Post Perineal Urethrostomy/Litter obsessed cat

[Hav]

Please can anyone help we are at our wits end over our boy. Hes a 15 month old moggy who mainly lives inside. However he has access to the outdoors when we are in, so this is every morning,all evening and all weekend. Up until he was a year old he was on Royal Canin dry kitten food. However we have recently been experimenting with other dry foods such as Iams. He started going outside at around 9 months old. So thats his bio done with!

He recently has started to suffer with cystitis.
He kept getting blocked and after 3 times of being catheterized, the Vet suggested Perineal Urethrostomy. By this point we were being driven crazy by his antics, trips to out of hours vets, not daring to leave him for more than a few hours at a time. We really didnt know what else to do so welcomed the idea of the operation.

Post op hes not 'behaved' that well. Initially he was good, only going to his litter when he needed to. However just over a week later his antics started again. Scratching around in the litter weeing, and then a few minutes later doing the same thing again and again. We've also put him on a mainly wet food diet to see if this helps.

We took him back to the vet where they did a scan of his bladder and said it looked normal and decided to treat it as cystitis and see how he goes. But it has continued. His latest 'thing' is every night when he comes inside, he goes back and forth to his litter tray sometimes until he does a poo. Then he seems to calm down and forget about it. Its not like he saves it up until he comes back inside as he has been using the flower bed whilst hes outside.

Has anyone got any tips or experience of post op perineal urethrostomy and the associated litter tray problems? It would be nice to hear from other litter paranoid cat owners.

[Hav]

Update
We had him back at the vets again this morning and he was blocked! I didnt think they could get blocked after they had Perineal Urethrostomy??????
We were prepared for the worst.

They managed to get him to wee without general anesthetic which was good news. They did a blood test and his kidneys are not damaged thankfully.

So we have him back home again on Hypovase, cystophan and metacam. He still looks so poorly. Im so worried about him.

They have said that the next time he blocks (which will prob be within a week at this rate) we will have to let him go. Im devastated but not giving up on him.

Im just so desperate for him to get over this and live the life he deserves to have.

[Meandmymunki]

Such a terrible situation for you have they not put him on the diet to prevent crystals forming?

[Kay]

how worrying for you

is he insured? I do think that if a cat is not cured by what is usually a last resort procedure, then a referral to a centre of excellence might be the only way forward, if finances are not an issue

don't be afraid to ask for a referral if it might help

[Hav]

He is insured but we've nearly got to the total he's insured up to. It breaks my heart to think its perhaps going to come down to a financial decision.
I genuinely believe our vets have gone the extra mile with him but its like he doesn't want to respond to any intervention.

He blocked pre op when he was on hypovase cystophan and metacam so to say I'm hopeful is an understatement.

It just feels so unfair with him being so young and such a lively character when he's well.

[Hav]

Such a terrible situation for you have they not put him on the diet to prevent crystals forming?

It was discussed however I don't think he has the crystal type. Think it's more to do with muscle spasms.

[Meandmymunki]

But if he is blocking then there has to be either crystals or the sand type grit there, we had one with it in my rescue who was in the diet until all crystals dissolved and then a slightly diff one to stop them reforming. We were offered the surgery too but didn't do it as the diet sorted him, they said that the op would make opening bigger so less likely to block but they did say then that it wasn't a cure if bigger crystals still formed.
It is one of the most difficult things to deal with unfortunately, fingers x'd for you.

[Hav]

Is that still the case if it's presumed ideopathic cystitis?
I'm totally bewildered by everything at the minute. I get the feeling it very unclear as to what causes cystitis but seems to be on the increase

[Meandmymunki]

I may be wrong but cystitis is inflammation and needs either metacam or antibiotics to treat to reduce the iriitation but that wouldnt stop them weeing alltogether, and the operation your boy just had wouldnt be used to treat that as its specificaly for blockages so that the cat will then be able to pass the grit or crystals easier.

[Crewella]

My Daz had several blockages last year due to struvite crystal 'sand', the number of blockages went into double figures. We did discuss the perineal urethrostomy op as a last resort, but eventually managed to get control of the cystitis.

The muscle spasms are due to the blockage, but in my view there has to be an underlying cystitis problem that sets the whole process off, causing inflammation, which causes a blockage, which means the cat strains, which causes the muscle spasms.

Daz, too, was on hypovase, cystophan and metacam post-blockages, as well as a urinary diet, but the thing I found most helpful was upping the amount of water in his diet. The hypovase is to help the muscle spasms that can occur after a blockage, the metacam is an anti-inflammatory and pain killer, and the cystophan helps to line the bladder wall and guard against irritation, as well as having a calming effect in case the cystitis is stress related. What the extra water in the diet does is flush through the bladder contents more quickly, so whatever irritants are in there don't get a chance to build up and cause a problem in the first place.

I know some people swear by water fountains to encourage a cat to drink, but I was desperate, and found it better to add about 2 tablespoons of water to wet food at each meal. That way I could be sure of exactly how much he got.

I know exactly how you feel, I was very confused and scared when this all happened to Daz, but we did get through it. Daz is still on cystophan and extra water, but it's been months since he's had any problems. Touch wood.

