Now my flutd cat needs another surgery. Seeking advice.

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spacey

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As if I needed another kitty with more medical problems. My 15 year old cat Jiminy had a perenial urethrostomy done in 2004. In 2007 he had to have the urethral opening surgically widened due to stricturing (scar tissue). Last year he had started to close up again, so we took him back to our original vet (who is 250 miles) because she thought she could widen the urethral opening enough to stop this problem. Well on Jiminys check-up at Banfield yesterday, this vet says the urethral opening is stricturing and closing again. Jiminy gets bacterial UTIs about every 4 to 6 months and has had to take lots of antibiotics. The vet at Banfield does not do surgeries, but my vet here that did the second surgery in 2007 said he could do another one. My question is does anyone know if a third surgery for this scarring/stricturing would be too much. Has anyone else had to go through this with a cat that has had a PU? Between this and Spaceys diabetes (His BGs have been better at nadirs and I have lowered his insulin) I am bewildered. Any advice would be appreciated. My CRF kitty Cheetah is holding her own for now, thank God. Lori
 
My cat Merlin had his PU surgery done in Feb 2008 but we've never had a problem (knock on wood!) with stricturing.

This might seem a little odd, but my ER Vet has a regular practice attached to it, which is where he got his surgery done. Because they tended to see emergency cases, they did a lot more PU surgeries. I wonder if there is something like this near you? Maybe you could get a second opinion from them if there is a reputable one near you.
 
Thank you for replying Diana. I have done some research on the internet, and there have been some cases of this problem in kitties that have had PU surgeries. I live in a smaller town, so its harder to find vets here that do these delicate surgeries. Jiminys original vet (before we moved) seemed to think that the surgery she did to widen the urethral opening last year would eliminate this from recurring again. I was stunned when the vet at Banfield told me Friday that the opening was once again too small. There is an emergency hospital close by, thats a good idea. I will give them a call. I'm just scared another surgery would create even more scarring, but will have to do something. I have read that not every cat that has had a PU has this problem, but a few do. Thanks for the advice, I will post updates on Jiminy. Lori, Spacey and Jiminy
 
My civi Lightning blocked repeatedly and had the PU surgery. About a year later he had blocking problems again and had another PU surgery. It has now been over ten years without problems.
 
Oh thats good Larry that your kitty is good after that second surgery. If you don't mind me asking, what diet is your kitty on? I am wondering if all the royal canin SO and Hills CD I have fed Jiminy is actually doing more harm than good. I read somewhere that having a male cat neutered makes them more prone to FLUTD. After what I have gone through with Jiminy, I will never have another tomcat neutered again. Thanks for replying and good luck with your kitties.
 
I don't know if this would be helpful or not. I did see information from Dr. Pierson at catinfo.org on this. Maybe a consult with her would help? I don't know ..just a thought.
 
spacey said:
After what I have gone through with Jiminy, I will never have another tomcat neutered again.
Click to expand...


Please re-think this. Having an unaltered male cat poses many problems...... Incredibly smelly urine.....marking their territory....breaking out of the house to breed.....aggression secondary to hormonally-driven frustration.....etc.

Humans need to re-think the way that we are feeding them (dry food - including the illogical Rx diets).....not moving away from neutering them.

See Urinary Tract Health below.
 
Dr. Pierson, is this stricturing/scarring that is going on with Jiminy normal? I feed him dry and canned Royal Canin SO and sometimes Hills CD. Any advice on Jiminy? He goes to a new vet tomorrow, for a second opinion, as Banfield does not do these types of surgeries, and I cannot travel back to Jiminys original vet at this time. Thanks Lori
 
I needed to add that I do feed Jiminy canned at mealtimes, but he does graze on the dry food in between. I honestly do not think his problem is from blocking. Its that the tissue around the urethral opening starts closing after a period of time. Plus, Jiminy has cystitis. On his urinalysis last week, there were no crystals present.
 
My PU cat also had to have PU surgery done twice due to the stricturing.

The only problem he has had since the second surgery is he sometimes gets UTI infections.

Good luck
 
Thank you. I was beginning to think Jiminy was the only cat with this problem. Sorry to hear your kitty had to have another surgery though. This will be Jiminys 3rd after the original PU surgery, if this other vet feels its necessary again. Good luck to you and your kitty as well.
 
Ok since this discussion is about urinary crystals and surgery I have a question..
My Pepper has large crystals (confirmed by vet on tuesday- he was seen by the vet and urinalysis ran). Pepper had cried loud the night before and I isolated him to collect his urine, took it in at lunch time then vet call and request to have Pepper brought in rt away. Now Pepper is on canned Hills s/d for temporary. If Pepper does not pee or is showing lethargy or meowing or doens't want me to touch him the vet said I must call him right away. He explained.

