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Dr. Deb
Dr. Deb, Cat Veterinarian
Category: Cat
Satisfied Customers: 9776
Experience:  I have been a practicing veterinarian for over 30 years.
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Two weeks ago we noticed that our previously healthy 15 year

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Two weeks ago we noticed that our previously healthy 15 year old cat was unable to wee. We took him to the emergency vets who discovered he had a half full bladder but they were unable to get a sample from him. The following day they catheterised him and discovered mucus plugs. Over the next 7 days he stayed at the vets where he appeared to recover a little, but needed to be catherterised again and when he was able to urinate by himself he still was only able to do small wees at best, ***** ***** fully emptied his bladder. He finally stopped weeing again and this time it was discovered that he had two kidney stones. On Tuesday he was operated on and the stones (and some 'sludge') were removed and sent away for analysis to discover what type of stones they are. We were able to bring him home the next day and he has continued to do small wees but we are taking him for daily checks at the vets and he appears to be able to empty his bladder now. Unfortunately when he was having his operation the vet discovered that not only was his bladder wall very 'thickened' but there was also an 'area of concern' that the vet has biopsied and also sent for analysis. Because of the holidays we probably won't get the results until the new year. While this is obviously a concern our immediate worries are that because he has eaten so little over the last fortnight he has dropped quite a lot of weight, and the other problem is he is still doing little wees. He had been taking 25mg of Dantrium combined with 10mg of Phenoxybenzamine twice a day but this was causing drooling and it was feared that this might have been contributing to his loss of appetite. Consequently today the dose of Dantrium was changed to 2mg (twice daily) of Valium. He is also taking half a tablet of Temegesic 3 times a day and half a Marbocyl once daily. My immediate concerns are that within 15 mins of his first dose of Valium this afternoon (we only gave him 1mg) he was staggering around the kitchen. However he did suddenly start eating well and was playing with his toys. Because of his being unstable on his feet we reduced the evening dose to half a mg. I am not sure it has kicked in yet. My other concern is that he is still only doing little wees (though he hasn't become blocked again since having his stones removed), and I'm not sure when we would expect to see this improve? He periodically goes in and out of his litter tray until he is empty - this restlessness is distressing to watch. I'm sorry that this is quite a complex issue and obviously without the results of the biopsy and stone analysis we don't have a clear picture, but are we being impatient to expect him to be doing larger and less frequent wees by now?

UPDATE

I haven't received an answer since posting my question last night (UK time).  We have since given him two separate doses of half a mg of Valium which seems to be a better dose as he ate a little but wasn't nearly as wobbly on his feet.

Submitted: 2 years ago.
Category: Cat
Expert:  Dr. Deb replied 2 years ago.

Hello Michele, I'm Dr. Deb.
I recently came online and see that your question about Sid hasn't been answered. I'm so sorry that you've had to wait for a response especially under the circumstances,but if you still need assistance, I'd like to help if I can.

Valium can be a potent appetite stimulant but it can certainly cause balance issues as you found out when you gave him the full dose as prescribed. I'm glad that you decreased the dose and seem to have found one which he tolerates better. This drug can also be useful in cases such as this for it's effects on the bladder.

His behavior of increased frequency of urination and producing small amounts isn't uncommon after all that he's been through. As to when this behavior might improve, much depends on what the biopsy results indicate. If it comes back as cancer (obviously the worse case scenario), then it's possible that this behavior will continue for some time to come and probably worsen.
If it comes back as inflammation (or benign or anything other than cancer, in other words), then he may just need more time before his bladder tone returns to normal.
I typically advise owners that their cats may behave as you're seeing for a week or perhaps a little longer so you may be expecting a little bit too much too soon at this point.

I'm sure you're providing plenty of fluids for him which is encouraged to help flush out the bladder of remaining debris/sludge.

You might also discuss including Prazosin with your vet which can be used in combination with Valium in these patients which can often be of benefit after an obstruction.

I hope this helps although, again, my apologies for the delayed reply. Deb

Customer: replied 2 years ago.

Hi Dr Deb, We took him to the vet this morning to have his bladder felt and it was almost empty. He hasn't been doing the restless pacing and frequent litter tray visits since yesterday evening and seems much brighter in himself. I'm not sure why sometimes he appears to go into spasm and other times he is able to do a (small) wee and then not go again for another hour or so. This worry aside, his appetite is pretty good since starting the Valium and he isn't nearly as unsteady on the half a mg dose. He is playing and watching the world go by out of the window rather than spending the day in his basket as he has been since this all started. He is still only managing small wees, but at least he is able to wee which is an improvement on his pre-op situation. He had become quite weak and bony in such a short space of time it has been very alarming. I am just hoping that now he is eating again he will gain some weight. Obviously the long term outlook is dependent on the results of the biopsy, but I am heartened that he is so much brighter today. I just hope that the spasms will subside as they were causing him (and us) much distress. Kind regards. Michele

Expert:  Dr. Deb replied 2 years ago.

Michele:
Thanks for taking the time to send me an update about Sid, especially since it sounds pretty encouraging all things considered.

In cases such as this, sometimes it can take a while for the bladder to return to normal and it can be a challenge to find the right combination of medications which will be of benefit.

I'd share your concern about his body condition but, hopefully, he'll put on weight now that his appetite has returned. Even healthy older cats do tend to lose muscle which contributes to their skinny appearance but they have so few reserves when this occurs that I always like to see them a little plumper, if possible:)

I hope you'll continue to keep me posted about him if you have the time. I'd like to know the results of the biopsy and stone analysis.

Best of luck. Deb

Dr. Deb, Cat Veterinarian
Category: Cat
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Experience: I have been a practicing veterinarian for over 30 years.
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Customer: replied 2 years ago.

Will do, thank you. I appreciate he is an old cat but he's always been in excellent health and up until two weeks ago didn't look his years. We have an 18 year old that's still going strong, and our next door neighbour has a 21 year old so I'm hoping we still have some time with him left. He's a wonderful cat and a big part of our family so obviously all this has been a big worry. Thank you for your advice, it has helped set my mind at rest. Michele

Expert:  Dr. Deb replied 2 years ago.

Michele:
You're more than welcome and thanks for the rating and bonus; it's greatly appreciated.

You must be doing something right to have that many cats in the neighborhood live such long lives. I just lost my fabulous 20+ cat earlier this year who was relatively healthy up until the time he wasn't so I know how traumatic it is when they become ill.

I'll look forward to continued updates about him. Regards, Deb

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