my cat cannot urinate: catheter vs PU surgery?

maysa

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Our Persian boy is 7 and a half years old..

About two weeks ago he started squatting for urine but nothing would come out, he had shown some signs of excess visiting to the litter box around last March but with no blockage and the blood tests came out normal then, so the vet said it was an infection and after a 3 day antibiotic course he was ok, this time he vomited on Sunday and sneezed so we thought it was cold , then on Monday symptoms was clear , he spent the whole day in the litter box squatting with no urination at all, by evening we took him to the vet who emptied his bladder (and clear urine came out then) and told us not to worry , and prescribed him meloxicam and enrofloxacin , we returned home he kept staying in the litter box the whole night with nothing came out, and finally he woke us up at 8am on Sunday morning screaming of pain !!

We rushed to the only vet clinic we could find open this early, they had difficulty inserting a cannula and catheter tube up the penis, but eventually they relieved him off a huge amount of very bloody urine.

Later that day his vet catheterized him and put him on meloxicam and enrophloxacin again for 6 days and IV fluids to flush his body of the urine. and said the catheter would come off in 4 days and he would be able to urinate on his own as by then the swelling that blocked him would be gone, then he went on vacation, and his substitute insists on surgery (PU) with no promise that he will have control over his urination, provided that he makes it through surgery, that is if the catheter doesn't work. Until we made our minds, he was put on epicephine for another 3 days

4 days later the catheter came off, and by then his urine was clear... after 4 hours he was squatting again.. We had to spend the night trying to express his bladder but he kept squatting.. In the morning he was catheterized, bloody urine again, and later that day drew blood and urine samples...

His BUN was very high (93 out of 30), his creatinine (3.4 out of 2) not very high yet not normal though, his white cell count is gigantic, the urine contained few crystals of magnesium, and some blood. The xray showed no big stones but turbid urine, he has crystals, he was put on Vitamin C , Cystone, Synolux antibiotic for 6 days , Azodyl , while continuing the IV fluids.

To us surgery is out of the question because of his age and kidneys, and seeing how much the procedure is not sure-fire. He is on Royal Canin Renal S/O renal wet food now and still catheterized after almost 10 days.
Now we gotta get the catheter removed but we are too scared to get to square one , after all medications and antibiotics , we really don't know what to do?, will another catheter help? Or what?
 

white shadow

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with no urination at all.......... the vet.. prescribed him meloxicam

Later that day his vet catheterized him and put him on meloxicam...
Two quick points for you.......

Meloxicam should never, ever be given to a cat with urinary obstruction.......this drug destroys kidney tissue de facto.

Cats' livers can not metabolize this type of drug - so, it must be excreted by the kidneys (where it does its damage)......therefore, it is completely, utterly counter-intuitive to use this drug in this situation.

This is worse than bad medicine - in my book, that's malpractice !
To us surgery is out of the question because of his age and kidneys........
I don't understand why his age is an issue/consideration in ruling out surgery......at 7 1/2, he is "in his prime".  Secondly, you mentioned "kidneys" there....what about his kidneys? Does he have an existing kidney condition? Perhaps you could elaborate specifically on why you included kidneys in resisting surgery.........
...he had shown some signs of excess visiting to the litter box around last March but with no blockage and the vet said it was an infection and after a 3 day antibiotic course he was ok
I suspect that's where the problem started......unless that "Vet" used some hitherto unknown, super new marvel of antibiotic therapy, there's no way that three days of standard antibiotic treatment will eradicate any urinary tract infection....what you're seeing now may well be a more resistant, well-entrenched bacterial infection.

Getting a s second medical opinion is often beneficial when circumstances are difficult/complicated....this applies in veterinary medicine as well. I think you'd be well advised to find a competent feline specialist to review everything.

The American Association of Feline Practitioners membership list shows one Egyptian member....you can search yourself here: http://www.catvets.com/cat-owners/find-vets-and-practices   Click on "more options" and you'll see a drop-down menu for "Country" - I used only that search criteria and found the Vet's name. If you can't get this to work for yourself, post back and I'll send you the name in a message.......I don't want to be seen as possibly promoting any Veterinarian.

Also, please understand that that a Vet's membership in that organization doesn't guarantee competency - it would be a good place to start looking, though.
 
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maysa

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Thank you White Shadow for your response,

He had been on meloxicam for a week and stopped for almost a week now, i googled it before approving it but i found no complaints , and i have a very trusted english cat lover who told me it's a good antiinflammatory and pain killer ,
Anyways, he not on anymore now.

