Perineal urethrostomy

SillyMangoX

I still can't sleep with my worry for Dude, I'm stressed to the max and haven't stopped crying since Monday night. It's so hard to express his bladder, I had to bring him to the vet twice today to be done, and even the vet was finding it difficult. He's getting a catheter inserted in the morning which will help over the weekend but it isn't a long term solution. We could live with his incontinence (As could he!) with no objections, I have no problem cleaning up puddles if he would leave them around but he cannot pee at all. So because of all this I have been doing extensive research into anything at all that could help, because I'm not willing to give up without exhausting every option, and I came across a surgical procedure used to prevent blockages in cats with crystals / stones etc. called a perineal uretherostomy, where basically the penis is amputated (:eek:) and a new, wider opening is made to make it easier to pass urine. So basically what I am asking here is if anyone knows if this procedure is performed in Ireland? (any info I got was from american websites) And has anyone ever gone through this option with their feline friend?
Thanks for reading!!

Zapperzy

I remember watching a programme on telly maybe a year or two ago where this was performed on a cat in UCD, it was one of those programmes on rte that follow the VH in UCD. Are there any vets specialising in urology in Ireland?

SillyMangoX

A quick google search doesn't seem to bring up any, but maybe someone will know from personal experience!

anniehoo

This is just so awful SM.

I'm just wondering if he has nerve damage to his bladder how a urethrostomy would help if it's a procedure done for blockages? I would imagine the bladder still wouldn't function properly even if there was a wider opening or redirected. I may be wrong as I don't know anything about the procedure, but it sounds like he'd have to have a functioning bladder no?

Are you going to ask your vet about it? Reading a bit online it seems there are people who manually express their cats bladders and have done for years once they get the hang of it. Would this be a road you'd be willing to go down?

Aru

if its nerve damage stopping him from being able to relax the muscles and sphincters of the bladder to let out pee then a urethral surgery is not likely to help,as the problem is higher up and bladder function related im afraid. im afraid learning to express the bladder and seeing will fuction recover in time is the only way to go really...

SillyMangoX

Yeah it's looking like it isn't a possibility, I was thinking if the opening was wider it would allow to urine to freely dribble out but after talking to a vet this isn't the case, he would have to have a functioning bladder for it to work
I would have absolutely no problem expressing his bladder for years to come but he is just near impossible to express, the problem is that the nerve damage is lower down, so he does have feeling in his abdomen so when we go to express him all the muscles seize up and it's very very painful for him. The catheter is in for the weekend, he will be going to get it out on Monday and left with us overnight to see if he passes anything and if he doesn't and we still have such difficulty expressing him we're going to have a very tough decision to make

Zapperzy

I really feel for you SM Your doing all you can do for him though so he has the best possible chance. Fingers, toes and paws all crossed here

sparkle_23

Poor Dude and poor you.. Fingers and paws crossed here too

snoman

I'm so very, very sorry that you're going through such an awful time.... fingers tightly crossed.

SillyMangoX

I'm sorry for posting so much about this but I am just beside myself with worry. I haven't slept more than 2 hours a night since Monday because I've either been worried sick about Dude or sitting up with him to make sure he's alright. I can't stop crying and it makes me feel worse because if this is my last weekend with him I want him to enjoy it and not have me upset all the time.

I am giving him everything he wants and needs, he had a big bowl of fish for dinner and a bit of a rich tea biscuit and I held him up in my arms so he could swat at the Christmas tree. Whenever he wants to snuggle I will leave whatever I'm doing and sit under him for as long as he wants.

All the rest of the time I am spending playing with him with all his favourite old toys. He is still so much himself, he is running around the sitting room, purring, kneading, trying to beat up his siblings, sleeping well, eating and drinking fantasticly, taking all his medications without the slightest protest, barely protesting when I disconnect/reconnect his catheter to the bag.

He isn't in any pain, he's bright eyed, playful, the same loving kitten as he has been since I had him when he was a tiny baby. How on earth can I make the decision to end such a happy beautiful life? I have no problem with euthanasia and have made the decision before, but that was different, he was suffering. Dude is so happy and full of life, I feel as though I would be betraying him. I can't look into his happy little face without bawling crying and even my mom who never ever gets emotional over anything has cried several times over the last few days. I don't want to lose my little buddy, he helped me through so so much over the last year and words cannot describe just how much I love and adore him. I know people always say if you love something you should let it go, but I don't think I'm strong enough to make that decision for a cat that isn't suffering in any way other than not being able to pee.

I know on Monday I'm going to be an emotional wreck more so than I am now. I've never wished, begged and prayed so hard in my entire life. It feels like too short a time together. Looking at his charts today in the vets he is only 10 months and one day old. I know I have given him the best life I could have and he wanted for nothing but the guilt is just wrecking me. If somebody else had adopted him, if I left him with the fosterer, if I never agreed to start letting him outside, if I came home from town an hour earlier...

