My Experience With Blockages and PU Surgery

[skwidjybo]

Holy cow, this thread has saved my sanity. I wanted to create an account to say thank you to everyone who has posted before me on this thread - thank you for sharing your experiences and concerns and for creating a place for us cat moms and dads to have an open dialogue about this tricky procedure. I'm just beginning my journey with PU surgery, but I know I will reread this thread as my kitty recovers. I spent hours yesterday reading and researching and this thread was so incredibly helpful!

Alba (the orange and white kitty in my avatar) is the kitty in question. In 2013, shortly after I met their cat dad, I noticed that his behavior was a little unusual. I grew up with cats all my life so I knew what normal looked like, but my SO had never had cats before. Alba kept going in and out of the litter box, not peeing much. When my SO spotted blood-tinged urine, I told him to bring Alba to the vet. First guess? UTI. Antibiotics helped, but the problem persisted. An x-ray showed stones in his bladder. We tried to dissolve them with prescription food, hoping they were struvite. Alas, they were calcium oxalate. He had a cystotomy in September 2013 and they successfully removed 10 stones.

That was my first experience with kitty surgery. Recovery was emotionally draining, but totally worth it. He was peeing larger amounts than I'd ever seen from him, and he appeared to be his normal, happy self. He had a completely smooth and beautiful recovery. The only new development was that he occasionally drips a drop or two of pee after running out of the litter box, but the vet said that was not a concern. He's been on Royal Canin Urinary SO since (wet twice a day with a dry food treat midday).

Flash forward to 2016. Alba's behavior has been normal and consistent. He's still fussy about the litter boxes, but he is peeing decent amounts. On Wednesday night, I noticed that he dripped on a table, and when I went to wipe it away, I noticed that it was pink. Not good. I called the vet Thursday morning and we brought him in. We just thought it would be a UTI. Another x-ray showed a completely clean bladder, but a lot of mineralization in his urethra. So much that we thought it was an actual bone in his body. A solid line of crystals.

Trying to stay calm, we talked through the options. We decided to take him in to a nearby veterinary hospital that specializes in complicated surgical procedures. We brought him in through the ER on Friday morning and spoke with a couple of surgeons, and they spoke with the head of surgery. They said that they would first try to flush the stones/mineralization back into the bladder by using a catheter. If that works, cystotomy #2. If that doesn't work, PU.

Once Alba was prepped, they tried the catheter. Didn't work. They couldn't even get the smallest catheter to even enter the urethra at all. All of the doctors and surgeons we spoke with were amazed that Alba could still pee at all. It looked like a full blockage based on x-rays and the attempted catheterization, but our miracle baby was somehow still able to pee. I'm so happy we brought him in when we did. I can't even imagine what might have happened if I hadn't spotted it.

Our surgeon suggested PU, and we agreed. He did share that some of the mineralization may be above the point where he could surgically reach. That if he was unable to remove that mineralization, they would have to do a prepubic or subpubic urethrostomy (relocating the urethra somewhere else on the abdomen). I could hardly find any information about that procedure, but everything I found suggested that it doesn't really help the cat's quality of life. Who knows if he could control his urination? How would we be able to effectively care for him? If it came to that, we would have to discuss whether or not to put him down.

Alba went into surgery and we prayed and hoped for the best. Fortunately, our miracle baby pulled through once more. Our surgeon was able to remove all mineralization and crystallized tissue! He was able to do a standard, traditional PU, and it went smoothly. We're keeping Alba at the vet until Monday morning (two days post-op) so they can keep him catheterized and monitor his intake. We just got a call that he's doing really well and ate a huge breakfast (classic Alba), and we are going to visit him soon.

I'm worried about his recovery period at home, but I know that we can create a safe and comfortable environment for him. I'm mostly concerned about a stricture or the incision healing improperly. Does anyone know how likely that is? I know all cats are different, and obviously I'm going to ask the vet as well, but I thought I'd put out some feelers here too.

Sending love and good vibes to all of your kitties today!

 

[brittkay87]

Hello all who posted on this topic!! Thank you thank you thank you!!! I just spent the last couple hours reading all 11 pages of all your stories and they have given my the most comfort I have had in 6 days!

