Our experience with PU surgery recovery with one year update
Background
Our 9-year-old Persian Rescue cat exhibited little to no symptoms of urinary crystals until he was completely blocked and had to be rushed to the vet for emergency catheterization. The only symptom may have been some smaller urine clumps in the litter boxes, but we have 5 cats and one of them weighs only 4 pounds, so I didn’t think much.
The month following the blockage was a nightmare. The cat (Guido) never fully regained his ability to urinate even though his bloodwork indicated that his kidney function returned to normal. Some days were better than others but mostly he struggled. He was eating, but emptying his bladder took about an hour – multiple litter pan visits producing dime sized urine clumps. Each time, he would lick and often cried and hissed. To add to the problem, the straining was causing diarrhea which was worrisome since our goal was to keep him well-hydrated. It was heart breaking to watch him struggle so much.
In the beginning, the vet suspected that the trauma caused by the catheter was causing pain and that we just had to wait until he felt comfortable enough to urinate. Our vet tried everything. We switched all the cats to Royal Canin SO and started Guido on the wet SO. He was on muscle relaxers and eventually valium in addition to steroids. We had to take him to the vet twice in 3 weeks for the 3-day pain block and even more times for hydration. After 3 weeks, our vet explained that we were running out of options and suggested surgery. He provided the names of three specialists.
Fortunately, our regular vet knows his limitations and suggested a surgeon. This is very specialized MAJOR surgery and I am glad that we chose a highly credentialed doctor who is board certified. We had to travel 25 miles, but it was well worth it to have a surgeon who performed this surgery regularly and was very confident of a positive outcome.
We met with the surgeon and he was confident that Guido was a good surgery candidate. He explained that he often did the surgery on highly compromised cats – cats that had suffered months of catheterizations and trauma.
Surgery
Surgery was on a Friday and they released him on Saturday. He was on the 3-day pain block, but he was still prescribed 5 days of pain pills (2x per day) and 7 days of antibiotics (liquid – 2x per day). Although the surgery went well he did not do well in the hospital. He would not eat and would not use the litter pan. They eventually released him because he peed on his blanket and peed on his pee pad.
Post-Surgery
We have a large master bath and opted to place him in there. They explained that he needed to be in a quiet area where he could rest, isolated from the other cats and that he was not to jump or move around a lot. We put a large pillow on the floor and covered it with a blanket and white towels. The white towels were perfect – we could see if there was blood (and there was) and could bleach them every day.
As expected, he was disoriented and confused for the first couple of hours at home. He didn’t seem to be in any pain. He calmed down after about an hour and ate and peed in the litter pan. They warned us not to remove his soft collar for two weeks unless he was under supervision. It was sad watching him bang into the walls and trying to drink from his water bowl but he figured it out by Day #3,
His incision and bruising were a bit shocking. They shaved his butt and the back of his legs and there was bruising in both areas. The incision was about 2” -2 ½”. The bruising was completely gone by Day #7 with just a couple of faint spots.
Litter – We were told that our normal clumping litter could stick to his incision and that we should use “Yesterday’s News” cat litter. It was awful and Guido hated it (this is what he wouldn’t use at the hospital). The pellets are huge, dark and absorbent. I had no idea whether he was peeing or how much. I researched online and found that Hartz makes a paper clumping litter. We rushed out on his second day home to buy it. It was PERFECT– the pellets are white and turn into blue clumps with urine. I could see exactly what he was producing and whether there was blood. Guido hated the Hartz litter – the pellets are large and it probably felt like stepping on stones but it was exactly what we needed. The Hartz litter is rather expensive but it lasts forever because you just replace what you take out.
Litter Pan
Guido could not figure out how to manipulate his soft collar to get into the litter pan with the soft collar. At first, I looked for a manufactured litter pan that had a “U” shaped front. I wound up cutting a “U” in the front of the litter pan of an existing litter pan and covered the sharp edges with duct tape. He was much more comfortable going in and out.
Post Surgery – Days 2-7
In the beginning (for the first 5 days) he was holding his urine and only peed twice a day (which was worrisome). He was not straining to pee and was producing a healthy stream of urine. He finally started urinating normally (2-3 times a day) on Day #6.
His surgery was on Friday and he did not have a bowel movement until Tuesday evening. I called the vet earlier that day and they suggested that I add pumpkin. I was surprised that he ate it, but I don’t think it had any effect on his bowel movement later that day.
