Post Pu Surgery

[PJBoy]

Hi everyone.

I have read countless threads on both this website and others, reading others describe their experiences with their cat recovering/going through the PU surgery. I've now decided I need to make a thread myself to hopefully get some answers from what I'm experiencing as I'm having a difficult time finding threads related to my exact issue with his recovery.

Last Thursday, 9 days ago, my sweet boy PJ had PU surgery after us rushing him into the vet due to straining among other issues. They sedated him and tried to use a catheter to unblock but unfortunately he was so severely blocked the catheter couldn't fit and the only option was to get the surgery. Luckily his surgery went well, the vet said they needed to make the widening a bit larger than usual but that was the only odd thing that happened. Since then, I've been running in and out of the vet with constant concerns. My concern at this moment is that since coming home from surgery, he has not once yet had a constant stream of urine come out. Although he is peeing which is GREAT compared to the alternative, he is peeing NON STOP. He goes to the litter box once a minute, sometimes multiple times in a minute, for hours at a time. It's literally constant, despite the hours in which he sleeps. He is generally peeing small amounts, sometimes none comes out but luckily he has for the most part been consisntely having at least a few drops of urine come out. My concern here is that it doesn't seem normal for him to be going in and out so often.. it seems as if that indicates some sort of pain? I've brought him to my vet twice because of this and I've received few answers. My vet is making it sound like this is very normal but on all threads I've read, if a cat is peeing post surgery they're generally peeing normal amounts. When PJ goes, it just drips out.. I just hope someone can give me some insight and answers onto whether their cat has experienced this and if this is infact a normal thing for him to experience. I don't know where to turn at this point, I want to trust my vet but I'm skeptical. I don't want my poor boy to be going in and out this often and never be able to pee normally. Does this get better with more time? hopefully someone can give me an answer. I haven't slept more than 2 hours since the surgery each night due to monitoring of his pee so heavily. Thanks for reading everyone.

 

[PJBoy]

I should also mention my boy is generally in high spirits and seems ok otherwise.. its hard to know since PJ is a very affectionate and loving boy. Just want to know if this going back and forth with little pee is normal!

 

[Furballsmom]

Hi! I don't know, --is this something where his muscles have to recover to function properly?
Hopefully someone with experience will weigh in for you

 

[FeebysOwner]

Hi. When you say the vet says PJ's current peeing behavior is common after PU surgery, was that by phone or an actual vet visit where he could look at PJ? If the vet hasn't seen him yet, isn't he about due to go back and get the sutures out? You could push the issue then, and it will also give the vet a chance to take a look.

I have heard that it is somewhat common for cats that go through PU to continue to get bladder infections as well as stone formation - as the surgery does not prevent this.

You've probably already done a ton of reading on PU, but here is an article that might be worthy of reading.
Perineal Urethostomy (PU), Blocked Cat, Bladder Stones, Animal Hospital, Ypsilanti

 

[Jem]

This is just an opinion...

Have you ever had a UTI? you know the sensation that you have to pee because it's all irritated and stuff but nothing but a few drops come out because your bladder is empty? That could be what's going on.
Has he had ANY full pees at all? Is he incontinent because they made the opening wider? He may need a medication to help tone his urinary muscles to help with proper control.

 

[PJBoy]

Thanks for your reply, everyone. FeebysOwner , I brought him into the vet with my concern, not done over the phone. He didn't check for anything and dismissed my concern. I then brought him to another vet to ask the same questions, and he said he is friends with my original vet and then just called my original vet and essentially regurgitated what my original vet said cause he didn't know.. And thanks for the link, I definitely have read that and tons of other stuff, I'm only concerned as everything I've read didn't really involve the same recovery that PJ seems to be experiencing.

Jem , Thanks for your response. I definitely think it could be a UTI, as the symptoms do line up and he is susceptible to them due to his surgery. I have ANOTHER appointment with ANOTHER vet today after 2 different vets not helping, so I hope this one will actually look at him enough to help find an answer. I can tell his is pain and suffering because of not being able to express his bladder properly.. I will also mention the medication to help with muscle control. Hope all goes well with this vet!!

 

[PJBoy]

Oh and Jem to answer your specific question, no, he hasn't had any large normal pees. Sometimes he sits and drips long enough for it to form small-medium sized puddles, but my concern is that he is not actually having a stream of urine come out and that he's straining so hard to get that small amount of pee to come out. I feel so bad for my poor boy.

 

[FeebysOwner]

Yowz. Hope this third vet is NOT a friend of the other two...

And, yes, your description would suggest another infection, which as I said, is common in PU cats. I am also wondering if the surgery itself could attribute to a new infection. When did he get off antibiotics after surgery?

 

[PJBoy]

FeebysOwner , I hope so too! I am bringing in the records I have of all treatment he has received thus far, therefor telling the vet I am here for a second opinion, not for them to just speak to my original vet and gain nothing yet again.

He was constipated for about 5-6 days , he hadn't gone while at the vet or once coming home, so was put onto laxatives and once those kicked in a few days ago, PJ began getting horrible runs that were constantly leaking into his wound. We brought him into the vet and the doctor said it was due to antibiotics and took him off of them (I believe this happened on Monday the 17th, 4 days after he came home.) But the doctor then gave him an antibiotic shot that apparently lasts 2 weeks, so he should still technically be on the antibiotic. I do hope it is something fixable like a UTI or another infection that just requires medication and isn't something more serious..

 

[FeebysOwner]

Good information! Thanks. I do know that one of Feeby's UTIs didn't respond to the antibiotic shot they gave her (because of the type of bacteria in the infection), so she had to put on a different antibiotic. So, if you get this new vet to do a urinalysis, make sure it includes a urine culture (usually 3 days for results) to make sure the antibiotic is right for the type of infection they find.

When do you have the appointment?

 

[PJBoy]

Good information! Thanks. I do know that one of Feeby's UTIs didn't respond to the antibiotic shot they gave her (because of the type of bacteria in the infection), so she had to put on a different antibiotic. So, if you get this new vet to do a urinalysis, make sure it includes a urine culture (usually 3 days for results) to make sure the antibiotic is right for the type of infection they find.

When do you have the appointment?

Thats great to know, thank you! I didn't consider that possibility and will make sure the vet does that if she does indeed do a urinalysis (which I will be asking for.) The appointment is in about an hour. Unfortunately I am stuck at work so my boyfriend will be bringing him in.. as the paranoid pet owner I am, I have a big list written out of things I want to be passed onto the vet...hehehe.

I am also entertaining the idea that possibly this straining and inability to pee properly is to do with his crystals? I was told after his surgery he had "numerous" crystals, although the surgery doesn't involve taking them out, I'm hoping theres not such a build up that thats what is causing this issue. Since he's on Royal Canin Urinary SO now, I'm hoping they will be peed out and disappear.. do you know if crystals can naturally disappear with a different diet or NEED to be removed surgically? I assume since my vet never told me that they need to be removed, and said it was ok that they were there, that there is no issues. But I just want to make sure as I'm not getting many answers elsewhere.

 

[lalagimp]

If he was given narcotic pain relief, the constipation was likely from that. Tommy would go every 2-3 days. He didn't like to right after surgery, but if he had be given buprenorphine, he wasn't going to go for 3-5 days. Then he strained so hard he vomited, still didn't poop, and eventually a half hour later, he pooped.

If your cat has urgency to keep doing small piddles in the box, then I'm not sure why no vet has recommended a short course of Prazosin while things readjust, considering they don't believe that there is a UTI involved.

Our PU recovery was pretty uneventful. February will be two years go. He was urinating one good stream every day since he had come home.

 

[Jem]

What medications does he currently have to take?

Although mine didn't get PU surgery, I do have experience with severe cystits. If his surgery was only 9 days ago, and they did find crystals, he probably still has quite a bit of inflammation in his bladder, tract, etc...
When my little one was recovering from his blockage, he needed to on 5 different medications to correct everything and was on (some of) them for almost a month.

 

[PJBoy]

If he was given narcotic pain relief, the constipation was likely from that. Tommy would go every 2-3 days. He didn't like to right after surgery, but if he had be given buprenorphine, he wasn't going to go for 3-5 days. Then he strained so hard he vomited, still didn't poop, and eventually a half hour later, he pooped.

If your cat has urgency to keep doing small piddles in the box, then I'm not sure why no vet has recommended a short course of Prazosin while things readjust, considering they don't believe that there is a UTI involved.

Our PU recovery was pretty uneventful. February will be two years go. He was urinating one good stream every day since he had come home.

That definitely may have been it, that sounds similar to PJ. Luckily he is now pooping fine, its sometimes quite wet, but at least he seems to be going regularly now.

And yes, putting him on Prazosin sounds like the right thing to do, hopefully it would help him control his muscles and be able to pee properly... I don't know why my first vet(s) didn't mention this either. :/ Today at the vet if they rule out any sort of infection I will be asking if that is something we can put him on.

Thanks for your input, and I'm so glad your kitty has had a successful recovery!

 

[FeebysOwner]

do you know if crystals can naturally disappear with a different diet or NEED to be removed surgically?

