First off, thank you, everybody, for your comments and support. Since this is primarily a food/weight loss blog, I am always surprised when my lifestyle posts receive commentary. I was really surprised at the amount of comments and stories I received of other people who are dealing with the P.U. surgery. I am so glad that others were able to use this account as a resource for what they were going through!! Please, if you have any experience with a P.U., post your account in the comments. I hope these stories can provide support and help for others for years to come.
Now, for the updates:
Yesterday was one week from when Shadow had his last catheter inserted, and I noticed that his urine was still bloody. By this point it should have cleared up. That, along with frequent urination, led me to suspect he is suffering from a UTI. I’m honestly shocked it’s taken him this long to develop one. I think he’s had 7-8 caths at this point?
Anyways, I called the vet last night to ask if I should get him an antibiotic or what. Dr. S is out for the week, and he’d written on the chart that he wanted to culture the catheter when he pulls it. An antibiotic would render that null and void. Dr. E said that she would need to run a urinalysis to see if he needs an antibiotic or an anti-inflammatory (UTI or cystitis). I dropped Shadow off last night so they could look at him today.
Dr. H took him today (I really like him!) and called me a little while ago to tell me that Shadow does have a UTI. He called Dr. S, but he is out in rural Nebraska or something like that, and hasn’t returned the call yet. Although he didn’t want to “make a decision on Dr. S’s patient,” he ultimately decided that he couldn’t just leave Shadow with a UTI. He gave him an antibiotic injection that should clear it up. He also observed that Shadow had popped a stitch (one of four), but he thought that would be fine since he still had three others and didn’t want to sedate him for that. I was clear to come pick him up, which I planned on doing right after dinner.
Fun change of plans, though! Dr. H called again a few minutes ago to say that when he gave Shadow one final look over, he saw where he’d popped a second stitch on the catheter. Now one whole side was undone… not good. Since Shadow had just had dinner, and also that antibiotic injection, he didn’t want to sedate him and stitch it back in place tonight. Lil buddy is going to stay the night again, get the cath sewn back into place in the morning (hope he doesn’t pop it overnight…), and come home when I get off work tomorrow.
I’m off to go visit him and deliver his nightly dose of amitriptyline!
They shaved Shadow’s bum for me! And for some reason, instead of stitching down the old cath, they put in a new one… not sure why. The doc had gone by the time I got there to pick Shadow up. Maybe he got his old cath out last night? Maybe Dr. H just felt like a Slippery Sam (this model) would be better, since it’s much more flexible and comfortable than the Tomcat model he had in before? Who knows. I’m not confident this one will hold, since it looks like it’s stitched in pretty firmly. But Shadow is WILD. He’s acting like he feels GREAT, so maybe the injectable antibiotic has really perked him up and he won’t be straining enough to pop this one. We’ll see.
The girls at the front desk had to tell Shadow goodbye… and ominously followed up with “See you tomorrow!” *facepalm*
Shadow is fighting having his bum wiped even more than before. I think it’s because the baby wipes are cold. He squalls when they touch his newly-shaved skin. I guess this is why they have wipe warmers.
And I might need one for my cat.
I drop Shadow off to be checked on because his urine is still bloody and he is squatting frequently. They clean his bum up pretty good again, since it’s so difficult to do at home (I am giving him a bath every 2 days at this point, and wiping him with baby wipes in between). Somehow, while he is there, he pops his doughnut. The bladder is lacerated in several places. Kristine, the awesome vet tech who loves Shadow, clips his nails for me and I go get him a new doughnut.
When he comes home, this is how he emerges from the crate. No clue how he did it.
The second doughnut bites the dust.
Fed up, I rip open an old pillow, throw out the bladder, and stuff the sausage full of cotton batting. I grimly inform Shadow that his doughnut is going to be a lot heavier than it used to be, but dammit, he brought this upon himself.
I drop Shadow off Monday evening at the surgeon’s. His bum is absolutely disgusting, despite all of my efforts. Although he has not continuously kept a catheter in for 30 days, he has had one in daily since since 4.6.15. I want Dr. S to evaluate him on Tuesday and determine whether it’s time to remove this final catheter (Dr. H’s, kept in for 19 days, 5 days longer than the one Dr. S had in him at first… but honestly, I can’t declare Dr. H the winner of the catheter contest, since Dr. S pulled his original one early. I deem the two of them tied for longest-remaining catheter!)
