our cat needed a perineal urethrostomy....

update: Well, he had the surgery Sunday night. We visited him last
night and he was happy to see us, purring for the first time,
according to the vets. We made the decision to keep him in the
hospital until today, and I was planning on picking him up, but i just
called in and they advised keeping him at least one more day, because
they said he was not urinating consistently. They seem to think this
is because of swelling, pain, and irritation from the surgery. Is this
common? They are going to catheterize him to drain his bladder, give
him something to decrease the swelling, and keep and eye on him for
another day.

They had a very good surgeon do this surgery, not a standard vet, so
I'm very much hoping that there isn't a stricture or scar tissue
already.

I hate for things like this to come down to finances, but this is now
becoming a massive financial burden on me (well over 3500 already, I'm
sure it will go up if he has to stay two more days; plus the $1300
from last month's catheterization and hospitalization). I desperately
hope that they don't have to reoperate, or, worse, find some other
problem.



pam (Mary) wrote in message ...
He's almost 10 years old. I have no illusions that he will live
forever. The surgery was very expensive, but I felt like he was
definitely not at "death's door" and will continue to live a great
life with this surgery. I just hope he doesn't hate us forever!

Aside from the possibility of infections, are there other problems to
watch out for that could result from this operation? He shares a house
with two other cats , they all share one box but I try to keep it
immaculately clean and use the blue silicone crystal litter which they
like and seems to seperate out the waste much more successfully.

Any tips, recommendations?

My cat had PU surgery. I was very worried whether or not I wsa doing the right
thing. Would he be okay psychologically without a penis? Would it be painful?
He was fine after surgery. It took him a few days to realize that he must now
squat instead of stand and pee backwards. His butt smelled a little for six
months. I had to take him to the vet to get his anus area shaved. He had
exploratory bladder surgery at the same time to rule out cancer so maybe that's
why he couldn't reach around and clean as well. I was supposed to put tea tree
oil on the new urethra area to toughen up the skin but I didn't. That stuff
burns! You made the right choice. My cat was 6 or 7 when he had the operation.

"zeno" wrote in message
om...
update: Well, he had the surgery Sunday night. We visited him last
night and he was happy to see us, purring for the first time,
according to the vets. We made the decision to keep him in the
hospital until today, and I was planning on picking him up, but i just
called in and they advised keeping him at least one more day, because
they said he was not urinating consistently. They seem to think this
is because of swelling, pain, and irritation from the surgery. Is this
common?


If the bladder was very distended it could've become overdistended or
atonic. A really stretched bladder wall can become incaÂ*pable of
contracting enough to initiate urination - might take a few days to rest a
damaged detrusor and return to normal.




They are going to catheterize him to drain his bladder, give
him something to decrease the swelling, and keep and eye on him for
another day.

They had a very good surgeon do this surgery, not a standard vet, so
I'm very much hoping that there isn't a stricture or scar tissue
already.


Stricture (of urethral stoma) is probably the most serious complication
associated with PU. However, most skilled surgeons that I know use the
Wilson technique for PU which has reduced stricture incidence from 50% to
about 10%.


I hate for things like this to come down to finances, but this is now
becoming a massive financial burden on me (well over 3500 already, I'm
sure it will go up if he has to stay two more days; plus the $1300
from last month's catheterization and hospitalization). I desperately
hope that they don't have to reoperate, or, worse, find some other
problem.

Try to relax a bit. Its sometimes a bumpy ride for a few days after this
procedure. Seems like this vet knows what he's doing.

Phil




pam (Mary) wrote in message
...
He's almost 10 years old. I have no illusions that he will live
forever. The surgery was very expensive, but I felt like he was
definitely not at "death's door" and will continue to live a great
life with this surgery. I just hope he doesn't hate us forever!

Aside from the possibility of infections, are there other problems to
watch out for that could result from this operation? He shares a house
with two other cats , they all share one box but I try to keep it
immaculately clean and use the blue silicone crystal litter which they
like and seems to seperate out the waste much more successfully.

Any tips, recommendations?