Pepper did pee more last and big poop. He did eat a fair amount. At lunch today I had to mix in fancy feast canned with the canned s/d but he did eat it.. What more can I do?

ADVICE/SUGGESTIONS please.. I can NOT afford an emergency visit. My vet is open tomorrow am. So far if Pepper pees between lunch time and 530pm today then I know things are still moving along well rt?
 
Oh .. pepper did have blood work and it looks really good- no infection. No blood was in Pepper's urine. The urine sample was concentrated so large number of crystals could be due to that? Pepper's urine in litter box after he was home was much more than what was for the sample I brought to the vet.. so I'm hoping the Hills s/d is getting him to drink more.. He is still not looking very "feeling healthy"
 
Hills SD contains DL-Methionine which acidifies the urine. An acid environment dissolves sturvite crystals. It also may have salt to encourage more water consumption. You want him to drink a lot of water. As I said above I add water to one of my cat's SU canned food so he drinks more water.
 
Pepper is being a stinker.. won't eat the s/d. I had to add warm water and feed it to him with a syringe , then isolated him and he finally peed..I'm still very nervous since the vet is only open until noon today and I have through tomorrow night to make it ..ifhe blocks I have no means to pay for the emergency room since it means at least $300 up front. so i will be syringing on/off today and watching him very very closely to make sure he is peeing. I mixed fancy feast in and no way wouldn't eat. I will pick up some of the dry s/d since he is a dry food eater - some is better than none.. and yes the foodis suppose to gethim to want to drink more water. any ideas on getting him to eat more I'd ap;preciate
 
The best advice I can give since Pepper is having this problem is get him to drink and the canned s/d only. If he has crystals, they need to dissolve or your kitty could block. I speak from a year and a half experience of going through this with Jiminy before the vet decided to do the PU. If your kitty continues to have problems, you might ask if they could do a catheter and IV fluids to remove any crystals that may cause your kitty to block. I did the PU on Jiminy as a last resort to his chronic cyctitis. Also, you might try purchasing a pet fountain. I have a several drinkwells and my cats love them.
 
Update on Jiminy-I took him to TWO vets on Friday. One said the urethral opening looked like it was too small but could be from the swelling due to the UTI. The other vet (who did Jiminys surgery in 2007) said the opening looked fine and thought it was due to swelling. I have had Jiminy on 1 Baytril per day since last Friday. He has an appointment with my CRF cats vet next Thursday. I can't rest until I know for SURE he is not closing. If that vet says he is OK, fine. If not, and they can't do the surgery, I will more than likely have to take him back to my old vet 250 miles away. Jiminy is urinating, but only in drops. Geesh. Please pray for him and Spacey.
 
Wow this scares me (to be blunt) My little boy and I will place you and the feline lovers on our prayer list. That is so scary. Is he drinking enough? This weekend I had to liquify gerber stage 2 ham food and the the turkey /squash flavor then syringe each slowly into pepper. He tolerated it but really don't want to have to do this every day. He has peed more but only 1-2 day. He has begun to eat the dry s/d but still working on getting him to eat the wet. He is isolated in the bathroom until he pees. Once he pees he is let out (there is no food out but there are several litter boxes).. i think he knows if he pees he gets out if not he stays in. I think this because the last two times he was in he peed within 5 mins then was at the door pounding to get out. and I let him out. I have placed him in his litter box when I put him in the bathroom, then rub his tummy with pressure (not to hurt him but to hopefully get him wanting to pee).. I pet his head while I do this to try and let him know I love him and I'm not trying to be mean.

I have the 360 fountain and I saw pepper drinking from it yesterday (yeah) and I also have a smaller fountain.
 
It sounds like you are keeping a good eye on Pepper. One of the things you need to watch for is blood in the urine. Does he have a steady stream when he urinates? Try to keep working with him on the canned s/d. I don't know if this is good advice, but a veterinarian told me once that tuna water could be given if all else fails, but in moderation. You might also ask your vet about IV fluids to help flush his system of any impurities, like crystals. That may help and is not that expensive, just for the IVs. But that would be up to your vets descretion. Prayers for Pepper as well.
 
