Male cat, 2 y/o, reoccurring fic, feeling lost and anxious myself about next steps

[tryingmybest]

Hello and thank you for reading.
For context my cat is indoor/ outdoor (outdoor during the day, indoor at night), has a brother he’s been bonded with since a kitten, and is a bit chubby but not overweight at 5.5 kg. We have a big backyard/outdoor area, with both wild growth and more manicured spots. Because my cats prefer to go to the bathroom outdoors we never really monitored their bathroom habits much. Two weeks ago my cat Duncan started vocalizing and acting very much in pain, so we took him to the vet and it turned out he had a physical obstruction in his urethra, which was removed that night and he was kept at the vets with a catheter for about two days. We immediately made the switch to both wet canned food and wet royal canin urinary diet+ mixed in water. The day after bring him home it happened again and we had to complete the same process at an emergency clinic, it was obviously a stressful time for him. He was sent home with anti anxiety medication. After bring him home the second time I noticed he was still straining and peeing in very small amounts. I’m honestly not good with managing my own stress just regularly so I believe I over worried and called the emergency vet again in fear he was blocked and, we were asked to bring him in immediately. When we got there they told me it’s normal for him to be peeing in very small amounts as his bladder was still small, and that they can also get the urge to pee when they don’t actually need to go with his condition (why didn’t they tell us to expect this before hand?ugh). The vet prescribed him tamsulosin which caused a lot of incontinence, after a few days we asked about lowering his dose, and they suggested stopping the medicine completely. Then he started straining again and I started to stress about his full bladder. We were told to bring him to his GP which we did and he was prescribed 3 new medicines. That night he was hissing in his litter box, we called again, they asked us to bring him in again (which I hated doing knowing it was more stress for him every time)I think we ended up bringing him in too many times (total of 3 extra check ups), but each time I explained his symptoms over the phone they asked me to bring him in, and I didn’t think it would be wise not to in case it really was an emergency. At this point he’s on 5 different medications and we’ve spent over $10,000. I’ve had to borrow this money from my mother (which I feel badly about) as I’m 21 y/o, working minimum wage, and starting my bachelors next year while still working. I’ve been on break for the last week and a half but I start work again soon. Because of all these trips to the vet my other cat started expressing some non-recognition aggression, so Duncan is now isolated in my room with a balcony, cat toys, greenery, feliway, cat fountain (which he’s never used ofc). I’ve done a lot of independent research and have done pretty much anything we can, apart from PU surgery. The really upsetting thing is that I dont think I can afford to borrow another $6,000 (which is what we were quoted) to have it done. His symptoms haven’t really been improving (although he is urinating but I can tell its painful for him) and he just isn’t his usual self because of how drugged up he is, but he’s also in more pain/ discomfort without them. I’m having a hard time grasping the reality of the situation, I’m feeling super deflated and like a failure for the situation he’s in.
I would love any advice/ comments but I do also have some more specific questions as well;
After how long of consistent routine would you expect the symptoms to alleviate?
When is the right time to begin reintroduction with his brother?
When do you decide it’s worth bringing your cat into the vet, when it contributes to stress each time?
or just some moral support would be nice to tbh. Hope you and all your kitties are doing well, thanks.

 

[FeebysOwner]

Hi and welcome to TCS, despite the reason for it. I can't offer much in the way of answering your questions, but I think it would help everyone here to know what medications he is on, for how long, and what the purpose of each is. And, to know all the vet(s) did procedurally/test wise.

As far as re-introducing your cats, try taking a towelblanket/etc. that your other cat's scent is on and rubbing Duncan with it, or use a brush on your other cat and then brush Duncan. This should make them smell more alike and stop the non-recognition aspect. It might take more than one time, but it might be that the meds Duncan is on could make him smell differently too. In that case, you could use the 'old vanilla' trick - Ode to vanilla extract | TheCatSite.

I hope other members come along very soon and offer their firsthand experiences with similar cases with their cats. Hang in there!

 

[tryingmybest]

Hey! Thank you for the advice and taking the time to write a response . I will take it for sure and take a look into the vanilla extract tip, I never heard of it! Hopefully
Here is a list of the medications he was prescribed:
Tamsulosin- Once a day to relax the bladder
Metacam- once a day for pain relief
Buprelieve- twice a say for pain relief
Cystaid- Once a day for bladder health/ lower urinary tract function
Gabapentin- 3 times a day (every 8 hours) anti- anxiety/ muscle relaxer (sedative)
After his first blockage the vet did a urine sample, there was a very visible amount of blood and no bacteria found. She also found a very small amount of crystals that she doesn’t think caused the blockage alone. She said there was a mucus like substance coming from his inflamed bladder that was causing the obstruction. The second time they did a blood test and found nothing abnormal. He had a catheter inserted twice for about 2 days each time. They also did a couple ultrasounds but just to look at hos bladder sizes what ofc varied.
Hanging in there for sure! haha thanks again

 

[silent meowlook]

Hi. Please be careful with the metacam. Look it up. It is hard on the kidneys and has a black box warning in the US. When a cat is blocked it causes damage to the kidneys and the metacam on top of that seems to be too much in my opinion. I am not a vet. But look up any medication that is prescribed for your cat and always look for drug interactions.

A PU surgery does not mean your cat won’t block again. So, don’t feel you have to do that surgery or if you do that it will solve all the problems.

Your cat is on a 100 % prescription canned diet right now? He should not have any dry food at all and no treats.

How is his weight?

I would strongly recommend keeping him inside only from now on or allowing access to outside only with a Catio. If he were to be outside and block again he may run off and hide.

When a urinary catheter is placed it causes irritation to the inside of the urethra which can cause cystitis resulting in frequent trips to the litter box only producing a little urine each time. This should be resolved in a week with most cats that I have seen.

It is important that you learn to palpate your cats bladder size so you can tell at home if he is blocked. Don’t do this until he has recovered from what I am sure is a very sore bladder right now. But do look up anatomy pictures for now. It will be hard to do if he is large. It is also best done in the standing position. But if his bladder is sore or if he is blocked he may bite you. So be careful and ask the vet to show you how to do it the next time he goes in, but don’t make a special trip to do so.

What is very important to these cats, is hydration. The best thing you can do to help him is keep him hydrated, thus diluting the urine in his bladder and also diluting any mucus that may be in there as well.

Low stress as this is linked to stress. Also hard to do with frequent vet visits. But a blocked cat is a true emergency, so if you weren’t sure if he was urinating, you were rite to take him in.

I wouldn’t worry about the other cat and him getting along rite now. He is to stressed for you to add more stress onto him. Get him healthy first. Keeping him in the room is a good idea for now.

Is there any way you can set up cat tv for him or even play cat videos on a computer for him all day when you are gone? These are videos of birds or lizards, things cats like to watch.

Make sure he has multiple places and things to drink from. Some cats like to drink from a glass. I prefer to have bottled water only and have one source set up wherever he hangs out and several other places. Some cats like water fountains. You just need constant reminders for him to drink.

Another thing you can talk to your vet about is doing subcutaneous fluids at home for him to also help flush out his bladder.

Bloody urine is expected in a blocked cat. I have seen cats urinate what looks like straight blood for several hours after they are unblocked.

Make sure he has two litter pans to himself.

You also might want to consider setting up an Arlo camera so you can monitor him when you are not home.

I hope he does better.