Day #5 – I happened to be in the room when he peed and had his second post-surgery bowel movement. To my horror, his bottom was bloody – bright red. I called the vet and they asked us to bring him in. The attending vet said that the area looked good but called the surgeon for his opinion. The surgeon asked us to bring him in the following day. Fortunately, the surgeon said that everything looked great and suspected that the straining to defecate probably caused a scab to fall off.
Day #6 – he finished his last day of pain meds and seemed uncomfortable. This was the day of the visit to the surgeon so the long car ride didn’t help. This was also the day that he started peeing more than twice a day and having a daily bowel movement.
Day #8 – Bruising almost gone and the final day of antibiotics
Days #9 - #14 – Our routine was well established. We faithfully kept his collar on and kept him isolated from the other cats. The vet’s office explicitly said that he wasn’t supposed to be around the other cats. They said that he wasn’t supposed to be jumping or running around. It was hard to keep him isolated as he felt better but we knew it was in his best interest.
Day #14 – His final vet visit for this whole nightmare and he was given the “all-clear”. He still had clearly visible stitches and some scabbing, but the vet said that the collar could come off and he could move about freely.
Day #14 and beyond
We are very happy that we made the decision to have the surgery. It took Guido a few days to get back into the household routine, but he started to thrive. I called the vet and it was a relief that he said I didn’t need to bring him into the office unless there were issues.
One Year Update:
Guido had his one year follow up last week. He is doing wonderful. There were no complications or infections in the last year. The only “damage” was to our budget. His weight is perfect, and he is thriving. All of our cats now only eat Royal Canin Veterinary Diet Urinary SO Dry Cat Food. We order the 17-pound bags from Chewy. We also order the Royal Canin Veterinary Diet Urinary Feline Cat Treats. I still feed them one small can of Fancy Feast (split between 3 of them) per day. I add hot water to make “gravy” (which is the only thing they actually eat). I know there is some controversy about this food, but all of our cats are doing fantastic with no health issues. Their weight is fine and they are all in perfect health.
In summary - we are very happy we opted for Guido's surgery with a board certified specialist. I have a coworker who's cat has urinary blockages. She has not opted for the surgery (her cat has never been fully blocked) and has probably spent more money over the last year with vet visits to address blockages. She constantly worries about his health and dreads the potential cost of an off hours emergency visit to the vet. Our life with our cats has returned to normal. The fact that Guido is a happy, healthy cat and we don't stress over his health now is worth all of last year's expenses.
Background
Our 9-year-old Persian Rescue cat exhibited little to no symptoms of urinary crystals until he was completely blocked and had to be rushed to the vet for emergency catheterization. The only symptom may have been some smaller urine clumps in the litter boxes, but we have 5 cats and one of them weighs only 4 pounds, so I didn’t think much.
The month following the blockage was a nightmare. The cat (Guido) never fully regained his ability to urinate even though his bloodwork indicated that his kidney function returned to normal. Some days were better than others but mostly he struggled. He was eating, but emptying his bladder took about an hour – multiple litter pan visits producing dime sized urine clumps. Each time, he would lick and often cried and hissed. To add to the problem, the straining was causing diarrhea which was worrisome since our goal was to keep him well-hydrated. It was heart breaking to watch him struggle so much.
In the beginning, the vet suspected that the trauma caused by the catheter was causing pain and that we just had to wait until he felt comfortable enough to urinate. Our vet tried everything. We switched all the cats to Royal Canin SO and started Guido on the wet SO. He was on muscle relaxers and eventually valium in addition to steroids. We had to take him to the vet twice in 3 weeks for the 3-day pain block and even more times for hydration. After 3 weeks, our vet explained that we were running out of options and suggested surgery. He provided the names of three specialists.
Fortunately, our regular vet knows his limitations and suggested a surgeon. This is very specialized MAJOR surgery and I am glad that we chose a highly credentialed doctor who is board certified. We had to travel 25 miles, but it was well worth it to have a surgeon who performed this surgery regularly and was very confident of a positive outcome.
We met with the surgeon and he was confident that Guido was a good surgery candidate. He explained that he often did the surgery on highly compromised cats – cats that had suffered months of catheterizations and trauma.
Surgery
Surgery was on a Friday and they released him on Saturday. He was on the 3-day pain block, but he was still prescribed 5 days of pain pills (2x per day) and 7 days of antibiotics (liquid – 2x per day). Although the surgery went well he did not do well in the hospital. He would not eat and would not use the litter pan. They eventually released him because he peed on his blanket and peed on his pee pad.
Post-Surgery
We have a large master bath and opted to place him in there. They explained that he needed to be in a quiet area where he could rest, isolated from the other cats and that he was not to jump or move around a lot. We put a large pillow on the floor and covered it with a blanket and white towels. The white towels were perfect – we could see if there was blood (and there was) and could bleach them every day.
