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Hi, I can help you with your question today.
I am having trouble understanding some of the history.
Are you aware of an injury to her tail that took place AFTER the diagnosis of stress related cystitis?
No. The injury was there all along, but not identified by the emergency vet. Instead she diagnosed cystitis and provided treatment. Today, unhappy about the cat's pain, we took her to our own vet, who identified the break in her tail.
I see. And other than pain and swelling, is she able to move the tail?
A bit swollen at the base and no, she does not seem able to move her tail - it is limp.
OK. Is she able to urinate normally, or does she seem to be retaining urine? Your vet may have been able to determine that, or you may know by what you are seeing in the litterbox.
She is passing urine - not a lot but quite frequently. But she has not yet passed a stool.
When she passes urine, are you seeing her posture normally, or is it leaking out?
Oddly, she seems to be lying almost horizontally. So maybe it is leaking out...
I see. This is something important to have evaluated by your regular vet.
We also need to know if she has normal anal tone.
If you have a thermometer at home, you can take her temperature and observe if she has normal anal tone.
Basically, many cats with tail injuries can recover.
The prognosis does change depending on the extent of the injury.
I'm trying to determine just how much damage there is with my questions here.
Do you think that it is OK that my usual vet - now elderly and thinking of retirement - has aid to leave it till next Monday...
It can take a full 6 months before we know with certainty if she will or will not recover completely.
No, we need to know more quickly.
If she is retaining urine, that means her bladder is inflated to capacity.
The urine you are seeing, may just leak out because her bladder cannot physically contain more.
If her bladder stays stretched to maximum capacity, this can cause permanent damage.
If she has a chance of recovering bladder function, we need to keep her bladder empty as much as possible.
The emergency vet who examined her on Monday night said that her bladder was 'shrunken'.
So, if a vet felt that her bladder was quite full, we need to express her urine. They should also demonstrate how to do that, so that you could do that at home on a regular basis.
I'm still concerned based on what you are seeing at home, and the fact that Monday night was probably immediately after her injury. She may not have had time for her bladder to fill up by that exam.
Are you suggesting that she may recover function - of bladder, tail and anus - without intervention?
Is there any intervention possible?
Yes, that is absolutely possible.
Amputation is an option too, but often the main concern is just keeping the tail from being soiled (with bandaging) until we determine, over time, the extent of her recovery.
If she is painful, we should continue pain medication in the meantime.
And is this all that we can do - wait? Or is there any intervention that might be helpful?
Yes, I absolutely recommend consulting a veterinary acupuncturist.
Our own vet has now given pain medication.
I don't do acupuncture myself, but I have seen amazing recoveries with this treatment.
I honestly don't understand it, but if it works...
Acupuncturist? Really? Are there such things?
Oh yes. Some vets are actually certified in TCVM (traditional Chinese veterinary medicine) which includes acupuncture, herbs, etc
In the UK? Can you recommend anyone.
I work in the US, so I don't know anyone personally. Here is a website that can help you locate someone locally : http://www.abva.co.uk/find-a-vet/
OK, I'll do that. I've had an acupuncture treatment once, recommended by a friend who swears by it , and found it painful and unhelpful. But anything to help Sophia...
Again, I do think it would be best if you can have someone palpate her bladder as soon as possible and make sure it isn't overly full.
As far as her tail is concerned: our vet found a clear lesion. Does that mean that she has to lose it or could the nerve be reconnected?
I know she can live without a tail, though not without proper bladder and excretory function...
Did you get a good idea how far down the tail (how many bones) the break or dislocation occurred?
Very high up.
The spinal cord itself actually ends around the 5th lumbar vertebrae (in the back).
The tail does contain many nerves that have branched from the spinal cord.
We cannot tell for sure how serious the nerve injury is at this point. The general assumption/rule is that a nerve can regenerate (if it is going to) at a rate of 1mm per day.
That is why it is generally a wait and see game.
We don't know for sure if the nerves can repair, and I they can, we don't know how long it may take with her particular injury.
And the acupuncture might help with the restoration of the tail nerves as well as the bladder and anal functions?
This is all helpful. So my experienced old vet is right about the waiting. Though I don't know what he would think of acupuncture... Is there anything else we should be aware of in order to help her?
Not really. Supportive care for her will just mean making sure she is eating and drinking well, able to urinate and defecate on her own (otherwise, learning to help her), and controlling any pain she might have.
Umm, how do we help her urinate and defecate?
Remember, the first issue is determining if she needs help or not.
If she does, your vet can demonstrate how to express her bladder (physically finding it with your hand, putting gentle constant pressure until it empties) and we can use stool softeners to help her pass stool.
OK. thank you very much. You have been very clear and helpful.
You're very welcome. I would love to hear an update on Sophia in the future! I will check in with you in a few days also in case you have further questions.
Thanks. Sophia is one of the most beautiful cats we have had, in a lifetime of keeping cats. She is a fluffy dark tortoiseshell we found abandoned at about nine months. She is affectionate, attached - a keen hunter, I'm afraid - and very territorial. She chases foxes!
Wow! Those torties are full of fire :)
Will you email me or should I check in on this site?
As far as I understand it, the site should email you to notify you.
Well, thanks again, Susan. Warm regards, Anne.
You're welcome! I hope you have a lovely holiday season too.