My story is about my little 2 year only kitty Gambit. He has been a healthy thriving little boy his whole life, that is until last Thursday night. My little boy woke me up at 4 am by hissing at his brother (very odd for him). He was unable to walk and just looked like he was uncomfortable no matter how he was laying. Poor baby. So we rushed him to an emergency vet at 4 am. The vet their couldn't figure out what was wrong with him. She said all blood work was normal, basic vitals normal, and she said at that time his bladder was still small. She recommended we go to a neurospecialist at a vet hospital 40 min away. So that was our next step.

When we arrived at the vet hospital we once again check in through emergency and by this time his bladder felt bigger and hard. She attempted to express him and no drips or anything. X-ray showed sludge and we were recommend the go to conservative treatment of decompressing the bladder, 72 hour cath, 24 hour observation after cath removal and discharge home.

Well after they inserted the cath ans decompressed the bladder they found that on the ultrasound he had some free fluid in his abdomen, culture showed it was urine. Luckily after contrast study they found his bladder had not ruptured but because it was so stretched it was weeping through the cell walls.

So 4 days later we get the call our little guy can go home and was peeing after the cath removal. Go pick him up and drive him the 40 min drive home and he is cuddly and purring... for about 4 hours and then he was not acting well again. Once again straining in his box, only getting drops of urine, and poor baby was in so much pain his jaw would just quiver and his whole body trembling... back into the car for a 40 min ride back and midnight. I was crying uncontrollably.

That was last night. And he was blocked again. After only getting to see my baby for 4 hours in 5 days here we were saying goodbye again as they prepared to do another decompression and cath. Our doctor called this morning didn't even hesitate at this point to recommend a PU, mainly because he went such a short period of time before reblocking and they thought the likelihood of it happening again was high. So got a call from the surgeon a few hours later and they just finished his surgery a few hours ago. So far surgeon said he did great and everything went as planned. If he does well tonight and tomorrow morning he may come home tomorrow evening.

Thank you to all who shared there stories and gave me something to read while my baby was getting his surgery done. Prayers for a good recovery.

I have done so much research on UO and PU over the last 6 days that I think I could write a book. I also think I could tell you the protein, fat, carbs, phosphorus, and ingredients of 18 different categories foods (prescription and non), also could recite the recipe for homemade raw food and quote how much meat g riders cost. I bought 2 more litter boxes, a water fountain, and am obsessed with cleaning. So needless to say stressed doesn't begin to cover how I am feeling. I'm exhausted, worried, scared, and now thanks to this page finally hopeful. As all of us hear feel, we just want healthy fur babies. So I am doing all I can.

I will keep you all posted over the next few days.

2 questions:
1. Me and my husband both have day jobs and the baby will be home for that time by himself. Obviously in a secluded room away from his brother. How quickly did you feel comfortable leaving them alone. I was hoping after a couple days to have him by himself for a couple hours at a time to get him used to it before we just to a whole work day.

2. Have any of you tried the Iams prescription food? The first ingredient is chicken versus hills which is pork byproduct. Just curious. Vet says either would be fine but want to know if anyone has used it.

Again. Thank you!! Sorry for the novel I just wrote. Good luck to all those going though this torture.

 

[brittkay87]

received_10207362891405193.jpeg

• brittkay87
• Aug 9, 2016

Here is a picture of my babies. Gambit is the white, gray, and black one. His brother O'Malley misses his best friend!

 

[piglet]

brittkay87,

would you mind please posting an update on how your baby, gambit, is doing? i do hope very well!!

my 2 yr old boy, piglet, has had a terrible 4 1/2 months. on apr 17, 2016 i rushed him to the emergency room. the next day he had a cystotomy....struvite crystals and stones, sludge, plug, etc. i thought that was bad enough, but when he could not pee normally after that...constantly in the box with just tiny bits...no vet could really figure out why.

finally, i found a board certified surgeon at VSC working with the Univ of Illinois in Chicago. i had prepared myself for a PU believing he must have gotten a stricture somehow. she said she was inclined to think he didn't need a PU as she had seen very few strictures in her career. she conferred with the board certified internal medicine doctor who agreed thinking it was probably a functional as opposed to mechanical obstruction as he was seemingly having spasms we could see on the outside.

he was put on prazosin for 2 weeks thinking that might relax the urethral spasms, but it did not work.