My cat had PU surgery. I was very worried whether or not I wsa doing the
right
thing. Would he be okay psychologically without a penis? Would it be
painful?
He was fine after surgery. It took him a few days to realize that he
must now
squat instead of stand and pee backwards. His butt smelled a little for
six
months. I had to take him to the vet to get his anus area shaved. He had
exploratory bladder surgery at the same time to rule out cancer so maybe
that's
why he couldn't reach around and clean as well. I was supposed to put
tea tree
oil on the new urethra area to toughen up the skin but I didn't. That
stuff
burns! You made the right choice. My cat was 6 or 7 when he had the
operation.

"zeno" wrote in message
om...
update: Well, he had the surgery Sunday night. We visited him last
night and he was happy to see us, purring for the first time,
according to the vets. We made the decision to keep him in the
hospital until today, and I was planning on picking him up, but i just
called in and they advised keeping him at least one more day, because
they said he was not urinating consistently. They seem to think this
is because of swelling, pain, and irritation from the surgery. Is this
common?


If the bladder was very distended it could've become overdistended or
atonic. A really stretched bladder wall can become incaÂ*pable of
contracting enough to initiate urination - might take a few days to rest a
damaged detrusor and return to normal.




They are going to catheterize him to drain his bladder, give
him something to decrease the swelling, and keep and eye on him for
another day.

They had a very good surgeon do this surgery, not a standard vet, so
I'm very much hoping that there isn't a stricture or scar tissue
already.


Stricture (of urethral stoma) is probably the most serious complication
associated with PU. However, most skilled surgeons that I know use the
Wilson technique for PU which has reduced stricture incidence from 50% to
about 10%.


I hate for things like this to come down to finances, but this is now
becoming a massive financial burden on me (well over 3500 already, I'm
sure it will go up if he has to stay two more days; plus the $1300
from last month's catheterization and hospitalization). I desperately
hope that they don't have to reoperate, or, worse, find some other
problem.

Try to relax a bit. Its sometimes a bumpy ride for a few days after this
procedure. Seems like this vet knows what he's doing.

Phil




pam (Mary) wrote in message
...
He's almost 10 years old. I have no illusions that he will live
forever. The surgery was very expensive, but I felt like he was
definitely not at "death's door" and will continue to live a great
life with this surgery. I just hope he doesn't hate us forever!

Aside from the possibility of infections, are there other problems to
watch out for that could result from this operation? He shares a house
with two other cats , they all share one box but I try to keep it
immaculately clean and use the blue silicone crystal litter which they
like and seems to seperate out the waste much more successfully.

Any tips, recommendations?

My cat had PU surgery. I was very worried whether or not I wsa doing the
right
thing. Would he be okay psychologically without a penis? Would it be
painful?
He was fine after surgery. It took him a few days to realize that he
must now
squat instead of stand and pee backwards. His butt smelled a little for
six
months. I had to take him to the vet to get his anus area shaved. He had
exploratory bladder surgery at the same time to rule out cancer so maybe
that's
why he couldn't reach around and clean as well. I was supposed to put
tea tree
oil on the new urethra area to toughen up the skin but I didn't. That
stuff
burns! You made the right choice. My cat was 6 or 7 when he had the
operation.

Update:

well, not good. the surgery went well, but he went into heart failure
two days after. He had been exhibiting "unusual swelling" around the
sutures and they gave him some medication to control this, and he was
also urinating incosistently. they recatheterized him, and after that,
he went back into heart failure. They put him in oxygen with
nitroglycerine for a day, then took him out of oxygen, told us he
seemed to be improving. They sent him home with us yesterday, but he
does not look good to me. He is not eating, I guess he is urinating
although not in a box, I think it's drippling down his back legs; he
is lethargic and tired, basically the way he was when he first went
into heart failure in February. I don't know what to do. We've already
paid them $5k for the surgery and hospitalization for a week, I'm
afraid to stress him out by taking him in again for them to say, 'well
he is recovering from heart failure." he doesn't seem to be obstructed
but I can't really tell. I suppose I should call them and see what
they recommend. I just want them to tell me what they can do within
reason. He does not seem to be suffering horribly but he is obviously
not happy.

