Seeking Feedback On Pu Surgery Related To Urethral Stricture.

meganandmoo

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I know I've been somewhat of a serial-poster these past couple weeks, but as the situation with our Moo continues to evolve, I have come to depend more and more on this community for insight and support.

In a very small nutshell, Moo blocked at the end of November, and has been on a slew of meds and in and out of the vet regularly. He is otherwise normal, but he is still only having small, frequent pees, and is dribbling urine constantly. He is not emptying his bladder fully, and that's a big concern.

Our vet spoke today with an internal medicine specialist, who feels pretty certain that Moo's issue is that there is scar tissue causing stricture in his urethra, preventing him from passing normal streams of urine.

We now have to look at our options very realistically, having spent $2,500 up to this point (most of it racked up on our credit card).

Option 1: Moo could have a stint inserted in his urethra by the specialist. It would remain there his whole life. This is the optimal prognosis, but it also costs $4,000, and quite frankly, is not even the tiniest bit within our means. Thus, we cannot choose this option.

Option 2: Moo could have a balloon inserted in his urethra and gradually blown up to try stretch the urethra open. Chances are more scar tissue would form following the procedure.

Option 3: I asked our vet if PU surgery could still be an option. Her advice is that certainly it's cheaper at $2K (a stretch, but we could probably manage it)...but, she can't guarantee it would 100% work, and that he wouldn't dribble or re-block following. Logistically speaking, this is the most viable option within our means, apart from euthanasia, which makes me absolutely sick to my stomach, but is a reality we now have to consider after over a month of money and stress invested into this situation. She said Moo's not really the typical candidate for PU, as he hasn't re-blocked, and can't really offer me any insight into what his odds are of a positive outcome following the surgery.

Which is why I'm coming here.

Considering our options, and the PU surgery being the most viable choice for us, I am really just looking for firsthand feedback on what kind of outcome to expect following the procedure, especially it being the "less ideal" option. Some have told me it's a customary procedure, no complications, and that life goes on beautifully after! Others have told me to expect a difficult and horrific recovery (I've read my share of accounts here and elsewhere), and that there were more complications that arose after.

We have a big choice to make here, because it boils down to the surgery, or a much harder choice that tears me up to think about...and I guess I'm worried about the possibility that we could spend $2K, and the harder of the choices could still wind up inevitable, with us having already gone past our means. We have already modified Moo's and our lifestyle to help him get better - food, environment, antidepressants - so we are aware that remaining committed to his wellness will help to ensure the procedure's potential success.

I know there are many posts here about personal experiences with PU, but any related the surgery being the result of scar tissue in the urethra, and what the outcomes were from that?

As always, community, thank you in advance for your help. I am so grateful.
 

Furballsmom

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Hi!
I don't recall if I posted for you previously, and he didn't have scar tissue problems but
if I may comment regarding surgery vs euthanasia, my boy had the pu surgery when he was about 2 and is now 13 and is doing well.
 

lalagimp

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Tommy blocked three times - the first from crystals and the second two were in the same week and were likely from cystitis.
I raised all my credit limits and said I can do one more round, or I have to put him down. Do I wait until the next blockage, and hope he stops blocking that last one, or do the surgery? I can't afford to keep treating this mystery. The professionals couldn't give me a solid answer on what his affliction was or how to stop it. I had already changed his diet, lowered his pH, and he was the perfect weight after dieting for four years.

Next month is two years since he had his last blockage and PU that week. He's a glamour story... no complications. He peed the very next day at the vet, came home that night, and has been peeing every day since. No dribbling. We treat his constipation he's had off and on for years since before, with a bit of miralax on his food throughout the day.

I asked my boyfriend in February of 2017 "What if this doesn't fix it? What if this happens again?" -
"Then we spent $2,400 to get x indeterminate amount of months with him after this point, and it's money well spent."
 
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meganandmoo

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Tommy blocked three times - the first from crystals and the second two were in the same week and were likely from cystitis.
I raised all my credit limits and said I can do one more round, or I have to put him down. Do I wait until the next blockage, and hope he stops blocking that last one, or do the surgery? I can't afford to keep treating this mystery. The professionals couldn't give me a solid answer on what his affliction was or how to stop it. I had already changed his diet, lowered his pH, and he was the perfect weight after dieting for four years.

Next month is two years since he had his last blockage and PU that week. He's a glamour story... no complications. He peed the very next day at the vet, came home that night, and has been peeing every day since. No dribbling. We treat his constipation he's had off and on for years since before, with a bit of miralax on his food throughout the day.

I asked my boyfriend in February of 2017 "What if this doesn't fix it? What if this happens again?" -
"Then we spent $2,400 to get x indeterminate amount of months with him after this point, and it's money well spent."
For the record, your account just put me into tears. I'm so very happy to hear the PU was a success for you, as your situation sounds very much like the deliberation we're going through currently. We rescued our boy last August, and he showed no signs of issues until his blockage this past November. I've been beating myself up: what could I have done different to prevent this? My husband assures me there's no value in the "what if's", but it's hard not to dwell in guilt.

Your question is the exact one we're asking ourselves right now, so it is so reassuring to hear your outcome was positive. I really appreciate the perspective of, "it's money well spent."

This has been such an emotionally difficult (and devastating) journey, and to be honest, I've been running on fumes since this began in November with the challenge of it all, so that certainly doesn't help one to see things groundedly. We keep thinking, if we just give him some more time, if we modify this and adjust that, he'll get better - we're now over a month with no real progress, and the vets are baffled (in fact, my vet feels so badly for me, she started to cry as I stood in my appointment yesterday shedding tears over our frustration). Part of me wants to just keep waiting (thinking he'll get better!), and another part of me wants to just bite the bullet on the surgery to make it all better, you know? It's especially tough because he is acting normal otherwise and not re-blocking, but the fact he's incontinent puts a strain on our household, and impacts his quality of life.