That all depends on their severity. Even with my female cat, her stones were so monumental that she had to have them surgically removed (8 years ago), and as since been on urinary care foods. However, I have heard other members talk about the foods dissolving crystals that are smaller. An ultrasound would likely be needed to determine the amount/size - maybe an x-ray, but I am not sure.

Also, lalagimp 's mention of pain killers - great cause of a lot of constipation not just in cats but people as well. I don't think the antibiotics should have been stopped early... Prazoin, as also mentioned by lalagimp might be another thing to mention.

 

[PJBoy]

That all depends on their severity. Even with my female cat, her stones were so monumental that she had to have them surgically removed (8 years ago), and as since been on urinary care foods. However, I have heard other members talk about the foods dissolving crystals that are smaller. An ultrasound would likely be needed to determine the amount/size - maybe an x-ray, but I am not sure.

Also, lalagimp 's mention of pain killers - great cause of a lot of constipation not just in cats but people as well. I don't think the antibiotics should have been stopped early... Prazoin, as also mentioned by lalagimp might be another thing to mention.

Oh ok! I have assumed since he never mentioned my cat needing surgery to remove them that he was ok, but maybe he is incorrect... Maybe he will get an x-ray today to help figure that out. I will definitely make sure it is brought up as an option again.

And, right?! I even mentioned how I thought it was more likely due to pain killers, and he still told me he needed to be taken off antibiotics. But he was then given a 2 week antibiotic shot so I hope that is working in place of the pills he was taken off of... I will definitely be getting my boyfriend who is bringing PJ in shortly to mention Prazoin if there is no infection (or maybe regardless).

 

[Jem]

do you know if crystals can naturally disappear with a different diet or NEED to be removed surgically?

One of my cats had struvite crystals, they cleared up just by switching his food. But we found that the RC SO was ineffective, the Hills Science Diet CD is what worked for him.

The SO foods work by increasing your cats thirst to get them to drink more, the theory is to keep things flushed, as we all know that most cats don't drink enough. I'm not sure if the SO actually dissolves crystals as well or just flushes them.

Where as the CD acidifies the urine to keep crystals from forming and dissolves existing crystals.

Cats naturally make acidic urine, and don't usually get enough moisture so both foods can work but as I said the SO did nothing for mine.

 

[PJBoy]

What medications does he currently have to take?

Although mine didn't get PU surgery, I do have experience with severe cystits. If his surgery was only 9 days ago, and they did find crystals, he probably still has quite a bit of inflammation in his bladder, tract, etc...
When my little one was recovering from his blockage, he needed to on 5 different medications to correct everything and was on (some of) them for almost a month.

Currently, he is taking only a probiotic called Fortiflora. When PJ was taken off his antibiotic pills (and then given an antibiotic shot) due to that apparently causing his overly wet stools, they gave him the probiotic to help with that. He is already done all of his previous medication, which included Meloxicam for pain for 5 days (which I found out through research can be very dangerous for cats..) Zeniquin for 5 days, and clavaseptin for the antibiotic (which he was taken off early and given a shot of Convenia instead).

I feel maybe he still needs to be on medication to sort out all of the inflammation and pain that as you mentioned he is probably experiencing due to crystals.. Hopefully the vet today will give us something to help with that.

 

[PJBoy]

One of my cats had struvite crystals, they cleared up just by switching his food. But we found that the RC SO was ineffective, the Hills Science Diet CD is what worked for him.

The SO foods work by increasing your cats thirst to get them to drink more, the theory is to keep things flushed, as we all know that most cats don't drink enough. I'm not sure if the SO actually dissolves crystals as well or just flushes them.

Where as the CD acidifies the urine to keep crystals from forming and dissolves existing crystals.

Cats naturally make acidic urine, and don't usually get enough moisture so both foods can work but as I said the SO did nothing for mine.

Thanks for all this info!! Maybe switching him onto Hills Science Diet CD will be more effective for him. I will give him a bit more time on Royal Canin (I just bought 24 cans :O) but if it does not help then switching onto CD may be a good option.

 

[Jem]

I re-read your whole thread, and I really think you should ask the vet about an anti-inflammatory. The fact that they couldn't catheter, the fact that they had to make the opening bigger than usual, the fact that he still has not had a "full" pee, the fact that he needed the surgery in the first place. I really think he has pretty bad cystitis.

Have you noticed at all if his "opening" twitches or spasms at all? Even if he's not trying to pee?
Along with the medication for muscle tone and control, you could also ask about a relaxant, he could be experiencing muscle spasms which would also impede his urination.