Dr. S does indeed remove Shadow’s catheter on the 12th of May! I requested that they keep Shadow for several days to monitor him, since he never had problems immediately. I get daily updates and I go visit every afternoon. Shadow is peeing, often and easily!!! I am surprised also that the cone and doughnut are completely gone. He is free-ranging it in the cage, with no safety devices prohibiting him from licking his crotch. Things look very promising.
Knowing that CB and I are going to be out of town that weekend, I arrange to board Shadow there over the weekend. My mom will come feed my other cats and pill Storm, but I just am not comfortable leaving Shadow by himself yet.
Shadow comes home!! After work, I pick him up. He is screaming vigorously. When we get home, he demands food. I feed him and go upstairs to work on mine and CB’s dinner. When I come back downstairs, he is sprawled across his daddy’s lap, just like he used to do before he got sick. I ask CB if he put him there, and he tells me no, Shadow came and climbed up on his lap of his own accord.
It is a very happy moment.
I find out sometime later that week that the catheter culture came back positive for a UTI. The most effective antibiotic to treat this type of infection is amoxicillin. I ask for a liquid rather than a pill, since Shadow takes his Prazosin much easier than his Amitriptyline, and Dr. S provides me with what appears to be the same lurid pink liquid I took when I was sick as a child.
Shadow stays on the antibiotic until it runs out. I think I gave him his last dose sometime in the week of June 1st.
About that time, because he has been doing so well, I call Dr. S and ask about weaning him off the Prazosin. Dr. S advises that we do so very gradually, because he is still not convinced that part of Shadow’s problem isn’t neurological. He advises that we drop the dosage from 10 units twice daily to 5 units twice daily for a week, then to 2.5 units twice daily for a week, then to 2.5 units once daily for a week, and then nothing. We will have to observe him very carefully while doing this and make sure there is still no problem.
This morning I dropped Shadow down to 2.5 units twice daily of the Prazosin, after he successfully completed a week at 5 units with no issue. Yesterday I heard him peeing loudly and strongly. It is a wonderful sound.
He has started playing again, quite vigorously. He loves chasing the laser. This morning he was wrestling with his sister. He doesn’t want to play with the feather on a stick as much as he did before, which kind of baffles me since it was his favorite toy, but who knows? I’m glad he’s being active.
I would be lying if I said I’m not scared shitless that something else is going to happen. All in all, this took six months of our lives to get a grip on. Shadow came very close to dying on Easter. Every time he goes to the litter box or I see him licking his crotch, I hold my breath a little. I find myself loving on him frequently, and offering him treats when he seems listless just to make sure he is. I’m somewhat paranoid. Every morning before I go to work, I have to pet him and kiss him and tell him that I love him.
Throughout all of this, I have dealt with the most compassionate and professional veterinary staff. I love Dr. H to pieces. She will continue to be our primary care vet, but I will definitely take my kitties to the surgeon’s if something happens after normal vet hours (they close at 5:30, before I get home from work – the surgeon’s office is open until 9pm, with a vet present until midnight). Dr. S has been wonderfully kind, patient, and determined to see Shadow through this thing. I have nothing but love and respect for the multiple vets, techs, and staff I dealt with there. At all times, I felt like everyone involved in Shadow’s care was 100% invested in his recovery.
This was so important. Some of you have commented about your experiences and been skeptical about your vets and the care they have given your children. If you’re one of those people, I cannot recommend enough – find another vet. You have to have someone you can have a working relationship with. I often felt like I was being the psychotic/neurotic pet mom, constantly calling and bringing Shadow in to be examined. But your cat’s health should be of the utmost importance to both you and his doctor. I am so incredibly grateful for the care and compassion that the staffs of my vet’s office, the surgeon’s office, and emergency clini gave Shadow. They are the reason he is still here (and seriously, preceptor Amanda, if you ever read this, I am going to need you to come practice here in Clarksville permanently – you saved him when he was knocking at death’s door and you will never know how much I love you for that).
Again, thank you everyone for all of your well-wishes. Shadow is doing fine!
PS: I have had several inquiries about the cost of this entire process. I’m not going to pull out all of my receipts, but here’s a rough estimate:
Vet – emergency fees, attempted catheter insertion (which failed); actual catheter insertion: around $1,000 altogether
Surgeon – surgery: around $800; widening procedure and new catheter: $100; boarding, cath culture, urinalysis, antibiotics: around $200ish (all followups and additional procedures were covered by original surgery costs)
Emergency clinic – emergency fees, hospitalization, bloodwork: around $500
Total cost: $2600ish, but probably closer to $2750 when you count the refills of Prazosin, Buprenorpherine, and Amitriptyline
Actual cost: Shadow’s life = fucking priceless