Two intestinal surgeries + abscess draining in the span of a week

gabicards

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I'll start off with a timeline of my cat's health issues in the past two weeks, to make it easier for you to understand:

26/11 - Threw up 4x in one morning. Rushed to the vet, who did a physical exam and noticed that Louie (my cat) felt discomfort when he touched a part of his intestines. He gave him a shot to stop the vomiting, another liquid medication I had to give him for 3x, and sent us home.
27/11 - I called the vet in the morning because Louie spent the previous 24hr refusing to eat or drink water, and he barely moved. He told me to go to the emergency, I did, and he had surgery for an intussusception that afternoon. Nothing was found inside him, and a piece of his intestines was cut.
28/11 - Recovery going well, but he had a fever.
29/11 - The emergency clinic called me, said his apetite was back and he was ready to come home. We were confused and asked if that was safe, they said yes, so we went. At the clinic, they explained to me that he had a small inflammation at the site of the surgery, saying it was normal, and told me I didn't need to keep him from moving around the apartment or jumping on the bed or on the couch ("you can pick him up and help him if he's hesitating"), and I could feed him normally. I needed to give him anti-acid medication (for humans), and two antibiotics.
30/11 - I called his regular vet again, he asked me to go over to his clinic so that he could see all the documents the emergency clinic had given me regarding his surgery. He read through them, explained what the intussusception was and that it could happen again, now that we know he might have a pre-disposition for it. He told me I could remove the cone from his head and put him in a onesie instead, so I did. He also told me not to offer his regular amount of food, because he wanted to avoid pressuring the internal sutures on his intestines.
30/11 - 03/12 - Louie didn't want to eat. He moved less and less throughout the week. I called his vet 4x, basically once a day, to ask if this behaviour was normal, and he wasn't concerned. I posted on this forum too because I was starting to panic.
04/11 - My friends and I learned how to take his temperature, it was at 39.8. I called the emergency clinic, and the vet that picked up the phone told me "we don't consider that temperature a fever. You can bring him here tomorrow or on Monday for us to have a look at him, as him not eating could mean he's in pain".
05/11 - His temperature was at 38.6. I called the emergency clinic and scheduled to go there in the afternoon. I took him there again, they did an ultrasound and told me he had an abscess at the site of the surgery, and "another blockage", which they said looked like fur, right in front of the place where they operated before. He needed another surgery, and the prognosis wasn't good. He lost 0.5kg during the week. I authorised the surgery, as I didn't see any other way out of the situation, and the vet gave me 5 minutes with him... I realized it could be the last time I'd see him.

The 2nd surgery "went well" according to the vets and it was less complicated then they originally assumed. They cut another part of his intestines out. His temperature was at 39 when they called me for an update this morning, and they said I could go visit at 5pm today (so in 1 hour).

I'm holding out hope I'll be able to bring him back home, but this past week traumatised me completely and I don't trust the people that have been handling the situation to give me good advice anymore, so I feel helpless. Maybe I'm being unfair, but I feel like I've been chasing the vets and that the only reason he didn't die on the 27th and on the 5th was that I kept insisting. I kept being told he was fine.

He's not out of danger yet, but I'd like to be prepared to take care of him if he pulls through. If anybody could give me advice on these topics, I'd be grateful:
  • Would it be safer for him to be kept in a playpen, without places where he could jump on, during his initial recovery?
  • I bought him gastrointestinal food, different types because I was trying to get his apetite back. He's not a big fan of wet food... does it sound like it might be okay to give him dry food, or should we stick with wet for the time being? (Pressure on stitches, quantity, easier absorption, I don't know).
  • Should I ask for the vets to give him pain medication? He wasn't getting any last week. But now I'm wondering if he'd be alive now if he wasn't feeling pain from the condition, so I'm scared.
  • Are there any questions I should ask before his discharge? Would it be better to ask the clinic to keep him there longer? I'm terrified because of that abscess he had despite being on two different antibiotics.
I feel like I won't rest easy for several weeks if he does come home, and I'm sad that I've lost trust in the people that could be helping me.
 
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gabicards

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A correction: his temperature on 05/11 was 39.6, not 38.6.

I should also add he tested positive for coronavirus and parvovirus last year, after I adopted him. We found out while trying to understand why his diarrhoea wouldn't go away (he had a horrible case of giardiasis that took us 8 months to get rid of).
 

silent meowlook

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Hi. He needs to go to a Veterinary Internal medicine Specialist. I would start calling around to find one.
Yes confine.
No dry food unless he won’t eat anything else.
Yes pain medication provided it’s not Metacam or Meloxicam. Buprenorphine is good.
Ask about SQ fluids at home.
Ask for copies of records and blood work.
Ask if they sent a sample of his intestines in for pathology.
Ask for a referral to a specialist.
I am so sorry you both are going through this.
You are right to be concerned.
 
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gabicards

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Hi. He needs to go to a Veterinary Internal medicine Specialist. I would start calling around to find one.
Yes confine.
No dry food unless he won’t eat anything else.
Yes pain medication provided it’s not Metacam or Meloxicam. Buprenorphine is good.
Ask about SQ fluids at home.
Ask for copies of records and blood work.
Ask if they sent a sample of his intestines in for pathology.
Ask for a referral to a specialist.
I am so sorry you both are going through this.
You are right to be concerned.
Hi! Thanks a lot for your replies over the past week. I'm writing this down and I'll ask someone that speaks better French to come along with me so that they can help ask for those things.
 
