Need Advice on PU Surgery Wound

[fionasmom]

I certainly am not expert on the use of the laser and a big dog's feet are probably very different than the area where your cat would need it.

You have a good plan in place to continue on with this, stressful though it is. Keep us posted. I have seen several specialists with my animals and sometimes they can cut to the chase a lot more quickly, which might end up costing less in the long run than a vet who is going to continually try something new that does not work.

 

[MoMoMeow]

I certainly am not expert on the use of the laser and a big dog's feet are probably very different than the area where your cat would need it.

You have a good plan in place to continue on with this, stressful though it is. Keep us posted. I have seen several specialists with my animals and sometimes they can cut to the chase a lot more quickly, which might end up costing less in the long run than a vet who is going to continually try something new that does not work.

I looked into laser procedures more, and an option for treatment it can aide in is post-operative soft tissue trauma, so possibly it could be done if a vet gives it the okay. I feel like that's what his wound falls under.

I'll definitely be updating with more news as it unfolds.

 

[MoMoMeow]

Alright, I will preface this by saying it has definitely been a while, but I do have an update for my boy's situation. I've been saving money in the case of another surgery, and making plans to care for him after as need be. I've been keeping a close eye on the wound, cleaning as necessary.

So, I saw a board certified surgeon that I had found, and firstly, the clinic itself they are at is so much better than the one I took him to for his surgery. Everyone is nice, helpful, and knowledgeable. I regret that in the moment of panic and concern I jumped the gun on finding a good surgeon who would communicate better with me.

Apparently, his wound is supposed to look like this. It is supposed to be splayed open, and formed into a spout of sorts, as the doctor told me. He drew me a diagram and explained it so more in depth than what I desperately tried to find online or ask the other vet. He did say, though, that the wound is way too inflamed. The tests taken will be back in a few days, but they suspect that there is a certain bacteria that needs targeted antibiotics in order to be rid of, not the generalized type. I suspect that if this is the case, then he's had it ever since post op, as it has always been inflamed like this. A wound culture was done as well as a urinalysis. He has no signs of stricture, and his urethra is still a good size.

A revision is not necessary if he is still able to urinate, which he is doing very well with, but if that ever changes then he would need to move a new urethra into the lower stomach area. The original area is too damaged now to be operated on, basically. But, luckily, that is not needed at this time.

To my surprise, he basically confirmed that the vet I had his surgery with did not know what they were doing. The stitches were not supposed to be down the middle, but framing either side of the red area in his pictures. He said he didn't know why they did that, which is disheartening. I know that the situation was dire and I had to think and act quickly in order to save my lovely boy, but if I could go back in time and change my decision on who would put him under the knife, I would 100%.

This is basically a short summary of all I learned, but i could go into more detail on some questions if there are any.

I stress to anyone reading this thinking about PU surgery for your cat, to do your research on a good, responsive, and board certified surgeon. It can save you a great deal of confusion and complications.

 

[fionasmom]

Thank you for updating the thread. We always want to know how treatment and recovery evolve and it is very helpful to other, even far down the road.

Don't blame yourself. You made the best decision that you could at the time. It is not possible to know how competent someone is just by having a consultation with them, so we always have to hope for the best to some extent. The fact that something is crucial makes it even worse when it comes to making a decision.

You have moved on to a much better specialist who knows exactly what to do. Hopefully the antibiotics will take care of this, so just go one step at at time. Often the exact correct antibiotic will make a huge difference.

 

[MoMoMeow]

Thank you for updating the thread. We always want to know how treatment and recovery evolve and it is very helpful to other, even far down the road.

Don't blame yourself. You made the best decision that you could at the time. It is not possible to know how competent someone is just by having a consultation with them, so we always have to hope for the best to some extent. The fact that something is crucial makes it even worse when it comes to making a decision.

You have moved on to a much better specialist who knows exactly what to do. Hopefully the antibiotics will take care of this, so just go one step at at time. Often the exact correct antibiotic will make a huge difference.