On Wed, 20 Oct 2004 13:49:20 -0400, "Phil P."
wrote:


"zeno" wrote in message
om...
Our cat had suffered his third blockage in eight months (his second
within a month), and something like his fifth or sixth blockage of his
life (he is over 9 years old) this past weekend. They were unable to
catheterize him this time, the catheter would only go in a very short
way and then just stop. The vet recommended (well, basically said they
had to do) a perineal urethrostomy, because the only way they could
drain his bladder at that point was with a needle. Of course, we said,
go ahead; they are excellent vets (Berkeley Dog and Cat/Special
Veterinary Services) and called a great surgeon in to do the
operation. From all I can tell so far (he is still recovering) he is
doing great although they claim he is very aggressive and angry, but
is urinating well and eating voraciously (he always has).

Still, I'm feeling horribly guilty.


You shouldn't, you saved your cat's life and probably gave him another 10
years of good-quality life! If he reblocked when you weren't around or
couldn't get him to an emergency clinic he probably would have died from
acute renal failure and/or hyperkalemia.
.

I realize that we did everything
we could for him, we was on a special diet of C/D for over a year, and
he is already being treated for an enlarged heart (a rare case,
though, where the cardiazem seems to be reversing the condition, and
prognosis is great!


I think Cardiazem (diltiazem) works like magic in many cats with myocardial
hypertrophy! It even reduces the risks of blood clots.



he was diagnosed with this after his first
blockage of the past year, by worse vets; they catheterized him


Its quite possible that your cat needed a PU because the previous vet may
have caused irreversible tissue damage to the urethra while inserting the
catheter. The urethral mucosa in blocked cats is very fragile and almost
always inflamed and easy to tear.


and
anesthetized him and he became very ill, went into heart failure;

Oh no! My guess is the vet probably used ketamine to anesthetize him -
ketamine is extcreted through the kidneys -- not a wise choice for a cat
with a urethral obstruction.


this
is when I found the new specialists who said "bah" to the original
three-month-lifespan prediction,


I would have said a little more than "bah" about the previous vet - but I'm
not a vet, so I could get away with cursing him out. :-


and he's now going strong,
heartwise). I'm rambling, sorry,

Keep rambling! I love to hear success stories!


I'm looking to make sure that we did
the right thing.


You most certainly did. The wisest thing was going to another vet and
getting a second opinion.


He's almost 10 years old. I have no illusions that he will live
forever.

No, but you probably gave him another 10 years! I could live with that.


The surgery was very expensive, but I felt like he was
definitely not at "death's door" and will continue to live a great
life with this surgery.

Don't second guess yourself, you made the right call.


I just hope he doesn't hate us forever!

Naa. He doesn't know you ordered the procedure. ;-


Aside from the possibility of infections, are there other problems to
watch out for that could result from this operation?

UTIs are a problem with PU cats - but keeping the litter box immaculate will
minimize the likelihood of occurance. I assume the vet kept him for a day or
two after surgery - so, the serious post-op complications were averted.



He shares a house
with two other cats , they all share one box

Uh ah, 1 box per cat plus 1. You need two more litter boxes.



but I try to keep it
immaculately clean and use the blue silicone crystal litter which they
like and seems to seperate out the waste much more successfully.

Any tips, recommendations?

Keep tabs on his water intake and urine production - feed canned food, and
shoot the other vet (just kidding).

Good luck.

Phil

Update:

well, not good. the surgery went well, but he went into heart failure
two days after. He had been exhibiting "unusual swelling" around the
sutures and they gave him some medication to control this, and he was
also urinating incosistently. they recatheterized him, and after that,
he went back into heart failure. They put him in oxygen with
nitroglycerine for a day, then took him out of oxygen, told us he
seemed to be improving. They sent him home with us yesterday, but he
does not look good to me. He is not eating, I guess he is urinating
although not in a box, I think it's drippling down his back legs; he
is lethargic and tired, basically the way he was when he first went
into heart failure in February. I don't know what to do. We've already
paid them $5k for the surgery and hospitalization for a week, I'm
afraid to stress him out by taking him in again for them to say, 'well
he is recovering from heart failure." he doesn't seem to be obstructed
but I can't really tell. I suppose I should call them and see what
they recommend. I just want them to tell me what they can do within
reason. He does not seem to be suffering horribly but he is obviously
not happy.