I had asked about the IV Fluids and he wasn't too worried about it at this time. I'd rather just get on with it. but if I must syringe liquid to make sure he is getting enough I will. Saturday I syringed in 20mls.. he was that patient.. then he did pee twice which was very good. This is one of the only solid ways I know how to make sure he is getting the right about of fluids
 
Sometimes I will syringe feed Jiminy pedialyte. This assures me he is getting enough liquid and staying hydrated as well. Jiminy goes to the vet again Thursday. I am hoping he agrees with the other vet and it is just swelling. Still on his antibiotics. Keep us updated on Pepper.
 
never thought of that.. how much do you dilute it and could I give it to a cat with renal issues- do you know? Pepper doens't have renal issues but my older cat I'ld like to make sure she is hydrated.. rt now I'm offering Hills a/d old cat..
 
While IV fluids are very desirable, subQ fluids are also very helpful. Various vets I have had recommended subQ fluids for urinary issues.
 
yes sorry that is what I meant. I'm off of work on thursday and friday.. I'm going to take both khan (diabetic) and Pepper for vet to look at..I'll be back online later tonight.
 
You are right Larry. I don't know how I could have forgotten Jiminy's early sub-qs before his surgery. I have been through so much with Jiminy I completely forgot about the sub-qs. My CRF cat Cheetah has fortunately not needed them yet. She is 18 and has CRF, blind and is on blood pressure meds, but is holding steady with her BUN and creatinine levels. I think when I take Jiminy in on Thursday I will ask if sub-qs might help his infection. Still hoping it is swelling and not scar tissue closing again.
In answer to your question pepperthecat, I give Jiminy undilluted pedialyte. I have never given my CRF cat Cheetah pedialyte. But I will ask my vet if its OK to give it to a CRF cat.
 
thank you I will try the pedialyt tonight.. unflavored correct?

I syringed in watered down Hill's s/d -- 20mls at minimum. He finally peed this morning.. stinker didn't pee or poop while isolated in the bathroom but did it in the litter box in Khan's room (diabetic cat)! no poop but did pee. He did eat 1 1/2 bowls so 3/4 cup of food so that is good. As long as he is increasing the amt of his peeing I'm feeling pretty good. I did isolate him again in the bathroom for the day.. to see if he poops or pees.
 
pepperthecat1969 said:
My Pepper has large crystals (confirmed by vet on tuesday- he was seen by the vet and urinalysis ran). Pepper had cried loud the night before and I isolated him to collect his urine, took it in at lunch time then vet call and request to have Pepper brought in rt away.
Click to expand...
how old was pepper's urine sample? i don't have my notes with me (at work now), but don't crystals form in urine (even if there was none at collection time) within a very short period? Dr Lisa? Larry?

eta: found it, from Dr Lisa's site: http://catinfo.org/?link=urinarytracthe ... ary_Issues
A check for crystals is also not accurate because crystals can form once outside of the bladder in as quickly as 30 minutes. This problem of a 'false positive' can be an issue with urine obtained from a free-catch sample at home, as well as one obtained via cystocentesis that is sent to an outside lab due to the same time delay. If your vet wants to accurately assess for crystals, the urine must be looked at 'in-house' within 30 minutes of cystocentesis or the urine being voided.

did you run the urine sample into the vet's right away after collecting it, or if not, how long after had it been sitting before the vet had a chance to look at it?
 
Yes I've read that on Dr. Lisa's webpage catinfo.org.. I did ask my vet about obtaining a clean sample and I stated my concern based on exactly what you are referring to. He told me yes that could be an issue however in Pepper's case the crystals are large, urine is concentrated and knowing how Pepper is acting is enough to know he needs to be isolate, placed on Hills s/d (short term) and watched very closely-pushing liquids. He was specific about keeping a very close eye on amt of liquid he is consuming, peeing/poop and how he is acting- especially for pain level. What my concern is .. how long do I go on isolating him? and not worrying that those crystals are going to block him up? when is there "breather- past the worrying point" time? Is it a must to run xrays? Cost is an issue since I have 4 senior cats all with issues right now.. if an xray is not urgent to know what to do then I skipped it since I have a hyperthyroid cat (losing wt-not wanting to eat-just placed on thyroid medication), diabetic cat, breast cancer cat and then Pepper's issue. If some test is necessary I will work out a payment plan with my vet- I just don't want to not know and end up regretting not doing a preventative measure/test or whatever. scary since there is so much to know. what is it that I don't know-what have I not done that should be done. same for my diabetic cat.. which I'll post on my daily post today. so with this said is why pepper's care went in the direction it did. I am open to any feedback/comments etc. :) thank you.
 
Unfortanately the time frame was between 745am and noon.. so 4 hrs.. I could not know when he peed since I was at work. If he sat at the vet's office he could sit there for a few days without peeing due to stress. I wonder if by this thursday is enough time for the Hills s/d to kick in and begin to work..if so would it be beneficial to take Pepper in and have a clean urine test obtained at the vet? Would the clinic have the ability to perform an accurate urine test?
 
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