Thank you very much for the kind words. I'm trying not to be to downtrodden about it. In the end I can't change the past, I can only move forward and do my best to give him a good life regardless of past decisions.

I was extremely surprised to know that this is how he is supposed to look, as I was under the impression that wherever stitches are is where skin is supposed to mend together. I tried to look online for healed up incision sites, but there's not many references unfortunately. I did another search after the visit and did find some that I hadn't seen before, that confirm that this is the regular state of healed it should be at. I'm not concerned with cosmetics aspect though, I'm just glad it's normal and that he is passing urine regularly and easily. I'll help him keep the area clean for the rest of his life if that's what he needs, it's a miniscule price to pay to keep this wonderful boy with me, happy and healthy.

I'm hoping and praying it turns out to be something specific antibiotics can cure, but for now I will have to wait and see. He's on general antibiotics and some anti inflammatory meds until the results are in, so I won't have to worry on that end at least.

I'll do another update when the tests come back and I know more.

 

[shadowsrescue]

I have a cat that had PU surgery 2017. It was a hard recovery. He then blocked again 2 years later. I was unsure if he would survive. But he did and was doing very well. Then in 2022 he had a bout of cystitis. It was 3 weeks of agony. But once again he recovered. I always worry this time of year as each one of his issues have been in April or early May.

I have found that by getting as much water into his diet as possible is a great thing. I feed him both canned food and raw food only. No dry. I add additional water to each meal. His food often looks like soup. I also give him Corn Silk extract 2x each day. If I feel he might be heading towards a flare, I up the corn silk to 3x a day.

My boy is very very stressy. The slightest thing upsets him. We tried him on Prozac for awhile, but it was one of the contributing factors in his second block. Prozac can cause urinary retention. Two years ago we switched to Gabapentin 2x a day. We started at 50 mg 2x a day. Last year we upped to 75 mg 2x a day. Unfortunately he is once again getting agitated so we are in the process of upping him to 100 mg 2x a day. This is probably the upper limit for him.

Taking care of a cat with urinary blockages is hard. I have cameras on all my litter boxes to be sure that he urinates daily. I have 5 other cats so I need to know. My boy cannot get along with most of the other cats so he is separated from them for most of the day. Fortunately he is still a happy boy. He loves to play, loves to snuggle and sit on my lap. He is a former stray and I know his issues from his past contribute to his issues now. I do the absolute best I can for him.

You have done so much for your boy and you have a good plan in place if additional support is needed. I am glad you came back and updated.

 

[MoMoMeow]

I have a cat that had PU surgery 2017. It was a hard recovery. He then blocked again 2 years later. I was unsure if he would survive. But he did and was doing very well. Then in 2022 he had a bout of cystitis. It was 3 weeks of agony. But once again he recovered. I always worry this time of year as each one of his issues have been in April or early May.

I have found that by getting as much water into his diet as possible is a great thing. I feed him both canned food and raw food only. No dry. I add additional water to each meal. His food often looks like soup. I also give him Corn Silk extract 2x each day. If I feel he might be heading towards a flare, I up the corn silk to 3x a day.

My boy is very very stressy. The slightest thing upsets him. We tried him on Prozac for awhile, but it was one of the contributing factors in his second block. Prozac can cause urinary retention. Two years ago we switched to Gabapentin 2x a day. We started at 50 mg 2x a day. Last year we upped to 75 mg 2x a day. Unfortunately he is once again getting agitated so we are in the process of upping him to 100 mg 2x a day. This is probably the upper limit for him.

Taking care of a cat with urinary blockages is hard. I have cameras on all my litter boxes to be sure that he urinates daily. I have 5 other cats so I need to know. My boy cannot get along with most of the other cats so he is separated from them for most of the day. Fortunately he is still a happy boy. He loves to play, loves to snuggle and sit on my lap. He is a former stray and I know his issues from his past contribute to his issues now. I do the absolute best I can for him.

You have done so much for your boy and you have a good plan in place if additional support is needed. I am glad you came back and updated.

