Hi all! I'm new here, though I've spent hours searching through old threads here during this past (exhausting, expensive, and stressful) month since my little boy had his first (and second, and third...) urinary blockage. Everyone here has seemed so knowledgeable, and any experiences or advice you could offer would be much appreciated. I apologize in advance for the length of this post; it's been a hectic month, and a lot has gone on!
First, my questions:
He had the PU surgery done yesterday, and the vet sent him home today with Clavamox & Buprinex. I have him in an XL dog crate with homemade litter (newspaper through the shredder on top of a wee wee pad,) a water bowl, and some blankets/toys. He's on Royal Canin S/O wetfood, fed 1/2 a can twice daily. Zero dry food. He's got his E-collar, but he's a mischievous little one (never name your pet after the God of Mischief), and he keeps finding ways to lick himself around it. I'm doing everything in my power to prevent him from licking the incisions. I've also got a Feliway diffuser, to help with the stress, and he's kept in a separate part of the house, where the other animals (& most of the people) can't bother him.
1. What is the best way to keep the surgical site clean? Should I use pet wipes, or a warm wet cloth, or just leave it be? I'm sort of scared to touch it, but I want to do my absolute best to keep him from getting infected.
2. Does anyone have any positive experiences with the PU surgery?
3. What warning signs should I be watching out for right now? I know straining in the box is a big obvious one, but is there anything else? How often should I expect him to pee?
4. Any other advice during this difficult time? I want to help him heal as best I can.
Loki is my 3-year-old domestic shorthair with unimaginably bad luck (or good luck, depending on how you look at it.) He was rescued from a local kill shelter at 5 weeks. At that time, the shelter had already partially neutered him (removed one testicle at 3 weeks old... don't even get me started) and he had a case of feline herpes that wreaked havoc on his weakened immune system. One of his eyes ruptured, and at 6 weeks we had to have it totally removed; he healed like a champ. Then at a year and a half, the testicle the shelter's surgeon missed was removed from his abdomen to avoid risk of torsion. Now, at 3, he had his first urinary blockage about a month ago.
The first blockage was in late June. He must have been blocked for a while, because when I rushed him to the ER, he was howling, roaring, and panting (Loki is, generally, a very quiet cat.) Urine tests showed he had a low concentration of struvite crystals and high levels of bacteria. The vet unblocked and catheterized him for 3 days, kept him for observation for an extra day, and sent him home with Buprinex for the pain, Clavamox tabs for the infection, and Phenoxybenzamine for muscle spasms. The following 3 weeks were filled with vet visits every 24-48 hours because he was still struggling, although passing some urine, and needed to be expressed regularly. At this time, I thought I could play vet and decided not to feed him the prescription diet, because clearly meat by-products and corn flour were not good enough for my little boy. (The fact that he didn't want to eat the RX food - which I believe he associated with his hospital stay - seemed to justify my decision.) I feel like my lack of cooperation regarding his diet lead to his re-blocking, despite 3 weeks of trying every high-quality, grain-free, low-phosphorus food Dr. Lisa Pierson's chart could suggest.
After 3 weeks of back-and-forth visits, including one midnight ER visit because he was peeing blood, my vet suggested Elavil, which I was strongly opposed to. Note that during this time, Loki was passing urine, but in small amounts, and urinating inappropriately (on the bed, furniture, blankets, his toys, etc.) The vet said that it was probably bacteria or crystals or spasms, although she elected not to run tests on a urine sample I had the ER vets collect. We continued with the same ineffective treatment. I was supposed to be leaving town, and I wanted to get a second opinion before I left, so I brought him to another vet the following day.
As soon as the vet felt his bladder, he said that Loki was reblocked, and had probably been partially blocked for a while, which was why he was still passing urine but still struggling. Another 3 day hospital stay, catheterization, the works. The vet observed that Loki had a very narrow urethra, and that PU surgery would be our best option if he were to block again.
Loki came home after blockage #2 and peed rivers, likely due to the large amounts of SubQ they gave him. I have never been so excited over cat pee in my life. He was on prednisone, clavamox, and twice the amount of phenoxy, and things seemed to be looking up.
About 24 hours after he was home, however, Loki started struggling in the box again. Nothing passed. We ran him to the ER, where they unblocked him a 3rd time. We knew that we couldn't keep on going like this, and transferred him to his vet in the morning, where they did the PU surgery right away. Now he's home, recovering. And here we are.
My little boy has had a hell of a month. Countless injections of steroids, antibiotics, painkillers, SubQ fluids, and of course the catheters and anesthetics and sedatives. (He's been sedated 4 times in 4 weeks, and he has a heart murmur, which worries me greatly.)
I know that stress can lead to blockages, and the past few months have been very stressful for Loki & I. We've moved 3 times in 3 months - from the apartment we'd lived in his whole life, to a dingy apartment that we had to quickly vacate due to shifty landlords and major construction, into the basement at my mom's house, where she has 4 cats of her own. I am 23, a part-time office manager, who has been struggling to save enough money to go back to school & finish a degree. So far, this past month of treatment has cost nearly $6,000, which is all the money I'd put aside for college and then some. I'm very blessed to have had some help - my aunt did a fundraiser to cover the PU surgery, because it truly meant life or death to this cat, and with the help of some wonderful pet lovers, we raised enough money in time to get the treatment done. But now I'm worried, possibly because I've spent a month worrying non-stop over this sick little boy who means the world to me. I want to give his surgery the greatest chance at success I can, and I know the surgery was his best chance for survival.
So, like I said, sorry for the long, long, long post. Anyone have any advice for a young, worried pet-mommy looking to nurse her little furbaby back to health?