On Wed, 20 Oct 2004 13:49:20 -0400, "Phil P."
wrote:


"zeno" wrote in message
om...
Our cat had suffered his third blockage in eight months (his second
within a month), and something like his fifth or sixth blockage of his
life (he is over 9 years old) this past weekend. They were unable to
catheterize him this time, the catheter would only go in a very short
way and then just stop. The vet recommended (well, basically said they
had to do) a perineal urethrostomy, because the only way they could
drain his bladder at that point was with a needle. Of course, we said,
go ahead; they are excellent vets (Berkeley Dog and Cat/Special
Veterinary Services) and called a great surgeon in to do the
operation. From all I can tell so far (he is still recovering) he is
doing great although they claim he is very aggressive and angry, but
is urinating well and eating voraciously (he always has).

Still, I'm feeling horribly guilty.


You shouldn't, you saved your cat's life and probably gave him another 10
years of good-quality life! If he reblocked when you weren't around or
couldn't get him to an emergency clinic he probably would have died from
acute renal failure and/or hyperkalemia.
.

I realize that we did everything
we could for him, we was on a special diet of C/D for over a year, and
he is already being treated for an enlarged heart (a rare case,
though, where the cardiazem seems to be reversing the condition, and
prognosis is great!


I think Cardiazem (diltiazem) works like magic in many cats with myocardial
hypertrophy! It even reduces the risks of blood clots.



he was diagnosed with this after his first
blockage of the past year, by worse vets; they catheterized him


Its quite possible that your cat needed a PU because the previous vet may
have caused irreversible tissue damage to the urethra while inserting the
catheter. The urethral mucosa in blocked cats is very fragile and almost
always inflamed and easy to tear.


and
anesthetized him and he became very ill, went into heart failure;

Oh no! My guess is the vet probably used ketamine to anesthetize him -
ketamine is extcreted through the kidneys -- not a wise choice for a cat
with a urethral obstruction.


this
is when I found the new specialists who said "bah" to the original
three-month-lifespan prediction,


I would have said a little more than "bah" about the previous vet - but I'm
not a vet, so I could get away with cursing him out. :-


and he's now going strong,
heartwise). I'm rambling, sorry,

Keep rambling! I love to hear success stories!


I'm looking to make sure that we did
the right thing.


You most certainly did. The wisest thing was going to another vet and
getting a second opinion.


He's almost 10 years old. I have no illusions that he will live
forever.

No, but you probably gave him another 10 years! I could live with that.


The surgery was very expensive, but I felt like he was
definitely not at "death's door" and will continue to live a great
life with this surgery.

Don't second guess yourself, you made the right call.


I just hope he doesn't hate us forever!

Naa. He doesn't know you ordered the procedure. ;-


Aside from the possibility of infections, are there other problems to
watch out for that could result from this operation?

UTIs are a problem with PU cats - but keeping the litter box immaculate will
minimize the likelihood of occurance. I assume the vet kept him for a day or
two after surgery - so, the serious post-op complications were averted.



He shares a house
with two other cats , they all share one box

Uh ah, 1 box per cat plus 1. You need two more litter boxes.



but I try to keep it
immaculately clean and use the blue silicone crystal litter which they
like and seems to seperate out the waste much more successfully.

Any tips, recommendations?

Keep tabs on his water intake and urine production - feed canned food, and
shoot the other vet (just kidding).

Good luck.

Phil

wrote in message
...
Update:

well, not good. the surgery went well, but he went into heart failure two
days after. He had been exhibiting "unusual swelling" around the sutures and
they gave him some medication to control this, and he was also urinating
incosistently. they recatheterized him, and after that,
he went back into heart failure. They put him in oxygen with
nitroglycerine for a day, then took him out of oxygen, told us he seemed to
be improving. They sent him home with us yesterday, but he does not look
good to me. He is not eating, I guess he is urinating although not in a box,
I think it's drippling down his back legs; he is lethargic and tired,
basically the way he was when he first went
into heart failure in February.