You sound like an absolutely wonderful owner. All of these methods you've mentioned I am currently doing or have done with my boy, and I wholeheartedly back them up with my own confirmation that they work effectively. And to add on to it, I believe that Cantharis has also helped a great deal with my boy's flare-ups. It completely stopped one in it's tracks. I buy Denes brand, made in the UK. It might be worth to look into or ask your vet about it, to see if it can help your kitty.

I agree, it's very hard to take care of a cat with cystitis. Seeing them in pain, hearing the sounds they make, and feeling hopeless when the things you try don't break the flare-ups or anxious over when the next will happen is rough. It really breaks my heart just to reflect on what my boy has been through. I monitor him in the litter box like a hawk, and measure his urine output for my own peace of mind and to catch anything ahead of time as well.

Much like your own kitty, he's a sweet, cuddly, beautiful soul, and I'd do anything for him. Thank you for your kindness. I will post and update until the very end of this journey in hopes that it will help someone else and their cat.

 

[shadowsrescue]

Thank you for the Cantharis recommendation. I do have it in my tool chest, but often forget how much it helps. I had not heard of Denes brand. I will take a look.

 

[MoMoMeow]

Thank you for the Cantharis recommendation. I do have it in my tool chest, but often forget how much it helps. I had not heard of Denes brand. I will take a look.

Of course, no problem. Hopefully it can help again, or help anyone that reads this. For such a small bottle, it's enough for about almost two months for my boy, I believe. It does take a while to ship, but I buy in bulk so that it'll last until the next order comes around.

 

[Seymour]

I read your story about seeing a specialist recently and I agree it makes all the difference in the world with this surgery. When my boy was in and out of the emergency hospital consistently with blockages and infections, my vet strongly recommended he have this surgery. We put it off feeling that it was a drastic solution, but his problems simply compounded from there. After a weekend spent in emergency vet offices we agreed he needed the surgery and our vet told us she would not do surgery that required such a high level of skill. She instead referred us to a practice in another city where one of the surgeons was a specialist in PU surgery. We drove him to see the surgeon, they admitted him and did the surgery (a very pricey experience) and he came home to several weeks of isolation and a cone of shame.

That was a number of years ago and he has not had a single issue since that time. The difference is all in the surgeon. In my opinion, having someone who is an expert surgeon to do this tricky surgery is worth the price you pay because the outcome is so much better. And PU surgery isn't something just any vet can do.

In the long run it costs a lot, but compared to the cost of treating the underlying issues over and over and emergency vet visits and hospitalizations, it's cheaper and healthier to have the surgery. We were just lucky that our vet sent us to the right person to do this surgery.

I hope your guy does better and you can put this behind you. But I wanted you to know that going with a specialist, if it comes to having to revisit this issue, is the right approach. We didn't realize at the time that this surgery required special expertise, but my vet did. We're glad we listened to her.

 

[MoMoMeow]

I read your story about seeing a specialist recently and I agree it makes all the difference in the world with this surgery. When my boy was in and out of the emergency hospital consistently with blockages and infections, my vet strongly recommended he have this surgery. We put it off feeling that it was a drastic solution, but his problems simply compounded from there. After a weekend spent in emergency vet offices we agreed he needed the surgery and our vet told us she would not do surgery that required such a high level of skill. She instead referred us to a practice in another city where one of the surgeons was a specialist in PU surgery. We drove him to see the surgeon, they admitted him and did the surgery (a very pricey experience) and he came home to several weeks of isolation and a cone of shame.

That was a number of years ago and he has not had a single issue since that time. The difference is all in the surgeon. In my opinion, having someone who is an expert surgeon to do this tricky surgery is worth the price you pay because the outcome is so much better. And PU surgery isn't something just any vet can do.

In the long run it costs a lot, but compared to the cost of treating the underlying issues over and over and emergency vet visits and hospitalizations, it's cheaper and healthier to have the surgery. We were just lucky that our vet sent us to the right person to do this surgery.

I hope your guy does better and you can put this behind you. But I wanted you to know that going with a specialist, if it comes to having to revisit this issue, is the right approach. We didn't realize at the time that this surgery required special expertise, but my vet did. We're glad we listened to her.

