Grainger (cat) is in the hospital with a Urinary Obstruction

[Kagney]

Hello everyone,

Its been a rough two days... Grainger, my 1 year old neutered male bob has been hospitalized since yesterday with a urinary obstruction. I've never posted about him in the cat forum, although I did introduce him here: viewtopic.php?f=91&t=13066 in the raccoon forum.

So here's what happened...

Wednesday night I got home a little late, and the SO mentioned that Grainger had an accident in the the bedroom (something he's NEVER done before). Not long after, we see him squatting and straining near the litter box, leaving a little dribble trail as he goes. He screamed bloody murder when picked up. At this point I'm thinking... "nasty UTI, but no biggie, we'll get him to the vet in the morning and all will be well"

The SO drops him of at the vet yesterday morning, and I get a call from the doctor not long after saying we have an emergency situation, that he is fully obstructed, and they need to do something NOW if we want to save him. She explains that this is extremely serious, and it will not be cheap. We talk things over for a while and come up with a care plan that I can almost afford. (Don't worry, he was already drugged to the gills before we even started talking about the financial end of things... this is apparently an extremely painful condition.)

So they put him under and get a catheter in, get him flushed, and break up some of the crystalline sediment causing the issue. The doc says she wants to keep him hospitalized over night with the catheter in place to give the swelling a chance to go down and get him going on his own again. One major problem though: because he is a bob, they have no tail to tape the cath tube to, and after he wakes up it keeps getting snagged and kinked causing him even more discomfort. I get off work a little early and go by to see him since I can't take him home... he doesn't even look like my Grainger-cat. He's slumped in the corner of the kennel with glazed eyes looking utterly heartbreaking, with cath and IV tubes every which-a-way, and hardly acknowledging my voice. I burst into tears, this was so much more than I had ever thought might be going on the night before.

So jump to this morning... Doc calls and says they've had a rough morning. He's got his feist back, but because he was feeling better, get managed to get out of his e-collar and pull out the cath. He is fully blocked again. Somehow, she managed to get the cath back in without knocking him out again, but because of this turn of events, he will have to stay in the hospital all day and over night again. She did mention though, that it was much easier to put in this time, and there were far fewer crystals, so (fingers crossed) with just one more day, he should be able to go home.

We've talked a lot about long term prognosis, and usually, its not great. If this has happened once, its much more likely to happen again. The doc wants to try totally re-working his diet, and hopefully, that will do the trick. We have also discussed surgery, but its not a minor surgery by any means, and from what I have read, the recovery is really really rough road.

Thank you to anyone who has read all of this novel. I guess I was hoping if anyone has gone through this (I'm terribly terribly sorry if you have!) they might be willing to share their experience and outcome. I found one post: viewtopic.php?f=24&t=11858&hilit=obstruction by Crafty, but there were no post-procedure updates and it was quite old.

Anyways, thanks again for "listening" guys. Here are of few pics of the little man...

[TamanduaGirl]

So sorry to hear that. Not had the problem with a cat they are more prone to getting blocked than dogs. Beaker had crystals and the prescription diet worked but I hated that it was basically a junk food so he's getting cranberry now but I need to test his pee soon to be sure that's working. Part of his problem was his prostate as it was keeping the pee in too long and he's been fixed since then.

Couldn't they tape the tube to his leg but leave a bit extra tube in the crotch area to account for movement? Then if it did get stepped on or what not the extra bit would keep it from pulling. Though that wont help if he gets the collar off.

[Ana]

How terrible, hopefully the office will give you a payment plan option, it's tragic that we ever mixed profit and basic health/quality of life. :(

[Kagney]

I actually just went to see him again. He looked worlds better than yesterday (but he was also as high a kite). He head-butted the crap out of me and acted generally thrilled to see me.

They found an answer to the cath tube problem... they scrapped the bag, and now its just super-short, and free dripping. To do it that way, they had to add antibiotics to his long list of meds, but he is WAY happier with this arrangement. He got a new collar too, one of the inflatable donut ones... he seems to appreciate that upgrade as well.

I spoke with the doc a little more about finances more this morning, and she assured me that anything over the target number we talked about yesterday she will authorize a payment plan for. You can't imagine how relieved I was to hear that. Shes trying to keep it as low as possible for me, but with another night of hospitalization, there's just no helping it. I was shocked and grateful to hear all of this; this is a fantastic veterinary practice, but they are definitely not the most affordable in town, and I've never known them to accept payments.