Have they told you what to expect? It cannot be normal for him to just
urinate down his leg, is it? I would get hold of one of the doctors and get
him to talk to me. I am sorry you and your kitty have to go through this.
After care is part of surgery--so they need to talk to you and tell you what
to expect and how to make him comfortable. Best of luck.

wrote in message
...
Update:

well, not good. the surgery went well, but he went into heart failure two
days after. He had been exhibiting "unusual swelling" around the sutures and
they gave him some medication to control this, and he was also urinating
incosistently. they recatheterized him, and after that,
he went back into heart failure. They put him in oxygen with
nitroglycerine for a day, then took him out of oxygen, told us he seemed to
be improving. They sent him home with us yesterday, but he does not look
good to me. He is not eating, I guess he is urinating although not in a box,
I think it's drippling down his back legs; he is lethargic and tired,
basically the way he was when he first went
into heart failure in February.

Have they told you what to expect? It cannot be normal for him to just
urinate down his leg, is it? I would get hold of one of the doctors and get
him to talk to me. I am sorry you and your kitty have to go through this.
After care is part of surgery--so they need to talk to you and tell you what
to expect and how to make him comfortable. Best of luck.

I am surprised about the outcome of the PU surgery. My lightning had it
done twice with no complications. It had to redone to open it up further
since he was still blocking. He has been OK for over 3 years now.

--
Larry - Owned by eight cats
"Mary" wrote in message
m...

wrote in message
...
Update:

well, not good. the surgery went well, but he went into heart failure
two
days after. He had been exhibiting "unusual swelling" around the sutures
and
they gave him some medication to control this, and he was also urinating
incosistently. they recatheterized him, and after that,
he went back into heart failure. They put him in oxygen with
nitroglycerine for a day, then took him out of oxygen, told us he seemed
to
be improving. They sent him home with us yesterday, but he does not look
good to me. He is not eating, I guess he is urinating although not in a
box,
I think it's drippling down his back legs; he is lethargic and tired,
basically the way he was when he first went
into heart failure in February.

Have they told you what to expect? It cannot be normal for him to just
urinate down his leg, is it? I would get hold of one of the doctors and
get
him to talk to me. I am sorry you and your kitty have to go through this.
After care is part of surgery--so they need to talk to you and tell you
what
to expect and how to make him comfortable. Best of luck.

I am surprised about the outcome of the PU surgery. My lightning had it
done twice with no complications. It had to redone to open it up further
since he was still blocking. He has been OK for over 3 years now.

--
Larry - Owned by eight cats
"Mary" wrote in message
m...

wrote in message
...
Update:

well, not good. the surgery went well, but he went into heart failure
two
days after. He had been exhibiting "unusual swelling" around the sutures
and
they gave him some medication to control this, and he was also urinating
incosistently. they recatheterized him, and after that,
he went back into heart failure. They put him in oxygen with
nitroglycerine for a day, then took him out of oxygen, told us he seemed
to
be improving. They sent him home with us yesterday, but he does not look
good to me. He is not eating, I guess he is urinating although not in a
box,
I think it's drippling down his back legs; he is lethargic and tired,
basically the way he was when he first went
into heart failure in February.

Have they told you what to expect? It cannot be normal for him to just
urinate down his leg, is it? I would get hold of one of the doctors and
get
him to talk to me. I am sorry you and your kitty have to go through this.
After care is part of surgery--so they need to talk to you and tell you
what
to expect and how to make him comfortable. Best of luck.

On Sun, 24 Oct 2004 23:53:35 GMT, "Mary"
wrote:


Have they told you what to expect? It cannot be normal for him to just
urinate down his leg, is it?

they said he would dribble, so this seems to be what is happening. The
aftercare they suggested was (aside from monitoring and clavamox) cold
compresses 4 times a day (we're probably doing more than that); he is
certainly dribbling on himself. I'm assuming that maybe he isn't
making more of an effort because of his exhaustion from the heart
problem. I just gave him a compress and he seems unchanged, no worse
than when they sent him home, so I don't think I'll take him into
emergency today, but keep and eye on him. When his heart went bad
before, it was four days before he started rebounding, he only ate
reluctantly. My worry is that his spirits are so low, he has a stupid
code around his neck, he's uncomfortable, that he might just not try
to eat at all. Although he has been drinking water which is good.

I would get hold of one of the doctors and get
him to talk to me. I am sorry you and your kitty have to go through this.
After care is part of surgery--so they need to talk to you and tell you what
to expect and how to make him comfortable. Best of luck.