I'm still crossing everything that he will pee is little brains out come Monday but as they say, prepare for the worst, hope for the best. Anyway I'm sorry for my ramblings, I can barely see the screen through my tears. The only thing that seems to be helping me get through this is to write everything out, and even then it's not helping much.

sparkle_23

I'm fighting back tears reading your post. I feel like I know him well because of all the pics and stories I read about him. You can't blame yourself.. cats are mischievous little yokes...I wish we could talk sense to them and make them stay away from the road and high trees and sharp stuff that cut them!

I completely get what you are saying about putting a seemingly healthy kitty down.. It seems so silly to do it just because he can't wee. And the poor little guy looks so happy in all your pics. I find it hard to believe he was in an accident only a few days ago.

In 2011 I had 2 kittens, one we don't know what happened her.. the other little guy died on the road. We had only had them 3 weeks and it broke my heart. Took me a long long time to get over it. I can't even imagine how you feel having to try make this decision after having Dude for so long. Especially when you helped bottle feed him. I'm really hoping and praying that he will be ok.

SillyMangoX

Sorry for posting that last night, I was sure today was going to be the day because even with the catheter he wasn't passing anything, so I brought him to the vets this morning thinking that it might be our last trip there and wouldn't you know it, he pissed all over the carrier! So the catheter is working! Now
Please god when it comes out it will continue working.

PurplePrincess

Hi SillyMango,

I just wanted to say Dude is so lucky to have such a caring and compassionate owner, you've given him every chance so here's hoping that he's weeing like a racehorse on Monday. Me, Missy and Willow will have fingers and paws crossed for you both.

sparkle_23

SillyMangoX wrote: »

Sorry for posting that last night, I was sure today was going to be the day because even with the catheter he wasn't passing anything, so I brought him to the vets this morning thinking that it might be our last trip there and wouldn't you know it, he pissed all over the carrier! So the catheter is working! Now
Please god when it comes out it will continue working.

It's good to get all those feelings and thoughts out of your head! Then you can concentrate on takin care of the little guy!!

DBB

Isn't it funny how easily something as bloody stupid as our pet taking a pee can become so all-encompassing?! We take so much for granted, not realising how important these things are until they're gone!
SMX, as you know, I've been in the same place, praying and praying for a pee to happen! He will be so sore and bruised at the min, so having that catheter in could well mark a turning point, allowing him to mend those damaged nerves without having to think of the consequences of an over-full bladder.
Will be waiting for updates, and along with everyone else here, rooting for him like mad!

SillyMangoX

DBB wrote: »

Isn't it funny how easily something as bloody stupid as our pet taking a pee can become so all-encompassing?! We take so much for granted, not realising how important these things are until they're gone!
SMX, as you know, I've been in the same place, praying and praying for a pee to happen! He will be so sore and bruised at the min, so having that catheter in could well mark a turning point, allowing him to mend those damaged nerves without having to think of the consequences of an over-full bladder.
Will be waiting for updates, and along with everyone else here, rooting for him like mad!

When I think of all the times I gave out to him for peeing as a kitten!! I don't know if this is in any way a sign of recovery or function returning, but when you touch his sacrum all up along his back starts rippling in spasm. Possibly a nerve returning? We can only hope! Oh and also this eve he was scratching around in his litter tray and squatted, so my mam said we'll syringe the bladder and see and he passed about 3 mls of urine. Maybe he felt like he needed to go? We're taking anything as a positive at the mo!!

taytobreath

i hope there is a happy ending to this . good luck and ill say a little prayer.

taytobreath

SillyMangoX wrote: »

When I think of all the times I gave out to him for peeing as a kitten!! I don't know if this is in any way a sign of recovery or function returning, but when you touch his sacrum all up along his back starts rippling in spasm. Possibly a nerve returning? We can only hope! Oh and also this eve he was scratching around in his litter tray and squatted, so my mam said we'll syringe the bladder and see and he passed about 3 mls of urine. Maybe he felt like he needed to go? We're taking anything as a positive at the mo!!

surely thats a massive positive that he passed urine. give him time, it could be he needs retraining on the whole toilet issue.
i really hope things go in the positive... they willl ,cats are brilliant healers

SillyMangoX

taytobreath wrote: »

surely thats a massive positive that he passed urine. give him time, it could be he needs retraining on the whole toilet issue.
i really hope things go in the positive... they willl ,cats are brilliant healers

Well he passed the urine with the help of the catheter so it's hard to know et if it's a positive or not, but having the catheter gives him the chance to recover for the weekend anyway. It's not a case of any retraining/behavioural thing, I'm sure if he could go he would, but sure hopefully it will all be okay on Monday. Was talking to my mam after she got home from the pub tonight about the while situation and the fact he seems to be showing some
Improvement, if the vets don't disagree with us we will definitely give him longer than til Tuesday, even if it means having to bring him to the vet to be expressed twice a day. In the broad scheme of things, we weighed it up and think that a few minutes discomfort each day would be better than the alternative. Obviously if it was massively hurting him then we wouldn't put him through it but even the vet said he's just giving out by growling and grumbling, if he was actually in a lot of pain he wouldn't tolerate it at all/ would be biting and scratching at them. It's so hard to make these decisions, I'm constantly second guessing myself but in the end I will do everything possible for my little man cat!

sparkle_23

I'm no expert on animal health in anyway but it's only early days! Like if a person was in an accident they would take ages to heal so you know maybe Dude is gettin there slowly but surely!

