Post PU Surgery Worries

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RoxieHeart

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Oh yeah, and his poop is looking better than it ever has with this new moisture-centric mindset, by the way! He used to get a little constipated from time to time so it's a double win for this household. ♡
 

Kira85

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I’m ever so pleased he’s healing perfectly ❤ what a journey you’ve been through and it’s almost coming to an end.

Things are good this end overall. He’s using the litter box perfectly, adjusted to his new diet and back to his mischievous self! My only concern is that we’ve still got the cone on unfortunately. Soon as we remove it, he aggressively licks the area and it starts to bleed again. I spoke to the vet and they said to wean him off slowly and eventually he will be less interested in the area. Today I let him have his cone off supervised. He went and hid in the cat tree tunnel and licked it again in a split second. He made it bleed and now I feel so deflated and frustrated….argh! 😫

I will post a picture now of what he currently looks like down there. Sorry if anyone is squeamish.
 

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fionasmom

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It does look as if it is really healing up! If he is aggressively licking, I would do what the vet says. If it were just "checking", it would be a different story. But you should see a decline in licking as it has been slightly over a month.
 

Kira85

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Thank you for your reply. Yep, he’s healing beautifully. The urethra is slightly exposed and pinkish, that’s the area he dives for first. I’ve definitely learnt my lesson not to let him out of my sight now.
 

fionasmom

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Please keep us posted. There certainly might be some irritation there that is minor but enough to bother him.
 
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RoxieHeart

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Figured I'd come back in here now that I know for sure what's been going on. It has been a trying, exhausting, and emotional journey that still isn't over. So the UTI went away for about 3 days, then came back with gusto. He was peeing a ton in small bits again, vocalizing, even pooping seemed to be painful just because it would mess with the neighboring urethra (as a human that had chronic UTIs for a while, relatable.)

So we take him in, they come back in with a test tube that looks bloody, like the urine was just like if you'd put a few drops of red food coloring into it. She says it might be resistant and recommended a culture and discouraged against antibiotics until we hear back. My poor lil baby gets sent home with some gabapentin. They offered the choice of buprenorphine again or gabapentin but as someone who's worked in pharmacy and seen him go absolutely bonkers with a fever on buprenorphine I figured the calming effects of gabapentin would be more productive in his comfort. Silver lining, it does seem to help him a lot. He's been a lot more relaxed and cuddly with smaller bouts of pain since, and I was reassured that he's perfectly hydrated. Yay. Thanks for that advice by the way, the fact that I've done everything I humanly can as an owner in the face of all of this is so reassuring and that wouldn't be the case without you all recommending a fountain and to probably get him on wet food.

So it's been about a week, culture came back and it's resistant to ALMOST EVERYTHING. I have a personal theory that giving him the injectable kind as the first try is probably why this is happening. I've done a lot of anxiety reading on how you probably should be doing less crazy antibiotics first because this one can make things resistant to it and other classes if it doesn't clear the infection. Sigh. But this doesn't change the past, so I'm just hitting the ground running and focusing on just getting this boy BETTER.

They said the culture did at least react to a couple things, however. One was something they don't have access to anymore, the other is one they have to special order since it's generally not used because it's dangerous to humans. Goodness gracious. It was my husband on the phone so I don't know the name of it, but it's a liquid I'm going to need to wear gloves to give to him every day for 3 weeks.

I'm just fighting for this sweet baby's life and I'm so tired, but I can't give up and I won't. I'll keep you guys posted on how everything goes once the medicine arrives.
 

fionasmom

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Thank you for letting us know; I am sorry that you have had such an issue with the infection and that your poor boy has had to go through all of this.

You are right that you can only start from here and you were not to know that the previous antibiotic use was not going to be successful. Is the gabapentin still keeping him comfortable while you wait for the antibiotic?
 
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RoxieHeart

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As comfortable as he can be. I'll take him seeming relaxed and cozy for parts of the day rather than none at all, but it's also heartbreaking when it's clear that it's worn off a bit and he's just pacing and meowing. :( He's already on 100mg twice a day though (he's very large built 15 lb cat) so this is the best we can do. I just have to exhale, breathe, be grateful that it responded to anything at all, and hope that this is the course that finally gets him recovered and back to his old self. They did say that if this somehow doesn't work that it isn't end of the road though, we'd just have to take him to a specialist. So that's what I'm holding on to for now.
 