Yes, I completely agree with you. The panic of the circumstances, the stress of the emergency visits, and my greatly impacted judgement lead me to make the wrong decision. I take that fault completely, and can only promise my boy that I'll do better for him in the future. I've definitely learned a lot through this mistake.

I'm glad you were able to see a specialist first thing and have your cat do well afterwards, hearing good outcomes like that about these situations when there's a good chunk of negative ones to outweigh them makes me incredibly happy.

Fortunately, the specialist did not have any other concerns he shared with me other than the inflammation. I'm just relieved the doctor that performed his surgery performed it well enough not to cause him any severe complications. She made him able to urinate on his own without agony, I'll definitely give her that.

To be honest, the clinic I went to did not make me aware of the seriousness of the surgery the way you describe your vet to have had. They were very indifferent about the matter, I guess? I don't know how to describe the situation truly in the way that I experienced it, but it was a mess and I should've known better. After the specialist sat me down and drew out diagrams and explained everything to me, I realize that I had a completely, and definitely incorrect, idea of what this surgery was supposed to be based on everything I was told before and what I found online.

Regardless, I'm hoping to to put this behind me and him as well. I won't be taking him back to that first clinic, and will either find another, or continue to take him to this one doing his lab tests, as they're sort of a hybridized clinic and also friendly people.

 

[fionasmom]

After the specialist sat me down and drew out diagrams and explained everything to me, I realize that I had a completely, and definitely incorrect, idea of what this surgery was supposed to be based on everything I was told before and what I found online.

I agree with S Seymour about the specialist. However, you are still placing too much of the blame on yourself. It was not your job to have such a high level of expertise with PU surgeries that you would have known what was happening. That is what we pay vets and doctors for.

Some vets do believe that they are up for anything whether or not they are, not to mention that they fee they will charge is important to them. The opposite, who are out there, is my dog's vet who refused to perform his surgery because she said that there were much more qualified specialist and sent me to one.

 

[MoMoMeow]

I agree with S Seymour about the specialist. However, you are still placing too much of the blame on yourself. It was not your job to have such a high level of expertise with PU surgeries that you would have known what was happening. That is what we pay vets and doctors for.

Some vets do believe that they are up for anything whether or not they are, not to mention that they fee they will charge is important to them. The opposite, who are out there, is my dog's vet who refused to perform his surgery because she said that there were much more qualified specialist and sent me to one.

I'm still struggling a lot with the weight that my decision has negatively affected my sweet boy, but I'm trying to see it like how you've described it. You're definitely right, I do not have surgical expertise or extensive veterinary medical knowledge.

I quite literally didn't even know that male cats so commonly have issues with their bladders, as he's my first, until it suddenly happened. I definitely didn't know a surgical procedure existed for it until he continued to decline despite routine treatment methods, and the doctors kept mentioning it to me.

It's going to take me a while to push through the guilt I feel, but I'm holding on to the new positives of this situation that the specialist has given me.

 

[MoMoMeow]

Update!

The vet called with the results of his tests. His urine is good, no infections found within it. His wound culture came back with three types of bacteria, but all them are sensitive to the amoxicillin/clavamox that he's still currently on. I'm going to be picking up another week's worth of that per request of the specialist, and then see where he's at after he's finished all the antibiotic treatment.

At the end of the course, I'll be posting more photos of the area, which should hopefully no longer be infected and inflamed from the meds, to share what a healed PU surgery can look like with anyone that needs a reference or comparison in the future.

 

[fionasmom]

So glad that you got some good news, even if he does need to continue the antibiotic.

 

[MoMoMeow]

So glad that you got some good news, even if he does need to continue the antibiotic.

Thank you, it's definitely a fresh breath of air! I'm really relieved it came back as something simple, I've been pretty anxious since the last visit with what-if's and the like. Happy to be proven wrong in this case. Luckily he seems to do well on amoxicillin with no physical symptoms or anything, so it should be smooth sailing for the extended course of it.