next they put him on amitriptyline (an anti-depressant) for 30 days which also did not work.

next step was to do a dye contrast with a catheter up his penis and into urethra and bladder to see if there was, indeed, a stricture or other problem blockage and there was a stricture!

so...my poor boy had a PU 2 weeks ago on aug 17, 2016.

now... 16 days later, i am a worried mess. at first, he was peeing normally (after bleeding a little bit for the first three pees). after that, i was blown away that he was peeing at normal intervals a cat would pee and decent amounts. i was ecstatic!!!

today, he went  a small amount, but after that he went into his box three times and seemingly produced nothing. i will be beyond heartbroken, if he blocks again. I love him so much and have cried my eyes out over these long months. i adopted him with his brother at 10 weeks old. they are best friends.

aside from spending so far about $10,000 (no kidding) i can't imagine having to decide to put him to sleep after everything he has gone through physically. he is the sweetest cat ever!! a buff-colored tabby.

if anyone can give their experience and if this type of thing happened to their cat, PLEASE let me know the outcome.

thank you so very much!!

helen, piglet (and brother pooh)

 

[piglet]

skwidj...

how is your alba doing??? it sounds like he had similar issues as my piglet having both a cystotomy and a PU, only his was all within a 4 month period...apr 17, 2016 - aug 17, 2016.

i do hope he has recovered perfectly!! would you mind please letting me know. i am so concerned about my sweet boy.

i wrote the details about him in this thread.

thank you!!!

helen

 

[piglet]

hi pisces,

i am so sorry for the delaying replying to you. last i wrote, i said that piglet had avoided the PU but instead was put on prazosin. i worte that he peed after that, but i was very sadly mistaken. i could have sworn it was he who did it, but it must have been his brother as he continued peeing small amounts. he ended up having the PU on aug 17, 2016. now 16 days later, i am so worried.

will you please update on how bear is doing now 1 1/2 years after his PU in March 2015? also, why did he have to have a revision again? did he block again after the initial one? today is the first day that piglet has gone in his box three times without producing anything. he did this morning a little bit.

thank you!!!!!!

if anyone else, can reply also, i'd be so grateful.

thanks,

helen

 

[brittkay87]

Hello Piglet!!

So sorry to hear about your and your kitties experience!

So after his PU at the beginning of August there were a few issues... I wrote my post right after his surgery so since then here is what happened.

We got a call the next day as we were about to make the 40 min drive to the hospital that his stream wasn't what they normally like to see so they ended up wanting to keep him for an extra night. The next morning we get a call from the surgeon saying he needs to go back in and revise one of his sutures. I was more than fine with this because they caught it early before they even sent him home. Afternoon got the word he could come home the next day.

I got him home and the first night was fine. The next day I noticed that the site looked dry and he wasn't able to go in a full stream (just drips like a faucet). So I called the hospital and because it was the weekend the surgeon wasn't there and it was just his resident. So I got told that it was hard to say if he was blocked again because they needed to see him to be sure. So 40 min drive in and another trip through pet emergency at 10 at night.

We get there and at this point I am in a fit because this will be the 3rd time we have had to bring him through emergency less then 48 hours of him being home. So we see the vet and she tells us he is not blocked (good news?), and that is bladder is small and appears fine. She said the surgical resident stated the site looked fine. They thought he was having trouble getting a full stream because he "wasn't pushing hard enough because he is in pain". We left with a new pain patch, a muscle relaxer, and a secondary pain medication. They said as long as he is emptying his bladder it is fine and he is not blocked. They also showed me how to feel for is bladder and to know when it is enlarged.

We were told that we should give the medicine a week to work. Well one week later still just drops, he began straining more and more, and it took 15+ minutes for him to pee. So after a week of waiting for the medicine to work we already had our followup for his suture removal scheduled in 2 days(It has now been 2 weeks since we brought him home).

Bring him in for his suture removal and I already know that they are going to have to do something else because once again I'm in a fit. So bring him in and express my concerns for his straining and not having a normal stream and how it is getting worse ans worse. Also his site just didn't look right. I get a call from the surgeon 30 min after dropping him off and he states that he will need another revision because he developed scar tissue over the site and it was blocking his urethra. The surgeon was great though and apologized for me being dismissed when I brought him in earlier and told me that I wouldn't have to pay a dime for this time around. Also gave me his personal number so I could call and give daily updates.

So that brings us to today. We brought him home last week and have been fortunate this time around. He has been peeing normal for 7 days now!! Which is the most he has done in the last month and a half! We have one more week with the cone and isolation before we take him back again for his suture removal.

All I can say is trust your gut!! You know your kitty better than anyone and if you feel like something isn't right then speak up and trust your feelings. I hope all goes well with your baby! This is such a stressful (and expensive) process. I have been a mess and can totally relate to the frustration when you are told that this will solve all the problems and your baby still isn't ok. I may or may not have went off on a few of technology vet tech, even though I know it's not there fault (oops)! May sure you are on a one to one bases with your surgeon. Don't be afraid to call and see what the options are. I know I saw one post on here about someone's kitty needing a stint put in during the healing process because the site kept wanting to close and I think that worked for her kitty. Don't lose hope! Sending thoughts and prayers!

 

[brittkay87]

Piglet,

I would suggest reading this thread if you are concerned for suture site closure. This is the kitty I mentioned that had the stint put in! Made me feel like there was another option and you might be able to mention it to the surgeon.

http://www.thecatsite.com/t/282195/theodore-has-taken-a-turn-for-the-worst-advice-please

Post #183 is a photo of the stent. It's not overly graphic, but it is a close-up!

 

[pisces7386]

Piglet,

We still don't know what cause Bear's first blockage, he had no stones that the doc told us about. From his first blockage to the first surgery was only 4 days .They took the first stitches out 14 days after the first surgery. The appointment to take them out was around noon and by dinner we were giving him pain meds to sedate him enough that he would stop trying to pee because he was producing nothing but trying almost constantly. We decided on the doing the revision 15 days after the first surgery (1 day after getting the stitches out). The vet explained that he had strictures- scar tissue that had been held out of the way by the stiches- but that it was now blocking his urethra since the stitches were removed. They had us put him right back on the bladder relaxer (prazosin?) and did the revision a few days later ( they had some emergency cases come in and a sick surgeon that delayed things). It was a tough decision, we talked about ending his troubles, but we decided to try one more time since it wasn't a chronic issue yet. I know I was worried about another two weeks of watching him 24/7, I was at the end of my rope already. The surgeon said she opened up his 'opening' way more than normal and that he would have a higher risk for bladder infections, but shouldn't have trouble passing urine again. We kept him on the bladder relaxer longer after the second surgery, but he also did much better with the second surgery from the get-go.

Those hours after he got his first set of stitches removed were to worst- He went from peeing like a normal cat to just drips. I actually got a pipette out of my college chemistry kit and measured how much water it took to make the same size clump that Bear was making in the litter box- he was producing 1 to 2 ml  

 I don't know everything, but I am so happy we went with the second surgery (we actually couldn't afford it, but our emergency vet/surgeon has an 'angel fund' for people with pets who have a good chance at a much longer life if only the owner could afford it)   

I hope that answers your question Piglet- please let me know if you have more questions. 

 

[webmiss]

We've had two cats that had the Pu surgery. The most important thing I learned from dealing with cats who have urinary issues is diet. We were introduced to the royal canin urinary SO food shortly after our second cats Pu surgery. That food is a life saver. I can attest that I saw kidney stones reduce in size over a month period of him eating the food. It was a miracle ( now if only they could come up with something like that for us humans!!! - im a chronic kidney stoner myself )

After the switch to that food , never again did our cats have infections, blocks, mucus plugs, or any sign of problems. Sadly we just lost our last boy with the pu to unrelated health problems.

But I am a Royal canin believer!

 

[snowysmom]

Hi does anyone know a way to keep my cat from licking his new opening. (We are 3 weeks post op. The vet said he would heal alot faster if he did not lick the new opening) In most other regards he is doing fine.

 

[skwidjybo]

Snowysmom, I kept the cone on my kitty for close to 5 weeks. We took it off after 3, but he overgroomed and gave himself a rash! I'd err on the side of caution and leave it on until the hair starts to grow around the new opening.

 

[skwidjybo]

Piglet,

I am so sorry for not responding to you sooner! I thought I set up the little e-mail notifications that would alert me for new posts on this thread. I will check it more frequently now.