I did find research helped - these websites were very helpful in giving me a better overall picture of what was happening:

http://www.marvistavet.com/html/body_fe ... t_dis.html" onclick="window.open(this.href);return false;

http://www.catinfo.org/?link=urinarytracthealth" onclick="window.open(this.href);return false;

[Hav]

Thanks for that advice crewella. It's so reassuring to know someone else has been through all of this. Touch wood he's alright at this minute. But that's how I feel we're all living minute by minute!
He's on a high dosage of hypovase whereas before he's been on a low one when he's blocked.
I'm going to monitor his drinking because I've always thought he's a good drinker but I might be mistaken. He is on a mainly wet food diet I say mainly because his brother only likes dry food and often he eats that too because he's a greedy thing!

I've got everything crossed for him

[Crewella]

All paws here crossed for him too. (((hugs)))

[Jan]

My thoughts are really with you. I completely agree with Crewella.

Our Blackie was diagnosed with Idiopathic Cystitis in early April (I was told he was about 24 hours from death when we took him in). We were given the bad news that it will keep recurring.

He had another bout a month ago. On both occasions, Blackie was given a course of Metacam but on the 2nd occasion, he was also given a 7 day course of an anti-spasmodic tablet called Dantrium. He's now on Cystophan for the rest of his life - as well as the Hills c/d Urinary Stress diet- which thankfully he seems to like. The vet was very insistent that Blackie has wet food only and I was also told to get as much water down him as possible to keep his bladder flushed through as he refuses to drink water from any source (be it fountain, tap, bowl etc). So like Crewella, I add a tablespoon of warm water to every meal and give it a good mix so that his food looks like its in a broth. He must like it as there's no water left in his bowl when he finishes his meal.

As Blackie has always been a cat that jumps at his own shadow, it was no surprise to the vet that he developed this condition for which the cause is stress related as I was told he has no stones or crystals.

I so hope Crewella that now I've giving him so much water, along with his Cystophan, Blackie will end up like Daz ...going months without a flare-up. Its been a very worrying few months since early April. Can't tell you how relieved I am when I come downstairs in the morning to find he's urinated in his tray

[Crewella]

I was wondering how Blackie was doing as I was replying - glad he's doing well so far.

I really hope your boy is doing OK, Hav. What's his name, by the way - sorry if I've missed it but I can't see a name?

All paws still crossed. xx

[Baggypants]

Is he on any medication for stress? By the sounds of how many occurences he's had I'm sure when he has to visit the tray it's going to stress him a little?

My Elsie had a couple of repeat occurences of cystitis - no-where near as bad yours - and it only stopped once she started to take zylklene. It's a natural supplement that you can add to their food that helps them deal with stress. It might be worth considering?

[Hav]

I've no idea if it's stress related or not. I wish I knew.
Unfortunately I can't be around all day to monitor him as I have to go to work.

I just wish he understood when I said to him that if he doesn't stop this it will kill him.

I've been giving him extra water and his special food arrived today. I have a feliway plugged in all day too and as soon as I'm home I let him outside to play.

I wish there was a magic wand to wave. Everytime he walks to his litter tray I feel sick.

I'm terrified were going to lose him.

[Hav]

Crewella he's called jareth.
He started with it 21st may, has been catheterised 4 times and also had his bladder expressed by the vets a few times too.

I wish I knew what stressed him out if that's the case.

I'm at the vets again right now!

[Crewella]

Poor Jareth - your experience sounds so horribly familiar after all we went through with Daz.

One other thought - is he overweight? I remember that last time Daz went in with a blockage (Aug/Sept last year) there were three other blocked male cats at the vets, all were overweight. Daz himself was 6.5kg at his heaviest - I had him on a diet all last year, and I'm sure the kilo he lost was helpful. He's a big chunky late-neutered tom, but 5.5kg seems about right for him.

My vet managed to express Daz a few times when he had minor blockages too. Looking back, it felt like we were trying to get him through the worst stages with the Metacam and hypovase (he was on dantrium at one stage too) until things calmed down and the cystophan, weight loss and added water finally pulled him round long term. They said he had idiopathic cystitis, but he's one of the least stressed-looking cats in the world, so I found the stress thing really hard to understand as well. When they tested for crystals, he had very fine struvite crystals so went on the C/D urinary diet - which comes in a low calorie version too - helpful if weight is an issue.

I'm racking my brains here trying to think of anything that might be helpful - and sending all the positive vibes I can muster. I really hope you can get him past this.

(((hugs))) and fusses to Jareth.

[Hav]

He's not overweight. He has the most athletic build ever! We've brought him home but he's passing blood. The vet said there's little we can do anymore.

Think we're going to go back tonight and put him to sleep.

Thank you for everyone's support this last week. This forum is fantastic.

I don't want anyone to think I've given up on him it's just we and the vet have tried everything. And he doesn't respond to anything.
I'm in tears posting this but I'm also seeing him struggle and now it just feels like it might be the right time.

You are very loved jareth x x x

[Crewella]

I do understand, we were almost at that point several times, and it was partly down to my vet's encouragement that we carried on. I'm so very sorry.

[Hav]

Just in case any one has been following this story:

Last night we had the terrible decision to make and he was put to sleep. I'm absolutely heart broken but he was uncomfortable. Not blocked but tender and passing blood. I couldn't see him carry on like that. We'd ran out of options and despite all our and the vets efforts nothing seemed to work for him.

Miss him like crazy.

He's safe now. Our special lad taken too soon.
Run free jareth x

[Crewella]

Rip lovely Jareth. You were much loved. xx