So...fingers crossed... the swelling will go down over night and I'll be collecting my little monster tomorrow morning.

Side note: Gizzi has been an absolute terror ever since she saw her bubba leave the house yesterday morning in the carrier. She woke us up twice last night climbing on the dining room table (something she only does when really acting out) and throwing things off. Shes also been extra vigilant about trying to barge into the bathroom (shes not allowed in there, its Grainger's eating and alone-time room) to see if maybe we're hiding him in there after all. Here's a pic I took of them a few weeks ago. I tried to post it with the others in the last post, but there wasn't enough room.

[Ash]

I'm so glad to hear he's doing better. Poor little guy. I'm glad you were able to see him a few times. Animals do love their people and I'm sure it was a comfort to him to see your face in such a scary place.

Oh my goodness, Gizzi! She was just looking around for her kitty.

Update here when you know more or when he gets home. Grainger is a beautiful cat.

[pat]

Kagney,

I am so sorry to hear of your cat's illness poor thing. I hope he continues to improve, sounds like he is on a road to recovery.
vets can be pretty darn expensive at least they are willing to arrange payments plans.

keep us updated

[Kagney]

Rough weekend...

Well, we got to bring him home on Saturday and he's doing ok. Not phenomenal, but ok. He really scared me Saturday night, I thought he had totally blocked again, and we were already prepping for the trip to the ER, but after his evening drugs he made enough progress for us to wait it out.
He's going on his own, but he has to really really struggle for it, and he's obviously still dealing with a lot of pain. He likes his drugs though, and he's receiving a whole slew of them twice a day: anti-inflamatories, antibiotics, muscle relaxants, and several different pain killers... and we're administering subcutaneous fluids once a day.
There seems to have been a little more litter box progress last night over Saturday night, so we'll take these tiny baby steps of progress if that's the best we can get. I spoke with the office again this morning, and the vet reassured me about his slow progress. His poor little body went through so much, and his bladder and urethra are so inflamed and sore right now that it will be at least a week before he's feeling even close to normal again. So baby steps are still steps forward.

He's only just over a year old. It just seems so unfair for him to have to go through all of this so early in life. We're doing everything we can for him, and he's a real fighter.

Thanks for the kind words everyone.

[pat]

glad to hear he is home. sounds like your poor guy will have a long road to recovery
I am sure it is hard on you as well. it is never easy to see our animals in distress

what causes urinary obstruction? I hear that a lot in cats and I don't know what causes it.
maybe some inherent it

[Kagney]

Here's what my vet had to say about causes...
In Grainger's case, its a combination of anatomy and of him not consuming enough water. He's been on a totally dry diet all his life, and hasn't been drinking enough water or otherwise getting the fluids he needs. This has caused crystalline sediment in his urine which had basically coated the inside of his urethra. (The vet described it like this... if you remember doing the science experiment as a kid where you dip a string in salt water and watch the crystals form and coat the string... kind of like that, but on the inside.) Because the male cat anatomy is so unforgiving (the urethra gets really really narrow at and just before the penis) they can get stopped up really easily. This in turn wreaks havoc on the bladder and kidneys if not caught right away. A blockage can kill a cat in less than 3 days if untreated. And even if they are treated, because its happened once, its far more likely to happen again. I think there can be genetic factors involved also, like a more narrow than common urethra.
There are other types of blockages and other causes, but basically, it comes down to their anatomy not being able to tolerate much more than normal pee.
The surgery to fix this basically involves removing the penis and reworking things down there to give him something more like lady parts to work with. Apparently this makes it stretchier and easier pass whatever he needs to. This is a really really major surgery though, and they only resort to it after a cat has blocked multiple times. The recovery is really hard on them and the chance of infection is high.

I never had any clue about any of this before last week. I've had several male cats over the years and never had any problems to speak of. I'll never feed a male cat a totally dry diet every again though, that's for sure.