I think having the contrast dye procedure done will be helpful (in spite of the added cost) because if the vet can say, Yes, for certain his urethra is partially blocked," then we know for sure the surgery is a no-brainer choice. I'm planning to book that appointment when I see her this afternoon.

Thank you again, so much, for sharing your Tommy's success story - I truly appreciate it!
 
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meganandmoo

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Hi!
I don't recall if I posted for you previously, and he didn't have scar tissue problems but
if I may comment regarding surgery vs euthanasia, my boy had the pu surgery when he was about 2 and is now 13 and is doing well.
Thank you so much for this. We feel so helpless not knowing how to help him, or if the choice we make is the right one, and feeling the extreme financial strain of this experience, so it is indeed encouraging to hear your boy has had such remarkable success with the surgery.
 

Furballsmom

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You mentioned wondering how to help otherwise, and that you have made changes,
--has your vet said anything about canned food, water fountains, filtered water etc?
 
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meganandmoo

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You mentioned wondering how to help otherwise, and that you have made changes,
--has your vet said anything about canned food, water fountains, filtered water etc?
Yeah, Moo has been on a Royal Canin Urinary Care SO diet since the initial blockage - wet only, no dry whatsoever. We did try transitioning him to raw, but that's what appears to have caused our visit to the emergency vet this past weekend (feared it was a blockage, turns out it was gastrointestinal). We are adding water to his meals - we've also been doing D-Mannose (although his urine was confirmed sterile), a urinary care supplement, Rescue Remedy, CBD oil, glucosamine, Feliway filter - as soon as I've read about and research something that works, we've incorporated it to help giving him a fighting chance.

Unfortunately I haven't observed Moo drinking out of his water bowl, and we deliberated a fountain, but he's never been fussy about water previously, so we haven't purchased one yet - but we have been adding the water to his meals to compensate.

We'd really hoped with all the changes we've made, we'd see some progress, so it's frustrating to wind up here - but, if the issue is indeed urethral stricture (which we should know for sure by Friday when we have the contrast dye procedure one), then that would certainly explain his inability to empty his bladder (he expressed a ton of urine when she palpitated him last night, and then again today).
 

reba

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My cat had PU surgery last Friday. It's funny before you try and make a decision you see all the threads about how successful it was and when you're on the other side all I seem to find is the one's with problems. So it's nice to read Tommy's story. I tried to find out what the life expectancy was after the surgery, I think I found one article that said 2-3 years. As I've said before, it's astounding the dearth of research on this given that every single vet in the country knows it's a problem.
 

lalagimp

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My cat had PU surgery last Friday. It's funny before you try and make a decision you see all the threads about how successful it was and when you're on the other side all I seem to find is the one's with problems. So it's nice to read Tommy's story. I tried to find out what the life expectancy was after the surgery, I think I found one article that said 2-3 years. As I've said before, it's astounding the dearth of research on this given that every single vet in the country knows it's a problem.
He's fine from that, three years later.
Now he's hyperthyroid. We just finished week #4. When we do week #6 I hope the vet says he can do I-131.
Everything I read is always a 3 year expectancy. They say that after hyper, too. Either heart failure or kidney issues. His kidneys are testing fine and his cardiac levels were huge, but would need to be twice as high for CHF. His liver is almost recovered. I don't think we're going to get the heart murmur to disappear but whatevs, I guess. He's turning 11 around May.
 

reba

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How did you know he was hyperthyroid?
I honestly was hoping it would be longer. He's only 6. I wonder why it reduces their life expectancy so much. My sister's cats lived 20 years. I bottle fed these kittens so I wonder if that's why they aren't so robust. All have had IBD problems.
 

lalagimp

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Because I couldn't manage his symptoms. It looked like IBD issues, only not. I scheduled his appointment, wrote down all the electronic notes I could find, and saw that he had not been okay since August. We hadn't realized how much we were feeding him either, for him not to be gaining. He kept vomiting loose hair at 2 am several times a week. He had his labs come back as hyperthyroid with elevated liver and heart. Today his labs said he's too low on his T4 value, so we're the other direction. We are trying to get his I-131 treatment because this is stupid.
 

shadowsrescue

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My cat did not have an easy time with his PU surgery. Yet it did save his life. The recovery was hard. We were back to the ER vet 3x after being released. He needed constant monitoring as he hated the cone. He was a magician at getting it off. It took a full 3 weeks for recovery. It was a rough time.

He then did well for 2 years. Unfortunately he blocked again last year in April. This was due to anti anxiety meds that caused urinary retention. He was back to the ER for days. Once the anti anxiety meds left his body he was able to urinate again.

It is still a day to day monitoring. He is on d mannose as needed and corn silk 2-3x a day. I also give Cosequin daily. He does not drink water and didn't like the fountain. I add extra water to his all canned food diet each day. I also have found that he loves to lick the empty cat food can. I then add more water to this and he gets plenty of water.

I have wireless cameras on all my litter boxes. I have 5 other cats so I have to be sure he is going each day. He is a daily worry. Yet he is young ( 6 now) and I would not give up on him.

PU can be a life saver. My boy would have died without it. Some cats just breeze through recovery. My boy is anxious and being at the ER vet for almost a week about did him in. Once home we had to go back 3x and each trip was harder and harder on him. Pain meds are so necessary. When he was somewhat sedated from them, he was much happier. I missed interacting with him, but it was rest he needed.

Even though my cat had a hard time ( and me too!). I would do it all over again.
 
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