As expected, he was disoriented and confused for the first couple of hours at home. He didn’t seem to be in any pain. He calmed down after about an hour and ate and peed in the litter pan. They warned us not to remove his soft collar for two weeks unless he was under supervision. It was sad watching him bang into the walls and trying to drink from his water bowl but he figured it out by Day #3,
His incision and bruising were a bit shocking. They shaved his butt and the back of his legs and there was bruising in both areas. The incision was about 2” -2 ½”. The bruising was completely gone by Day #7 with just a couple of faint spots.
Litter – We were told that our normal clumping litter could stick to his incision and that we should use “Yesterday’s News” cat litter. It was awful and Guido hated it (this is what he wouldn’t use at the hospital). The pellets are huge, dark and absorbent. I had no idea whether he was peeing or how much. I researched online and found that Hartz makes a paper clumping litter. We rushed out on his second day home to buy it. It was PERFECT– the pellets are white and turn into blue clumps with urine. I could see exactly what he was producing and whether there was blood. Guido hated the Hartz litter – the pellets are large and it probably felt like stepping on stones but it was exactly what we needed. The Hartz litter is rather expensive but it lasts forever because you just replace what you take out.
Litter Pan
Guido could not figure out how to manipulate his soft collar to get into the litter pan with the soft collar. At first, I looked for a manufactured litter pan that had a “U” shaped front. I wound up cutting a “U” in the front of the litter pan of an existing litter pan and covered the sharp edges with duct tape. He was much more comfortable going in and out.
Post Surgery – Days 2-7
In the beginning (for the first 5 days) he was holding his urine and only peed twice a day (which was worrisome). He was not straining to pee and was producing a healthy stream of urine. He finally started urinating normally (2-3 times a day) on Day #6.
His surgery was on Friday and he did not have a bowel movement until Tuesday evening. I called the vet earlier that day and they suggested that I add pumpkin. I was surprised that he ate it, but I don’t think it had any effect on his bowel movement later that day.
Day #5 – I happened to be in the room when he peed and had his second post-surgery bowel movement. To my horror, his bottom was bloody – bright red. I called the vet and they asked us to bring him in. The attending vet said that the area looked good but called the surgeon for his opinion. The surgeon asked us to bring him in the following day. Fortunately, the surgeon said that everything looked great and suspected that the straining to defecate probably caused a scab to fall off.
Day #6 – he finished his last day of pain meds and seemed uncomfortable. This was the day of the visit to the surgeon so the long car ride didn’t help. This was also the day that he started peeing more than twice a day and having a daily bowel movement.
Day #8 – Bruising almost gone and the final day of antibiotics
Days #9 - #14 – Our routine was well established. We faithfully kept his collar on and kept him isolated from the other cats. The vet’s office explicitly said that he wasn’t supposed to be around the other cats. They said that he wasn’t supposed to be jumping or running around. It was hard to keep him isolated as he felt better but we knew it was in his best interest.
Day #14 – His final vet visit for this whole nightmare and he was given the “all-clear”. He still had clearly visible stitches and some scabbing, but the vet said that the collar could come off and he could move about freely.
Day #14 and beyond
We are very happy that we made the decision to have the surgery. It took Guido a few days to get back into the household routine, but he started to thrive. I called the vet and it was a relief that he said I didn’t need to bring him into the office unless there were issues.
One Year Update:
Guido had his one year follow up last week. He is doing wonderful. There were no complications or infections in the last year. The only “damage” was to our budget. His weight is perfect, and he is thriving. All of our cats now only eat Royal Canin Veterinary Diet Urinary SO Dry Cat Food. We order the 17-pound bags from Chewy. We also order the Royal Canin Veterinary Diet Urinary Feline Cat Treats. I still feed them one small can of Fancy Feast (split between 3 of them) per day. I add hot water to make “gravy” (which is the only thing they actually eat). I know there is some controversy about this food, but all of our cats are doing fantastic with no health issues. Their weight is fine and they are all in perfect health.
In summary - we are very happy we opted for Guido's surgery with a board certified specialist. I have a coworker who's cat has urinary blockages. She has not opted for the surgery (her cat has never been fully blocked) and has probably spent more money over the last year with vet visits to address blockages. She constantly worries about his health and dreads the potential cost of an off hours emergency visit to the vet. Our life with our cats has returned to normal. The fact that Guido is a happy, healthy cat and we don't stress over his health now is worth all of last year's expenses.