[Kagney]

The little monster is feeling a lot more like himself again! He has improved greatly over the past few days, and is using the bathroom almost like normal. We are still continuing his medication regimen for now. He is also getting very very restless being stuck in the bathroom. I take that as a really great sign though; if he's feeling well enough to be bored then we are defiantly making headway. He has woken us up two nights in a row now, running laps and playing in the middle of the night. (I wish I knew how one cat can sound like 3 or 4 panicked deer trapped in the bathroom ) We gave him a little time out of his "sick room" yesterday and will do so again today. He is still having accidents outside the box though, and we can't monitor his box progress well enough if he is sharing a box with Giz again, so he'll continue to be stuck in confinement for most of the day... for now.

So, hopefully we're on the upswing here. I've been hesitant to post and speak too soon, but he is steadily improving now, and I honestly couldn't he happier!

[pat]

thank you for the info. so glad he is improving. I know how hard it is to see our animals in distress

you mentioned he just gets dry food. do you think feeding him can food would help along with his dry food?
mine get can food along with the dry everyday. maybe I shouldn't speak too soon, but, I never had any problems with them.
however, as you mentioned it could be hereditary.

again, so glad he is improving, also sorry you had to endure his illness and the vet bills.

thank you for update.

[Kagney]

Pat,

Yes, he will be on nothing but canned food for the rest of his life, possibly prescription diet. I couldn't believe it when the vet told me that of all the canned store brands out there she recommended Friskies (turkey and giblet pate, specifically) over anything else for its nutritional and fluid content. This BLEW MY MIND, I had been feeding him Blue Buffalo Wilderness thinking I had him on the best diet possible.

Ok, next thing...

I almost feel that I need to defend myself a little bit about the money end of things here...

I mentioned it in my first post because it was the first thing the doctor brought to my attention as soon as we found out there was a very serious problem. The original estimate was just under $1000, and that was just for the FIRST DAY of standard treatment.
I'm sure there are a lot of people who consider that to be an insignificant amount, but unfortunately I am not one of them. Especially as an unexpected expense and with the knowledge that it was probably going to take a whole lot more than that to get him totally well again. On top of that, there was never any guarantee that this would even work. The doctor told me from the very beginning that he may need surgery, but we couldn't even know if he needed surgery until we tried this treatment regimen first.

I love my pets more than anything. They are like my kids, and I would give my last penny for them.
The terrifying part of all this was not knowing how much more it would take, worrying that he would take another nose-dive, and wondering if I would even have enough to save him if that happened.

[pat]

I personally don't think the vets prescription diet food is much better. some vets push their food.
one of my dogs died awhile ago from their prescription diet. maybe it changed by now, but, I am not taking any chance.
you could boil some chicken for your cat too. don't have to do it all the time. my cats love chicken, but, they don't get it everyday.

I feed my cats purina dry and can food. I have 6 cats, so can't afford to get the more expensive stuff.
all cats have been fine on it. some lived to over 20 years old.

I completely understand you will pay whatever it takes to get your cat back on track. I am the same way.
really glad he continues to improve.

[Kagney]

Update:

Well, things had been going really really well. He had been steadily improving until he started using the bathroom anywhere he pleased to show us how upset he was that he was being confined... the vet recommended that we start letting him back outside during the day again to get him back in his accustomed habits. That was last weekend and earlier this week. He had been doing great and we were able to stop meds and fluids.

Yesterday morning, however, the SO noticed him straining and trickling again, so I called the vet in a panic. She let me come by to pick up another 14 days worth of Prazosin and told us to start fluids again.

The SO had to run home for something in the middle of the day and found quite a surprise when he got there... We had let Grainger out for the day in the morning, as usual, and somehow the little monster had managed to get into the SOs workshop and fall into a bucket of used motor oil and diesel fuel. NO. I AM NOT KIDDING. He was COVERED in a mixture of used MOTOR OIL and DIESEL FUEL. The SO bathed him as best he could but soon realized that he wasn't going to be able to get him totally clean by himself. He left Grainger in the bathroom, with a heater after getting him as clean as he could. When I got home and opened the bathroom door... dear God, the fumes were still bad enough to make anyone sick. I don't know how much he might have ingested trying to clean himself before the SO found him, and after his first bath, for that matter.
Well, I got in the bathtub with him and spent a good 10-15 minutes scrubbing and re-scrubbing with the SO there on stand-by to help, and together we got him almost totally clean. Even being bath #2, the water was completely black and oily by the time we finished.
I did forget to mention though, we went ahead and gave him the Prazosin and a quarter of a Tramadol before we started the second bath. (We still had the original crisis of preventing another blockage to deal with after we got all of the toxic crap off of him) I was freaking out the whole time about adding the stress of dealing with this situation to his current urinary problems, but there was no option but to get him clean.