About his kidneys i mentioned his kidneys blood test results above, they are not good , he has a suspected acute renal faliure,

And according to what i read here and out PU is not the solution , a lady here did it 3 times and the 3 times failed !!
I will not jeopardize my cat's life for some curable crystals !

And he is not old may be, but old enough to not to be knocked out for hours for such major procedure, plus he has chronic immuity issue, he almost doesnt have an immunity at all since he was younger.

About the link you sent me , it has one vet 5 hours far from where i am , so i cant go to him espically i am in the capital city where vets' offices are more equipped
 

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I'd really suggest considering visiting another vet for a second opinion, if possible. Has he received any anti spasm medication? My cat has received that each time & that has helped to calm down his bladder so he can begin to urinate more regularly. I'm afraid it is hard for us to suggest if you should or shouldn't go for the PU surgery, but don't completely disregard it because it has failed with some other cats. 7.5 is not too old for anesthesia, but I can understand your hesitation if he has other previous medical issues. I'd hope that the vet is taking all of that in consideration in making this suggestion. 
 
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maysa

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@rlavach thank you for checking my post , that's so kind of you.
the first time he took the catheter off he was reblocked in minutes , it wasnt spasms , and i know he is not that old
But his kidneys are suspected to be in an acute renal failure, and his chronic immunity condition dont make him the best candidate for such huge procedure !
Plus PU commonly fails and has to be redone ! I would have cut an organ of his over nothing then, if i failed , no vet will agree on reknocking him out again to fix it , too dangerous , so he will be left to die or cut open to die too!
Put in mind that Egypt has no good vets at all to perform it.

Not to mention that crystals are curable, why would i choose such a dramatic irreversable procedure for a curable problem?

It's his first blockage throughtout his life and it's early to consider PU at all,
All i am asking fof is people who had similar experience with same aged cats to share it with me
 

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Why is he on the renal diet rather than the urinary dissolution diet? Hills c/d or hills s/d may be a better choice.

If he has acute kidney failure that can be caused by the urinary blockage or by a urinary tract infection that has spread to the kidneys. My vet always gives a full course of antibiotics. Catheters are known to cause infections. As soon as you introduce a catheter you should add antibiotics.

My cat was given a drug to help him relax. I will have to look up his medical records and get back to you.

Poison can cause kidney failure but this sound more like he has bacteria or crystals in his kidneys. An x ray would be helpful to check for crystals in the kidneys.. ultrasound would be even better. Some crystals don't show on x rays.

I would push for antibiotics. Is the cat on iv fluids?
 
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maysa

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Why is he on the renal diet rather than the urinary dissolution diet? Hills c/d or hills s/d may be a better choice.

If he has acute kidney failure that can be caused by the urinary blockage or by a urinary tract infection that has spread to the kidneys. My vet always gives a full course of antibiotics. Catheters are known to cause infections. As soon as you introduce a catheter you should add antibiotics.

My cat was given a drug to help him relax. I will have to look up his medical records and get back to you.

Poison can cause kidney failure but this sound more like he has bacteria or crystals in his kidneys. An x ray would be helpful to check for crystals in the kidneys.. ultrasound would be even better. Some crystals don't show on x rays.

I would push for antibiotics. Is the cat on iv fluids?



Hey @Sarah Ann , thank you for your response , you may check my original post above , it has answers for most of the questions you asked,
Hill C/D i guess is not available in Egypt , will check vets' offices and pet store though
 
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maysa

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UPDATE : i removed his catheter 2 hours ago, his skin and penis are all very irritated that he wants to lick them constantly, but he went to the litter box two times so far , urinating few amount of urine ( his first pee on his own in 16 days) i guess he will need a strong antiinflammatory and another round of antibiotic , but wish he keeps on urinating on his own and doesnt block again like the last time , i am crying like a baby wishing it to work out this time ,, pray for him guys :creamper::creamper:
 
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maysa

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Hey @Sarah Ann , thank you for your response , you may check my original post above , it has answers for most of the questions you asked,
Hill C/D i guess is not available in Egypt , will check vets' offices and pet store though

Sarah Ann Egypt doesnt have Hills cat food at all ,i've been searching everywhere the last couple of hours, even vets have never heard of it.

I googled it though, and i found no big difference between it and Royal Canine Renal wet food , if you have further information plz share it
 

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So are you going to put him on royal canine urinary so?
 
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maysa

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So are you going to put him on royal canine urinary so?


No used to be on Royal Canine Urinary dry food since March , i stopped all the dry food after he got sick , he is now on Royal Canine Renal wet food, it's for kidneys as well as urinary tract , mineral free and PH balanced , beside the meds. I menrtioned in the last two lines of the original post. Wish this all work :frown2:
 
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