Alba is doing so so well and seems to have had a near perfect recovery. I know we're not completely out of the woods yet, but everything is looking good. The only thing that was odd was some straining while pooping, but we got some medicine and he's back to normal now. He's stealing everyone's food and being a jerk to his cat sibs!

Slightly unrelated - my mom has a cat named Piglet. Terrific name!

While Alba was healing, there were a few times he went in and out of the box without peeing. I work from home so I was able to monitor him REALLY closely and I figured out that it always happened right before he had to poop. Because he was still healing and was on meds/antibiotics, that whole area must have felt sensitive, and forcing pee/poop was probably uncomfortable. Alba's issue resolved after a day or two, no stricture. Has Piglet been peeing and/or pooping since you posted?

I know it's been a few weeks since your post, but I hope your little Pig is peeing freely now. I agree with the others who are saying to trust your gut. You know your kitty better than anyone else. If you think something is up, bring Piglet to the vet. Sending you good vibes! Please let us know how Piglet is doing.

 

[tessierrose]

Well I'm happy to report it has been two years since Vinny's PU procedure and he is doing well!

I am very happy to see this thread has helped many. This experience was one of the hardest things I've been through with my pets...

He and Lola are on the Urinary SO Moderate Calorie Vet prescription food and they have lost a healthy amount of weight!!

Wishing everyone on here all the best!! Xoxox

 

[fergiefurr]

IMG_1894.PNG

• fergiefurr
• Oct 16, 2016

. Hey guys my bit had pu surgery a week ago today. Recovery has been going great. I first came home last Saturday and noticed something was wrong immediately with him. I watched him for about an hour before I knew it must be crystals. I called the after hour vet and got him in right away. Sure enough he was blocked, they took him right in and had a hard time getting a catheter into him but managed to unblock him and flush him out. They went to out the perment catheter in so they could watch him over a few days. But could not get it in. Best case they went in the next morning and he was peeing. But he wasn't he was blocked again. They were unable to get a catheter in and found a rupture in his urethra. At this point surgery was the only option. I was lucky to have a vet I volunteer with at spay and neuter clinics preforming the surgery. With the rupture it was unknown if the surgery could even be done just depending on where the rupture was. 50/50 chance was not the odds I wanted to hear but we went for it! I got a call back saying the rupture was just behind where he usually likes to cut for surgery but has seen worse. I can't even explain the emotions I went through that weekend. And some May think I'm crazy but this little grey stay cat we took in 5 years ago is my heart animal. I can't imagine being without him. They kept smokey for about 24 hours and released him to me. Now this is where I find out the vet has done the surgery for free because he knows how much I do for animals and is paying it forward. Recovery has been going great he is leaking urine but they said it probably because of one of the meds he's on. He doesnt like the yesterday's news. Still trying to find some kind of alternative in my small town. But I'm hopeful for his furture.

 

[fergiefurr]

IMG_2003.JPG

• fergiefurr
• Oct 18, 2016

. So we are a week and 2 days after surgery we are now peeing in the box. And pooping we got a check up call from our vet today they are glad to hear he is doing so well. He is definitely feeling more himself one happy mom here!

 

[mammasboys]

​What is Calm Food?

 

[fergiefurr]

IMG_2309.JPG

• fergiefurr
• Oct 29, 2016

so it's three weeks tomorrow that smokey had surgery. Life is pretty much back to normal here. Still keeping a watchful eye so he doesn't clean himself raw. We had his stones tested and it looks like it's from our hard water. So we will be filtering or using bottled water from now on.

 

[pisces7386]

I would like to ask about Urinary track infections. We've gone almost two years since little Bear's PU without a UTI. I had him in to the vet this week for constipation and she suggested that it may be a UTI causing actions that we are interpreting as constipation. We haven't done a urine test yet, but we may tomorrow. 

How often do you all see Infections? I know normal treatment is antibiotics, but do you do anything else to help treatment? Prevention?

 

[fergiefurr]

When I was talking to my vet who did surgery he did warn that they are more prone to uti's but thinks they are over written about in books. I asked maybe if it's because they are not keeping as clean back there as before. And he believes that is the reason. So I am going to try keeping up with baby wiping him every few days. And hopefully that will prevent any from happening.