We gave him about an hour and a half to calm down and get totally dry before we gave fluids. Shockingly, giving him the fluids went pretty smoothly. (he had developed a pretty strong resentment about being poked and having to sit there for 2-3 minutes being pumped with water) But, he had also had his first dose of Tramadol in over a week, so he was pretty stoned.

He seemed like he was doing pretty well this morning. All the smell and residue from his diesel dunk was gone, he had used the box, and ate like a champ. We agreed to let him stay inside in the bathroom for the day with his bed and his heater.

Crazy update, I know, but that's where we are at the moment. I just keep hoping we can help him work through this and get back to equilibrium.
That, and keep him out of other trouble... he's a disaster, but he is one loved little cat.

[vulpini]

I'm sorry to hear about this, Kagney! I know how scary urinary issues with cats can be! (and cats always manage to find a way to surprise you, don't they I bet he found the only bucket of motor oil in the entire room, and probably the only tiny exit to /get/ to that room hah) I don't know much about bobs--is it a genetic thing?

I've had three urinary tract scares with my female and male cat. First time, my female cat was frequenting the litter box way more than usual, and when I noticed and went to watch her, she would just sit there and not be able to pee. After a bout of frantic internet searches (which gave me the same panic you get when you search "I have a headache" and the geniuses over at Web MD tell you you have brain cancer ) we took her into the vet and they determined that there weren't that many crystals in her urine, so they prescribed pain medicine and I think gave her antibiotics and just told us to let it pass on its own. Same thing second time.

As pat said, my vet also told us that Frisky's pate is the best food for them, and not to get the little cut-up in-gravy pieces because the nutritional content isn't as high (I was shocked. Always thought Frisky's was sort of junk food, I guess, but I think the fancy pet foods fool you into thinking that they need human-grade meat when really they're just as happy and apparently healthy eating chicken by-product mixed with unidentifiable meat.... ) Since switching both our cats (around 12 lbs each--not fat, just very tall and long American Shorthairs) to a complete wet-food diet (half a can each twice a day, which is what our vet said he gives his cats, too) and changing their running water fountain more frequently, we've (knock on wood) had zero issues. Also, interestingly enough, she seemed to have both her problems with it when people where coming in and out of the house to paint because this stressed her out a lot. Apparently stress can trigger these, for whatever reason, so now that her environment has calmed down, she's been healthier in that regard.

My male cat had what we thought was a UTO once (on dry food diet)--he would strain to pee and I knew how dangerous they could be. Unfortunately we realized he might have one around midnight, and the nearest emergency vet is extremely expensive for just a hunch. So I gave him the same dosage of pain medicine that my female cat got during her treatment, and planned to take him to the vet the next morning. Woke up and he was perfectly fine! Cats are weird that way, I guess.

A last note about the dry food--before we switched to wet food they were getting 1/4 a cup of this really fancy dry food that had all the"right" ingredients and seemed great. The vet said the problem with dry food is that 1. since cats already don't drink much water, they need it from their food as well, and dry food obviously just doesn't provide that. 2., they bind the dry food pellets together with this food glue that is not nutritional. As a whole, the dry food just doesn't provide them with the raw nutrients they get from wet food. For our cats, at least, who rarely drink water (even from their fancy running fountain, which I recommend if your cat doesn't drink--for whatever reason it fascinates them into drinking more ), they still only drink a few times per day.

I wish you the best with your cat! He's beautiful!

Oh, and if you guys ever have to take a cat in for a urinary problem and they can't draw urine from the bladder because it isn't full (sick cats won't drink much water and so it's hard to get a sample), they'll have to keep your cat at the office until they can find it. So.....this means if you can bring your own sample in, you save a lot of money and save your cat a lot of stress. I know you guys won't find this gross because really, it's not, but I was able to get a sample from my cat when she had a second urinary problem. Saved about $100 and saved the problem from being exacerbated due to the stress of her staying in the vet's office.