic. And you are right, it would smell. So, let’s go with viable live tissue. I almost think infection would smell and I don’t really see infected looking tissue.

If all is healthy tissue, then why is it still open? It honestly looks like the way it is almost stretched looking, that it can’t close. In my experience a wound like that unable to remain closed on its own would have stents sewn In to keep it closed. Stents are tiny pieces of tubbing sewn along the edges of the wound forcing it to close.
I would think after all this time it would have granulated in, but it didn’t and that is a big question of why.

is it completely separate from the urethra?

I know you have spent a ton on him and that is frustrating. I do think a visit to a specialty hospital might be best because they may be able to look at it and say what’s wrong. I do fear it might be another surgery.

The above said, you also have to weigh in his mental health and the stress involved in all these visits.
Maybe, if you think there is improvement, you can try longer. I would think that keeping the area as dry as possible with as little interference as possible might help. In the photos it looks very wet. Usually things need to dry to heal.

If you have trouble with conversations with less than helpful people, I would do any communication with this vet through email. That way you can take your time to get your point across

Veterinarians have often become veterinarians because they don’t do well with people. If she knows there is a problem, chances are she will be defensive. So be careful to be kind in your wording. Speak more as a friend needing help than a person who’s best friend was wronged. Ask don’t demand if she is like you say. I am sure you will do fine.

Try sending her a picture and ask if it looks okay to her and go from there.

it is a complicated surgery. But you did the best you could for your cat and the bottom line is your cat is alive and fairly happy except for the e collar..

 

[IndyJones]

It could possably be turning into gangreen im not sure either way that purple tint and raw flesh look to it is concerning.

It almost looks like there is puss down there too. Urine is not that dark usualy. Kabuto sometimes steps in his pee (arthritis) and its not that brownish yellow. Only light yellow at best.

 

[MoMoMeow]

I’m sorry if I was to direct. When I read posts I feel for the cat and person involved and it gets personal for me. Sadly even writing I don’t have much of a filter and usually post before reading what I wrote.

if the area doesn’t look purple, or black, it most likely isn’t necrotic. And you are right, it would smell. So, let’s go with viable live tissue. I almost think infection would smell and I don’t really see infected looking tissue.

If all is healthy tissue, then why is it still open? It honestly looks like the way it is almost stretched looking, that it can’t close. In my experience a wound like that unable to remain closed on its own would have stents sewn In to keep it closed. Stents are tiny pieces of tubbing sewn along the edges of the wound forcing it to close.
I would think after all this time it would have granulated in, but it didn’t and that is a big question of why.

is it completely separate from the urethra?

I know you have spent a ton on him and that is frustrating. I do think a visit to a specialty hospital might be best because they may be able to look at it and say what’s wrong. I do fear it might be another surgery.

The above said, you also have to weigh in his mental health and the stress involved in all these visits.
Maybe, if you think there is improvement, you can try longer. I would think that keeping the area as dry as possible with as little interference as possible might help. In the photos it looks very wet. Usually things need to dry to heal.

If you have trouble with conversations with less than helpful people, I would do any communication with this vet through email. That way you can take your time to get your point across

Veterinarians have often become veterinarians because they don’t do well with people. If she knows there is a problem, chances are she will be defensive. So be careful to be kind in your wording. Speak more as a friend needing help than a person who’s best friend was wronged. Ask don’t demand if she is like you say. I am sure you will do fine.

Try sending her a picture and ask if it looks okay to her and go from there.

it is a complicated surgery. But you did the best you could for your cat and the bottom line is your cat is alive and fairly happy except for the e collar..

Thank you for your kind words, I really only want the best for him. No worries, I'm fine with no filtering, as I want to have honest opinions on a issue very few to no people seem to have had with this procedure in particular.

It has changed in time from that last visit, and looks as healthy as an open wound can be, it's just like stuck now. One of the vet's had told me that it wouldn't close as it healed and would stay open, due to how he had torn open his very first set of stitches. Another told me the flesh was granulated, but obviously that would've meant it would be healed by now, so I'm not sure what's the problem with it. There is no scar tissue whatsoever.

It looks to be separate from his urethra, at the least she told me that was healed so I believe her.

Yeah, I try to keep it as dry as he'll let me. He's so very defensive about that area now, it's sad to see basically the PTSD that all this has caused him. He shakes when he gets nervous enough about me having to hold him still to look at it, some of the time. I have to go very slow and reassure him it's just me. How he'll act with another potential vet visitand another procedure is daunting to think of.

I think I'll try to contact her one more time, through email, and try to communicate as you've said. If I get the same responses as last time or feel as though working with her won't be his best option, I'll go with a specialist.

Also, I did contact the Animal Rehab someone linked, but had to email as they were closed yesterday. If I don't hear back in the next day or so, I'll try to call to see if they know anyone closer to me.

Not to jump in, but yes, I think so. I wouldn't spend any more time, since you've already tried communicating with her.


From what I'm reading, for whatever reason this current surgeon isn't vested in following up or following through.

Feel free to share opinions, I desperately need them as I'm at a loss.

I think I'll try one more time to get answers, but mostly I feel the same. I'm still gathering potential specialists to contact, but I feel as though the inconsistency of behavior towards me and him isn't worth trying to work with/through anymore if that's all I'm going to get.

 

[MoMoMeow]

It could possably be turning into gangreen im not sure either way that purple tint and raw flesh look to it is concerning.

It almost looks like there is puss down there too. Urine is not that dark usualy. Kabuto sometimes steps in his pee (arthritis) and its not that brownish yellow. Only light yellow at best.

I'm not sure. Odor would be an indicator, and it smells like fur and cat to me when I test. Extreme discomfort would be another, I think, and he's as irritable as I would be if someone was prodding around at my wound.

I might try to post another picture, as I just checked him again and I believe the flashlight might've made the red parts seem darker than they are. It looks dark pink to me right now, no purple.

The brownish yellow you see is is the colloidal silver I'm currently trying out on him, it's a deep bronzy toned liquid I soak on the wound and sometimes it soaks onto his fur, I clean it up to the best of my ability and however long his patience runs. His coloring is very prone to staining on the white sections. His urine color is light yellow when it gets on his fur before I wipe him.

 

[silent meowlook]

Okay, why don’t we try not cleaning it or touching it for a week and see what happens. Anything you apply may be keeping it wet enough so that it doesn’t heal. Just try leaving it alone and see what happens.

 

[MoMoMeow]

Okay, why don’t we try not cleaning it or touching it for a week and see what happens. Anything you apply may be keeping it wet enough so that it doesn’t heal. Just try leaving it alone and see what happens.

I suppose I haven't tried this yet, besides when he was on the antibiotics. I can try it out and keep an eye on it.

 

[fionasmom]

I wonder if laser therapy would heal this. I think it is Class 3 lasers which are used for wounds; Class 4 are the incisional ones. Years ago the use of a laser was incredibly effective on the feet of one of my GSDs who had horribly abraded wounds from paralysis. However, I don't know if it would work in your case but it might be worth asking.
What is veterinary laser therapy?

I wonder if a veterinary dermatologist would be of any help?

The current vet is not working with you and she may have reached the extent of her ability to handle this. Even a different vet in a different practice might be of some help if you can't find the specialist that you probably do need.

You really have tried to do the right things for your cat and did not deserve these complications.

 

[IndyJones]

I wonder if laser therapy would heal this. I think it is Class 3 lasers which are used for wounds; Class 4 are the incisional ones. Years ago the use of a laser was incredibly effective on the feet of one of my GSDs who had horribly abraded wounds from paralysis. However, I don't know if it would work in your case but it might be worth asking.
What is veterinary laser therapy?

I wonder if a veterinary dermatologist would be of any help?

The current vet is not working with you and she may have reached the extent of her ability to handle this. Even a different vet in a different practice might be of some help if you can't find the specialist that you probably do need.

You really have tried to do the right things for your cat and did not deserve these complications.

At this point it probably needs some degree of debridement the tissue looks damaged to me. My grandmother had a scrape on her leg from the car door that would stay kind of red and not heal she had a psw nurse come and do that. I don't think laser therapy alone worked for her but ymmv.

 

[MoMoMeow]

I wonder if laser therapy would heal this. I think it is Class 3 lasers which are used for wounds; Class 4 are the incisional ones. Years ago the use of a laser was incredibly effective on the feet of one of my GSDs who had horribly abraded wounds from paralysis. However, I don't know if it would work in your case but it might be worth asking.
What is veterinary laser therapy?

I wonder if a veterinary dermatologist would be of any help?

The current vet is not working with you and she may have reached the extent of her ability to handle this. Even a different vet in a different practice might be of some help if you can't find the specialist that you probably do need.

You really have tried to do the right things for your cat and did not deserve these complications.

He's such a sweetheart, he really didn't deserve the hand dealt to him in life medical wise.

It's funny, I was actually wondering the same thing about the laser procedure. The only doubts I have is that the area is so delicate, I guess? All the stuff I read about this surgery made emphasis on how fragile the tissue there is, and how there isn't a lot to work with if complications arrive (i.e. probably needing a graft for correction, I guess.)

It's worth a shot to ask about, nonetheless.

I've never had to contact a vet dermatologist myself before, but my sister had gone to one for her large breed dog and said the pricing was way high up. I'm not sure if it'd be less for a small cat, I'll have to look around and see what facilities offer and if wound care specifically can be done from them near me.

I feel as though I'm going to end up going to a specialist, but I'm curious to hear what his original surgeon has to say in finality. I'll hear her out, and move on if I don't feel like it'll be his best option. Throughout the years even before he came along I've had extremely bad luck in finding practices that treat me and my animals with proper care. I've had to move on from each one I've found, and this has been the longest I've continued to go to a specific clinic, and even they have their ups and downs.

I did find another cat only clinic, though it's pretty far from me. I think the doctors and staff there sound alright, and if I can't find a specialist I might jump the gun and see if they'll help him.

At this point it probably needs some degree of debridement the tissue looks damaged to me. My grandmother had a scrape on her leg from the car door that would stay kind of red and not heal she had a psw nurse come and do that. I don't think laser therapy alone worked for her but ymmv.

Debriment has also crossed my mind, but as I said before, the area is very delicate apparently. I have to get a vet's opinion to know for sure whether or not this is an option.