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RoxieHeart

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Calling the vet today to double check on when he needs to be checked up on (this was the oooonly antibiotic that the infection responded to so I'm extra hecking nervous about it getting resistant to this too) but I figured I could at least give some more updates. He is seemingly feeling better, albeit he still has these little pees all over his litter box. He also knows the exact times I give him his apparently awful tasting liquid medicine. Pharmacy said it's chicken flavored and I believe them, but this stuff is probably really bitter because I have to scoop him up and put him in the office where he gets his food cause he knows it's coming and really really hates it. He is such a good baby tho, he'll gobble up the gabapentin mixed in some wet food right after and eats a bunch of his normal food after that just fine. This morning he even hopped up into my lap and just purred and purred just a few minutes after before he fell asleep from pets. :') I have no idea what I've done to deserve such a loving and understanding cat, but I'm grateful this stuff isn't ruining our relationship and super crossing my fingers that it works.
 

fionasmom

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Flavored cat medication is still a work in progress. Thank you for the update and it is good to know that he is at least feeling a little better.
 

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Calling the vet today to double check on when he needs to be checked up on (this was the oooonly antibiotic that the infection responded to so I'm extra hecking nervous about it getting resistant to this too) but I figured I could at least give some more updates. He is seemingly feeling better, albeit he still has these little pees all over his litter box. He also knows the exact times I give him his apparently awful tasting liquid medicine. Pharmacy said it's chicken flavored and I believe them, but this stuff is probably really bitter because I have to scoop him up and put him in the office where he gets his food cause he knows it's coming and really really hates it. He is such a good baby tho, he'll gobble up the gabapentin mixed in some wet food right after and eats a bunch of his normal food after that just fine. This morning he even hopped up into my lap and just purred and purred just a few minutes after before he fell asleep from pets. :') I have no idea what I've done to deserve such a loving and understanding cat, but I'm grateful this stuff isn't ruining our relationship and super crossing my fingers that it works.
Its probably like flavoured buckley's tastes awful and it works. Even the flavoured kids medications still taste like medicine. Its all gross.

If you get the pills you can just pop it in their mouth and make them swallow by rubbing the neck or blowing in their muzzle.
 
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RoxieHeart

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I hear chloramphenicol is just awful in general; I fear having to taste the tablet would be even worse compared to the quick lil 0.5 ml squirt (I've gotten quite good at getting it in at least!) I did finally manage to call the vet Friday and it seems they want me to wait out the 3 weeks before another urinalysis and if he's still infected it's off to a specialty vet. To be quite honest I can tell he's starting to hurt again so I think I'm just going to take this into my own hands and get a second opinion from a cat specialist now rather than waiting for it to get awful again. I'm so exhausted and worried about having to make a hard decision. We have the funds to keep trying but like... What happens if the only antibiotic that the infection was sensitive to doesn't work? What can we possibly do?
 

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Hi. Going to a specialist sooner than later would be best. Not to sound like a jerk, but I will anyway. I am sure this infection could have been managed before he was given random antibiotics without a culture done to see what it would respond to.

This is something I have seen so many general practice vets do, and never have seen a specialist do. I’ve worked for both.

It is frustrating because allot of times, I think that the vets are trying to X-ray peoples pocketbooks ( so to speak), and just do whatever they may have found to work in some cases. I don’t know. But each time an antibiotic is used unsuccessfully there is more of a chance of a superbug forming. Do you know if this is a staph infection? Ask for a copy if you can.

Getting into the more hard core antibiotics, you might want to start some probiotics. Just start them gradually so as not to cause GI upset.

This is great that he is eating wet food and using the fountain. You really need to dilute all of this in the bladder.

You are doing great as his advocate and he would not be alive without you.

After some time, it’s different for each cat, they can become resistant, or build up a tolerance to the Gabapentin. When I worked at the cat hospital, we would increase the dose, so do ask your vet about that.

Regarding the Buprenorphine, it’s rare, but some cats develop hyperactivity and hyperthermia with opioids. Please make sure that any place new flags that on his file.
 
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RoxieHeart

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Not a jerk at all and thank you so much for the reassurance! If anything I agree with you completely, I've googled so much out of fear and panic and it's actually really validating to have someone who's worked in the field confirm what I thought the second I looked further into it: They never should have hecking skipped to that Convenia as a first try. I'm not any kind of college level but I worked as a pharmacy tech for 7 years and you learn enough second hand to know that antibiotic resistance is becoming so much of a problem, AND that some doctors can be really full of themselves despite being wrong. So the second I read up on that and resistant utis in cats and then had confirmed with the culture (after round 2 of Convenia, nonetheless!) that his infection is EXTREMELY resistant I got kind of mad.

I also heard that this particular antibiotic usually means getting kitty's blood checked from time to time? So the way they kind of brushed me off on the phone and said to just wait out and see also really like, mm, like at the risk of TMI I'm really glad I had therapy that day because it really does feel like I've been gaslit about the severity of everything for a long time (off this site at least, you guys have been so real and I appreciate all of the support. I mean it.) They are a great, caring office, but I swear every horror story about needing to go get a second opinion seems to be coming true right now. Blugh.

Probiotics sound like a great idea, and I will absolutely ask if I can get a copy of the culture papers when I go buy more of his wet food. Also thanks for the tip on making sure they know about his wild buprenorphine reactions!

I'm gonna keep fighting, and you've definitely given me some confidence to get the ball rolling sooner than later. Thank goodness I live in a city where there's 3 cat specialists within 30 minutes of me.
 
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RoxieHeart

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Got all of his paperwork and the pharmacy refilled his antibiotic course in little individual doses this time since the bottle was being too cumbersome to get a reasonable dose without having to try 10 times. Glad I asked where his normal vet was wanting to refer me to, since even when I first called the cat vet I'd been eyeballing since last month, turns out they too would simply culture and refer me to the same place! Bit of an edit of my earlier post in that regard, he's getting like, *specialist* specialist care at a Blue Pearl location that's about 25 minutes away. The places I was looking at before seem to just be cat-centric vets that at least in hindsight might have picked up on doing something different sooner than now, but no use crying over spilt milk. Looking at the actual specialty clinic's website it seems like they have a lot of equipment and diagnostic stuff that I haven't ever seen in regards to pets so I'm hoping this will give us an actual plan of action. Waiting for the scheduler to call me back but it's been an emotionally exhausting day. Thanks again for the confidence boost, he's already starting to vocalize a lot again so if I'd procrastinated at all I think we'd be in worse sorts. :(
 
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RoxieHeart

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OH right and I can look at the culture paper now, looks like it's Enterococcus to answer your question about if it's staph or not. He did seem to be feeling so much better for a while there, crossing my fingers we can figure out what's causing this.
 
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RoxieHeart

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So I get lab results tomorrow but I gotta say it is so relieving to finally talk to someone who isn't just like "Well let's try antibiotics again lol" They shaved a rectangle across his belly for an ultrasound and nothing came up there, so fears of cancer or something life threatening are gratefully gone. Most of the talk was about potentially hyperthyroidism or just that his anxiety is really high and the measures we need to take to calm him down; likely kitty Prozac. I'll let you all know what the blood & urine culture says tomorrow. It's like night and day, the anxiety is mostly gone now that I know they're actually trying everything.
 

silent meowlook

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So I get lab results tomorrow but I gotta say it is so relieving to finally talk to someone who isn't just like "Well let's try antibiotics again lol" They shaved a rectangle across his belly for an ultrasound and nothing came up there, so fears of cancer or something life threatening are gratefully gone. Most of the talk was about potentially hyperthyroidism or just that his anxiety is really high and the measures we need to take to calm him down; likely kitty Prozac. I'll let you all know what the blood & urine culture says tomorrow. It's like night and day, the anxiety is mostly gone now that I know they're actually trying everything.
So happy to read this. You have to advocate for your cats or they just don’t get the help they do desperately need.

Good job getting him help.
 
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