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gabicards

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I spent one hour with him today. Couldn't talk to any vets, though... they dropped him off in a room with me, then come back half an hour later with a bowl containing 3 different types of food (two wet and one dry), because they wanted to see if he'd eat with me around. Apparently he's been refusing food.

No news about his state, he seemed alert and quite agitated to me. It seems likely that they will call me to pick him up tomorrow, but I'll ask them to keep him one extra day and do full exams before we leave (which apparently they did last time as well). I've already found another clinic that is said to be well equipped nearby that I'll take him to soon, and I'll ask about the specialist.
 

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silent meowlook

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He is adorable! I didn’t realize you are In France. I hope everything works out. Please keep us posted! He is far to cute to be going through this.
 
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gabicards

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Any news?
The vet should be calling within the next couple of hours. But we're at that stage where no news is good news - they only call once a day, in the morning, unless there's an emergency. I'm really scared about what they will tell me regarding him refusing food, though. He was still doing it yesterday and they said he might need a probe to gain some strength (he's lost a lot of weight).

I've already contacted a couple of French people to come along with me when I get the green light to pick him up. At this point I'm fully expecting him to come back home, but obviously concerned about his condition... I'll likely take him to another clinic before the week ends. I'm hoping having a French speaker with me will make them give me more detailed information about whatever the hell happened to make a 2nd surgery necessary.

Thanks so much for asking!
 
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gabicards

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Vets called, I'm supposed to pick him up in a few hours. They sent me "a summary" of his surgery via e-mail:

Type of intervention: Enterectomy on mesenteric abscess

SURGICAL INTERVENTION

Sagittal approach to the abdomen.
Exteriorization and inspection of the handles.
Visualization of an abscess at the mesenteric border of the previous enterectomy site. No obstruction
digestive. Drainage of the abscess. Doubtful tightness. Large enterectomy of the affected portion, intestinal suture at the
4-0 monofilament. Rinsing of the digestive wound. Rinsing the abdomen. Epiploisation.
Sutures plan by plan. Closure of the skin plane with absorbable 3-0 monofilament.


I translated it from French, but I still don't understand it entirely. Can anyone confirm to me that this means he didn't actually have another blockage? It sounds like the problem was the abscess that evolved from the inflammation he already had when I picked him up from the clinic 9 days ago, following the first surgery... It all just sounds scary to me.
 

silent meowlook

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It does state there was no blockage the second time. The abscess was drained and rinsed then he was sutured. I don’t know why he had the abscess.
 
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gabicards

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Louie is back home and seemingly more interested in food. He's eaten about half a sachet of Purina's gastrointestinal wet food, which he doesn't even like (never cared much for wet food). We've adapted the living room and made some make-shift "stairs" for him to be able to go up the couch. There's no places in here for him to jump on, and he'll be kept inside a big dog playpen at night.

The vet didn't give me any medication for the pain, despite me asking. They said he seems comfortable and they stopped with the morphine yesterday (I imagine there's still some in his system, then...). He's active and purring a lot.

I'm learning to take his temperature and will do it twice a day. I'll also try to schedule a visit at the new vet on Friday (5 days after his surgery) and I'll ask for an ultrasound to check how he's healing internally. Fingers crossed we don't get any infections anymore :(
 

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Glad he is doing well. Sad that they didn’t prescribe any pain medication for him afterwards. That’s just sad. But hopefully it won’t be too bad for him! I bet you’re glad to have him home. I bet he’s glad to be home.
 
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gabicards

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Oh oh, I think the wet food he's eating is making his poop very soft. He just stepped on it... I hadn't realized cleaning it would be this hard since I can't just pick him up and put him in the bathtub.

What are the dangers of feeding him dry food at this stage? With fortiflora?
 

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I would avoid dry food. Most likely it is the stress that caused the soft poop. Which, is far better than him having hard poop right now.
 
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gabicards

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Ah, so wet food won't necessarily cause soft stool? I was told when he was a kitten that I should avoid it (he had diarrhoea often, which we later discovered was giardiasis). Is it okay to add fortiflora to the wet food then?
 
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gabicards

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Took Louie to the vet yesterday, he didn't have a fever and she said his wound his healing nicely once again.

Following the vet visit I'm noticing the same behaviour from last week, though. Reduced apetite (though he did eat a bit of wet food), sleepiness and he's avoiding me. Once again I think he's in pain and it's driving me up a wall that everyone's refusing to give him medication for it - the biggest problem is that I don't understand why. I'm wondering if they're afraid it would mask any problematic symptoms regarding infections.

I'm waiting on my flatmate to wake up for me to take his temperature again, I feel like he's running a fever. I can't believe this is happening again and right after seeing the vet.
 
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gabicards

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He's at 38.9 now. I definitely took his temperature correctly, and his vet told me until 39 is normal temperature.

Hopefully this time around he's just sore after the vet had a look at the wound yesterday. Please keep your fingers crossed, I'm so scared again. I'll call the vet today and beg for something for the pain and monitor his temperature.
 

silent meowlook

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I don’t understand why they won’t give you some buprenorphine for his pain. There is nothing safe for cats over the counter or prescription that you can give him. So frustrating.
 
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