JKM

Hi,

I am only coming to this thread now so I really hope I'm not too late to offer some advice. I have experience with perineal urethrostomy. My cat Ollie had the procedure almost 3 years ago. It sounds like your situation is remarkably similar to mine so I would look into it again if I were you. We found a vet in Cork who does the procedure. Please PM me if you want the details of Ollie's story and have any questions.
I know what you're going through right now, believe me, I've been there. It's horrendous. Don't give up hope. I didn't and like you did a tonne of research and because of that I still have Ollie with me today.

JKM

Here's a link to a thread I posted back in 2011. I don't know if it will be of any help, I hope so.

http://www.boards.ie/vbulletin/showthread.php?t=2056225432

SillyMangoX

Thank you so much that's just what I needed to hear for a but of hope! Thankfully Dudes pelvis isn't broken, and I keep testing nerve function myself and it seems to be coming lower and lower, on wednesday when I rubbed his back there was no reaction, today his sacrum is quite sore when touched and while there's nothing at the tail base yet, there is some coming I think. I'm just wondering if that surgery is an option I'm our situation how much did it cost you? We unfortunately don't have insurance but do have some money saved, was planning on doing a grooming course with it but Dude is way more important!!

JKM

SillyMangoX wrote: »

Thank you so much that's just what I needed to hear for a but of hope! Thankfully Dudes pelvis isn't broken, and I keep testing nerve function myself and it seems to be coming lower and lower, on wednesday when I rubbed his back there was no reaction, today his sacrum is quite sore when touched and while there's nothing at the tail base yet, there is some coming I think. I'm just wondering if that surgery is an option I'm our situation how much did it cost you? We unfortunately don't have insurance but do have some money saved, was planning on doing a grooming course with it but Dude is way more important!!

Glad to help! I just pm'd you there with a bit more info. I'm crossing all my fingers and toes for Dude to make a full recovery!

SillyMangoX

Another update, we went to the vets this morning with the intention of taking the catheter out, but as there is no sign of infection we will leave it in for another few days. He had somehow managed to rip a stitch even though we hadn't taken the collar off him but the vet did a repair job on it. Now we have another decision to make. Do we amputate his tail? Apparently in some cases the dead weight of the tail can impede nerve recovery, but then again in other cases it does absolutely nothing. So the big question is do we put him through another anaesthetic and surgery, more time in the cone and more time catheterised? Because if it doesn't work we are only delaying the inevitable. Right now I'm leaning towards the amputation, in the hope that it may help. He is provisionally booked in, so we will spend the next few days making a decision on where to go from here, but at least we didn't have to remove the catheter today so it gives a longer time for recovery.

SillyMangoX

He must be feeling a bit better because he is currently having 'the zoomies'. He woke me up by trying to maul me and is now running around the room with a little mouse. Thank god my mam is off work tomorrow so I'll be able to go to bed for a few hours while she minds him, I've been sleeping on the couch since he came home!

Also, decided we are going to go ahead and amputate his tail, because the poop in the tray shows some signs of recovery so we shall help him in anyway we can. Also, while in his zoomie mode he was stalking the feather which used to make his tail go 90 miles an hour, he hadn't even made an attempts since we got him home but this morning he wiggled all his hips and his tail just flung limply from side to side! So he does seem to be getting a small bit of feeling back.

I can't get over how much of a trooper he is, any time my other cats have had a cone they've been miserable and just sit there, Dude has been flying it around the place as if there was nothing different. He sits quietly and let's me empty his bladder when he's sleepy and he also let me cut his nails. He's such a good boy so he is going to get every chance to get through this

Layinghen

SMX you are doing a fantastic job with Dude, but you need to look after yourself as well. Try and get as much rest as you can while your Mam looks after Dude. He is one very lucky kitty to have such a dedicated Mummy.

SillyMangoX

He hasn't pooped in his litter at all today

SillyMangoX

Another poop!!!! That's 1 out of 4 in the tray which ain't bad at all

anniehoo

SillyMangoX wrote: »

Another poop!!!! That's 1 out of 4 in the tray which ain't bad at all

Yay!But...

C'mon THE PEE!!!!

SillyMangoX

anniehoo wrote: »

Yay!But...

C'mon THE PEE!!!!

I think he may be getting somewhere there, after he pooped, I checked him and he had no more left to do but he still went and squatted for a while in the tray so maaaaybe he thought he had to go?! He can't do it with the catheter anyway! Although earlier when I was syringing him he got hyper and ran off when it was still open... Had to wash pee off the walls :pac: